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Giovagnoli MR, Ciucciarelli S, Castrichella L, Giansanti D. Artificial Intelligence in Digital Pathology: What Is the Future? Part 2: An Investigation on the Insiders. Healthcare (Basel) 2021; 9:healthcare9101347. [PMID: 34683027 PMCID: PMC8544344 DOI: 10.3390/healthcare9101347] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 07/15/2021] [Revised: 10/08/2021] [Accepted: 10/09/2021] [Indexed: 01/01/2023] Open
Abstract
Motivation: This study deals with the introduction of artificial intelligence (AI) in digital pathology (DP). The study starts from the highlights of a companion paper. Objective: The aim was to investigate the consensus and acceptance of the insiders on this issue. Procedure: An electronic survey based on the standardized package Microsoft Forms (Microsoft, Redmond, WA, USA) was proposed to a sample of biomedical laboratory technicians (149 admitted in the study, 76 males, 73 females, mean age 44.2 years). Results: The survey showed no criticality. It highlighted (a) the good perception of the basic training on both groups, and (b) a uniformly low perceived knowledge of AI (as arisen from the graded questions). Expectations, perceived general impact, perceived changes in the work-flow, and worries clearly emerged in the study. Conclusions: The of AI in DP is an unstoppable process, as well as the increase of the digitalization in the health domain. Stakeholders must not look with suspicion towards AI, which can represent an important resource, but should invest in monitoring and consensus training initiatives based also on electronic surveys.
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Affiliation(s)
- Maria Rosaria Giovagnoli
- Facoltà di Medicina e Psicologia, Università Sapienza Roma, Piazzale Aldo Moro, 00185 Rome, Italy; (M.R.G.); (S.C.); (L.C.)
| | - Sara Ciucciarelli
- Facoltà di Medicina e Psicologia, Università Sapienza Roma, Piazzale Aldo Moro, 00185 Rome, Italy; (M.R.G.); (S.C.); (L.C.)
| | - Livia Castrichella
- Facoltà di Medicina e Psicologia, Università Sapienza Roma, Piazzale Aldo Moro, 00185 Rome, Italy; (M.R.G.); (S.C.); (L.C.)
| | - Daniele Giansanti
- Centre Tisp, Istituto Superiore di Sanità, 00161 Rome, Italy
- Correspondence: ; Tel.: +39-06-49902701
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Giovagnoli MR, Giansanti D. Artificial Intelligence in Digital Pathology: What Is the Future? Part 1: From the Digital Slide Onwards. Healthcare (Basel) 2021; 9:healthcare9070858. [PMID: 34356236 PMCID: PMC8304979 DOI: 10.3390/healthcare9070858] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 07/01/2021] [Accepted: 07/04/2021] [Indexed: 12/13/2022] Open
Abstract
This commentary aims to address the field of Artificial intelligence (AI) in Digital Pathology (DP) both in terms of the global situation and research perspectives. It has four polarities. First, it revisits the evolutions of digital pathology with particular care to the two fields of the digital cytology and the digital histology. Second, it illustrates the main fields in the employment of AI in DP. Third, it looks at the future directions of the research challenges from both a clinical and technological point of view. Fourth, it discusses the transversal problems among these challenges and implications and introduces the immediate work to implement.
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Affiliation(s)
| | - Daniele Giansanti
- Centre Tisp, Istituto Superiore di Sanità, 00161 Roma, Italy
- Correspondence: ; Tel.: +39-06-49902701
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Virgilio E, Giarnieri E, Giovagnoli MR, Montagnini M, Villani S, Proietti A, D'Urso R, Cardelli P, Balducci G, Cavallini M. Combined Analysis of Intragastric Malignant Exfoliation and Ca 72.4 Concentration in Stomach Adenocarcinoma: The "GL1 Ca 72.4" Parameter. Acta Cytol 2020; 64:563-571. [PMID: 32526755 DOI: 10.1159/000508019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2020] [Accepted: 04/15/2020] [Indexed: 12/24/2022]
Abstract
INTRODUCTION/OBJECTIVE Differently from other digestive malignancies, gastric cancer (GC) pathobiology is still little known and understood. Recently, cytopathology and molecular biology on gastric juice/gastric lavage (GJ/GL) of GC patients have provided novel and interesting results in terms of screening, diagnosis, prognosis, and therapy. However, entertaining cytologic examination and molecular test as a unified solo-run test is previously unreported. Our aim was to assess the new parameter "GL Ca 72.4" for GC patients. METHODS Between April 2012 and July 2013, GJ/GL obtained from 37 surgical GC patients were tested for the presence/absence (GL1/GL0) of exfoliated malignant cells along with the intragastric concentration of Ca 72.4 (normal value <6.49 ng/mL: Ca 72.4n; elevated level ≥6.49 ng/mL: Ca 72.4+). RESULTS At a median follow-up of 79.3 months, all the GC alive patients were "GL0 Ca 72.4n." The "GL1 Ca 72.4+" parameter, in comparison with GL0 Ca 72.4n, strongly correlated with deeper tumor invasion (p = 0.027), severe nodal metastasis (p = 0.012), worst metastatic node ratio (p = 0.041), higher number of metastatic lymph nodes (30 vs. 20 nodes, p = 0.014), angiolymphatic invasion (p = 0.044), advanced stage (p = 0.034), and adjuvant therapy (p = 0.044). The Kaplan-Meier model showed that GL1 Ca 72.4+ subjects had shorter overall survival (OS) than GL0 Ca 72.4n cases (9.7 vs. 43.2 months, respectively, p = 0.042). At univariate analysis, the GL1 Ca 72.4+ parameter resulted a significant prognostic factor for OS (p = 0.023). CONCLUSIONS The combined cyto-molecular parameter "GL1 Ca 72.4+" appears to be a strong indicator of aggressive tumor behavior and a significant prognostic factor of poor survival for GC patients.
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Affiliation(s)
- Edoardo Virgilio
- Department of Medical and Surgical Sciences and Translational Medicine, Sapienza University, St. Andrea Hospital, Rome, Italy,
| | - Enrico Giarnieri
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, Sapienza University, St. Andrea Hospital, Rome, Italy
| | - Maria Rosaria Giovagnoli
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, Sapienza University, St. Andrea Hospital, Rome, Italy
| | - Monica Montagnini
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, Sapienza University, St. Andrea Hospital, Rome, Italy
| | - Sandra Villani
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, Sapienza University, St. Andrea Hospital, Rome, Italy
| | - Antonella Proietti
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, Sapienza University, St. Andrea Hospital, Rome, Italy
| | - Rosaria D'Urso
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, Sapienza University, St. Andrea Hospital, Rome, Italy
| | - Patrizia Cardelli
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, Sapienza University, St. Andrea Hospital, Rome, Italy
| | - Genoveffa Balducci
- Department of Medical and Surgical Sciences and Translational Medicine, Sapienza University, St. Andrea Hospital, Rome, Italy
| | - Marco Cavallini
- Department of Medical and Surgical Sciences and Translational Medicine, Sapienza University, St. Andrea Hospital, Rome, Italy
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Virgilio E, Proietti A, D'Urso R, Cardelli P, Giarnieri E, Giovagnoli MR, Montagnini M, Villani S, Balducci G, Cavallini M. Elevated Gastric Juice Carbohydrate Antigen 72.4 (Ca 72.4) Is an Independent Prognostic Factor of Poor Survival for Gastric Cancer Patients. Anticancer Res 2020; 40:1691-1695. [PMID: 32132076 DOI: 10.21873/anticanres.14121] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 02/03/2020] [Accepted: 02/06/2020] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM As of 2020, carbohydrate antigen 72.4 (Ca 72.4) has been rarely investigated in the gastric juice (GJ) of patients with gastric cancer (GC). Our aim was to analyze the significance and role of this tumor antigen in the GJ of our GC population. PATIENTS AND METHODS Between April 2012 and July 2013, 37 patients with operable GC were prospectively investigated to determine the GJ Ca 72.4 levels before surgical manipulation. RESULTS GJ Ca 72.4 ≥6.49 ng/ml strongly correlated with the traditional categories of aggressive cancer (advanced tumor depth and stage, lymph node invasion and metastatic lymphatic ratio, indication to adjuvant treatment). It also associated with shorter survival (p=0.049) and is, thus, suggested as an independent factor of poor prognosis in GC patients (p=0.047). CONCLUSION The GJ Ca 72.4 parameter should be considered an indicator of an aggressive tumor phenotype and should be used in the prognostic assessment of GC patients.
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Affiliation(s)
- Edoardo Virgilio
- Department of Medical and Surgical Sciences and Translational Medicine, Faculty of Medicine and Psychology, University "Sapienza", St. Andrea Hospital, Rome, Italy
| | - Antonella Proietti
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, University "Sapienza", St. Andrea Hospital, Rome, Italy
| | - Rosaria D'Urso
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, University "Sapienza", St. Andrea Hospital, Rome, Italy
| | - Patrizia Cardelli
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, University "Sapienza", St. Andrea Hospital, Rome, Italy
| | - Enrico Giarnieri
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, University "Sapienza", St. Andrea Hospital, Rome, Italy
| | - Maria Rosaria Giovagnoli
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, University "Sapienza", St. Andrea Hospital, Rome, Italy
| | - Monica Montagnini
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, University "Sapienza", St. Andrea Hospital, Rome, Italy
| | - Sandra Villani
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, University "Sapienza", St. Andrea Hospital, Rome, Italy
| | - Genoveffa Balducci
- Department of Medical and Surgical Sciences and Translational Medicine, Faculty of Medicine and Psychology, University "Sapienza", St. Andrea Hospital, Rome, Italy
| | - Marco Cavallini
- Department of Medical and Surgical Sciences and Translational Medicine, Faculty of Medicine and Psychology, University "Sapienza", St. Andrea Hospital, Rome, Italy
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Virgilio E, Giarnieri E, Montagnini M, Villani S, Giovagnoli MR, Mercantini P, Balducci G, Cavallini M. Advances in Intraluminal Exfoliative Cytology of Gastric Cancer: Oncologic Implication of the Sixth Metastatic Route (Metastasis VI). Anticancer Res 2019; 39:4019-4022. [PMID: 31366483 DOI: 10.21873/anticanres.13557] [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: 05/31/2019] [Revised: 06/27/2019] [Accepted: 06/28/2019] [Indexed: 11/10/2022]
Abstract
Historically, analysis of intragastric exfoliative cytology (IEC) of gastric cancer (GC) was used with a diagnostic intent only. With the successful advent of endoscopic biopsy, the rate of detection of GC has improved worldwide and, as a consequence, IEC has been progressively abandoned. Today, however, there is a renewed interest in this field of research, as witnessed by several pertinent publications. As discussed in this review, in fact, currently the importance of analyzing IEC in patients with early and advanced GC seems to reside in its clinicopathological and prognostic significance. In fact, compared to non-sloughing tumors, GC exhibiting intragastric exfoliation was recently associated with an aggressive tumor phenotype (characterized by deeper infiltration of the gastric wall, lymph nodal or distant metastases, angiolymphatic and perineural invasion) and poorer prognosis. Adoption of IEC examination in routine practice might help identify patients at higher risk of developing local recurrence and peritoneal metastasis from early and advanced GC, optimizing their treatment and improving quality of life and life expectancy.
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Affiliation(s)
- Edoardo Virgilio
- Department of Medical and Surgical Sciences and Translational Medicine, Faculty of Medicine and Psychology, Sapienza University, St. Andrea Hospital, Rome, Italy
| | - Enrico Giarnieri
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, Sapienza University, St. Andrea Hospital, Rome, Italy
| | - Monica Montagnini
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, Sapienza University, St. Andrea Hospital, Rome, Italy
| | - Sandra Villani
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, Sapienza University, St. Andrea Hospital, Rome, Italy
| | - Maria Rosaria Giovagnoli
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, Sapienza University, St. Andrea Hospital, Rome, Italy
| | - Paolo Mercantini
- Department of Medical and Surgical Sciences and Translational Medicine, Faculty of Medicine and Psychology, Sapienza University, St. Andrea Hospital, Rome, Italy
| | - Genoveffa Balducci
- Department of Medical and Surgical Sciences and Translational Medicine, Faculty of Medicine and Psychology, Sapienza University, St. Andrea Hospital, Rome, Italy
| | - Marco Cavallini
- Department of Medical and Surgical Sciences and Translational Medicine, Faculty of Medicine and Psychology, Sapienza University, St. Andrea Hospital, Rome, Italy
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Virgilio E, Giarnieri E, Giovagnoli MR, Montagnini M, Proietti A, D'Urso R, Fegiz A, Mercantini P, Balducci G, Cavallini M. Gastric Lavage Malignant Cells (yGL) and Hypohemoglobinemia (yAnemia) as New Systems of Tumor Regression Grading and Prognostic Prediction for Gastric Cancer After Neoadjuvant Treatment. Anticancer Res 2019; 39:1019-1027. [PMID: 30711990 DOI: 10.21873/anticanres.13208] [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: 12/25/2018] [Revised: 01/17/2019] [Accepted: 01/22/2019] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM Although reckoned necessary for survival benefit, neoadjuvant chemotherapy (NAC) of gastric cancer (GC) patients has so far provided questionable results. Consequently, searching for new and clearer systems of response to NAC, post-NAC re-evaluation and prognostic prediction appears essential. The purpose of this study was to examine endogastric cytopathology and hemoglobin level count as new features, potentially useful for GC patients after NAC. PATIENTS AND METHODS Between April 2012 and October 2018, 21 of 116 patients with resectable GC received NAC and were investigated for the presence of free-floating malignant cells in their gastric lavage (yGL1) and the development of hypohemoglobinia (yAnemia). RESULTS yGL1 and yAnemia were found in 11 and 12 patients, respectively. yGL1 correlated with the traditional parameters of tumor regression (p=0.0424). Both yGL1 and yAnemia were found to be independent predictive factors of overall and progression-free survival (p≤0.0364). CONCLUSION In the light of our results, the yGL1 and yAnemia appear two promising, simple and interesting clinicopathological features which should always be examined for better clarifying GC patients' response to NAC.
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Affiliation(s)
- Edoardo Virgilio
- Department of Medical and Surgical Sciences and Translational Medicine, Faculty of Medicine and Psychology, University "Sapienza", St. Andrea Hospital, Rome, Italy
| | - Enrico Giarnieri
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, University "Sapienza", St. Andrea Hospital, Rome, Italy
| | - Maria Rosaria Giovagnoli
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, University "Sapienza", St. Andrea Hospital, Rome, Italy
| | - Monica Montagnini
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, University "Sapienza", St. Andrea Hospital, Rome, Italy
| | - Antonella Proietti
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, University "Sapienza", St. Andrea Hospital, Rome, Italy
| | - Rosaria D'Urso
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, University "Sapienza", St. Andrea Hospital, Rome, Italy
| | - Alessandra Fegiz
- Department of Medical and Surgical Sciences and Translational Medicine, Faculty of Medicine and Psychology, University "Sapienza", St. Andrea Hospital, Rome, Italy
| | - Paolo Mercantini
- Department of Medical and Surgical Sciences and Translational Medicine, Faculty of Medicine and Psychology, University "Sapienza", St. Andrea Hospital, Rome, Italy
| | - Genoveffa Balducci
- Department of Medical and Surgical Sciences and Translational Medicine, Faculty of Medicine and Psychology, University "Sapienza", St. Andrea Hospital, Rome, Italy
| | - Marco Cavallini
- Department of Medical and Surgical Sciences and Translational Medicine, Faculty of Medicine and Psychology, University "Sapienza", St. Andrea Hospital, Rome, Italy
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Virgilio E, Giarnieri E, Giovagnoli MR, Montagnini M, Proietti A, D'Urso R, Mercantini P, Balducci G, Cavallini M. Long non-coding RNAs in the gastric juice of gastric cancer patients. Pathol Res Pract 2018; 214:1239-1246. [PMID: 30078471 DOI: 10.1016/j.prp.2018.07.023] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [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: 06/06/2018] [Revised: 07/22/2018] [Accepted: 07/23/2018] [Indexed: 01/01/2023]
Abstract
Differently from other digestive malignancies, gastric cancer (GC) carcinogenesis seems more heterogeneous and unclear. This entails failing in identification of reliable serum tumor markers for screening early GC (EGC) as well as persisting ominous prognosis of this disease. Recently, investigation of human noncoding genome, especially long noncoding molecules (lncRNAs), has provided promising data. As for GC, however, since the current information on GC-specific lncRNAs is still scarce and comes largely from analyses performed on tissue or serum of affected patients, we decided to review the current literature dealing with expression of such molecules in the gastric juice (GJ) of GC patients. In the case of GC, in fact, several cytological and molecular works have already demonstrated GJ to be an interesting biological material for improving clinicopathologic and prognostic knowledge of this cancer. For this review, we burrowed into the literature on lncRNAs expressed in GJ of GC patients. PubMed, Science Direct, Scopus, Web of Science, Google Scholar and ResearchGate were the search engines entertained. As of 2018, only seven studies have been reported. LINC00152, AA174084, UCA1, RMRP, ABHD11-AS1, LINC00982 and H19 were the GJ lncRNAs examined. Following our review, we can conclude that, due to their high specificity and reliability, GJ lncRNAs should deserve a prominent role in the field of GC research: importantly, they could be used for screening EGC, ameliorating the existing methods of staging (which are still far from being completely accurate), improving the prognostic capacity of the current diagnostic armamentarium and, finally, providing new and valuable therapeutic targets.
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Affiliation(s)
- Edoardo Virgilio
- Departments of Medical and Surgical Sciences and Translational Medicine, Faculty of Medicine and Psychology, Sapienza University, St. Andrea Hospital, Rome, Italy.
| | - Enrico Giarnieri
- Departments of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, Sapienza University, St. Andrea Hospital, Rome, Italy
| | - Maria Rosaria Giovagnoli
- Departments of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, Sapienza University, St. Andrea Hospital, Rome, Italy
| | - Monica Montagnini
- Departments of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, Sapienza University, St. Andrea Hospital, Rome, Italy
| | - Antonella Proietti
- Departments of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, Sapienza University, St. Andrea Hospital, Rome, Italy
| | - Rosaria D'Urso
- Departments of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, Sapienza University, St. Andrea Hospital, Rome, Italy
| | - Paolo Mercantini
- Departments of Medical and Surgical Sciences and Translational Medicine, Faculty of Medicine and Psychology, Sapienza University, St. Andrea Hospital, Rome, Italy
| | - Genoveffa Balducci
- Departments of Medical and Surgical Sciences and Translational Medicine, Faculty of Medicine and Psychology, Sapienza University, St. Andrea Hospital, Rome, Italy
| | - Marco Cavallini
- Departments of Medical and Surgical Sciences and Translational Medicine, Faculty of Medicine and Psychology, Sapienza University, St. Andrea Hospital, Rome, Italy
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Abstract
We tested the presence of tumour polypeptide antigen (TPA) in lower urinary tract cells from 59 workers exposed to known bladder carcinogens and from 30 control subjects. We then correlated immunocytological expression and serum TPA levels. Lower urinary tract cells from 31 subjects gave either moderately or strongly positive immunocytological stains. Five also had high serum TPA. The detection of TPA by cytology and in serum differed significantly in workers exposed to cancer agents and the control group.
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Affiliation(s)
- M R Giovagnoli
- Department of Experimental Medicine, 1st University La Sapienza, Rome, Italy
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Giovagnoli MR, Reale G, Cosentino L, Manna A, Midulla C, Marchei G, Vecchione A. Evaluation of the Expression of Tissue DF-3 and MCA and the Corresponding Serum Values in Patients with Breast Carcinoma. Int J Biol Markers 2018; 9:140-4. [PMID: 7829893 DOI: 10.1177/172460089400900303] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Two specific monoclonal antibodies for breast tissue (DF3 and MCAb-12) and the corresponding tumor markers CA15-3 and MCA in serum have been evaluated in 50 patients with breast cancer and in 15 controls. The expression of these antigens in tissue was poorly correlated with the common prognostic parameters. Their presence in serum was associated with an altered distribution of the antigens in the cell. The expression of these antigens in tissue enables us to select patients for serological follow-up and to evaluate tumor differentiation from a functional point of view.
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Affiliation(s)
- M R Giovagnoli
- Department of Experimental Medicine, University, La Sapienza, Roma, Italy
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Virgilio E, Balducci G, Mercantini P, Giarnieri E, Giovagnoli MR, Montagnini M, Proietti A, D'Urso R, Cavallini M. Laparoscopic Intragastric Surgery for Treating Early Gastric Cancer. Anticancer Res 2018; 38:1911-1916. [PMID: 29599306 DOI: 10.21873/anticanres.12428] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [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: 01/12/2018] [Revised: 02/09/2018] [Accepted: 02/13/2018] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM Although there is an increasing number of studies on laparoscopic resection of early gastric cancer (EGC), as of 2018 no standardized strategy exists. We reviewed available literature dealing with laparoscopic intragastric (intraluminal) surgery (LIGS) conducted for patients with EGC to better define indications, benefits and limitations of this particular minimally invasive technique. MATERIALS AND METHODS PubMed, MEDLINE, Science Direct, Scopus, Web of Science, Google Scholar and ResearchGate were the search engines investigated. Only LIGS for EGC was entertained; studies conducted for other gastric diseases were excluded. Suitable articles written in all languages were included in the review. RESULTS As of 2018, we found 19 studies dealing with LIGS for EGC: studies on 72 humans and four pigs were identified. Among 72 human participants, there were 59 mucosal, five submucosal and one subserosal cancer. CONCLUSION Based on our review, LIGS appears as a cogent option to endoscopic resection for treating superficial EGC.
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Affiliation(s)
- Edoardo Virgilio
- Department of Medical and Surgical Sciences and Translational Medicine, Faculty of Medicine and Psychology, Sapienza University, St. Andrea Hospital, Rome, Italy
| | - Genoveffa Balducci
- Department of Medical and Surgical Sciences and Translational Medicine, Faculty of Medicine and Psychology, Sapienza University, St. Andrea Hospital, Rome, Italy
| | - Paolo Mercantini
- Department of Medical and Surgical Sciences and Translational Medicine, Faculty of Medicine and Psychology, Sapienza University, St. Andrea Hospital, Rome, Italy
| | - Enrico Giarnieri
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, Sapienza University, St. Andrea Hospital, Rome, Italy
| | - Maria Rosaria Giovagnoli
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, Sapienza University, St. Andrea Hospital, Rome, Italy
| | - Monica Montagnini
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, Sapienza University, St. Andrea Hospital, Rome, Italy
| | - Antonella Proietti
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, Sapienza University, St. Andrea Hospital, Rome, Italy
| | - Rosaria D'Urso
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, Sapienza University, St. Andrea Hospital, Rome, Italy
| | - Marco Cavallini
- Department of Medical and Surgical Sciences and Translational Medicine, Faculty of Medicine and Psychology, Sapienza University, St. Andrea Hospital, Rome, Italy
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Virgilio E, Giarnieri E, Giovagnoli MR, Montagnini M, Proietti A, D'Urso R, Mercantini P, Valabrega S, Balducci G, Cavallini M. Gastric Cancer Cells in Peritoneal Lavage Fluid: A Systematic Review Comparing Cytological with Molecular Detection for Diagnosis of Peritoneal Metastases and Prediction of Peritoneal Recurrences. Anticancer Res 2018; 38:1255-1262. [PMID: 29491048 DOI: 10.21873/anticanres.12347] [Citation(s) in RCA: 12] [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: 12/15/2017] [Revised: 01/27/2018] [Accepted: 01/29/2018] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM Detecting free tumor cells in the peritoneal lavage fluid of gastric cancer patients permits to assess a more accurate prognosis, predict peritoneal recurrence and select cases for a more aggressive treatment. Currently, cytology and molecular biology comprise the two most popular methods of detection that are under constant study by researchers. MATERIALS AND METHODS We burrowed into the available literature comparing cytological with molecular detection of free intraperitoneal gastric cancer cells. PubMed, Science Direct, Scopus and Google Scholar were the search engines investigated. RESULTS As of 2017, 51 dedicated studies have been published. Messenger RNA of carcinoembryonic antigen was the genetic target most frequently described. The genetic technique is usually superior to cytology in sensitivity (38-100% vs. 12.3-67% respectively), whereas cytological examination tends to show a slight pre-eminence in specificity (approximately 100%). CONCLUSION So far, given the imperfection of each method, employment of both cytology and molecular examination seem to be mandatory.
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Affiliation(s)
- Edoardo Virgilio
- Department of Medical and Surgical Sciences and Translational Medicine, Faculty of Medicine and Psychology, Sapienza University, St. Andrea Hospital, Rome, Italy
| | - Enrico Giarnieri
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, Sapienza University, St. Andrea Hospital, Rome, Italy
| | - Maria Rosaria Giovagnoli
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, Sapienza University, St. Andrea Hospital, Rome, Italy
| | - Monica Montagnini
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, Sapienza University, St. Andrea Hospital, Rome, Italy
| | - Antonella Proietti
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, Sapienza University, St. Andrea Hospital, Rome, Italy
| | - Rosaria D'Urso
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, Sapienza University, St. Andrea Hospital, Rome, Italy
| | - Paolo Mercantini
- Department of Medical and Surgical Sciences and Translational Medicine, Faculty of Medicine and Psychology, Sapienza University, St. Andrea Hospital, Rome, Italy
| | - Stefano Valabrega
- Department of Medical and Surgical Sciences and Translational Medicine, Faculty of Medicine and Psychology, Sapienza University, St. Andrea Hospital, Rome, Italy
| | - Genoveffa Balducci
- Department of Medical and Surgical Sciences and Translational Medicine, Faculty of Medicine and Psychology, Sapienza University, St. Andrea Hospital, Rome, Italy
| | - Marco Cavallini
- Department of Medical and Surgical Sciences and Translational Medicine, Faculty of Medicine and Psychology, Sapienza University, St. Andrea Hospital, Rome, Italy
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Virgilio E, Balducci G, Mercantini P, Giarnieri E, Giovagnoli MR, Montagnini M, Proietti A, D'Urso R, Cavallini M. Preoperative gastric lavage in gastric cancer patients undergoing surgical, endoscopic or minimally invasive treatment: An oncological measure preventing peritoneal spillage of intragastric cancer cells and development of related metastases. Med Hypotheses 2018; 114:30-34. [PMID: 29602460 DOI: 10.1016/j.mehy.2018.02.023] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Revised: 02/19/2018] [Accepted: 02/20/2018] [Indexed: 01/15/2023]
Abstract
In addition to classical metastatic pathways, recently gastric cancer was described having an alternative route called "endoluminal exfoliation". Provisional analyses demonstrated, in fact, this kind of shedding is associated with several clinico-pathological features indicative of aggressive behavior and resulted to be an independent prognostic factor entailing poor prognosis. Compared with non-sowing counterparts, in fact, patients affected with exfoliating early and advanced gastric carcinomas met with shorter overall survival, disease free survival, progression free survival and time to tumor progression. In spite of these interesting results, however, the clinico-pathological and oncological significance of this unconventional metastatic route is still to be clarified. Such an investigation is further urged by the increasing widespread employment of minimally invasive treatments for gastric cancer which include a wide spectrum of intragastric interventions and maneuvers. Indeed, endoscopic mucosal resection, endoscopic submucosal dissection, endoscopic full-thickness resection, intragastric laparoscopic surgery and hybrid procedures all take place inside of the stomach. However, iatrogenic perforations can occur during execution of these treatments leading to spillage of malignant cells from gastric to the peritoneal cavity or trocar insertion sites. Furthermore, many other gastric conditions and interventions can collide with endogastric presence of floating cancer cells: spontaneous ulceration or perforation, laparotomy surgery, gastrointestinal occlusion, diverticula. Viability, migration and intraluminal transportability of the intragastric floating cancer cells represents another original and intriguing topic. All these considerations led us to entertain the hypothesis that removing the exfoliated cancer cells from the gastric lumen could save patients from the dreaded potential risk of spillage. Performing gastric lavage before starting any kind of tumor intervention could be the most appropriate procedure to adopt with prophylactic intent. Should our speculation prove to be clinically significant, preoperative gastric lavage should be pointed out as a simple but cogent method useful for preventing oncological mishaps such as spillage of gastric cancer cells and development of related recurrences or metastases.
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Affiliation(s)
- Edoardo Virgilio
- Department of Medical and Surgical Sciences and Translational Medicine, Department of General Surgery, Faculty of Medicine and Psychology, University "Sapienza", St. Andrea Hospital, via di Grottarossa 1035-39, Rome 00189, Italy.
| | - Genoveffa Balducci
- Department of Medical and Surgical Sciences and Translational Medicine, Department of Emergency Surgery, Faculty of Medicine and Psychology, University "Sapienza", St. Andrea Hospital, via di Grottarossa 1035-39, Rome 00189, Italy
| | - Paolo Mercantini
- Department of Medical and Surgical Sciences and Translational Medicine, Department of Emergency Surgery, Faculty of Medicine and Psychology, University "Sapienza", St. Andrea Hospital, via di Grottarossa 1035-39, Rome 00189, Italy
| | - Enrico Giarnieri
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, University "Sapienza", St. Andrea Hospital, via di Grottarossa 1035-39, Rome 00189, Italy
| | - Maria Rosaria Giovagnoli
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, University "Sapienza", St. Andrea Hospital, via di Grottarossa 1035-39, Rome 00189, Italy
| | - Monica Montagnini
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, University "Sapienza", St. Andrea Hospital, via di Grottarossa 1035-39, Rome 00189, Italy
| | - Antonella Proietti
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, University "Sapienza", St. Andrea Hospital, via di Grottarossa 1035-39, Rome 00189, Italy
| | - Rosaria D'Urso
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, University "Sapienza", St. Andrea Hospital, via di Grottarossa 1035-39, Rome 00189, Italy
| | - Marco Cavallini
- Department of Medical and Surgical Sciences and Translational Medicine, Department of General Surgery, Faculty of Medicine and Psychology, University "Sapienza", St. Andrea Hospital, via di Grottarossa 1035-39, Rome 00189, Italy
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Virgilio E, Giarnieri E, Giovagnoli MR, Montagnini M, Proietti A, D'Urso R, Mercantini P, Balducci G, Cavallini M. Gastric Juice MicroRNAs as Potential Biomarkers for Screening Gastric Cancer: A Systematic Review. Anticancer Res 2018; 38:613-616. [PMID: 29374683 DOI: 10.21873/anticanres.12265] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [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: 11/17/2017] [Revised: 11/30/2017] [Accepted: 12/06/2017] [Indexed: 12/12/2022]
Abstract
BACKGROUND/AIM To date, the combination of gastroscopy with biopsy remains the only test validated for screening gastric cancer (GC). Currently, analysis of circulating microRNAs (miRNAs or miRs) is providing interesting information on GC prognosis, but since these molecules are shared by several types of cancer, its clinical use could be questionable and difficult. MicroRNAs in gastric juice (GJ) could represent a cogent alternative to screening GC by biopsy. MATERIALS AND METHODS We investigated the pertinent literature dealing with GC GJ microRNAs through four popular search engines (PubMed, Science Direct, Scopus and Google Scholar). RESULTS As of 2017, only four studies had been published and were all from Chinese experience. MiR-421, miR-129, miR-21, miR-106a and miR-133a were the five molecules studied in the GJ of the enrolled patients. CONCLUSION The GJ miRNA test is reliable and reproducible. The discussed GJ miRNAs appear to be new potential biomarkers for the screening of GC.
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Affiliation(s)
- Edoardo Virgilio
- Department of Medical and Surgical Sciences and Translational Medicine, Faculty of Medicine and Psychology, Sapienza University, St. Andrea Hospital, Rome, Italy
| | - Enrico Giarnieri
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, Sapienza University, St. Andrea Hospital, Rome, Italy
| | - Maria Rosaria Giovagnoli
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, Sapienza University, St. Andrea Hospital, Rome, Italy
| | - Monica Montagnini
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, Sapienza University, St. Andrea Hospital, Rome, Italy
| | - Antonella Proietti
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, Sapienza University, St. Andrea Hospital, Rome, Italy
| | - Rosaria D'Urso
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, Sapienza University, St. Andrea Hospital, Rome, Italy
| | - Paolo Mercantini
- Department of Medical and Surgical Sciences and Translational Medicine, Faculty of Medicine and Psychology, Sapienza University, St. Andrea Hospital, Rome, Italy
| | - Genoveffa Balducci
- Department of Medical and Surgical Sciences and Translational Medicine, Faculty of Medicine and Psychology, Sapienza University, St. Andrea Hospital, Rome, Italy
| | - Marco Cavallini
- Department of Medical and Surgical Sciences and Translational Medicine, Faculty of Medicine and Psychology, Sapienza University, St. Andrea Hospital, Rome, Italy
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Virgilio E, Balducci G, Mercantini P, Giarnieri E, Giovagnoli MR, Montagnini M, Proietti A, D'Urso R, Cavallini M. Utility of Nasogastric Tube for Medical and Surgical Oncology of Gastric Cancer: A Prospective Institutional Study on a New and Precious Application of an Old and Economic Device. Anticancer Res 2018; 38:433-439. [PMID: 29277806 DOI: 10.21873/anticanres.12241] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Revised: 11/15/2017] [Accepted: 11/17/2017] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM Concerning gastric cancer (GC), nasogastric tube (NGT) is routinely employed for peri-operative decompression and palliative enteral nutrition. Additionally, we believe to have found a further application. PATIENTS AND METHODS Between April 2012 and April 2017, 96 GC patients received preoperative nasogastric lavage (GL). All samples were cytologically examined to detect the presence (GL1) or absence (GL0) of malignant cells. Data were analyzed with classificatory, staging and prognostic purpose. RESULTS GL1 was detected in 46 GC patients: association with tumor depth, lymph node and distant metastasis, lymphovascular and peri-neural invasion, diffuse type and signet-ring cells was significant (respectively p=0.0274, 0.0324, 0.0446, 0.0287, <0.0001, 0.0413, <0.0001). GL1 entailed significantly poorer overall (OS), progression-free, disease-free survival and tumor progression (18 vs. 32 months). At multivariate analysis, GL1 was an independent prognostic factor for worse OS (p=0.0287). CONCLUSION NGT seems an economic oncologic measure useful for obtaining information on GC staging and prognosis.
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Affiliation(s)
- Edoardo Virgilio
- Medical and Surgical Sciences and Translational Medicine, Faculty of Medicine and Psychology "Sapienza", St. Andrea Hospital, Rome, Italy
| | - Genoveffa Balducci
- Medical and Surgical Sciences and Translational Medicine, Faculty of Medicine and Psychology "Sapienza", St. Andrea Hospital, Rome, Italy
| | - Paolo Mercantini
- Medical and Surgical Sciences and Translational Medicine, Faculty of Medicine and Psychology "Sapienza", St. Andrea Hospital, Rome, Italy
| | - Enrico Giarnieri
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, University "Sapienza", St. Andrea Hospital, Rome, Italy
| | - Maria Rosaria Giovagnoli
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, University "Sapienza", St. Andrea Hospital, Rome, Italy
| | - Monica Montagnini
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, University "Sapienza", St. Andrea Hospital, Rome, Italy
| | - Antonella Proietti
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, University "Sapienza", St. Andrea Hospital, Rome, Italy
| | - Rosaria D'Urso
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, University "Sapienza", St. Andrea Hospital, Rome, Italy
| | - Marco Cavallini
- Medical and Surgical Sciences and Translational Medicine, Faculty of Medicine and Psychology "Sapienza", St. Andrea Hospital, Rome, Italy
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15
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Virgilio E, Giarnieri E, Giovagnoli MR, Montagnini M, Proietti A, D'Urso R, Nigri G, Mercantini P, Ramacciato G, Cavallini M, Balducci G. Presence of cancer cells in gastric lavage of gastric cancer patients as an indicator of advanced disease, predictor of tumour aggressive phenotype and independent prognostic factor for poor survival: The endoluminal metastatic pathway of gastric cancer and GL0/GL1 classification. Cytopathology 2017; 29:41-48. [PMID: 29063636 DOI: 10.1111/cyt.12484] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/10/2017] [Indexed: 01/20/2023]
Abstract
OBJECTIVE As of 2017, the pathobiology of gastric cancer (GC) is far from fully understood; consequently, new methods of basic and advanced research have been proposed and tested. The presence (GL1) vs absence (GL0) of malignant cells exfoliated in gastric lavage (GL) of GC patients was formerly evaluated with diagnostic intent but not for staging or prognostic assessment. We investigated this hitherto unreported application of cytopathology. METHODS GL was preoperatively and prospectively collected from 80 GC patients and cytologically analysed. The results were compared with the classic clinicopathological features of GC and related to survival. The prognostic value of GL1 was assessed through univariate and multivariate analyses. RESULTS GL1 was detected in 36 samples (45%) and correlated with advanced tumour depth (T3-T4), lymphatic metastasis (N+), distant metastasis (M1) and lymphovascular invasion (LVI1; P=.0317, .0024, .003 and .0028, respectively). Overall survival (OS) was significantly shorter for GL1 (23 months) vs GL0 patients (42 months; P=.005) and GL1 vs GL0 T1 subjects (12.6 vs 47.8 months, P=.0029). Univariate analysis revealed that GL1, N+, M1, LVI1 and advanced stage were significantly associated with OS. Multivariate analysis assessed GL1 as the only independent prognostic factor for worse OS and progression-free survival (P=.0013 and .0107). CONCLUSIONS In the present study, GL1 was correlated with advanced disease, aggressive tumour behaviour and poor prognosis. Although additional studies are needed to confirm these findings, the GL0/GL1 classification can be applied to GC patients to achieve higher accuracy in staging, prognostic stratification and treatment selection.
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Affiliation(s)
- E Virgilio
- Department of Medical and Surgical Sciences and Translational Medicine, Faculty of Medicine and Psychology, University "Sapienza", St. Andrea Hospital, Rome, Italy
| | - E Giarnieri
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, University "Sapienza", St. Andrea Hospital, Rome, Italy
| | - M R Giovagnoli
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, University "Sapienza", St. Andrea Hospital, Rome, Italy
| | - M Montagnini
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, University "Sapienza", St. Andrea Hospital, Rome, Italy
| | - A Proietti
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, University "Sapienza", St. Andrea Hospital, Rome, Italy
| | - R D'Urso
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, University "Sapienza", St. Andrea Hospital, Rome, Italy
| | - G Nigri
- Department of Medical and Surgical Sciences and Translational Medicine, Faculty of Medicine and Psychology, University "Sapienza", St. Andrea Hospital, Rome, Italy
| | - P Mercantini
- Department of Medical and Surgical Sciences and Translational Medicine, Faculty of Medicine and Psychology, University "Sapienza", St. Andrea Hospital, Rome, Italy
| | - G Ramacciato
- Department of Medical and Surgical Sciences and Translational Medicine, Faculty of Medicine and Psychology, University "Sapienza", St. Andrea Hospital, Rome, Italy
| | - M Cavallini
- Department of Medical and Surgical Sciences and Translational Medicine, Faculty of Medicine and Psychology, University "Sapienza", St. Andrea Hospital, Rome, Italy
| | - G Balducci
- Department of Medical and Surgical Sciences and Translational Medicine, Faculty of Medicine and Psychology, University "Sapienza", St. Andrea Hospital, Rome, Italy
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Virgilio E, Proietti A, D'Urso R, Cardelli P, Giarnieri E, Montagnini M, Giovagnoli MR, Mercantini P, Balducci G, Cavallini M. Measuring Intragastric Tumor Markers in Gastric Cancer Patients: a Systematic Literature Review on Significance and Reliability. Anticancer Res 2017; 37:2817-2821. [PMID: 28551616 DOI: 10.21873/anticanres.11632] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Revised: 05/05/2017] [Accepted: 05/08/2017] [Indexed: 11/10/2022]
Abstract
As of 2017, no serum tumor marker has shown high levels of sensitivity or specificity for early detection, classification, staging, prediction and prognosis of patients affected by gastric cancer. In this regard, since 1975 several authors have investigated the gastric juice or gastric lavage of patients with gastric adenocarcinoma in order to determine the concentrations of intragastric tumor markers and discover the perfect antigen for this cancer. To date, however, a systematic review of the literature on intragastric tumor markers is still unreported. After a thorough search, we found important as well as unimportant findings and have come to clearly defined conclusions. We believe that describing the current state of knowledge achieved by the scientific community in this particular field of research could augment information on the complex pathobiology of gastric cancer and entail a deeper understanding of its unpredictable malignant behavior.
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Affiliation(s)
- Edoardo Virgilio
- Department of Medical and Surgical Sciences and Translational Medicine, Division of Emergency Surgery, Faculty of Medicine and Psychology, "Sapienza" University, Rome, Italy
| | - Antonella Proietti
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, "Sapienza" University, Rome, Italy
| | - Rosaria D'Urso
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, "Sapienza" University, Rome, Italy
| | - Patrizia Cardelli
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, "Sapienza" University, Rome, Italy
| | - Enrico Giarnieri
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, "Sapienza" University, Rome, Italy
| | - Monica Montagnini
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, "Sapienza" University, Rome, Italy
| | - Maria Rosaria Giovagnoli
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, "Sapienza" University, Rome, Italy
| | - Paolo Mercantini
- Department of Medical and Surgical Sciences and Translational Medicine, Division of Emergency Surgery, Faculty of Medicine and Psychology, "Sapienza" University, Rome, Italy
| | - Genoveffa Balducci
- Department of Medical and Surgical Sciences and Translational Medicine, Division of Emergency Surgery, Faculty of Medicine and Psychology, "Sapienza" University, Rome, Italy
| | - Marco Cavallini
- Department of Medical and Surgical Sciences and Translational Medicine, Division of Emergency Surgery, Faculty of Medicine and Psychology, "Sapienza" University, Rome, Italy
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17
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Virgilio E, Giarnieri E, Giovagnoli MR, Montagnini M, Proietti A, D'Urso R, Mercantini P, Balducci G, Cavallini M. Early Gastric Cancer Exfoliating into Gastric Lavage (GL1 EGC) Shows a More Aggressive Behavior and Poorer Survival Compared to the Non-Exfoliative Counterpart (GL0 EGC). Anticancer Res 2017; 37:4199-4203. [PMID: 28739707 DOI: 10.21873/anticanres.11810] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Revised: 05/05/2017] [Accepted: 06/05/2017] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM Early gastric cancer (EGC) is usually associated with excellent prognosis. Some cases, however, entail a poorer survival. Our aim was to assess if EGC exfoliating into gastric lavage (GL) has a more aggressive behavior than the non-exfoliative counterpart. PATIENTS AND METHODS Between April 2012 and April 2017, 96 gastric cancer patients were prospectively submitted to preoperative GL to detect the presence (GL1) or absence (GL0) of exfoliated malignant cells. RESULTS A total of 16 patients had EGC. T1b cases had significantly poorer overall (OS), progression-free (PFS) and disease-free survival (DFS) than their GL0 counterpart (16.3 vs. 61 months, p=0.0032). Similarly, the entire T1 class (T1a plus T1b EGCs) showed worse OS, PFS, DFS (15.5 vs. 61 months, p=0.0008) and time-to-tumor progression (17 vs. 61 months, p=0.0103). CONCLUSION In the case of EGC, the GL0-GL1 classification should become a routine clinical practice to identify the aggressive tumor phenotypes requiring for closer follow-up or additional treatment.
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Affiliation(s)
- Edoardo Virgilio
- Medical and Surgical Sciences and Translational Medicine, Faculty of Medicine and Psychology "Sapienza", St. Andrea Hospital, Rome, Italy
| | - Enrico Giarnieri
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, University "Sapienza", St. Andrea Hospital, Rome, Italy
| | - Maria Rosaria Giovagnoli
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, University "Sapienza", St. Andrea Hospital, Rome, Italy
| | - Monica Montagnini
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, University "Sapienza", St. Andrea Hospital, Rome, Italy
| | - Antonella Proietti
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, University "Sapienza", St. Andrea Hospital, Rome, Italy
| | - Rosaria D'Urso
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, University "Sapienza", St. Andrea Hospital, Rome, Italy
| | - Paolo Mercantini
- Medical and Surgical Sciences and Translational Medicine, Faculty of Medicine and Psychology "Sapienza", St. Andrea Hospital, Rome, Italy
| | - Genoveffa Balducci
- Medical and Surgical Sciences and Translational Medicine, Faculty of Medicine and Psychology "Sapienza", St. Andrea Hospital, Rome, Italy
| | - Marco Cavallini
- Medical and Surgical Sciences and Translational Medicine, Faculty of Medicine and Psychology "Sapienza", St. Andrea Hospital, Rome, Italy
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18
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Pisanu ME, Noto A, De Vitis C, Morrone S, Scognamiglio G, Botti G, Venuta F, Diso D, Jakopin Z, Padula F, Ricci A, Mariotta S, Giovagnoli MR, Giarnieri E, Amelio I, Agostini M, Melino G, Ciliberto G, Mancini R. Blockade of Stearoyl-CoA-desaturase 1 activity reverts resistance to cisplatin in lung cancer stem cells. Cancer Lett 2017; 406:93-104. [PMID: 28797843 DOI: 10.1016/j.canlet.2017.07.027] [Citation(s) in RCA: 71] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Revised: 07/27/2017] [Accepted: 07/30/2017] [Indexed: 12/11/2022]
Abstract
Poor prognosis in lung cancer has been attributed to the presence of lung cancer stem cells (CSCs) which resist chemotherapy and cause disease recurrence. Hence, the strong need to identify mechanisms of chemoresistance and to develop new combination therapies. We have previously shown that Stearoyl-CoA-desaturase 1 (SCD1), the enzyme responsible for the conversion of saturated to monounsaturated fatty acids is upregulated in 3D lung cancer spheroids and is an upstream activator of key proliferation pathways β-catenin and YAP/TAZ. Here we first show that SCD1 expression, either alone or in combination with a variety of CSCs markers, correlates with poor prognosis in adenocarcinoma (ADC) of the lung. Treatment of lung ADC cell cultures with cisplatin enhances the formation of larger 3D tumor spheroids and upregulates CSCs markers. In contrast, co-treatment with cisplatin and the SCD1 inhibitor MF-438 reverts upregulation of CSCs markers, strongly synergizes in the inhibition of 3D spheroids formation and induces CSCs apoptosis. Mechanistically, SCD1 inhibition activates endoplasmic reticulum stress response and enhances autophagy. These data all together support the use of combination therapy with SCD1 inhibitors to achieve better control of lung cancer.
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Affiliation(s)
- Maria Elena Pisanu
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, 00161 Rome, Italy
| | - Alessia Noto
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, 00161 Rome, Italy
| | - Claudia De Vitis
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, 00161 Rome, Italy
| | - Stefania Morrone
- Department of Experimental Medicine, Sapienza University of Rome, 00161 Rome, Italy
| | - Giosuè Scognamiglio
- Experimental Pharmacology Unit, National Cancer Institute, Fondazione "G. Pascale" - IRCCS, 80131 Naples, Italy
| | - Gerardo Botti
- Director Dept. Pathology National Cancer Institute, Fondazione "G. Pascale" - IRCCS, 80131 Naples, Italy
| | - Federico Venuta
- Department of Surgical Sciences and Organ Transplantation "Paride Stefanini", Sapienza University of Rome, 00161 Rome, Italy
| | - Daniele Diso
- Department of Surgical Sciences and Organ Transplantation "Paride Stefanini", Sapienza University of Rome, 00161 Rome, Italy
| | - Ziga Jakopin
- Faculty of Pharmacy, University of Ljubljana, Ljubljana, Slovenia
| | - Fabrizio Padula
- Section of Histology and Embryology, Department of Anatomy, Histology, Forensic Medicine and Orthopedics, Faculty of Pharmacy and Medicine, Sapienza University of Rome, 00161 Rome, Italy
| | - Alberto Ricci
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, 00161 Rome, Italy
| | - Salvatore Mariotta
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, 00161 Rome, Italy
| | | | - Enrico Giarnieri
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, 00161 Rome, Italy
| | - Ivano Amelio
- Medical Research Council, Toxicology Unit, Leicester University, Hodgkin Building, LE1 9HN Leicester, UK
| | - Massimiliano Agostini
- Medical Research Council, Toxicology Unit, Leicester University, Hodgkin Building, LE1 9HN Leicester, UK; Department of Experimental Medicine and Surgery, University of Rome "Tor Vergata", 00133 Rome, Italy
| | - Gerry Melino
- Medical Research Council, Toxicology Unit, Leicester University, Hodgkin Building, LE1 9HN Leicester, UK; Department of Experimental Medicine and Surgery, University of Rome "Tor Vergata", 00133 Rome, Italy
| | - Gennaro Ciliberto
- Scientific Directorate, IRCSS Regina Elena National Cancer Institute, 00128 Rome, Italy
| | - Rita Mancini
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, 00161 Rome, Italy.
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19
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Di Napoli A, Pepe G, Giarnieri E, Cippitelli C, Bonifacino A, Mattei M, Martelli M, Falasca C, Cox MC, Santino I, Giovagnoli MR. Cytological diagnostic features of late breast implant seromas: From reactive to anaplastic large cell lymphoma. PLoS One 2017; 12:e0181097. [PMID: 28715445 PMCID: PMC5513491 DOI: 10.1371/journal.pone.0181097] [Citation(s) in RCA: 67] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Accepted: 06/26/2017] [Indexed: 11/18/2022] Open
Abstract
Late breast implant seroma may be the presentation of a breast implant-associated anaplastic large cell lymphoma (BI-ALCL), which claims for a prompt recognition. However, BI-ALCL diagnosis on fine-needle aspiration (FNA) might be challenging for pathologists lacking experience with peri-implant breast effusions. Sixty-seven late breast implant seromas collected by FNA from 50 patients were evaluated by Papanicolaou smear stain and immunocytochemistry on cell blocks. A diagnostic algorithm based on the cellular composition, cell morphology and percentage of CD30+ cells was developed. Histological evaluation of the corresponding peri-prosthetic capsules was also performed. Most of the effusions (91% of the samples) were classified as reactive and 9% as BI-ALCL. In the BI-ALCL cases, medium-to-large atypical cells expressing CD30 represented more than 70% of the cellularity, whereas in in the reactive effusions CD30+ elements were extremely rare (<5%) and consisted of non-atypical elements. The reactive effusions were categorized into three patterns: i) acute infiltrate with prominent neutrophilic component (33% of the samples); ii) mixed infiltrate characterized by a variable number of neutrophils, lymphocytes and macrophages (30% of the samples); iii) chronic infiltrate composed predominantly of T lymphocytes or macrophages with only sporadic granulocytes (37% of the samples). The inflammatory cytological patterns were consistent with the histology of the corresponding capsules. Our results indicate that cytological analysis of late breast implant effusions, supported by the knowledge of the heterogeneous cytomorphological spectrum of late seromas, is a valuable approach for the early recognition of BI-ALCL.
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MESH Headings
- Adult
- Aged
- Antigens, CD/metabolism
- Antigens, Differentiation, Myelomonocytic/metabolism
- Breast Implantation
- Breast Neoplasms/pathology
- CD3 Complex/metabolism
- Female
- Gene Rearrangement
- Humans
- Ki-1 Antigen/metabolism
- Klebsiella oxytoca/isolation & purification
- Lymphocytes/cytology
- Lymphocytes/metabolism
- Lymphoma, Large-Cell, Anaplastic/pathology
- Macrophages/cytology
- Macrophages/metabolism
- Middle Aged
- Neutrophils/cytology
- Neutrophils/metabolism
- Pseudomonas aeruginosa/isolation & purification
- Receptors, Antigen, T-Cell, gamma-delta/genetics
- Receptors, Antigen, T-Cell, gamma-delta/metabolism
- Seroma/diagnosis
- Seroma/microbiology
- Serratia marcescens/isolation & purification
- Staphylococcus aureus/isolation & purification
- Young Adult
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Affiliation(s)
- Arianna Di Napoli
- Department of Clinical and Molecular Medicine, Sapienza University, Pathology Unit, Sant'Andrea Hospital, Roma, Italy
- * E-mail:
| | - Giuseppina Pepe
- Department of Clinical and Molecular Medicine, Sapienza University, Pathology Unit, Sant'Andrea Hospital, Roma, Italy
| | - Enrico Giarnieri
- Department of Clinical and Molecular Medicine, Sapienza University, Cytology Unit, Sant'Andrea Hospital, Roma, Italy
| | - Claudia Cippitelli
- Department of Clinical and Molecular Medicine, Sapienza University, Pathology Unit, Sant'Andrea Hospital, Roma, Italy
| | | | - Mauro Mattei
- Breast Unit, Sant’Andrea Hospital, Sapienza University, Roma, Italy
| | - Maurizio Martelli
- Department of Cellular Biotechnologies and Hematology, Sapienza University, Policlinico Umberto I, Rome, Italy
| | - Carlo Falasca
- Department of Clinical and Molecular Medicine, Sapienza University, Cytology Unit, Sant'Andrea Hospital, Roma, Italy
| | | | - Iolanda Santino
- Department of Clinical and Molecular Medicine, Sapienza University, Microbiology Unit, Sant'Andrea Hospital, Roma, Italy
| | - Maria Rosaria Giovagnoli
- Department of Clinical and Molecular Medicine, Sapienza University, Cytology Unit, Sant'Andrea Hospital, Roma, Italy
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20
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Benevolo M, Allia E, Gustinucci D, Rollo F, Bulletti S, Cesarini E, Passamonti B, Giovagnoli MR, Carico E, Carozzi FM, Mongia A, Fantacci G, Confortini M, Rubino T, Fodero C, Prandi S, Marchi N, Farruggio A, Coccia A, Macrì L, Ghiringhello B, Ronco G, Bragantini E, Polla E, Maccallini V, Negri G, Giorgi Rossi P. Interobserver reproducibility of cytologic p16 INK4a /Ki-67 dual immunostaining in human papillomavirus-positive women. Cancer Cytopathol 2016; 125:212-220. [PMID: 27926800 DOI: 10.1002/cncy.21800] [Citation(s) in RCA: 18] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Revised: 10/14/2016] [Accepted: 10/17/2016] [Indexed: 01/26/2023]
Abstract
BACKGROUND The accumulation of cyclin-dependent kinase inhibitor 2A (p16ink4a ) protein in a cell is associated with neoplastic progression in precancerous cervical lesions. Dual staining for p16ink4a and Ki-67 has been proposed as a triage test in cervical cancer screening for women who test positive for human papillomavirus DNA. In this study, interobserver reproducibility of the interpretation of this test was assessed. METHODS Forty-two immunostained, liquid-based cytology slides were divided into 2 sets and were interpreted by 17 to 21 readers from 9 different laboratories, yielding a total of 816 reports. Immunostaining results were classified as positive, negative, inconclusive, or inadequate. After evaluation of the first set of slides and before circulation of the second set, the results were discussed in a plenary meeting. The 10 slides with the most discordant results were evaluated again by selected expert cytopathologists. RESULTS The overall κ value was 0.612 (95% confidence interval [CI], 0.523-0.701), it was higher for the positive and negative categories (κ = 0.692 and κ = 0.641, respectively), and it was almost null for the inconclusive category (κ = 0.058). Considering only readers from laboratories with documented experience, the κ value was higher (κ = 0.747; 95% CI, 0.643-0.839) compared with nonexperienced centers (κ = 0.498; 95% CI, 0.388-0.616). The results were similar in both sets of slides (κ = 0.505 [95% CI, 0.358-0.642] and κ = 0.521 [95% CI, 0.240-0.698] for the first and second sets, respectively). Reinterpretation of the slides with the most discordant results did not provide any improvement (first evaluation, κ = 0.616 [95% CI, 0.384-0.866]; second evaluation, κ = 0.403 [95% CI, 0.182-0.643]). CONCLUSIONS Dual staining for p16 ink4a and Ki-67 demonstrated good reproducibility, confirming its robustness, which is a necessary prerequisite for its adoption as a triage test in cervical cancer screening programs that use human papillomavirus DNA as a primary test. Cancer Cytopathol 2017;125:212-220. © 2016 American Cancer Society.
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Affiliation(s)
| | - Elena Allia
- Central Cervicovaginal Screening Unit and Center for Cancer Epidemiology and Prevention, Turin, Italy
| | - Daniela Gustinucci
- Laboratory Screening Unit, Local Health Authority-Umbria 1, Perugia, Italy
| | | | - Simonetta Bulletti
- Laboratory Screening Unit, Local Health Authority-Umbria 1, Perugia, Italy
| | - Elena Cesarini
- Laboratory Screening Unit, Local Health Authority-Umbria 1, Perugia, Italy
| | - Basilio Passamonti
- Laboratory Screening Unit, Local Health Authority-Umbria 1, Perugia, Italy
| | | | - Elisabetta Carico
- Cytopathology Unit, St Andrea Hospital, "Sapienza" University, Rome, Italy
| | - Francesca M Carozzi
- Human Papillomavirus Laboratory and Molecular Oncology Unit, Regional Cancer Prevention Laboratory, Institute for Cancer Study and Prevention, Florence, Italy
| | - Alessandra Mongia
- Human Papillomavirus Laboratory and Molecular Oncology Unit, Regional Cancer Prevention Laboratory, Institute for Cancer Study and Prevention, Florence, Italy
| | - Giulia Fantacci
- Human Papillomavirus Laboratory and Molecular Oncology Unit, Regional Cancer Prevention Laboratory, Institute for Cancer Study and Prevention, Florence, Italy
| | - Massimo Confortini
- Human Papillomavirus Laboratory and Molecular Oncology Unit, Regional Cancer Prevention Laboratory, Institute for Cancer Study and Prevention, Florence, Italy
| | - Teresa Rubino
- Institute for Research and Health Care (IRCCS), "Arcispedale S. Maria Nuova" Hospital, Reggio Emilia, Italy
| | - Cristina Fodero
- Institute for Research and Health Care (IRCCS), "Arcispedale S. Maria Nuova" Hospital, Reggio Emilia, Italy
| | - Sonia Prandi
- Institute for Research and Health Care (IRCCS), "Arcispedale S. Maria Nuova" Hospital, Reggio Emilia, Italy
| | - Natalina Marchi
- Unit 17, Local Health and Social Care Facility, Este Monselice, Italy
| | - Angelo Farruggio
- Unit 17, Local Health and Social Care Facility, Este Monselice, Italy
| | - Anna Coccia
- Central Cervicovaginal Screening Unit and Center for Cancer Epidemiology and Prevention, Turin, Italy
| | - Luigia Macrì
- Central Cervicovaginal Screening Unit and Center for Cancer Epidemiology and Prevention, Turin, Italy
| | - Bruno Ghiringhello
- Central Cervicovaginal Screening Unit and Center for Cancer Epidemiology and Prevention, Turin, Italy
| | - Guglielmo Ronco
- Central Cervicovaginal Screening Unit and Center for Cancer Epidemiology and Prevention, Turin, Italy
| | | | - Enzo Polla
- Provincial Health Care Service, Trento, Italy
| | - Vincenzo Maccallini
- Department of Pathology, Avezzano, Sulmona, and L'Aquila Local Health Trust-Abruzzo, Avezzano, Italy
| | - Giovanni Negri
- Department of Pathology, Bolzano Central Hospital, Bolzano, Italy
| | - Paolo Giorgi Rossi
- Institute for Research and Health Care (IRCCS), "Arcispedale S. Maria Nuova" Hospital, Reggio Emilia, Italy.,Interinstitutional Epidemiology Unit, Reggio Emilia Local Health Trust, Reggio Emilia, Italy
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Giansanti D, Pochini M, Giovagnoli MR. Integration of tablet technologies in the e-laboratory of cytology: a health technology assessment. Telemed J E Health 2016; 20:909-15. [PMID: 25290667 DOI: 10.1089/tmj.2013.0235] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
INTRODUCTION Although tablet systems are becoming a powerful technology, particularly useful in every application of medical imaging, to date no one has investigated the acceptance and performance of this technology in digital cytology. The specific aims of the work were (1) to design a health technology assessment (HTA) tool to assess, in terms of performance and acceptance, the introduction of tablet technologies (wearable, portable, and non portable) in the e-laboratories of cytology and (2) to test the tool in a first significant application of digital cytology. MATERIALS AND METHODS An HTA tool was proposed operating on a domain of five dimensions of investigation comprising the basic information of the product of digital cytology, the perceived subjective quality of images, the assessment of the virtual navigation on the e-slide, the assessment of the information and communication technologies features, and the diagnostic power. Six e-slides regarding studies of cervicovaginal cytology digitalized by means of an Aperio ( www.aperio.com ) scanner and uploaded onto the www.digitalslide.it Web site were used for testing the methodology on three different network connections. RESULTS Three experts of cytology successfully tested the methodology on seven tablets found suitable for the study in their own standard configuration. Specific indexes furnished by the tool indicated both a high degree of performance and subjective acceptance of the investigated technology. CONCLUSIONS The HTA tool thus could be useful to investigate new tablet technologies in digital cytology and furnish stakeholders with useful information that may help them make decisions involving the healthcare system. From a global point of view the study demonstrates the feasibility of using the tablet technology in digital cytology.
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22
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Virgilio E, Giarnieri E, Montagnini M, D''Urso R, Proietti A, Mesiti A, Giovagnoli MR, Mercantini P, Cavallini M, Balducci G. Analyzing Gastric Lavage of Gastric Cancer Patients: A Prospective Observational Study on Cytopathology and Determination of Intragastric CEA, CA 19.9, CA 72.4, and CA 50. Acta Cytol 2016; 60:161-6. [PMID: 27096417 DOI: 10.1159/000445765] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Accepted: 03/22/2016] [Indexed: 01/21/2023]
Abstract
OBJECTIVES To investigate gastric lavage (GL) cytopathology and immunometric analysis as novel clinicopathologic and prognostic parameters for gastric cancer (GC). STUDY DESIGN In 38 patients with gastric adenocarcinoma, we performed a cytopathologic analysis and an immunometric assay of GL using four tumor markers (CEA, CA 19.9, CA 72.4, and CA 50). The intragastric tumor marker levels were compared with a control group consisting of 41 non-GC patients to determine a statistically significant cutoff value. RESULTS GL cytopathology demonstrated the presence of cancer cells in 13 (34.2%) of the 38 GC patients: such a finding correlated to the parameters pT and pN with a statistically significant validity (p < 0.0267 and p < 0.0306, respectively). Measurement of intragastric CA 19.9 and CA 50 attained a statistically significant cutoff value (p < 0.002 and p < 0.0096, respectively), which was invalidated by the low sensitivity of the ROC curve analysis. CONCLUSIONS In contrast to determination of its tumor markers, GL cytopathology correlated well with pT and pN staging parameters. Should this and other features be corroborated by future studies, the GL cytology test could be routinely used to detect aggressive types of GC even at early stages and result in important progress in the knowledge, staging, prediction, as well as management and follow-up of this inauspicious type of cancer.
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Affiliation(s)
- Edoardo Virgilio
- Division of Emergency Surgery, Department of Medical and Surgical Sciences and Translational Medicine, Faculty of Medicine and Psychology, University Sapienza, St. Andrea Hospital, Rome, Italy
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23
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Roscilli G, De Vitis C, Ferrara FF, Noto A, Cherubini E, Ricci A, Mariotta S, Giarnieri E, Giovagnoli MR, Torrisi MR, Bergantino F, Costantini S, Fenizia F, Lambiase M, Aurisicchio L, Normanno N, Ciliberto G, Mancini R. Human lung adenocarcinoma cell cultures derived from malignant pleural effusions as model system to predict patients chemosensitivity. J Transl Med 2016; 14:61. [PMID: 26928703 PMCID: PMC4772534 DOI: 10.1186/s12967-016-0816-x] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [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: 12/14/2015] [Accepted: 02/13/2016] [Indexed: 12/31/2022] Open
Abstract
Background Lung cancer is the leading cause of cancer related deaths and Malignant Pleural Effusion (MPE) is a frequent complication. Current therapies suffer from lack of efficacy in a great percentage of cases, especially when cancer is diagnosed at a late stage. Moreover patients’ responses vary and the outcome is unpredictable. Therefore, the identification of patients who will benefit most of chemotherapy treatment is important for accurate prognostication and better outcome. In this study, using malignant pleural effusions (MPE) from non-small cell lung cancer (NSCLC) patients, we established a collection of patient-derived Adenocarcinoma cultures which were characterized for their sensitivity to chemotherapeutic drugs used in the clinical practice. Methods Tumor cells present in MPEs of patients with NSCLC were isolated by density gradient centrifugation, placed in culture and genotyped by next generation sequencing. In a subset of cases patient derived xenografts (PDX) were obtained upon tumor cell inoculation in rag2/IL2 knock-out mice. Isolated primary cultures were characterized and tested for drug sensitivity by in vitro proliferation assays. Additivity, antagonism or synergy for combinatorial treatments were determined by analysis with the Calcusyn software. Results We have optimized isolation procedures and culture conditions to expand in vitro primary cultures from Malignant Pleural Effusions (MPEs) of patients affected by lung adenocarcinomas, the most frequent form of non small cell lung cancer. Using this approach we have been able to establish 16 primary cultures from MPEs. Cells were banked at low passages and were characterized for their mutational pattern by next generation sequencing for most common driver mutations in lung cancer. Moreover, amplified cultures were shown to engraft with high efficiency when injected in immunocompromised mice. Cancer cell sensitivity to drugs used in standard chemotherapy regimens was assessed either individually or in combination. Differential chemosensitivity and different mutation profiles were observed which suggests that this isolation method could provide a platform for predicting the efficacy of chemotherapy in the clinical setting. Most importantly for six patients it was possible to establish a correlation between drug response in vitro and response to therapy in the clinic. Conclusions Results obtained using primary cultured cells from MPEs underscore the heterogeneity of NSCLC in advanced stage as indicated by drug response and mutation profile. Comparison of data obtained from in vitro assays with patients’ responses to therapy leads to the conclusion that this strategy may provide a potentially useful approach for evaluating individual chemosensitivity profile and tailor the therapy accordingly. Furthermore, combining MPE-derived primary cultures with their genomic testing allows to identify patients eligible to trials with novel targeted agents. Electronic supplementary material The online version of this article (doi:10.1186/s12967-016-0816-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Giuseppe Roscilli
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, Rome, Italy. .,Takis srl, Rome, Italy.
| | - Claudia De Vitis
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, Rome, Italy. .,Laboratory of Research and Diagnostics, Department of Surgery "P.Valdoni", Sapienza University of Rome, Rome, Italy.
| | | | - Alessia Noto
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, Rome, Italy. .,Laboratory of Research and Diagnostics, Department of Surgery "P.Valdoni", Sapienza University of Rome, Rome, Italy.
| | - Emanuela Cherubini
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, Rome, Italy.
| | - Alberto Ricci
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, Rome, Italy. .,Azienda Ospedaliera S. Andrea, Rome, Italy.
| | - Salvatore Mariotta
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, Rome, Italy. .,Azienda Ospedaliera S. Andrea, Rome, Italy.
| | - Enrico Giarnieri
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, Rome, Italy. .,Azienda Ospedaliera S. Andrea, Rome, Italy.
| | - Maria Rosaria Giovagnoli
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, Rome, Italy. .,Azienda Ospedaliera S. Andrea, Rome, Italy.
| | - Maria Rosaria Torrisi
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, Rome, Italy. .,Azienda Ospedaliera S. Andrea, Rome, Italy.
| | | | - Susan Costantini
- IRCCS Istituto Nazionale Tumori, Fondazione "G. Pascale", Naples, Italy.
| | - Francesca Fenizia
- IRCCS Istituto Nazionale Tumori, Fondazione "G. Pascale", Naples, Italy.
| | - Matilde Lambiase
- IRCCS Istituto Nazionale Tumori, Fondazione "G. Pascale", Naples, Italy.
| | | | - Nicola Normanno
- IRCCS Istituto Nazionale Tumori, Fondazione "G. Pascale", Naples, Italy.
| | - Gennaro Ciliberto
- IRCCS Istituto Nazionale Tumori, Fondazione "G. Pascale", Naples, Italy.
| | - Rita Mancini
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, Rome, Italy. .,Laboratory of Research and Diagnostics, Department of Surgery "P.Valdoni", Sapienza University of Rome, Rome, Italy.
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24
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Giarnieri E, Bellipanni G, Macaluso M, Mancini R, Holstein AC, Milanese C, Giovagnoli MR, Giordano A, Russo G. Review: Cell Dynamics in Malignant Pleural Effusions. J Cell Physiol 2015; 230:272-7. [PMID: 25205557 DOI: 10.1002/jcp.24806] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2014] [Accepted: 09/05/2014] [Indexed: 12/29/2022]
Abstract
Malignant pleural effusions (MPEs) are a common manifestation found in patients with lung cancer. After cytological and histological confirmation of malignancy, talc pleurodesis still remains the treatment of choice in patients with MPEs resistant to chemotherapy. Despite this, primary challenges include reduced quality of life and life expectancy in general. Therefore, a better understanding of the cell biology of MPEs, along with improvements in treatment is greatly needed. It has recently been demonstrated that MPEs may represent an excellent source for identification of molecular mechanisms within the tumor and its environment. The present review summarizes the current understanding of MPEs cells and tumor microenvironment, and particularly focuses on dissecting the cross-talk between MPEs and epithelial to mesenchymal transition (EMT), inflammation and cancer stem cells.
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Affiliation(s)
- Enrico Giarnieri
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, University La Sapienza, Rome, Italy
| | - Gianfranco Bellipanni
- Sbarro Institute for Cancer Research and Molecular Medicine, College of Science and Technology, Temple University, BioLife Science Bldg., Philadelphia, Pennsylvania
| | - Marcella Macaluso
- Sbarro Institute for Cancer Research and Molecular Medicine, College of Science and Technology, Temple University, BioLife Science Bldg., Philadelphia, Pennsylvania
| | - Rita Mancini
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, University La Sapienza, Rome, Italy
| | - Adam Carl Holstein
- Sbarro Institute for Cancer Research and Molecular Medicine, College of Science and Technology, Temple University, BioLife Science Bldg., Philadelphia, Pennsylvania
| | - Carla Milanese
- Sbarro Institute for Cancer Research and Molecular Medicine, College of Science and Technology, Temple University, BioLife Science Bldg., Philadelphia, Pennsylvania
| | - Maria Rosaria Giovagnoli
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, University La Sapienza, Rome, Italy
| | - Antonio Giordano
- Sbarro Institute for Cancer Research and Molecular Medicine, College of Science and Technology, Temple University, BioLife Science Bldg., Philadelphia, Pennsylvania.,INT-CROM, "Pascale Foundation" National Cancer Institute-Cancer Research Center, Mercogliano (AV), Italy.,Department of Medical and Surgical Sciences and Neurosciences, University of Siena, Siena, Italy
| | - Giuseppe Russo
- Sbarro Institute for Cancer Research and Molecular Medicine, College of Science and Technology, Temple University, BioLife Science Bldg., Philadelphia, Pennsylvania
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Giovagnoli MR, Bonifacino A, Neglia C, Benvenuto M, Sambati FV, Giolli L, Giovagnoli A, Piscitelli P. Diagnostic and therapeutic path of breast cancer: effectiveness, appropriateness, and costs--results from the DOCMa study. Clin Interv Aging 2015; 10:741-9. [PMID: 25945041 PMCID: PMC4407743 DOI: 10.2147/cia.s75486] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Objective An increase in breast cancer incidence has been documented in Italy and in other countries, and some women decide by themselves to undergo diagnostic examinations outside the official screening campaigns. The aim of this paper was to analyze – in terms of effectiveness, appropriate access, and related costs – the path spontaneously followed by a sample of Italian women for the early diagnosis of breast cancer. Subjects and methods A total of 143 women who consecutively referred themselves to the breast cancer outpatient facilities at the Sant’Andrea University Hospital in Rome from May to June 2007 were enrolled in the study, gave their consent, and were screened according to their individual risk factors for breast cancer. The entire diagnostic and therapeutic path followed in the previous 2 years by each of them, either at Sant’Andrea or in other medical facilities, was reviewed and evaluated in terms of its operative efficiency and fair economic value. Results The subjects’ mean age was 47.5 years (standard deviation 13.6 years); 55% of the women were <50 years old (28% <40 years), and were thus not included in the official screening campaigns; 97 women (70%) were requesting a routine control; and 49% of them had already undergone four to seven examinations before the enrollment, although no major risk factor was present in 73.5%. After enrollment in the study, nine of the patients had surgical interventions performed on them at Sant’Andrea’s, identifying five invasive carcinomas and two ductal in situ carcinomas and two benign lesions. Operative efficiency and fair economic value were found to be optimal only in diagnostic/therapeutic paths followed at Sant’Andrea. Conclusion The diagnostic path at Sant’Andrea’s specialized center for breast cancer diagnosis and therapy is characterized by higher operative efficiency and more sustainable costs than at general hospitals, outpatient facilities run by local health authorities, or private medical centers. This result seems to confirm the present tendency to refer high-risk patients for breast cancer directly to breast units like the one at Sant’Andrea.
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Affiliation(s)
- Maria Rosaria Giovagnoli
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, Sant'Andrea University Hospital, Rome, Italy
| | - Adriana Bonifacino
- Department of Medical-Surgical Sciences and Translational Medicine, Sapienza University of Rome, Sant'Andrea University Hospital, Rome, Italy
| | - Cosimo Neglia
- Euro Mediterranean Scientific Biomedical Institute (ISBEM), Brindisi, Italy
| | - Marco Benvenuto
- Euro Mediterranean Scientific Biomedical Institute (ISBEM), Brindisi, Italy ; Department of Economics, Scuola Superiore Sant'Anna, Pisa, Italy
| | | | | | | | - Prisco Piscitelli
- Coleman Ltd, Southern Italy Hospital Institute, Naples, Italy ; IOS, Southern Italy Hospital Institute, Naples, Italy
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26
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Noto A, De Vitis C, Roscilli G, Fattore L, Malpicci D, Marra E, Luberto L, D'Andrilli A, Coluccia P, Giovagnoli MR, Normanno N, Ruco L, Aurisicchio L, Mancini R, Ciliberto G. Combination therapy with anti-ErbB3 monoclonal antibodies and EGFR TKIs potently inhibits non-small cell lung cancer. Oncotarget 2014; 4:1253-65. [PMID: 23896512 PMCID: PMC3787155 DOI: 10.18632/oncotarget.1141] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [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] [Indexed: 01/11/2023] Open
Abstract
Personalized therapy of advanced non-small cell lung cancer (NSCLC) has been improved by the introduction of EGFR tyrosine kinase inhibitors (TKIs), gefitinib and erlotinib. EGFR TKIs induce dramatic objective responses and increase survival in patients bearing sensitizing mutations in the EGFR intracytoplasmic tyrosine kinase domain. However, virtually all patients develop resistance, and this is responsible for disease relapse. Hence several efforts are being undertaken to understand the mechanisms of resistance in order to develop combination treatments capable to sensitize resistant cells to EGFR TKIs. Recent studies have suggested that upregulation of another member of the EGFR receptor family, namely ErbB3 is involved in drug resistance, through increased phosphorylation of its intracytoplasmic domain and activation of PI3K/AKT signaling. In this paper we first show, by using a set of malignant pleural effusion derived cell cultures (MPEDCC) from patients with lung adenocarcinoma, that surface ErbB3 expression correlates with increased AKT phosphorylation. Antibodies against ErbB3, namely A3, which we previously demonstrated to induce receptor internalization and degradation, inhibit growth and induce apoptosis only in cells overexpressing surface ErbB3. Furthermore, combination of anti-ErbB3 antibodies with EGFR TKIs synergistically affect cell proliferation in vitro, cause cell cycle arrest, up-regulate p21 expression and inhibit tumor growth in mouse xenografts. Importantly, potentiation of gefitinib by anti-ErbB3 antibodies occurs both in de novo and in ab initio resistant cells. Anti-ErbB3 mAbs strongly synergize also with the dual EGFR and HER2 inhibitor lapatinib. Our results suggest that combination treatment with EGFR TKI and antibodies against ErbB3 should be a promising approach to pursue in the clinic.
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Affiliation(s)
- Alessia Noto
- Dipartimento di Medicina Clinica e Molecolare, Sapienza Universita' di Roma, Italy
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27
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Giansanti D, Boschetto A, Pochini M, Bottini L, Giovagnoli MR. Design of a process for image improvement in digital cytology: a preliminary technology assessement. Computer Methods in Biomechanics and Biomedical Engineering: Imaging & Visualization 2014. [DOI: 10.1080/21681163.2014.883940] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Paris I, Prelaj A, Onesti CE, Baldoni A, Giovagnoli MR, Bassanelli M, Lauro S, Marchetti P. Esophageal stenosis: a differential diagnosis between esophageal cancer and metastasis from other neoplasia. Anticancer Res 2014; 34:363-366. [PMID: 24403488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
BACKGROUND The occurrence of radiological mediastinal lymphadenopathy as the only evidence of tumor recurrence of cervical carcinoma is very rare. We report on such a case with stenosis of the esophagus. CASE REPORT A 36-year-old Caucasian woman, without any relevant history of gynecological cancer, underwent a trans-vaginal ultrasound with evidence of any cervical lesion locally extended. After histologically-proven diagnosis of squamous cell carcinoma of the cervix uterine, the patient was treated by neoadjuvant chemoradiation, followed by total abdominal hysterectomy with bilateral salpingoophorectomy. A subsequent close follow-up was negative for recurrence of disease until December 2008, two years after diagnosis. At that period, the patient experienced cough and severe dysphagia and for this reason she underwent several examinations including esophagogastroduodenoscopy, whole-body computed tomographic scan and bronchoscopy with transbronchial needle aspiration. Histology led to diagnosis of recurrence of cervical cancer, HPV31-positive, in multiple mediastinal lymphnodes, with infiltration of the esophageal mucosa. CONCLUSION Mediastinal lymphade-nopathy in patients with a history of cervical carcinoma should be suspicious of metastatic disease, even if there is no radiological evidence of distant metastases.
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Affiliation(s)
- Ida Paris
- Department of Medical Oncology, Ospedale S. Andrea, via di Grottarossa n°1035-1039, 00189, Rome, Italy.
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29
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Noto A, Raffa S, De Vitis C, Roscilli G, Malpicci D, Coluccia P, Di Napoli A, Ricci A, Giovagnoli MR, Aurisicchio L, Torrisi MR, Ciliberto G, Mancini R. Stearoyl-CoA desaturase-1 is a key factor for lung cancer-initiating cells. Cell Death Dis 2013; 4:e947. [PMID: 24309934 PMCID: PMC3877537 DOI: 10.1038/cddis.2013.444] [Citation(s) in RCA: 105] [Impact Index Per Article: 9.5] [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: 09/13/2013] [Revised: 10/04/2013] [Accepted: 10/08/2013] [Indexed: 12/21/2022]
Abstract
In recent years, studies of cancer development and recurrence have been influenced by the cancer stem cells (CSCs)/cancer-initiating cells (CICs) hypothesis. According to this, cancer is sustained by highly positioned, chemoresistant cells with extensive capacity of self renewal, which are responsible for disease relapse after chemotherapy. Growth of cancer cells as three-dimensional non-adherent spheroids is regarded as a useful methodology to enrich for cells endowed with CSC-like features. We have recently reported that cell cultures derived from malignant pleural effusions (MPEs) of patients affected by adenocarcinoma of the lung are able to efficiently form spheroids in non-adherent conditions supplemented with growth factors. By expression profiling, we were able to identify a set of genes whose expression is significantly upregulated in lung tumor spheroids versus adherent cultures. One of the most strongly upregulated gene was stearoyl-CoA desaturase (SCD1), the main enzyme responsible for the conversion of saturated into monounsaturated fatty acids. In the present study, we show both by RNA interference and through the use of a small molecule inhibitor that SCD1 is required for lung cancer spheroids propagation both in stable cell lines and in MPE-derived primary tumor cultures. Morphological examination and image analysis of the tumor spheroids formed in the presence of SCD1 inhibitors showed a different pattern of growth characterized by irregular cell aggregates. Electron microscopy revealed that the treated spheroids displayed several features of cellular damage and immunofluorescence analysis on optical serial sections showed apoptotic cells positive for the M30 marker, most of them positive also for the stemness marker ALDH1A1, thus suggesting that the SCD1 inhibitor is selectively killing cells with stem-like properties. Furthermore, SCD1-inhibited lung cancer cells were strongly impaired in their in vivo tumorigenicity and ALDH1A1 expression. These results suggest that SCD1 is a critical target in lung cancer tumor-initiating cells.
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Affiliation(s)
- A Noto
- 1] Department of Clinical and Molecular Medicine, Sapienza University of Rome, Italy [2] Laboratory of Research and Diagnostics, Department of Surgery 'P.Valdoni', Sapienza University of Rome
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Giansanti D, Pochini M, Giovagnoli MR. How tablet technology is going to change cooperative diagnosis in the cytology e-laboratory. Telemed J E Health 2013; 19:991-3. [PMID: 24134183 DOI: 10.1089/tmj.2013.0108] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Giarnieri E, De Vitis C, Noto A, Roscilli G, Salerno G, Mariotta S, Ricci A, Bruno P, Russo G, Laurenzi A, Giovagnoli MR, Ciliberto G, Mancini R. EMT markers in lung adenocarcinoma pleural effusion spheroid cells. J Cell Physiol 2013; 228:1720-6. [PMID: 23255165 DOI: 10.1002/jcp.24300] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2012] [Accepted: 11/27/2012] [Indexed: 01/15/2023]
Abstract
Epithelial-to-mesenchymal transition (EMT) is a process in which cells undergo a developmental switch from epithelial to mesenchymal phenotype. This process has been related to embryologic morphogenesis but also to cancer progression and metastasis. The aim of the current study was to investigate the expression of EMT-related markers in adherent and spheroid cell cultures derived from malignant pleural effusions (MPEs) of patients affected by lung adenocarcinoma. On the basis of efficient in vitro propagation, six cases of MPEs were selected and analyzed by immunocytochemistry staining for EMT markers and by RT-PCR for transcription factors known to orchestrate EMT. EMT markers immunostaining showed in spheroids a statistically significant correlation between the loss of E-cadherin immunoreactivity and overexpression of N-cadherin (P < 0.001). Likewise loss of EpCAM epithelial marker was coincident with Vimentin overexpression (P < 0.001). RT-PCR analysis of transcription factors Snail, Slug, and Twist showed a highly variable expression, although a general trend to increase was observed. Importantly, in some selected cases it was possible to establish a precise relationship between spheroid formation, EMT switch and increased upregulation of the marker related to cancer stemness such as ALDH positivity. Therefore, MPE-derived cell cultures, while recapitulating the heterogeneity of lung cancer, are a suitable system to study the mechanisms at the basis of EMT and to understand its relationship with the generation of cancer stem cells.
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Affiliation(s)
- Enrico Giarnieri
- Department of Clinical and Molecular Medicine, University of Rome La Sapienza, S Andrea Hospital, Rome, Italy.
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Ricci A, De Vitis C, Noto A, Fattore L, Mariotta S, Cherubini E, Roscilli G, Liguori G, Scognamiglio G, Rocco G, Botti G, Giarnieri E, Giovagnoli MR, De Toma G, Ciliberto G, Mancini R. TrkB is responsible for EMT transition in malignant pleural effusions derived cultures from adenocarcinoma of the lung. Cell Cycle 2013; 12:1696-703. [PMID: 23656788 PMCID: PMC3713128 DOI: 10.4161/cc.24759] [Citation(s) in RCA: 24] [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] [Subscribe] [Scholar Register] [Received: 03/25/2013] [Revised: 04/18/2013] [Accepted: 04/20/2013] [Indexed: 12/17/2022] Open
Abstract
Lung cancer is the leading cause of cancer-related mortality worldwide. Recent evidence indicates that tumors contain a subpopulation of cancer stem cells (CSCs) that are responsible for tumor maintenance and spread. CSCs have recently been linked to the occurrence of epithelial-to-mesenchymal transition (EMT). Neurotrophins (NTs) are growth factors that regulate the biology of embryonic stem cells and cancer cells, but still little is known about the role NTs in the progression of lung cancer. In this work, we investigated the role of the NTs and their receptors using as a study system primary cell cultures derived from malignant pleural effusions (MPEs) of patients with adenocarcinoma of the lung. We assessed the expression of NTs and their receptors in MPE-derived adherent cultures vs. spheroids enriched in CSC markers. We observed in spheroids a selectively enhanced expression of TrkB, both at the mRNA and protein levels. Both K252a, a known inhibitor of Trk activity, and a siRNA against TrkB strongly affected spheroid morphology, induced anoikis and decreased spheroid forming efficiency. Treatment with neurotrophins reversed the inhibitory effect of K252a. Importantly, TrkB inhibition caused loss of vimentin expression as well as that of a set of transcription factors known to be linked to EMT. These ex vivo results nicely correlated with an inverse relationship between TrkB and E-cadherin expression measured by immunohistochemistry in a panel of lung adenocarcinoma samples. We conclude that TrkB is involved in full acquisition of EMT in lung cancer, and that its inhibition results in a less aggressive phenotype.
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Affiliation(s)
- Alberto Ricci
- Department of Clinical and Molecular Medicine; University “La Sapienza”; Rome, Italy
- Center of Research; San Pietro Hospital; Rome, Italy
| | - Claudia De Vitis
- Department of Experimental and Clinical Medicine; Catanzaro, Italy
- Laboratory of Surgery “P. Valdoni”; University “La Sapienza”; Rome, Italy
| | - Alessia Noto
- Department of Clinical and Molecular Medicine; University “La Sapienza”; Rome, Italy
- Laboratory of Surgery “P. Valdoni”; University “La Sapienza”; Rome, Italy
| | - Luigi Fattore
- Department of Clinical and Molecular Medicine; University “La Sapienza”; Rome, Italy
- Laboratory of Surgery “P. Valdoni”; University “La Sapienza”; Rome, Italy
| | - Salvatore Mariotta
- Department of Clinical and Molecular Medicine; University “La Sapienza”; Rome, Italy
- Center of Research; San Pietro Hospital; Rome, Italy
| | | | - Giuseppe Roscilli
- Department of Clinical and Molecular Medicine; University “La Sapienza”; Rome, Italy
| | | | | | - Gaetano Rocco
- IRCCS Istituto Nazionale Tumori “G. Pascale”; Naples, Italy
| | - Gerardo Botti
- IRCCS Istituto Nazionale Tumori “G. Pascale”; Naples, Italy
| | - Enrico Giarnieri
- Department of Clinical and Molecular Medicine; University “La Sapienza”; Rome, Italy
| | | | - Giorgio De Toma
- Laboratory of Surgery “P. Valdoni”; University “La Sapienza”; Rome, Italy
| | - Gennaro Ciliberto
- Department of Experimental and Clinical Medicine; Catanzaro, Italy
- IRCCS Istituto Nazionale Tumori “G. Pascale”; Naples, Italy
| | - Rita Mancini
- Department of Clinical and Molecular Medicine; University “La Sapienza”; Rome, Italy
- Laboratory of Surgery “P. Valdoni”; University “La Sapienza”; Rome, Italy
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Bruno P, Ricci A, Esposito MC, Scozzi D, Tabbì L, Sposato B, Falasca C, Giarnieri E, Giovagnoli MR, Mariotta S. Efficacy and cost effectiveness of rapid on site examination (ROSE) in management of patients with mediastinal lymphadenopathies. Eur Rev Med Pharmacol Sci 2013; 17:1517-1522. [PMID: 23771540] [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] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
BACKGROUND The diagnostic and staging approach for the mediastinal lymphadenopathies, with or whithout pulmonary lesions endoscopically visible, is based on transbronchial needle aspiration (TBNA) during fiberoptic bronchoscopy and on mediastinoscopy. One important factor impacting on TBNA sensitivity is the rapid on site cytological examination (ROSE). AIM The aim of this study was to evaluate the economic impact of TBNA and TBNA + ROSE, in the diagnosis of these lesions. PATIENTS AND METHODS 120 patients, affected by mediastinal lymphadenopathies suspected for lung cancer, underwent TBNA during fiberoptic bronchoscopy: 60 patients without ROSE (group A) and other 60 with ROSE (group B). Whenever needle aspirations failed to provide diagnosis, the patient underwent mediastinoscopy. The economic impact of the diagnostic process was performed. RESULTS In group A, 39 patients (65%) obtained a diagnosis with TBNA while 21 patients (35%) required mediastinoscopy. In group B, 48 patients (80%) obtained a diagnosis with TBNA + ROSE, while 12 patients (20%) required mediastinoscopy. With regards to the costs of the procedures performed in the diagnostic process, the use of TBNA with ROSE as first diagnostic approach has saved a considerable amount of euros (19,413) compared to the use of TBNA without ROSE and the combined procedure increased (p < 0.02; chi square test) the sensitivity of TBNA by 15%. CONCLUSIONS ROSE significantly impacts on the diagnostic yield, as well as on the overall management costs of patients with mediastinal lymphadenopathy, suspected for lung cancer.
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Affiliation(s)
- P Bruno
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, Rome, Italy
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Ciliberto G, Noto A, De Vitis C, Barzellotti R, Roscilli G, Aurisicchio L, Raffa S, Ricci A, Mariotta S, Torrisi MR, Giovagnoli MR, Mancini R. Abstract 248: Stearoyl-CoA desaturase 1 is a key factor for lung cancer stem cell survival and expansion. Cancer Res 2013. [DOI: 10.1158/1538-7445.am2013-248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
In recent years studies of cancer development and recurrence have been significantly influenced by the Cancer Stem Cell (CSC) hypothesis. According to this, cancer is sustained by highly-positioned, chemoresistant cells with extensive capacity of self renewal, which are responsible for disease relapse after treatment with debulking agents. Growth of cancer cells as non-adherent spheroids in non differentiating conditions is regarded as a useful methodology to enrich for cells endowed with CSC-like features. We have recently reported that cell cultures derived from Malignant Pleural Effusions (MPE) of patients affected by adenocarcinoma of the lung are able to form spheroids in non-adherent conditions supplemented with selected growth factors, that these spheroids upregulate markers associated with stemness, can be serially propagated in vitro through several passages and, finally, give rise efficiently to tumors, which reproduce the same histopathological features of the original human tumor when implanted in immunodeficient mice. By expression profiling we also identified a set of genes whose expression is significantly upregulated in lung tumor spheroids vs adherent cultures. One of the most strongly upregulated gene was Stearoyl-CoA desaturase (SCD1), the main enzyme responsible for the conversion of saturated into monounsaturated fatty acids. In the present study we show both by RNA interference or through the use of a small molecule inhibitor that SCD1 is required for lung cancer spheroids propagation both in stable cell lines and in primary tumor cultures. SCD1 inhibition causes a dramatic impairment of survival of cells which express ALDH and other markers of stemness in vitro. Morphological examination and image analysis of the tumor spheroids formed in the presence of SCD1 inhibitors showed a different pattern of growth characterized by irregular cell aggregates. Electron microscopy revealed that the treated spheroids displayed several features of cellular damage and immunofluorescence analysis on optical serial sections showed apoptotic cells positive for the M30 marker, most of them positive also for the stemness marker ALDH, thus suggesting that the SCD1 inhibitor is selectively killing cells with stem like properties. Furthermore, SCD1-inhibited lung cancer spheroids were strongly impaired in their in vivo tumorigenicity. These results suggest that SCD1 is a critical target in lung cancer tumor initiating cells.
Citation Format: Gennaro Ciliberto, Alessia Noto, Claudia De Vitis, Roberta Barzellotti, Giuseppe Roscilli, Luigi Aurisicchio, Salvatore Raffa, Alberto Ricci, Salvatore Mariotta, Maria Rosaria Torrisi, Maria Rosaria Giovagnoli, Rita Mancini. Stearoyl-CoA desaturase 1 is a key factor for lung cancer stem cell survival and expansion. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 248. doi:10.1158/1538-7445.AM2013-248
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Lukic A, Iannaccio S, Heyn R, Villani S, Nobili F, Giarnieri E, Mancini R, Moscarini M, Giovagnoli MR. Satisfactory sampling in cytological cervical diagnosis: comparison between a conventional and a new sampling device. Anticancer Res 2013; 33:917-922. [PMID: 23482762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
AIM Inadequate cervical sampling is the most frequent cause of misdiagnosis in cervical cancer screening. The aim of this study was to test the ability of PapCone® versus the conventional sampling method (Ayre's spatula plus cytobrush) to collect ectocervical and glandular cells. MATERIALS AND METHODS In 18 healthy women, two ecto-endocervical samples, obtained by two different methods, were obtained at a three-month interval. Qualitative and quantitative parameters were evaluated. Ultrastructure features of sampling devices were analyzed by scanning electron microscopy (SEM) before and after sampling. RESULTS The χ(2) test revealed a statistically significant difference between the two methods: PapCone® caused less cell overlap and sampled less white blood cells (p<0.05) and more metaplastic cells (p<0.01). SEM evaluation highlighted the porous and spongy structure of PapCone® that was responsible for the large number of glandular cells on its surface. CONCLUSION Cervical smears performed by PapCone® were adequate and generally easier to screen than conventionally performed ones.
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Tucci S, Mancini R, De Vitis C, Noto A, Marra E, Lukic A, Giovagnoli MR, Moscarini M. Colostrum in menopause effects on vaginal cytology/symptoms. CLIN EXP OBSTET GYN 2013; 40:219-221. [PMID: 23971242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
The aim of this study was to assess the effects of three weeks of daily colostrum cream on vaginal cytology and local symptoms related to menopause. Genito-urinary symptoms and cell morphology were analyzed at time 0 (T0) and after three weeks (16 +/- days since the end of treatment) at time 1 (T1). Dyspareunia, vaginal dryness, and maturation index (MI) reached a statistically significant difference between T0 and T1. The results proved to be an alternative treatment for vaginal distress caused by lack of hormones in patients in which hormonal treatment is contraindicated.
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Affiliation(s)
- S Tucci
- Department of Gynecology and Obstetrics and Urology, Sapienza University of Rome, Rome, Italy.
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Carico E, Radici M, Losito NS, Raffa S, Firrisi L, Fabiano A, Manola M, Vecchione A, Giovagnoli MR. Expression of E-cadherin and α-catenin in T1 N0 laryngeal cancer. Anticancer Res 2012; 32:5245-5249. [PMID: 23225423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
AIM To determine whether modulation of expression of cell adhesion molecules occurs in neoplastic transformation of laryngeal epithelium and to investigate their possible role in clinical outcome. MATERIALS AND METHODS Fifty-five T1 N0 laryngeal biopsies were tested by immunohistochemistry for the E-cadherin/α-catenin adhesion complex. RESULTS High immunohistochemical expression of E-cadherin and α-catenin was found in 18% and 53% cases, respectively. Expression of both adhesion molecules decreased according to histological grading; a significant relationship was particularly found between high E-cadherin expression and G1 cases (p=0.013). High E-cad-herin expression was statistically associated with in situ carcinoma (p=0.006). Non-statistical significance was evidenced between these adhesion molecules and tobacco use or site of occurence. Regarding clinical outcome, recurrence was associated with low expression of both adhesion molecules. CONCLUSION E-cadherin and α-catenin down-regulation might be associated with neoplastic transformation in laryngeal tissues and might be regarded as a risk factor for clinical recurrence.
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Affiliation(s)
- Elisabetta Carico
- Department of Clinical and Molecular Medicine, Sapienza University, A.O. Sant'Andrea, Via di Grottarossa 1035, 00198 Rome, Italy.
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Belleudi F, Marra E, Mazzetta F, Fattore L, Giovagnoli MR, Mancini R, Aurisicchio L, Torrisi MR, Ciliberto G. Monoclonal antibody-induced ErbB3 receptor internalization and degradation inhibits growth and migration of human melanoma cells. Cell Cycle 2012; 11:1455-67. [PMID: 22421160 DOI: 10.4161/cc.19861] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Members of the ErbB receptor family are targets of a growing numbers of small molecules and monoclonal antibodies inhibitors currently under development for the treatment of cancer. Although historical efforts have been directed against ErbB1 (EGFR) and ErbB2 (HER2/neu), emerging evidences have pointed to ErbB3 as a key node in the activation of proliferation/survival pathways from the ErbB receptor family and have fueled enthusiasm toward the clinical development of anti-ErbB3 agents. In this study, we have evaluated the potential therapeutic efficacy of a set of three recently generated anti-human ErbB3 monoclonals, A2, A3 and A4, in human primary melanoma cells. We show that in melanoma cells expressing ErbB1, ErbB3 and ErbB4 but not ErbB2 receptor ligands activate the PI3K/AKT pathway, and this leads to increased cell proliferation and migration. While antibodies A3 and A4 are able to potently inhibit ligand-induced signaling, proliferation and migration, antibody A2 is unable to exert this effect. In attempt to understand the mechanism of action and the basis of this different behavior, we demonstrate, through a series of combined approaches, that antibody efficacy strongly correlates with antibody-induced receptor internalization, degradation and inhibition of receptor recycling to the cell surface. Finally, fine epitope mapping studies through a peptide array show that inhibiting vs. non-inhibiting antibodies have a dramatically different mode of binding to the to the receptor extracellular domain. Our study confirms the key role of ErbB3 and points to exploitation of novel combination therapies for treatment of malignant melanoma.
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Affiliation(s)
- Francesca Belleudi
- Istituto Pasteur-Fondazione Cenci Bolognetti, Dipartimento di Medicina Clinica e Molecolare, Sapienza Universita' di Roma, Rome, Italy
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Bruno P, Mariotta S, Ricci A, Duranti E, Scozzi D, Noto A, Mancini R, Giarnieri E, Giovagnoli MR. Reliability of direct sequencing of EGFR: comparison between cytological and histological samples from the same patient. Anticancer Res 2011; 31:4207-4210. [PMID: 22199282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
The results of a recent study have shown the superiority of treatment with gefitinib or erlotinib in lung tumors positive for epidermal growth factor receptor (EGFR) mutation. As a consequence, the complete diagnosis of lung cancer cannot be limited to histotype classification, but should include a series of molecular biology analyses. In most cases, the diagnosis of lung cancer is performed on cytological specimens; therefore, there is a need to obtain a complete and reliable molecular diagnosis on cytologic specimens. Brushing, transbronchial needle aspiration (TBNA) and broncho alveolar lavage during fibro-bronchoscopy allow the sampling of the lung and the mediastinal lymph node. The aim of this study was to demonstrate that direct sequencing of exons 19 and 21 of EGFR in lung tumors, carried out on the cytological samples obtained through fibro-bronchoscopy, is as reliable as the same analysis carried out on a histological surgical sample obtained from the same individual. We considered 50 patients with a histological diagnosis of lung adenocarcinoma whose cytological samples, obtained by fibro-bronchoscopy and histological samples, obtained by surgical resection were available. A comparison of the sensitivity and reliability of the molecular biology analyses carried out on histological and cytological samples of the same patient was carried out. The combined mutation percentage of exons 19 and 21 of EGFR was 10%. The results of the analyses carried out on cytological samples matched those obtained from the histological samples. The feasibility of EGFR analysis on cytological samples has already been demonstrated in previous studies, however these studies referred to the method of fluorescence in situ hybridization, or did not perform any comparison between histological samples from the same patient; our work, on the other hand, shows that direct sequencing of exons 19 and 21 of the EGFR gene is feasible on fibro-bronchoscopy cytological samples with the same reliability offered by the histological samples obtained from the same patient.
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Affiliation(s)
- Pierdonato Bruno
- UOC Pneumologia, Az. Osp. Sant'Andrea, via di Grottarossa 1035, 00189 Rome, Italy
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Mancini R, Giarnieri E, De Vitis C, Malanga D, Roscilli G, Noto A, Marra E, Laudanna C, Zoppoli P, De Luca P, Affuso A, Ruco L, Di Napoli A, Mesiti G, Aurisicchio L, Ricci A, Mariotta S, Pisani L, Andreetti C, Viglietto G, Rendina EA, Giovagnoli MR, Ciliberto G. Spheres derived from lung adenocarcinoma pleural effusions: molecular characterization and tumor engraftment. PLoS One 2011; 6:e21320. [PMID: 21789168 PMCID: PMC3138755 DOI: 10.1371/journal.pone.0021320] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2010] [Accepted: 05/30/2011] [Indexed: 11/19/2022] Open
Abstract
Malignant pleural effusions (MPEs) could represent an excellent source to culture a wide variety of cancer cells from different donors. In this study, we set up culture conditions for cancer cells deriving from MPEs of several patients affected by the most frequent form of lung cancer, namely the subset of non small cell lung cancers (NSCLC) classified as Lung Adenocarcinomas (AdenoCa) which account for approximately 40% of lung cancer cases. AdenoCa malignant pleural effusions gave rise to in vitro cultures both in adherent and/or in spheroid conditions in almost all cases analyzed. We characterized in greater detail two samples which showed the most efficient propagation in vitro. In these samples we also compared gene profiles of spheroid vs adherent cultures and identified a set of differentially expressed genes. Finally we achieved efficient tumor engraftment in recipient NOD/SCID mice, also upon inoculation of small number of cells, thus suggesting indirectly the presence of tumor initiating cells.
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MESH Headings
- Adenocarcinoma/genetics
- Adenocarcinoma/pathology
- Adenocarcinoma of Lung
- Aged
- Aged, 80 and over
- Aldehyde Dehydrogenase/metabolism
- Animals
- Biomarkers, Tumor/metabolism
- Cell Adhesion
- Cell Separation
- Computational Biology
- Female
- Gene Expression Regulation, Neoplastic
- Genes, Neoplasm/genetics
- Humans
- Immunohistochemistry
- Immunophenotyping
- Lung Neoplasms/genetics
- Lung Neoplasms/pathology
- Male
- Mice
- Mice, SCID
- Middle Aged
- Neoplastic Stem Cells/metabolism
- Neoplastic Stem Cells/pathology
- Pleural Effusion, Malignant/genetics
- Pleural Effusion, Malignant/pathology
- Reverse Transcriptase Polymerase Chain Reaction
- Spheroids, Cellular/metabolism
- Spheroids, Cellular/pathology
- Tumor Cells, Cultured
- Xenograft Model Antitumor Assays
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Affiliation(s)
- Rita Mancini
- Department of Clinical and Molecular Medicine, University of Rome La Sapienza S Andrea Hospital, Rome, Italy.
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Lukic A, Sbenaglia G, Carico E, DI Properzio M, Giarnieri E, Frega A, Nobili F, Moscarini M, Giovagnoli MR. Prediction of clinical outcome using p16INK4a immunocytochemical expression in low-grade squamous intraepithelial lesions and high-risk HPV-positive atypical squamous cells of undetermined significance in patients with and without colposcopic evident cervical disease. Exp Ther Med 2011; 2:853-858. [PMID: 22977588 DOI: 10.3892/etm.2011.316] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2011] [Accepted: 07/01/2011] [Indexed: 01/03/2023] Open
Abstract
p16INK4a as a diagnostic marker of a cervical intraepithelial neoplasia of grade 2+ (CIN2+) in atypical squamous cells of undetermined significance (ASC-US) and low-grade squamous intraepithelial lesion (LSIL) cytological samples has been analyzed, but has not yet been included in clinical routine practice. One hundred and ninety-one patients with an abnormal Pap test (84 ASC-US and 107 LSILs) who underwent colposcopy were selected for this study. At enrollment, 96 patients (Group 1) had a positive colposcopy and therefore underwent a cervical biopsy, while 95 (Group 2) had a negative colposcopy and were followed up for up to 1 year. Both groups were tested for p16INK4a using immunocytochemical methods, and the p16INK4a results were correlated with histology or follow-up outcome. In Group 1 ASC-US cases, 82% of lesions less than CIN2 were p16INK4a-negative and all CIN2 cases were p16INK4a-positive (p=0.00044). In Group 1 LSIL cases, 71% of lesions less than CIN2 were p16INK4a-negative and 87% of CIN2/3 were p16INK4a-positive (p=0.00033). Seventy-seven percent of Group 2 ASC-US patients with a negative 1-year follow-up (NF-U) were p16INK4a-negative at enrollment, while all patients with positive follow-up (PF-U) were p16INK4a-positive (p=0.00113). In Group 2 LSIL cases, 83% of patients with NF-U were p16INK4a-negative, while 65% of patients with PF-U were p16INK4a-positive at enrollment (p=0.0014). In fact, 39% of the positive p16INK4a LSIL patients had CIN2+ histological lesions. The positive predictive value of p16INK4a for CIN2+ was 50% in ASC-US and 52% in LSIL cases; the negative predictive value was 100 and 94%, respectively. In conclusion, in our patients, a negative p16INK4a appears to be a marker of the absence of CIN3, while a positive p16INK4a can be correlated with the presence of histological CIN2+ found at enrollment or during the subsequent follow-up. Thus, its clinical predictive value is independent from the colposcopic aspect at enrollment.
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Affiliation(s)
- Ankica Lukic
- Dipartimento Salute della Donna e Medicina Territoriale, UOC Ginecologia, Facoltà di Medicina e Psicologia, Sapienza Università di Roma, 00189 Rome
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Carico E, Atlante M, Giarnieri E, Raffa S, Bucci B, Giovagnoli MR, Vecchione A. E-cadherin and alpha-catenin expression in normal, hyperplastic and neoplastic endometrium. Anticancer Res 2010; 30:4993-4997. [PMID: 21187480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
UNLABELLED The aim of this study was to determine whether modulation of expression of cell adhesion molecules may occur in neoplastic transformation of endometrial epithelium. MATERIALS AND METHODS E-Cadherin and α-catenin protein expression were evaluated by immunohistochemistry in 124 biopsies representative of normal, hyperplastic and neoplastic endometrium. RESULTS In normal endometrium (proliferative, secretive and atrophic endometrium) strong homogeneous, E-cadherin and α-catenin reactivity was found; 58.3% and 66.6% of biopsies representative of simple hyperplastic endometrium were homogeneously positive for E-cadherin and α-catenin, respectively, whereas no samples representative of atypical hyperplasia showed evidence of homogeneous E-cadherin or α-catenin expression. No expression of homogeneous E-cadherin was seen in endometrial adenocarcinomas; α-catenin homogeneous immunostaining was observed in 2 G1 and 2 G2 out of 22 adenocarcinoma samples (18.2%). A homogeneous co-expression of both molecules was seen only in normal (70%) and simple hyperplastic (46%) endometrium. CONCLUSION These results suggest that E-cadherin and α-catenin down-regulation might be associated with neoplastic transformation of endometrial tissues.
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Affiliation(s)
- Elisabetta Carico
- UOD Citopatologia II Faculty of Medicine, University La Sapienza, AO Sant'Andrea, 00189 Rome, Italy.
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Giansanti D, Grigioni M, Giovagnoli MR. Virtual microscopy and digital cytology: fact or fantasy? Preface. Ann Ist Super Sanita 2010; 46:113-4. [PMID: 20567060 DOI: 10.4415/ann_10_02_02] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Daniele Giansanti
- Dipartimento di Tecnologie e Salute, Istituto Superiore di Sanità, Rome, Italy
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Giansanti D, Grigioni M, D'Avenio G, Morelli S, Maccioni G, Bondi A, Giovagnoli MR. Virtual microscopy and digital cytology: state of the art. Ann Ist Super Sanita 2010; 46:115-22. [PMID: 20567061 DOI: 10.4415/ann_10_02_03] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The paper approaches a new technological scenario relevant for the introduction of the digital cytology (D-CYT) in the health service. A detailed analysis of the state of the art on the status of the introduction of D-CYT in the hospital and more in general in the dispersed territory has been conducted. The analysis was conducted in a form of review and was arranged into two parts: the first part focused on the technological tools needed to carry out a successful service (client server architectures, e-learning, quality assurance issues); the second part focused on issues oriented to help the introduction and evaluation of the technology (specific training in D-CYT, health technology assessment in-routine application, data format standards and picture archiving computerized systems (PACS) implementation, image quality assessment, strategies of navigation, 3D-virtual-reality potentialities). The work enlightens future scenarios of actions relevant for the introduction of the technology.
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Affiliation(s)
- Daniele Giansanti
- Dipartimento di Tecnologie e Salute, Istituto Superiore di Sanità, Rome, Italy.
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Giovagnoli MR, Giarnieri E, Carico E, Giansanti D. How do young and senior cytopathologists interact with digital cytology? Ann Ist Super Sanita 2010; 46:123-9. [PMID: 20567062 DOI: 10.4415/ann_10_02_04] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Today thanks to the technological advances in information technology the scenario of utilization of digital cytology has radically changed. New competitive systems, such as client-server architectures are now available in digital cytology. Their application in telemedicine should be investigated. A new interactive tool designed for the final destination user (the cytopathologist) has been proposed. Taking into account the different expertise of the subjects of the study, the investigation was focused both on the senior cytopathologist and on the younger student pathologist. The methodology was tested on 10 students of a Master in cytopathology and on 3 senior cytopathologists. The study showed that the use of digital cytology applications is effective and feasible for telediagnosis. In particular, the study on younger and senior expert investigators showed that, although they interacted with the novel technology of the virtual slide in a different manner, all of them reached the objective of a "correct diagnosis". This investigation, in consideration of the effectiveness of the digital cytology, also showed other indirect and tangible cost-beneft and quantitative advantages. In particular for the learning methodologies for the students of the Master itself and for the biomedical personnel involved in diagnosis.
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Morelli S, Grigioni M, Giovagnoli MR, Balzano S, Giansanti D. Picture archiving and communication systems in digital cytology. Ann Ist Super Sanita 2010; 46:130-7. [PMID: 20567063 DOI: 10.4415/ann_10_02_05] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The paper describes a fundamental feature of digital cytology relevant to the implementation of the technology in the hospital net services: the electronic recording of the virtual slides (VS) in the hospital information system (HIS) through a picture archiving and communication system (PACS). Starting from the digital cytology (D-CYT) state of art and considering the most important products in the field, particular attention has been devoted in this review to the comparison with the digital radiology (D-RAD). Two main indications emerged from the study: 1. there is not a standard in the digital files relevant to the virtual slides in D-CYT, while in D-RAD the standard digital imaging and communications in medicine (DICOM), introduced by the National Electrical Manufacturers Association (NEMA), has been adopted from several years; 2. the PACS in D-CYT are not standardized from manufacturers. The study makes a proposal of a useful software architecture to improve the PACS integration for D-CYT applications, with potentialities in the HIS.
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Affiliation(s)
- Sandra Morelli
- Dipartimento di Tecnologie e Salute, Istituto Superiore di Sanità, Rome, Italy
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Giansanti D, Cerroni F, Amodeo R, Filoni M, Giovagnoli MR. A pilot study for the integration of cytometry reports in digital cytology telemedicine applications. Ann Ist Super Sanita 2010; 46:138-43. [PMID: 20567064 DOI: 10.4415/ann_10_02_06] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Up to date, tele-pathology in the three different forms of application, "dynamic", "static" and "virtual microscopy" has been mainly based on tele-hystology remote consulting. Today the diffusion of specialized WAN connections is guiding the research of new applications of tele-pathology. A specific analysis has been conducted, focused on digital cytology, in the biomedical laboratory of Sant'Andrea Hospital to investigate the technologies potentially useful to integrate in the LAN/WAN for telemedicine applications. Among the possible tools useful to be integrated in the LAN/WAN for telemedicine applications, the cytometry equipment available in the technical unity of cytometry has been considered important. The study finally provides a proposal for a tele-consulting architecture for the integration of cytometry reports both in the hospital LAN and the WAN for possible cooperative diagnosis and second opinion support.
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Affiliation(s)
- Daniele Giansanti
- Dipartimento di Tecnologie e Salute, Istituto Superiore di Sanità, Rome, Italy. E-mail:
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Bruno P, Pisani L, Ricci A, Falasca C, Giarnieri E, Mariotta S, Giovagnoli MR. Cytology on transbronchial needle aspiration (TBNA): not only for lung cancer. Anticancer Res 2010; 30:4769-4772. [PMID: 21115939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Transbronchial needle aspiration (TBNA) is a bronchoscopic technique allowing the sampling of cytological/histological material from mediastinal lymph nodes. TBNA is routinely used only in few centers for the staging of lung cancer, and even less frequently for the diagnosis of mediastinal metastases from extrapulmonary tumors. We illustrate 5 cases of mediastinal metastases from extrapulmonary tumors observed at our center in order to emphasize the usefulness of cytology and TBNA in the diagnosis of these pathologies. The 5 cases illustrated were: seminoma, uterine cervical carcinoma, pleural mesothelioma, pancreatic carcinoma, pericardial mesothelioma. In these 5 cases, albeit not of lung cancer, the cytology on TBNA allowed the rapid formulation of the correct diagnosis; its main advantage is that it can be performed during a simple fiberbronchoscopy under local anesthesia with less risk and at a lower cost than a computed tomography-guided needle biopsy or mediastinoscopy.
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Affiliation(s)
- Pierdonato Bruno
- UOC Pneumologia, Dipartimento di Medicina Clinica e Molecolare Sapienza Universita di Roma, Azienda Ospedaliera Sant’Andrea Roma, Italy.
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Ahmed BH, Giovagnoli MR, Mahad H, Tarsitani GG. Burden of HIV/AIDS infection before and during the civil war in Somalia. East Mediterr Health J 2010; 16:907-909. [PMID: 21469574] [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] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Somalia has suffered a massive internal population displacement and exodus that began in 1988 and is still ongoing during the prolonged and intermittent civil war. This review looks at the burden of HIV infection in Somali and the impact of civil war on its epidemiology. Serosurveys have indicated that HIV was not present in Somalia before the civil war and to date Somalia has had an HIV prevalence markedly below that of its neighbours. However, due to the ongoing war HIV sentinel surveillance cannot reach most of the affected areas in Somalia and the current HIV infection problem may be greater than the figures indicate.
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Affiliation(s)
- B H Ahmed
- School of Medicine, Sapienza University of Rome, Rome, Italy
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La Torre M, Ferri M, Giovagnoli MR, Sforza N, Cosenza G, Giarnieri E, Ziparo V. Peritoneal wash cytology in gastric carcinoma. Prognostic significance and therapeutic consequences. Eur J Surg Oncol 2010; 36:982-6. [PMID: 20591604 DOI: 10.1016/j.ejso.2010.06.007] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2010] [Accepted: 06/07/2010] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND AND AIMS The prognosis of patients with gastric cancer is poor, even following curative resection, and is related primarily to the extent of disease at presentation. In locally advanced gastric tumors, peritoneal lavage cytology (PLC) is a relevant prognostic factor. The Authors present their results of peritoneal washing cytology, evaluating the prognostic value of this technique, and discussing the clinical impact. PATIENTS AND METHODS From July 2003 to May 2008, results of PLC in 64 patients with histologically proven primary gastric adenocarcinomas were analyzed. At laparotomy the abdomen was irrigated with 200 ml of normal saline, and ≥50 ml were aspirated and examined by means of cytology and immunocytopathology. RESULTS PLC was positive in 7 cases (11%). Overall, 86% of patients with a positive PLC had a pT3/pT4 tumor and 100% with a positive PLC had an N-positive tumor (p < 0.001); 71% of patients with a positive PLC had a grade G3/G4 tumor (p = 0.001). At a median follow-up of 32 months, the cumulative 5-year survival was 28%. The median survival of patients presenting positive PLC (19 months) was significantly lower than that of patients with negative peritoneal cytology (38 months) (p = 0.0001). Multivariate analysis identified cytology as a significant predictor of outcome (p = 0.018). CONCLUSIONS Results in the present series demonstrated that patients with a positive peritoneal cytology had advanced disease and poor prognosis, thus indicating that patients with locally advanced gastric cancer should undergo staging laparoscopy and PLC examination in order to select those requiring more aggressive treatment. Future therapeutic strategies should include PLC examination in preoperative staging, in order to select patients for more aggressive treatment.
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Affiliation(s)
- M La Torre
- Department of Surgery, S. Andrea Hospital, Sapienza University of Rome, Rome, Italy.
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