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Torous VF, Wu RI, Monaco SE, Staats PN. Cytopathology fellowship recruitment: historical context, current state, and future considerations. J Am Soc Cytopathol 2023; 12:326-330. [PMID: 37088678 DOI: 10.1016/j.jasc.2023.03.006] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Revised: 03/24/2023] [Accepted: 03/27/2023] [Indexed: 04/01/2023]
Abstract
Fellowship recruitment and retention of a skilled workforce is one of the biggest challenges that not only cytopathology is facing but that the field of pathology in general is being confronted with. There have long been issues with the fellowship recruitment process for both applicants and fellowship directors, including pressure to move the application process earlier and earlier and frustrations stemming from applicants needing to determine different individual timelines and program requirements. The unified timeline for fellowship recruitment was established as an attempt to standardize the recruitment process and to address the key issues of the push for earlier and earlier decision-making, which placed significant anxiety on trainees, as well as the burden on programs of more unexpected openings. While institution of the unified timeline has had many successes, there have been problems as well. Here, we discuss the multifaceted and intertwined factors that affect fellowship recruitment with a review of the historical context and the current setting and with an eye towards future directions. In the end, the issues we are currently facing are complex and there is likely no perfect solution to fixing an inherently broken system. However, the ultimate goal should be in better supporting our trainees' development and promoting a more fair and equitable recruitment process. Only by working together can we optimize the process for both applicants and programs alike.
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Affiliation(s)
| | - Roseann I Wu
- Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | | | - Paul N Staats
- University of Maryland Medical Center, Baltimore, Maryland
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Witt BL, Zhou W, Ambaye AB, Bellizzi A, Booth CN, Sundling K, Nguyen L, Russell DK, Schinstine M, Staats PN, Thomsen J, Troxell M, Souers RJ, Dvorak J, Lin X, Kurtycz DFI. Using American Type Culture Collection Cell Lines to Evaluate Interlaboratory Variables for Estrogen Receptor and Human Epidermal Growth Factor Receptor 2 Immunostaining. Arch Pathol Lab Med 2023; 147:143-148. [PMID: 35639575 DOI: 10.5858/arpa.2021-0152-cp] [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] [Accepted: 01/04/2022] [Indexed: 02/05/2023]
Abstract
CONTEXT.— Most laboratories currently use patient tissues for validating immunohistochemical stains. OBJECTIVE.— To explore advantages of using cell lines with known antigenicity as a validation method. DESIGN.— Five American Type Culture Collection (ATCC) cell lines with known negative, low positive, and moderate to strong estrogen receptor (ER) expression as well as negative, equivocal, and positive human epidermal growth factor receptor 2 (HER2) expression were cultured and made into cell blocks. One block from each cell line was fixed in formalin and another in ethanol before cell block preparation. Two sets of paired unstained slides from each block were sent to 10 different laboratories for HER2 and ER staining to be stained on runs from different days according to each laboratory's defined protocol. RESULTS.— The 10 study participants evaluated 40 slides in a blinded fashion. For ER expression, all 80 interpretations for the ER strong and moderate positive cell lines had the target ER-positive result, and 74 of 80 ER-negative cell lines (92.5%) had agreement with the intended negative result. The ER low positive cell line showed varied but positive expression among all observers. The HER2 (3+)-positive cell lines yielded a target interpretation of 3+ in 65 of 80 interpretations (81.2%). For the HER2-negative cell line 69 of 78 interpretations (88.5%) were consistent with the target response (0 or 1+). No significant variation was observed between the ethanol- and non-ethanol-exposed cell lines, or between runs by the same laboratory. Variation from target results clustered within laboratories. CONCLUSIONS.— This study indicates that variability between laboratories can be identified by using cell lines for quantitative or semiquantitative immunohistochemistry when using cultured cell lines of known antigenicity. These cell lines could potentially play a role in aiding anatomic pathology laboratories in validating immunohistochemistry tests for formalin- and ethanol-fixed tissues.
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Affiliation(s)
- Benjamin L Witt
- From the Department of Pathology, University of Utah, Salt Lake City (Witt).,From the Institute for Clinical and Experimental Pathology, ARUP, Salt Lake City, Utah (Witt, Zhou)
| | - Wenhua Zhou
- From the Institute for Clinical and Experimental Pathology, ARUP, Salt Lake City, Utah (Witt, Zhou)
| | - Abiy B Ambaye
- From the Department of Pathology, University of Vermont Medical Center, Burlington (Ambaye, Schinstine)
| | - Andrew Bellizzi
- From the Department of Pathology, University of Iowa, Iowa City (Bellizzi)
| | - Christine N Booth
- From the Department of Pathology, Cleveland Clinic, Cleveland, Ohio (Booth)
| | - Kaitlin Sundling
- From the Department of Pathology, University of Wisconsin, Madison (Sundling, Kurtycz)
| | - Lananh Nguyen
- From the Department of Pathology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire (Nguyen)
| | - Donna K Russell
- From the Department of Pathology, University of Rochester, Rochester, New York (Russell)
| | - Malcolm Schinstine
- From the Department of Pathology, University of Vermont Medical Center, Burlington (Ambaye, Schinstine)
| | - Paul N Staats
- From the Department of Pathology, University of Maryland, Baltimore (Staats)
| | - Jean Thomsen
- From the Department of Pathology, Methodist Jennie Edmundson Hospital, Council Bluffs, Iowa (Thomsen)
| | - Megan Troxell
- From the Department of Pathology, Stanford University, Palo Alto, California (Troxell)
| | - Rhona J Souers
- From the Department of Biostatistics (Souers), College of American Pathologists, Northfield, Illinois
| | - James Dvorak
- From the Department of Proficiency Testing (Dvorak), College of American Pathologists, Northfield, Illinois
| | - Xiaoqi Lin
- From the Department of Pathology, Northwestern Medicine, Chicago, Illinois (Lin)
| | - Daniel F I Kurtycz
- From the Department of Pathology, University of Wisconsin, Madison (Sundling, Kurtycz)
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Hardy NL, Canakis A, Staats PN, Darwin P, Legesse T. Cytologic features of metastatic epithelioid uterine leiomyosarcoma to the pancreas. Diagn Cytopathol 2023; 51:E21-E24. [PMID: 36082519 DOI: 10.1002/dc.25051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 08/22/2022] [Accepted: 08/25/2022] [Indexed: 12/13/2022]
Abstract
Although uterine leiomyosarcoma (ULMS) is a rare disease, it accounts for a significant proportion uterine cancer-related deaths due to frequent metastasis and chemoresistance. The WHO currently recognizes the conventional (spindle), myxoid, and epithelioid variants of ULMS, the latter of which is the rarest, least understood, and cited as clinically more aggressive than the other variants. Descriptions of the histologic features of epithelioid ULMS are extremely limited, and are absent from the cytology literature which has only published descriptions of conventional ULMS or epithelioid variants of other LMS primaries. Therefore, we present a unique case of metastatic epithelioid ULMS to an unusual location, the pancreas, along with its cytologic features on endoscopic ultrasound-guided fine needle aspiration not previously described including pseudoglandular arrangements, scant cytoplasm, and frequent molding.
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Affiliation(s)
- Naomi L Hardy
- Department of Pathology, University of Maryland Medical Center, Baltimore, Maryland, USA
| | - Andrew Canakis
- Division of Gastroenterology and Hepatology, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Paul N Staats
- Department of Pathology, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Peter Darwin
- Division of Gastroenterology and Hepatology, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Teklu Legesse
- Department of Pathology, University of Maryland School of Medicine, Baltimore, Maryland, USA
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Lennerz JK, Pantanowitz L, Amin MB, Eltoum IE, Hameed MR, Kalof AN, Khanafshar E, Kunju LP, Lazenby AJ, Montone KT, Otis CN, Reid MD, Staats PN, Whitney-Miller CL, Abendroth CS, Aron M, Birdsong GG, Bleiweiss IJ, Bronner MP, Chapman J, Cipriani NA, de la Roza G, Esposito MJ, Fadare O, Ferrer K, Fletcher CD, Frishberg DP, Garcia FU, Geldenhuys L, Gill RM, Gui D, Halat S, Hameed O, Hornick JL, Huber AR, Jain D, Jhala N, Jorda M, Jorns JM, Kaplan J, Khalifa MA, Khan A, Kim GE, Lee EY, LiVolsi VA, Longacre T, Magi-Galluzzi C, McCall SJ, McPhaul L, Mehta V, Merzianu M, Miller SB, Molberg KH, Moreira AL, Naini BV, Nosé V, O'Toole K, Picken M, Prieto VG, Pullman JM, Quick CM, Reynolds JP, Rosenberg AE, Schnitt SJ, Schwartz MR, Sekosan M, Smith MT, Sohani A, Stowman A, Vanguri VK, Wang B, Watts JC, Wei S, Whitney K, Younes M, Zee S, Bracamonte ER. Ensuring remote diagnostics for pathologists: an open letter to the US Congress. Nat Med 2022; 28:2453-2455. [PMID: 36266514 DOI: 10.1038/s41591-022-02040-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Affiliation(s)
- Jochen K Lennerz
- Massachusetts General Hospital/Harvard Medical School, Department of Pathology, Center for Integrated Diagnostics, Boston, MA, USA.
| | - Liron Pantanowitz
- University of Michigan Health, Department of Pathology, Anatomic Pathology, Ann Arbor, MI, USA
| | - Mitual B Amin
- Oakland University William Beaumont School of Medicine, Department of Pathology and Laboratory Medicine, Anatomical Pathology, Royal Oaks, MI, USA
| | - Isam-Eldin Eltoum
- University of Alabama at Birmingham, Department of Pathology, Section of Cytopathology, Birmingham, AL, USA
| | - Meera R Hameed
- Memorial Sloan Kettering Cancer Center, Department of Pathology, Surgical Pathology Service, New York, NY, USA
| | - Alexana N Kalof
- The University of Vermont Medical Center, Department of Pathology & Laboratory Medicine, Surgical Pathology, Burlington, VT, USA
| | - Elham Khanafshar
- University of California San Francisco, Department of Pathology, Cytopathology, San Francisco, CA, USA
| | - Lakshmi P Kunju
- University of Michigan Health, Department of Pathology, Genitourinary Pathology, Surgical Pathology, Histology Laboratory, and Image Analysis, Ann Arbor, MI, USA
| | - Audrey J Lazenby
- University of Nebraska Medical Center, College of Medicine, Department of Pathology, Anatomic Pathology, Omaha, NE, USA
| | - Kathleen T Montone
- Hospital of the University of Pennsylvania, Department of Pathology and Laboratory Medicine, Division of Anatomic Pathology, Philadelphia, PA, USA
| | - Christopher N Otis
- Pathology at UMass Chan Medical School, Baystate Health Medical Center, Department of Pathology, Springfield, MA, USA
| | - Michelle D Reid
- Emory University School of Medicine, Winship Cancer Institute, Department of Pathology and Laboratory Medicine, Cytopathology and Anatomic Pathology/Cytopathology, Atlanta, GA, USA
| | - Paul N Staats
- University of Maryland School of Medicine, Department of Pathology, Anatomic Pathology Laboratory Operations, Baltimore, MD, USA
| | - Christa L Whitney-Miller
- University of Rochester Medical Center, School of Medicine & Dentistry, Vice Chair, Department of Pathology and Laboratory Medicine, Anatomic Pathology, Rochester, NY, USA
| | - Catherine S Abendroth
- Penn State Health Hershey Medical Center, Department of Pathology, Anatomic Pathology and Cytopathology, Hershey, PA, USA
| | - Manju Aron
- Keck School of Medicine of University of Southern California, Clinical Pathology, Los Angeles, CA, USA
| | - George G Birdsong
- Emory University School of Medicine, Department of Pathology & Laboratory Services, Atlanta, GA, USA.,Grady Memorial Hospital, Anatomic Pathology, Atlanta, GA, USA
| | - Ira J Bleiweiss
- University of Pennsylvania, Perelman School of Medicine, Department of Pathology, Breast Pathology, Philadelphia, PA, USA
| | - Mary P Bronner
- University of Utah, Department of Pathology, Anatomic Pathology, Salt Lake City, UT, USA
| | - Jennifer Chapman
- University of Miami Health System, Department of Pathology, Division of Hematopathology, Miami, FL, USA
| | - Nicole A Cipriani
- The University of Chicago, Department of Pathology, Anatomic Pathology Informatics, Chicago, IL, USA
| | - Gustavo de la Roza
- State University of New York-Upstate Medical University, Upstate University Hospital, Department of Pathology, Anatomic Pathology, Syracuse, NY, USA
| | - Michael J Esposito
- Northwell Health, North Shore University Hospital and Long Island Jewish Medical Center, Department of Pathology, Anatomic Pathology, Greenvale, NY, USA
| | - Oluwole Fadare
- University of California San Diego Health, Department of Pathology, Anatomic Pathology, San Diego, CA, USA
| | - Karen Ferrer
- Stroger Hospital of Cook County Health, Pathology & Laboratory Medicine, Surgical Pathology, Chicago, IL, USA
| | - Christopher D Fletcher
- Brigham & Women's Hospital/Harvard Medical School, Department of Pathology, Anatomic Pathology, Boston, MA, USA.,of Onco-Pathology, Dana Farber Cancer Institute, Boston, MA, USA
| | - David P Frishberg
- Cedars Sinai Medical Center, Department of Pathology and Laboratory Medicine, Los Angeles, CA, USA
| | - Fernando U Garcia
- Tower Health, Department of Pathology and Laboratory Medicine, West Reading, PA, USA
| | | | - Ryan M Gill
- University of California San Francisco, Moffitt-Long Hospital, Department of Pathology, Surgical Pathology, San Francisco, CA, USA
| | - Dorina Gui
- University of California Davis Health, Department of Pathology, Surgical Pathology, Davis, CA, USA
| | - Shams Halat
- Tulane University School of Medicine, Lakeside Hospital Laboratory, Department of Pathology, Surgical Pathology, New Orleans, LA, USA
| | - Omar Hameed
- Hospital Corporation of America, Pathology and Lab Services, Kansas City, MO, USA
| | - Jason L Hornick
- Brigham and Women's Hospital/Harvard Medical School, Department of Pathology, Boston, MA, USA
| | - Aaron R Huber
- University of Rochester Medical Center, School of Medicine and Dentistry, Department of Pathology and Laboratory Medicine, Rochester, NY, USA
| | - Dhanpat Jain
- Yale University School of Medicine, Department of Pathology, New Haven, CT, USA
| | - Nirag Jhala
- Temple University Hospital/Lewis Katz School of Medicine, Department of Pathology and Laboratory Medicine, Anatomic Pathology/Cytology, Philadelphia, PA, USA
| | - Merce Jorda
- University of Miami Miller School of Medicine, Department of Pathology & Laboratory Medicine, Miami, FL, USA
| | - Julie M Jorns
- Medical College of Wisconsin, Department of Pathology and Laboratory Medicine, Breast & Women's Health, Milwaukee, WI, USA
| | - Jeffrey Kaplan
- University of Colorado School of Medicine, Department of Pathology, Surgical Pathology and Anatomic Pathology Quality Management, Aurora, CO, USA
| | - Mahmoud A Khalifa
- University of Minnesota, Department of Laboratory Medicine and Pathology, Surgical Pathology, Minneapolis, MI, USA
| | - Ashraf Khan
- Pathology at UMass Chan Medical School, Baystate Health Medical Center, Department of Pathology, Springfield, MA, USA
| | - Grace E Kim
- University of California San Francisco, Department of Pathology and Laboratory Medicine, San Francisco, CA, USA
| | - Eun Y Lee
- University of Kentucky, Department of Pathology and Laboratory Medicine, Lexington, KY, USA
| | - Virginia A LiVolsi
- University of Pennsylvania, Perelman School of Medicine, Pathology and Laboratory Medicine, Surgical Pathology, Philadelphia, PA, USA
| | - Teri Longacre
- Stanford Medicine/Stanford Health Care/Stanford Medicine Children's Health, Surgical Pathology, Stanford, CA, USA
| | - Cristina Magi-Galluzzi
- The University of Alabama at Birmingham, Heersink School of Medicine, Department of Pathology Anatomic Pathology, Birmingham, AL, USA
| | - Shannon J McCall
- Duke University, Department of Pathology, Translational Research, Durham, NC, USA
| | - Laron McPhaul
- Harbor-UCLA Medical Center, Department of Pathology, Anatomic Pathology & Molecular Pathology, Torrance, CA, USA
| | - Vikas Mehta
- University of Illinois Health at Chicago, Department of Pathology, Surgical Pathology, Chicago, IL, USA
| | - Mihai Merzianu
- Roswell Park Comprehensive Cancer Center, Department of Pathology & Laboratory Medicine, Surgical Pathology, Buffalo, NY, USA
| | - Stacey B Miller
- Allegheny Health Network (AHN), Allegheny General Hospital (Primary), AHN Wexford Hospital, Allegheny Pathology Associates, Pathology and Laboratory Medicine, Surgical Pathology, Pittsburgh, PA, USA
| | - Kyle H Molberg
- UT Southwestern Medical Center, Department of Pathology, Dallas, TX, USA
| | - Andre L Moreira
- New York University (NYU) Grossman School of Medicine, NYU Langone Health, Department of Pathology, New York, NY, USA
| | - Bita V Naini
- University of California Los Angeles (UCLA) Health, David Geffen School of Medicine at UCLA, Clinical and Laboratory Pathology, Anatomic Pathology, Los Angeles, CA, USA
| | - Vania Nosé
- Massachusetts General Hospital/Harvard Medical School, Department of Pathology, Anatomic and Molecular Pathology, Boston, MA, USA
| | - Kathleen O'Toole
- Columbia University Irving Medical Center, Department of Pathology and Cell Biology, Anatomic Pathology, New York, NY, USA
| | - Maria Picken
- Loyola University Medical Center, Pathology and Laboratory Medicine, Surgical Pathology, Maywood, IL, USA
| | - Victor G Prieto
- The University of Texas, MD Anderson Cancer Center, Department of Pathology, Pathology-Lab Medicine, Houston, TX, USA
| | - James M Pullman
- Albert Einstein College of Medicine, Montefiore Medical Center, Anatomic Pathology, Bronx, NY, USA
| | - Charles M Quick
- University of Arkansas for Medical Sciences, College of Medicine, Department of Pathology, Anatomic Pathology, Little Rock, AR, USA
| | - Jordan P Reynolds
- Mayo Clinic, Department of Pathology, Cytopathology, Jacksonville, FL, USA
| | - Andrew E Rosenberg
- University of Miami, Miller School of Medicine, Department of Pathology and Laboratory Medicine, Anatomic Pathology, Miami, FL, USA
| | - Stuart J Schnitt
- Brigham and Women's Hospital/Harvard Medical School, Department of Pathology, Boston, MA, USA.,Dana-Farber Cancer Institute, Breast Oncologic Pathology, Boston, MA, USA
| | - Mary R Schwartz
- Baylor College of Medicine, Houston Methodist Hospital, Anatomic Pathology, Houston, TX, USA
| | - Marin Sekosan
- Stroger Hospital of Cook County Health, Pathology & Laboratory Medicine, Surgical Pathology, Chicago, IL, USA
| | - Michael T Smith
- Medical University of South Carolina, College of Medicine, Pathology and Laboratory Medicine, Anatomic Pathology, Charleston, SC, USA
| | - Aliyah Sohani
- Massachusetts General Hospital/Harvard Medical School, Department of Pathology, Surgical Pathology and Clinical Affairs, Boston, MA, USA
| | - Anne Stowman
- The University of Vermont Medical Center, Department of Pathology & Laboratory Medicine, Surgical Pathology, Burlington, VT, USA
| | - Vijay K Vanguri
- UMass Memorial Health, UMass Chan Medical School, Department of Pathology, Surgical Pathology, Worcester, MA, USA
| | - Beverly Wang
- University of California Irvine Medical Center, Department of Pathology, Anatomic Pathology, Orange, CA, USA
| | - John C Watts
- Beaumont Health, Surgical Pathology, Royal Oak, MI, USA
| | - Shi Wei
- University of Kansas Medical Center, Department of Pathology and Laboratory Medicine, Kansas City, KS, USA
| | - Kathleen Whitney
- Albert Einstein College of Medicine, Montefiore Medical Center, Anatomic Pathology, Bronx, NY, USA
| | - Mamoun Younes
- The George Washington University School of Medicine and Health Sciences, Department of Pathology, Surgical Pathology, Washington, DC, USA
| | - Sui Zee
- New York University (NYU) Grossman School of Medicine, NYU Langone Health, Department of Pathology, New York, NY, USA
| | - Erika R Bracamonte
- University of Arizona College of Medicine-Tucson, Department of Pathology, Anatomic Pathology, Tucson, AZ, USA
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Hardy NL, Staats PN. Metastatic mesonephric‐like endometrial adenocarcinoma diagnosed on transbronchial needle aspirate cytology. Diagn Cytopathol 2021; 50:86-90. [DOI: 10.1002/dc.24917] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 11/17/2021] [Accepted: 12/13/2021] [Indexed: 01/29/2023]
Affiliation(s)
- Naomi L. Hardy
- Department of Pathology University of Maryland Medical Center Baltimore Maryland USA
| | - Paul N. Staats
- Department of Pathology University of Maryland School of Medicine Baltimore Maryland USA
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Leiser D, Samanta S, Eley J, Strauss J, Creed M, Kingsbury T, Staats PN, Bhandary B, Chen M, Dukic T, Roy S, Mahmood J, Vujaskovic Z, Shukla HD. Role of caveolin-1 as a biomarker for radiation resistance and tumor aggression in lung cancer. PLoS One 2021; 16:e0258951. [PMID: 34762666 PMCID: PMC8584669 DOI: 10.1371/journal.pone.0258951] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 05/10/2021] [Accepted: 10/10/2021] [Indexed: 01/14/2023] Open
Abstract
Radiation therapy plays a major role in the treatment of lung cancer patients. However, cancer cells develop resistance to radiation. Tumor radioresistance is a complex multifactorial mechanism which may be dependent on DNA damage and repair, hypoxic conditions inside tumor microenvironment, and the clonal selection of radioresistant cells from the heterogeneous tumor site, and it is a major cause of treatment failure in non-small cell lung cancer (NSCLC). In the present investigation caveolin-1 (CAV-1) has been observed to be highly expressed in radiation resistant A549 lung cancer cells. CRISPR-Cas9 knockout of CAV-1 reverted the cells to a radio sensitive phenotype. In addition, CAV-1 overexpression in parental A549 cells, led to radiation resistance. Further, gene expression analysis of A549 parental, radiation resistant, and caveolin-1 overexpressed cells, exhibited overexpression of DNA repair genes RAD51B, RAD18, SOX2 cancer stem cell marker, MMPs, mucins and cytoskeleton proteins in resistant and caveolin-1 over expressed A549 cells, as compared to parental A549 cells. Bioinformatic analysis shows upregulation of BRCA1, Nuclear Excision DNA repair, TGFB and JAK/STAT signaling pathways in radioresistant and caveolin-1 overexpressed cells, which may functionally mediate radiation resistance. Immunohistochemistry data demonstrated heterogeneous expression of CAV-1 gene in human lung cancer tissues, which was analogous to its enhanced expression in human lung cancer cell line model and mouse orthotopic xenograft lung cancer model. Also, TCGA PanCancer clinical studies have demonstrated amplification, deletions and missense mutation in CAV-1 gene in lung cancer patients, and that CAV-1 alteration has been linked to poor prognosis, and poor survival in lung cancer patients. Interestingly, we have also optimized ELISA assay to measure caveolin-1 protein in the blood of A549 radiation resistant human xenograft preclinical mouse model and discovered higher level of caveolin-1 (950 pg/ml) in tumor bearing animals treated with radiation, as compared to xenograft with radiosensitive lung cancer cells (450 pg/ml). Thus, we conclude that caveolin-1 is involved in radio-resistance and contributes to tumor aggression, and it has potential to be used as prognostic biomarker for radiation treatment response, and tumor progression for precision medicine in lung cancer patients.
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Affiliation(s)
- Dominic Leiser
- Division of Translational Radiation Sciences (DTRS), Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, MD, United States of America
| | - Santanu Samanta
- Division of Translational Radiation Sciences (DTRS), Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, MD, United States of America
| | - John Eley
- Department of Radiation Oncology, School of Medicine, Vanderbilt University, Nashville, TN, United States of America
| | - Josh Strauss
- Department of Radiation Oncology, School of Medicine, Vanderbilt University, Nashville, TN, United States of America
| | - Michael Creed
- Department of Physiology, University of Maryland School of Medicine, Baltimore, MD, United States of America
| | - Tami Kingsbury
- Department of Physiology, University of Maryland School of Medicine, Baltimore, MD, United States of America
| | - Paul N. Staats
- Department of Pathology, University of Maryland, School of Medicine, Baltimore, MD, United States of America
| | - Binny Bhandary
- Division of Translational Radiation Sciences (DTRS), Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, MD, United States of America
| | - Minjie Chen
- Division of Translational Radiation Sciences (DTRS), Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, MD, United States of America
| | - Tijana Dukic
- Division of Translational Radiation Sciences (DTRS), Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, MD, United States of America
| | - Sanjit Roy
- Division of Translational Radiation Sciences (DTRS), Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, MD, United States of America
| | - Javed Mahmood
- Division of Translational Radiation Sciences (DTRS), Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, MD, United States of America
| | - Zeljko Vujaskovic
- Division of Translational Radiation Sciences (DTRS), Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, MD, United States of America
| | - Hem D. Shukla
- Division of Translational Radiation Sciences (DTRS), Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, MD, United States of America
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7
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Staats PN, Davey DD, Witt BL, Ghofrani M, Zhao C, Dodd LG, Goodrich K, Husain M, Kurtycz DFI, Russell DK, Shen RZ, Souers RJ, Tabatabai ZL, Crothers BA. Performance of specific morphologic features in distinguishing low-grade squamous intraepithelial lesions from high-grade squamous intraepithelial lesions in borderline cases: a College of American Pathologists Cytopathology Committee multiobserver study. J Am Soc Cytopathol 2021; 11:102-113. [PMID: 34903496 DOI: 10.1016/j.jasc.2021.11.001] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 11/03/2021] [Accepted: 11/05/2021] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Distinguishing between low-grade squamous intraepithelial lesions (LSIL) and high-grade squamous intraepithelial lesions (HSIL) can be difficult on certain Papanicolaou (Pap) tests, hindering interobserver concordance. We investigated the variables influencing the interpretation of LSIL versus HSIL in Pap test slides rejected from the College of American Pathologists PAP education program. MATERIALS AND METHODS Eleven cytologists, who were unaware of the reference interpretation, examined 21 Pap slides (11 submitted as LSIL and 10 as HSIL) rejected from the PAP education program and recorded the number of LSIL cells, HSIL cells, keratinized dysplastic cells, LSIL clusters with mixed HSIL cells, atypical squamous metaplasia, atypical glandular cells, the presence of inflammation or infectious organisms, and the overall interpretation (LSIL or HSIL). We evaluated the significance of these 11 variables using a nonlinear mixed model analysis. RESULTS LSIL had greater concordance (92 of 121 responses; 76.0% concordance) than HSIL (68 of 110 responses; 61.8% concordance; P < 0.001). The only predictors of misclassified cases were the number of atypical squamous metaplastic cells and the number of HSIL cells (P < 0.001). The more of these cells identified, the more likely the reviewers were to classify the slide as HSIL. The reproducibility of the diagnosis was fair (Gwet's agreement coefficient, 0.33). CONCLUSIONS Interobserver reproducibility is a challenge for a subset of cases with features intermediate between LSIL and HSIL. Atypical squamous metaplasia and dysplastic nuclei with a nuclear/cytoplasmic ratio greater than one half of the cell volume (HSIL) present on a Pap test influenced the likelihood that a reviewer would interpret the case as HSIL rather than LSIL.
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Affiliation(s)
- Paul N Staats
- Department of Pathology, University of Maryland School of Medicine, Baltimore, Maryland.
| | - Diane Davis Davey
- Department of Clinical Sciences, University of Central Florida College of Medicine, Orlando, Florida
| | - Benjamin L Witt
- Department of Pathology, University of Utah Health Sciences Center, Salt Lake City, Utah
| | - Mohiedean Ghofrani
- Department of Pathology, PeaceHealth Southwest Medical Center, Vancouver, Washington
| | - Chengquan Zhao
- Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Leslie G Dodd
- Department of Pathology, University of North Carolina Hospital, Chapel Hill, North Carolina
| | | | - Mujtaba Husain
- Department of Clinical Sciences, University of Central Florida College of Medicine, Orlando, Florida
| | - Daniel F I Kurtycz
- Department of Pathology and Laboratory Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Donna K Russell
- Department of Pathology, University of Rochester, Rochester, New York
| | - Rulong Z Shen
- Department of Pathology, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Rhona J Souers
- Biostatistics Department, College of American Pathologists, Northfield, Illinois
| | - Z Laura Tabatabai
- Department of Pathology, University of California, San Francisco, and San Francisco Veterans Affairs HealthCare System, San Francisco, California
| | - Barbara A Crothers
- Divisions of Gynecology and Breast Pathology and Cytopathology, Joint Pathology Center, Silver Spring, Maryland
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8
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Gavrielides MA, Ronnett BM, Vang R, Barak S, Lee E, Staats PN, Jenson E, Skaria P, Sheikhzadeh F, Miller M, Hagemann IS, Petrick N, Seidman JD. Pathologist Concordance for Ovarian Carcinoma Subtype Classification and Identification of Relevant Histologic Features Using Microscope and Whole Slide Imaging: A Multisite Observer Study. Arch Pathol Lab Med 2021; 145:1516-1525. [PMID: 33635941 DOI: 10.5858/arpa.2020-0579-oa] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/09/2020] [Indexed: 11/06/2022]
Abstract
CONTEXT.— Despite several studies focusing on the validation of whole slide imaging (WSI) across organ systems or subspecialties, the use of WSI for specific primary diagnosis tasks has been underexamined. OBJECTIVE.— To assess pathologist performance for the histologic subtyping of individual sections of ovarian carcinomas using the light microscope and WSI. DESIGN.— A panel of 3 experienced gynecologic pathologists provided reference subtype diagnoses for 212 histologic sections from 109 ovarian carcinomas based on optical microscopy review. Two additional attending pathologists provided diagnoses and also identified the presence of a set of 8 histologic features important for ovarian tumor subtyping. Two experienced gynecologic pathologists and 2 fellows reviewed the corresponding WSI images for subtype classification and feature identification. RESULTS.— Across pathologists specialized in gynecologic pathology, concordance with the reference diagnosis for the 5 major ovarian carcinoma subtypes was significantly higher for a pathologist reading on microscope than each of 2 pathologists reading on WSI. Differences were primarily due to more frequent classification of mucinous carcinomas as endometrioid with WSI. Pathologists had generally low agreement in identifying histologic features important to ovarian tumor subtype classification, with either optical microscopy or WSI. This result suggests the need for refined histologic criteria for identifying such features. Interobserver agreement was particularly low for identifying intracytoplasmic mucin with WSI. Inconsistencies in evaluating nuclear atypia and mitoses with WSI were also observed. CONCLUSIONS.— Further research is needed to specify the reasons for these diagnostic challenges and to inform users and manufacturers of WSI technology.
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Affiliation(s)
- Marios A Gavrielides
- From the Division of Imaging, Diagnostics, and Software Reliability, Office of Science and Engineering Laboratories (Gavrielides and Petrick)
| | - Brigitte M Ronnett
- the Departments of Pathology and Gynecology & Obstetrics, The Johns Hopkins Hospital, Baltimore, Maryland (Ronnett, Vang, Jenson)
| | - Russell Vang
- the Departments of Pathology and Gynecology & Obstetrics, The Johns Hopkins Hospital, Baltimore, Maryland (Ronnett, Vang, Jenson)
| | - Stephanie Barak
- the Department of Pathology, The George Washington University, Washington, District of Columbia (Barak, Lee)
| | - Elsie Lee
- Gavrielides is currently at AstraZeneca, Gaithersburg, Maryland.,the Department of Pathology, The George Washington University, Washington, District of Columbia (Barak, Lee)
| | - Paul N Staats
- the Department of Pathology, University of Maryland School of Medicine, Baltimore (Staats)
| | - Erik Jenson
- Lee is currently at HNL Lab Medicine, Allentown, Pennsylvania.,the Departments of Pathology and Gynecology & Obstetrics, The Johns Hopkins Hospital, Baltimore, Maryland (Ronnett, Vang, Jenson)
| | - Priya Skaria
- the Departments of Pathology and Immunology (Skaria and Hagemann), Washington University School of Medicine, St Louis, Missouri
| | - Fahime Sheikhzadeh
- Jenson is now with Hospital Pathology Associates, Minneapolis/St Paul, Minnesota.,the Electrical and Computer Engineering Department, University of British Columbia, Vancouver, Canada (Sheikhzadeh)
| | - Meghan Miller
- and the Department of Bioengineering, University of Maryland, College Park (Miller)
| | - Ian S Hagemann
- the Departments of Pathology and Immunology (Skaria and Hagemann), Washington University School of Medicine, St Louis, Missouri.,and Obstetrics and Gynecology (Hagemann), Washington University School of Medicine, St Louis, Missouri
| | - Nicholas Petrick
- From the Division of Imaging, Diagnostics, and Software Reliability, Office of Science and Engineering Laboratories (Gavrielides and Petrick)
| | - Jeffrey D Seidman
- and the Division of Molecular Genetics and Pathology, Office of In Vitro Diagnostics and Radiological Health (Seidman), Center for Devices and Radiological Health, US Food and Drug Administration, Silver Spring, Maryland
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9
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Staats PN, Parkash V, Otis CN, Sharma P, Ioffe O, Bracamonte ER. The Current State of Communication of Urgent and Significant, Unexpected Diagnoses in Anatomic Pathology. Arch Pathol Lab Med 2020; 144:1067-1074. [PMID: 32023089 DOI: 10.5858/arpa.2019-0436-oa] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/09/2019] [Indexed: 11/06/2022]
Abstract
CONTEXT.— The concept of critical diagnoses in anatomic pathology is relatively recent and rigorous study of the issue is quite limited. The College of American Pathologists and Association of Directors of Anatomic and Surgical Pathology issued a consensus statement in 2012. There has been no multi-institutional study of communication policies since then. OBJECTIVE.— To survey the policies of anatomic pathology laboratories regarding communication of critical values. DESIGN.— A survey of the Association of Directors of Anatomic and Surgical Pathology membership was performed using a 14-question electronic survey tool. RESULTS.— Responses were received from 38 institutions. Thirty-five of 38 (92%) had a policy on anatomic pathology critical values. Twenty-five of 38 (66%) respondents had read the College of American Pathologists/Association of Directors of Anatomic and Surgical Pathology consensus statement. Twelve of 38 (32%) institutions divided critical values into 2 categories, of which 9 used the College of American Pathologists/Association of Directors of Anatomic and Surgical Pathology terminology; 24 used only a single term, of which 11 used critical value. There was substantial variation in the diagnoses that were considered critical. A direct phone call to the responsible provider was uniformly considered an acceptable means of communication; all other methods had mixed or low support. The most common time frame was same day; many laboratories did not specify a timeframe. Most laboratories document date, time, and person to whom the result was communicated in the final report or an addendum report. Eighteen of 38 (47%) laboratories report an auditing mechanism for communication. CONCLUSIONS.— Policies for communication of critical/urgent/significant, unexpected results in anatomic pathology are the norm. However, there remains significant variation between institutions in the details of these policies.
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Affiliation(s)
- Paul N Staats
- Department of Pathology, University of Maryland School of Medicine, Baltimore (Staats, Ioffe)
| | - Vinita Parkash
- Department of Pathology, Yale School of Medicine, New Haven, Connecticut (Parkash)
| | - Christopher N Otis
- Department of Pathology, University of Massachusetts Medical School - Baystate, Springfield (Otis)
| | - Poonam Sharma
- Department of Pathology, Creighton University School of Medicine, Omaha, Nebraska (Sharma)
| | - Olga Ioffe
- Department of Pathology, University of Maryland School of Medicine, Baltimore (Staats, Ioffe)
| | - Erika R Bracamonte
- Department of Pathology, University of Arizona College of Medicine, Tucson (Bracamonte)
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10
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Mahmood J, Pandita R, Zhang A, Kamlapurkar S, Saeed A, Chen M, Staats PN, Shukla HD, Anvari A, Sawant A, Vujaskovic Z. RhoA/ROCK pathway inhibitor ameliorates erectile dysfunction induced by radiation therapy in rats. Radiother Oncol 2020; 150:174-180. [PMID: 32565390 DOI: 10.1016/j.radonc.2020.06.021] [Citation(s) in RCA: 4] [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] [Received: 01/14/2020] [Revised: 06/11/2020] [Accepted: 06/12/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVES Prostate cancer (PCa) treatment with radiation therapy (RT) has an excellent cure rate. However, Radiation-induced Erectile Dysfunction (RiED) is a common and irreversible toxicity impacting quality of life, and there is no FDA approved specific drug for RiED. We previously showed that prostate RT increased RhoA/ROCK signaling in the cavernous nerve (CN) and penile tissues, which may lead to RiED in rats. In this study, we investigated whether RhoA/ROCK pathway inhibition by a specific inhibitor called Hydroxyfasudil (HF) can improve RiED in our well-established rat model. MATERIALS/METHODS Male Sprague-Dawley rats were randomized to the following groups: sham-RT, HF-only, RT-only, and RT + HF. Rats were either exposed to a single dose of 25 Gy prostate-confined RT or a sham procedure. 10 mg/kg HF or normal saline was injected intraperitoneally. Erectile function was evaluated by intracavernosal pressure (ICP) and mean arterial pressure (MAP) measurements at week 14 post-RT. Cavernous nerve (CN) injury was evaluated by transmission electron microscopy (TEM), and penile tissue fibrosis by Masson trichrome staining (MT). RESULTS We have found that the HF treatment prior to RT showed significant (p < 0.001) improvement in ICP/MAP ratio, area under the curve, and maximum ICP value, compared to RT-alone rats. Furthermore, RT + HF treated rats exhibited increased CN myelination and decreased axonal atrophy, comparted to RT-only. HF treatment showed significantly decreased penile tissue fibrosis (p < 0.05) compared to RT-alone treated rats. CONCLUSION Our results provide the first preclinical evidence that targeting RhoA/ROCK pathway by HF may provide a novel therapeutic option for the treatment of RiED.
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Affiliation(s)
- Javed Mahmood
- Division of Translational Radiation Sciences (DTRS), Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, USA.
| | - Ravina Pandita
- Division of Translational Radiation Sciences (DTRS), Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, USA
| | - Angel Zhang
- Division of Translational Radiation Sciences (DTRS), Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, USA
| | - Shriya Kamlapurkar
- Division of Translational Radiation Sciences (DTRS), Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, USA
| | - Ali Saeed
- Division of Translational Radiation Sciences (DTRS), Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, USA
| | - Minjie Chen
- Division of Translational Radiation Sciences (DTRS), Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, USA
| | - Paul N Staats
- Department of Pathology, University of Maryland School of Medicine, Baltimore, USA
| | - Hem D Shukla
- Department of Neurology and Neurosurgery, Johns Hopkins University, School of Medicine, Baltimore, USA
| | - Akbar Anvari
- Division of Translational Radiation Sciences (DTRS), Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, USA
| | - Amit Sawant
- Division of Translational Radiation Sciences (DTRS), Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, USA
| | - Zeljko Vujaskovic
- Division of Translational Radiation Sciences (DTRS), Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, USA
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11
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Staats PN, Souers RJ, Nunez AL, Li Z, Kurtycz DFI, Goodrich K, Witt BL, Davey DD, Booth CN. The Differential Diagnosis of Reparative Changes and Malignancy: Performance in the College of American Pathologists Pap Education and Proficiency Testing Programs. Arch Pathol Lab Med 2019; 144:846-852. [DOI: 10.5858/arpa.2019-0298-cp] [Citation(s) in RCA: 1] [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] [Accepted: 09/10/2019] [Indexed: 11/06/2022]
Abstract
Context.—
Repair is a challenging diagnosis and a significant source of false-positive (FP) interpretations in cervical cytology. No large-scale study of performance of repair in the liquid-based era has been performed.
Objective.—
To evaluate the performance of repair in the College of American Pathologists Pap Education and Proficiency Testing (PT) programs.
Design.—
The FP rate for slides classified as repair was evaluated by preparation type, participant type (cytotechnologist, pathologist, or laboratory), and program. The specific misdiagnosis category and individual slide performance were also evaluated. The rate of misclassification of slides as repair by participants for other diagnostic categories in the Pap Education program was assessed.
Results.—
The overall FP rate was 1700 of 12 715 (13.4%). There was no significant difference by program or preparation type. Within the Education program there was no difference by participant type, but pathologists' FP rate in the PT program (47 of 514, 9.1%) was significantly better than cytotechnologists in the PT program (51 of 380, 13.4%) and pathologists in the Education program (690 of 4900, 14.1%). High-grade squamous intraepithelial lesions/cancers (HSIL+) accounted for 1380 of 1602 FP interpretations (86%) in Education, but 43 of 98 (43.9%) in PT. Most slides had a low rate of misclassification, but a small number were poor performers. False-negative diagnosis of HSIL+ as repair was less common, ranging from 0.7% to 1.8%.
Conclusions.—
Despite initial indications that liquid-based cytology might reduce the rate of misclassification of repair, FP interpretations remain common and are no different by preparation type. Misclassification is most commonly as HSIL or carcinoma, potentially resulting in significant patient harm.
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Affiliation(s)
- Paul N. Staats
- From the Department of Pathology, University of Maryland School of Medicine, Baltimore (Dr Staats); Statistics/Biostatistics (Ms Souers) and Surveys Department (Ms Goodrich), College of American Pathologists, Northfield, Illinois; Pathology Group of Louisiana, Baton Rouge (Dr Nunez); the Department of Pathology, Ohio State University Wexner Medical Center, Columbus (Dr Li); the Department of Path
| | - Rhona J. Souers
- From the Department of Pathology, University of Maryland School of Medicine, Baltimore (Dr Staats); Statistics/Biostatistics (Ms Souers) and Surveys Department (Ms Goodrich), College of American Pathologists, Northfield, Illinois; Pathology Group of Louisiana, Baton Rouge (Dr Nunez); the Department of Pathology, Ohio State University Wexner Medical Center, Columbus (Dr Li); the Department of Path
| | - Amberly Lindau Nunez
- From the Department of Pathology, University of Maryland School of Medicine, Baltimore (Dr Staats); Statistics/Biostatistics (Ms Souers) and Surveys Department (Ms Goodrich), College of American Pathologists, Northfield, Illinois; Pathology Group of Louisiana, Baton Rouge (Dr Nunez); the Department of Pathology, Ohio State University Wexner Medical Center, Columbus (Dr Li); the Department of Path
| | - Zaibo Li
- From the Department of Pathology, University of Maryland School of Medicine, Baltimore (Dr Staats); Statistics/Biostatistics (Ms Souers) and Surveys Department (Ms Goodrich), College of American Pathologists, Northfield, Illinois; Pathology Group of Louisiana, Baton Rouge (Dr Nunez); the Department of Pathology, Ohio State University Wexner Medical Center, Columbus (Dr Li); the Department of Path
| | - Daniel F. I. Kurtycz
- From the Department of Pathology, University of Maryland School of Medicine, Baltimore (Dr Staats); Statistics/Biostatistics (Ms Souers) and Surveys Department (Ms Goodrich), College of American Pathologists, Northfield, Illinois; Pathology Group of Louisiana, Baton Rouge (Dr Nunez); the Department of Pathology, Ohio State University Wexner Medical Center, Columbus (Dr Li); the Department of Path
| | - Kelly Goodrich
- From the Department of Pathology, University of Maryland School of Medicine, Baltimore (Dr Staats); Statistics/Biostatistics (Ms Souers) and Surveys Department (Ms Goodrich), College of American Pathologists, Northfield, Illinois; Pathology Group of Louisiana, Baton Rouge (Dr Nunez); the Department of Pathology, Ohio State University Wexner Medical Center, Columbus (Dr Li); the Department of Path
| | - Benjamin Lloyd Witt
- From the Department of Pathology, University of Maryland School of Medicine, Baltimore (Dr Staats); Statistics/Biostatistics (Ms Souers) and Surveys Department (Ms Goodrich), College of American Pathologists, Northfield, Illinois; Pathology Group of Louisiana, Baton Rouge (Dr Nunez); the Department of Pathology, Ohio State University Wexner Medical Center, Columbus (Dr Li); the Department of Path
| | - Diane Davis Davey
- From the Department of Pathology, University of Maryland School of Medicine, Baltimore (Dr Staats); Statistics/Biostatistics (Ms Souers) and Surveys Department (Ms Goodrich), College of American Pathologists, Northfield, Illinois; Pathology Group of Louisiana, Baton Rouge (Dr Nunez); the Department of Pathology, Ohio State University Wexner Medical Center, Columbus (Dr Li); the Department of Path
| | - Christine Noga Booth
- From the Department of Pathology, University of Maryland School of Medicine, Baltimore (Dr Staats); Statistics/Biostatistics (Ms Souers) and Surveys Department (Ms Goodrich), College of American Pathologists, Northfield, Illinois; Pathology Group of Louisiana, Baton Rouge (Dr Nunez); the Department of Pathology, Ohio State University Wexner Medical Center, Columbus (Dr Li); the Department of Path
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12
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Reader J, Harper AK, Legesse T, Staats PN, Goloubeva O, Rao GG, Fulton A, Roque DM. EP4 and Class III β-Tubulin Expression in Uterine Smooth Muscle Tumors: Implications for Prognosis and Treatment. Cancers (Basel) 2019; 11:cancers11101590. [PMID: 31635323 PMCID: PMC6826612 DOI: 10.3390/cancers11101590] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Revised: 10/10/2019] [Accepted: 10/12/2019] [Indexed: 02/07/2023] Open
Abstract
The microtubule-stabilizing agent docetaxel in combination with gemcitabine represents one of the most effective regimens against the aggressive gynecologic tumor leiomyosarcoma (LMS). Upregulation of class III β-tubulin has previously been shown to confer taxane resistance in a variety of human cancers. Prostaglandin E2 receptor EP4 is linked to progression of a variety of human cancers and may represent a novel target for tumor inhibition in LMS. We evaluated the hypotheses that EP4 and class III β-tubulin have increased expression in LMS in comparison to normal myometrium or benign tumors and that expression of class III β-tubulin correlates with resistance to taxanes and poor clinical outcome. Gene expression was examined using TCGA data and correlated with clinicopathologic outcome which demonstrated that class III β-tubulin is more highly expressed in more aggressive sarcomas with EP4 being widely expressed in all subtypes of sarcoma. Immunohistochemistry for EP4 and class III β-tubulin was performed on patients with LMS, leiomyomatosis/STUMP, leiomyoma, and normal myometrium. Expression of EP4 and class III β-tubulin were characterized for cell lines SK-UT-1, SK-UT-1B, and PHM-41 and these cell lines were treated with docetaxel alone and in combination with EP4 inhibitors. In taxane-resistant cell lines that overexpress class III β-tubulin and EP4, treatment with EP4 inhibitor resulted in at least 2-fold sensitization to docetaxel. Expression of class III β-tubulin and EP4 in LMS may identify patients at risk of resistance to standard chemotherapies and candidates for augmentation of therapy through EP4 inhibition.
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Affiliation(s)
- Jocelyn Reader
- Division of Gynecologic Oncology, University of Maryland School of Medicine, Baltimore, MD 21201, USA.
- University of Maryland Marlene and Stewart Greenebaum Comprehensive Cancer Center, Baltimore, MD 21201, USA.
| | - Amy K Harper
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Maryland School of Medicine, Baltimore, MD 21201, USA.
| | - Teklu Legesse
- Department of Pathology, University of Maryland School of Medicine, Baltimore, MD 21201, USA.
| | - Paul N Staats
- Department of Pathology, University of Maryland School of Medicine, Baltimore, MD 21201, USA.
| | - Olga Goloubeva
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD 21201, USA.
| | - Gautam G Rao
- University of Maryland Marlene and Stewart Greenebaum Comprehensive Cancer Center, Baltimore, MD 21201, USA.
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Maryland School of Medicine, Baltimore, MD 21201, USA.
| | - Amy Fulton
- University of Maryland Marlene and Stewart Greenebaum Comprehensive Cancer Center, Baltimore, MD 21201, USA.
- Department of Pathology, University of Maryland School of Medicine, Baltimore, MD 21201, USA.
- Baltimore Veterans Affairs Medical Center, Baltimore, MD 21201, USA.
| | - Dana M Roque
- University of Maryland Marlene and Stewart Greenebaum Comprehensive Cancer Center, Baltimore, MD 21201, USA.
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Maryland School of Medicine, Baltimore, MD 21201, USA.
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13
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Staats PN, Booth CN, Rosenthal DL, Crothers BA. Self-collected Papanicolaou tests in the United States market: more questions than answers. J Am Soc Cytopathol 2019; 8:342-351. [PMID: 31257176 DOI: 10.1016/j.jasc.2019.05.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 04/04/2019] [Revised: 05/21/2019] [Accepted: 05/23/2019] [Indexed: 01/21/2023]
Abstract
The United States Food and Drug Administration held a public hearing in January 2018 to consider how it should evaluate a self-collection device for cervical cytology. Although no such device has been approved for use in the US market, the implications for patients and cytologists could be both sweeping and complex. Herein, the existing literature basis for self-collected Papanicolaou testing is reviewed, and some questions raised by this testing are considered. Questions include: what would be the value to patients; how effective could self-collected Papanicolaou tests be; how might ordering and collection work; what are the unique pre-analytic, analytic, and post-analytic challenges of self-collected Papanicolaou testing; and what effect might self-collection have on cervical cancer rates?
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Affiliation(s)
- Paul N Staats
- Department of Pathology, University of Maryland School of Medicine, Baltimore, Maryland.
| | | | - Dorothy L Rosenthal
- Department of Pathology/Cytopathology, Johns Hopkins Medicine, Baltimore, Maryland
| | - Barbara A Crothers
- Breast, Gynecology and Cytopathology Service, Joint Pathology Center, Silver Spring, Maryland
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14
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Chain K, Legesse T, Heath JE, Staats PN. Digital image‐assisted quantitative nuclear analysis improves diagnostic accuracy of thyroid fine‐needle aspiration cytology. Cancer Cytopathol 2019; 127:501-513. [DOI: 10.1002/cncy.22120] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 02/14/2019] [Accepted: 03/06/2019] [Indexed: 12/14/2022]
Affiliation(s)
- Krista Chain
- University of Maryland School of Medicine Baltimore Maryland
| | - Teklu Legesse
- University of Maryland School of Medicine Baltimore Maryland
| | | | - Paul N. Staats
- University of Maryland School of Medicine Baltimore Maryland
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15
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Legesse T, Parker L, Heath J, Staats PN. Distinguishing non-invasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) from classic and invasive follicular-variant papillary thyroid carcinomas based on cytologic features. J Am Soc Cytopathol 2019; 8:11-17. [PMID: 30929754 DOI: 10.1016/j.jasc.2018.07.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [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: 06/20/2018] [Accepted: 07/18/2018] [Indexed: 06/09/2023]
Abstract
INTRODUCTION An international panel recently recommended reclassification of non-invasive follicular variant of papillary thyroid carcinoma (PTC) to non-invasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP). NIFTPs have little or no risk of recurrence and can be treated with lobectomy alone. Preoperative distinction of NIFTP from PTC will help avoid overtreatment. MATERIALS AND METHODS All thyroid tumors with a histologic diagnosis of PTC and preceding diagnostic cytology (n = 299) over a 5-year period were identified. Cases meeting criteria for NIFTP were reclassified as such. All NIFTP cases with available cytology (n = 6) and a similar number of randomly selected invasive follicular variant of papillary thyroid carcinoma (IFVPTC; n = 9) and classic PTC (cPTC, n = 11) were evaluated for 18 cytologic features. RESULTS A total of 35 (12%) lesions were reclassified as NIFTP, 194 (65%) were cPTC, and 70 (23%) were IFVPTC. The NIFTPs had a preceding cytologic interpretation of benign (31%), atypia of undetermined significance (34%), follicular neoplasm (9%), suspicious for malignancy (12%), or malignant (14%). Cytologically, NIFTP was distinguished from cPTC by absence of any architectural features in all 6 cases, and by absence of pseudoinclusions (P < 0.001) and multinucleated giant cells (P = 0.027) in nearly all. Nuclear pseudoinclusions (P = 0.001), marginal micronucleoli (P = 0.018), irregular branching sheets (P = 0.025), and linear arrangement (P = 0.025) favored IFVPTC over NIFTP. CONCLUSIONS NIFTPs were originally assigned to a variety of cytologic categories. There are several cytologic differences between NIFTP and cPTC or IFVPTC. Our findings support restricting the definitive diagnosis of PTC to cases with architectural features of PTC and/or intranuclear pseudoinclusions.
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Affiliation(s)
- Teklu Legesse
- Department of Pathology, University of Maryland School of Medicine, Baltimore, Maryland.
| | - Lynnette Parker
- Department of Pathology, University of Maryland School of Medicine, Baltimore, Maryland
| | - Jonathon Heath
- Department of Pathology, University of Maryland School of Medicine, Baltimore, Maryland
| | - Paul N Staats
- Department of Pathology, University of Maryland School of Medicine, Baltimore, Maryland
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16
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Crothers BA, Ghofrani M, Zhao C, Dodd LG, Goodrich K, Husain M, Kurtycz DF, Russell DK, Shen RZ, Souers RJ, Staats PN, Tabatabai ZL, Witt BL, Davey DD. Low-Grade Squamous Intraepithelial Lesion or High-Grade Squamous Intraepithelial Lesion? Concordance Between the Interpretation of Low-Grade Squamous Intraepithelial Lesion and High-Grade Squamous Intraepithelial Lesion in Papanicolaou Tests: Results From the College of American Pathologists PAP Education Program. Arch Pathol Lab Med 2018; 143:81-85. [DOI: 10.5858/arpa.2018-0003-cp] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Context.—
Obtaining diagnostic concordance for squamous intraepithelial lesions in cytology can be challenging.
Objective.—
To determine diagnostic concordance for biopsy-proven low-grade squamous intraepithelial lesion (LSIL) and high-grade squamous intraepithelial lesion (HSIL) Papanicolaou test slides in the College of American Pathologists PAP Education program.
Design.—
We analyzed 121 059 responses from 4251 LSIL and HSIL slides for the interval 2004 to 2013 using a nonlinear mixed-model fit for reference diagnosis, preparation type, and participant type. We evaluated interactions between the reference diagnosis and the other 2 factors in addition to a repeated-measures component to adjust for slide-specific performance.
Results.—
There was a statistically significant difference between misclassification of LSIL (2.4%; 1384 of 57 664) and HSIL (4.4%; 2762 of 63 395). There was no performance difference between pathologists and cytotechnologists for LSIL, but cytotechnologists had a significantly higher HSIL misclassification rate than pathologists (5.5%; 1437 of 27 534 versus 4.0%; 1032 of 25 630; P = .01), and both were more likely to misrepresent HSIL as LSIL (P < .001) than the reverse. ThinPrep LSIL slides were more likely to be misclassified as HSIL (2.4%; 920 of 38 582) than SurePath LSIL slides (1.5%; 198 of 13 196), but conventional slides were the most likely to be misclassified in both categories (4.5%; 266 of 5886 for LSIL, and 6.5%; 573 of 8825 for HSIL).
Conclusions.—
More participants undercalled HSIL as LSIL (false-negative) than overcalled LSIL as HSIL (false-positive) in the PAP Education program, with conventional slides more likely to be misclassified than ThinPrep or SurePath slides. Pathologists and cytotechnologists classify LSIL equally well, but cytotechnologists are significantly more likely to undercall HSIL as LSIL than are pathologists.
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Affiliation(s)
- Barbara A. Crothers
- From the Joint Pathology Center, Silver Spring, Maryland (Dr Crothers); the Department of Pathology, PeaceHealth Laboratories, Vancouver, Washington (Dr Ghofrani); the Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (Dr Zhao); the Department of Pathology, University of North Carolina Hospital, Chapel Hill (Dr Dodd); the Surveys Department (Ms Goodrich) a
| | - Mohiedean Ghofrani
- From the Joint Pathology Center, Silver Spring, Maryland (Dr Crothers); the Department of Pathology, PeaceHealth Laboratories, Vancouver, Washington (Dr Ghofrani); the Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (Dr Zhao); the Department of Pathology, University of North Carolina Hospital, Chapel Hill (Dr Dodd); the Surveys Department (Ms Goodrich) a
| | - Chengquan Zhao
- From the Joint Pathology Center, Silver Spring, Maryland (Dr Crothers); the Department of Pathology, PeaceHealth Laboratories, Vancouver, Washington (Dr Ghofrani); the Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (Dr Zhao); the Department of Pathology, University of North Carolina Hospital, Chapel Hill (Dr Dodd); the Surveys Department (Ms Goodrich) a
| | - Leslie G. Dodd
- From the Joint Pathology Center, Silver Spring, Maryland (Dr Crothers); the Department of Pathology, PeaceHealth Laboratories, Vancouver, Washington (Dr Ghofrani); the Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (Dr Zhao); the Department of Pathology, University of North Carolina Hospital, Chapel Hill (Dr Dodd); the Surveys Department (Ms Goodrich) a
| | - Kelly Goodrich
- From the Joint Pathology Center, Silver Spring, Maryland (Dr Crothers); the Department of Pathology, PeaceHealth Laboratories, Vancouver, Washington (Dr Ghofrani); the Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (Dr Zhao); the Department of Pathology, University of North Carolina Hospital, Chapel Hill (Dr Dodd); the Surveys Department (Ms Goodrich) a
| | - Mujtaba Husain
- From the Joint Pathology Center, Silver Spring, Maryland (Dr Crothers); the Department of Pathology, PeaceHealth Laboratories, Vancouver, Washington (Dr Ghofrani); the Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (Dr Zhao); the Department of Pathology, University of North Carolina Hospital, Chapel Hill (Dr Dodd); the Surveys Department (Ms Goodrich) a
| | - Daniel F.I. Kurtycz
- From the Joint Pathology Center, Silver Spring, Maryland (Dr Crothers); the Department of Pathology, PeaceHealth Laboratories, Vancouver, Washington (Dr Ghofrani); the Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (Dr Zhao); the Department of Pathology, University of North Carolina Hospital, Chapel Hill (Dr Dodd); the Surveys Department (Ms Goodrich) a
| | - Donna K. Russell
- From the Joint Pathology Center, Silver Spring, Maryland (Dr Crothers); the Department of Pathology, PeaceHealth Laboratories, Vancouver, Washington (Dr Ghofrani); the Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (Dr Zhao); the Department of Pathology, University of North Carolina Hospital, Chapel Hill (Dr Dodd); the Surveys Department (Ms Goodrich) a
| | - Rulong Z. Shen
- From the Joint Pathology Center, Silver Spring, Maryland (Dr Crothers); the Department of Pathology, PeaceHealth Laboratories, Vancouver, Washington (Dr Ghofrani); the Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (Dr Zhao); the Department of Pathology, University of North Carolina Hospital, Chapel Hill (Dr Dodd); the Surveys Department (Ms Goodrich) a
| | - Rhona J. Souers
- From the Joint Pathology Center, Silver Spring, Maryland (Dr Crothers); the Department of Pathology, PeaceHealth Laboratories, Vancouver, Washington (Dr Ghofrani); the Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (Dr Zhao); the Department of Pathology, University of North Carolina Hospital, Chapel Hill (Dr Dodd); the Surveys Department (Ms Goodrich) a
| | - Paul N. Staats
- From the Joint Pathology Center, Silver Spring, Maryland (Dr Crothers); the Department of Pathology, PeaceHealth Laboratories, Vancouver, Washington (Dr Ghofrani); the Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (Dr Zhao); the Department of Pathology, University of North Carolina Hospital, Chapel Hill (Dr Dodd); the Surveys Department (Ms Goodrich) a
| | - Z. Laura Tabatabai
- From the Joint Pathology Center, Silver Spring, Maryland (Dr Crothers); the Department of Pathology, PeaceHealth Laboratories, Vancouver, Washington (Dr Ghofrani); the Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (Dr Zhao); the Department of Pathology, University of North Carolina Hospital, Chapel Hill (Dr Dodd); the Surveys Department (Ms Goodrich) a
| | - Benjamin L. Witt
- From the Joint Pathology Center, Silver Spring, Maryland (Dr Crothers); the Department of Pathology, PeaceHealth Laboratories, Vancouver, Washington (Dr Ghofrani); the Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (Dr Zhao); the Department of Pathology, University of North Carolina Hospital, Chapel Hill (Dr Dodd); the Surveys Department (Ms Goodrich) a
| | - Diane Davis Davey
- From the Joint Pathology Center, Silver Spring, Maryland (Dr Crothers); the Department of Pathology, PeaceHealth Laboratories, Vancouver, Washington (Dr Ghofrani); the Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (Dr Zhao); the Department of Pathology, University of North Carolina Hospital, Chapel Hill (Dr Dodd); the Surveys Department (Ms Goodrich) a
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Jung S, Allen N, Arslan AA, Baglietto L, Barricarte A, Brinton LA, Egleston BL, Falk RT, Fortner RT, Helzlsouer KJ, Gao Y, Idahl A, Kaaks R, Krogh V, Merritt MA, Lundin E, Onland-Moret NC, Rinaldi S, Schock H, Shu XO, Sluss PM, Staats PN, Sacerdote C, Travis RC, Tjønneland A, Trichopoulou A, Tworoger SS, Visvanathan K, Weiderpass E, Zeleniuch-Jacquotte A, Dorgan JF. Anti-Müllerian hormone and risk of ovarian cancer in nine cohorts. Int J Cancer 2018; 142:262-270. [PMID: 28921520 PMCID: PMC5749630 DOI: 10.1002/ijc.31058] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Revised: 08/08/2017] [Accepted: 08/16/2017] [Indexed: 01/08/2023]
Abstract
Animal and experimental data suggest that anti-Müllerian hormone (AMH) serves as a marker of ovarian reserve and inhibits the growth of ovarian tumors. However, few epidemiologic studies have examined the association between AMH and ovarian cancer risk. We conducted a nested case-control study of 302 ovarian cancer cases and 336 matched controls from nine cohorts. Prediagnostic blood samples of premenopausal women were assayed for AMH using a picoAMH enzyme-linked immunosorbent assay. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using multivariable-adjusted conditional logistic regression. AMH concentration was not associated with overall ovarian cancer risk. The multivariable-adjusted OR (95% CI), comparing the highest to the lowest quartile of AMH, was 0.99 (0.59-1.67) (Ptrend : 0.91). The association did not differ by age at blood draw or oral contraceptive use (all Pheterogeneity : ≥0.26). There also was no evidence for heterogeneity of risk for tumors defined by histologic developmental pathway, stage, and grade, and by age at diagnosis and time between blood draw and diagnosis (all Pheterogeneity : ≥0.39). In conclusion, this analysis of mostly late premenopausal women from nine cohorts does not support the hypothesized inverse association between prediagnostic circulating levels of AMH and risk of ovarian cancer.
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Affiliation(s)
- Seungyoun Jung
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Naomi Allen
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, UK
| | - Alan A. Arslan
- Department of Obstetrics and Gynecology, New York University School of Medicine, NY, USA
- Departments of Population Health and Environmental Medicine and Perlmutter Cancer Center, New York University School of Medicine, New York, NY, USA
| | - Laura Baglietto
- Cancer Epidemiology Centre, Cancer Council of Victoria, Melbourne, Australia
- Centre for Epidemiology and Biostatistics, School of Population and Global Health, University of Melbourne, Australia
| | - Aurelio Barricarte
- Navarra Public Health Institute, Pamplona, Spain
- Navarra Institute for Health Research (IdiSNA) Pamplona, Spain
- CIBER Epidemiology and Public Health CIBERESP, Spain
| | - Louise A. Brinton
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, MD, USA
| | | | - Roni T. Falk
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, MD, USA
| | - Renée T. Fortner
- Division of Cancer Epidemiology, German Cancer Research Cancer, Heidelberg, Germany
| | - Kathy J. Helzlsouer
- Division of Cancer Control and Population Sciences, National Cancer Institute, MD, USA
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Yutang Gao
- Department of Epidemiology, Shanghai Cancer Institute, Shanghai, China
| | - Annika Idahl
- Department of Clinical Sciences, Obstetrics and Gynecology, Umeå University, Umeå, Sweden
| | - Rudolph Kaaks
- Division of Cancer Epidemiology, German Cancer Research Cancer, Heidelberg, Germany
| | - Vittorio Krogh
- Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Melissa A. Merritt
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
| | - Eva Lundin
- Department of Medical Biosciences, Pathology, and Public Health and Clinical Medicine: Nutritional Research, Umeå University, Umeå, Sweden
| | | | - Sabina Rinaldi
- International Agency for Research on Cancer, Lyon, France
| | - Helena Schock
- Division of Cancer Epidemiology, German Cancer Research Cancer, Heidelberg, Germany
| | - Xiao-Ou Shu
- Department of Epidemiology, Vanderbilt University School of Medicine, Nashville, Tennessee, USA
| | - Patrick M. Sluss
- Department of Pathology, Harvard Medical School, Boston, MA, USA
| | - Paul N. Staats
- Department of Pathology, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Carlotta Sacerdote
- Unit of Cancer Epidemiology, Città della Salute e della Scienza University-Hospital and Center for Cancer Prevention (CPO), Turin, Italy
| | - Ruth C. Travis
- Cancer Epidemiology Unit, University of Oxford, Oxford United Kingdom
| | | | - Antonia Trichopoulou
- Hellenic Health Foundation, Athens, Greece
- WHO Collaborating Center for Nutrition and Health, Unit of Nutritional Epidemiology and Nutrition in Public Health, Dept. of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Greece
| | - Shelley S. Tworoger
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Bringham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Kala Visvanathan
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Elisabete Weiderpass
- Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, Tromsø, Norway
- Department of Research, Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Genetic Epidemiology Group, Folkhälsan Research Center, Helsinki, Finland
| | - Anne Zeleniuch-Jacquotte
- Departments of Population Health and Environmental Medicine and Perlmutter Cancer Center, New York University School of Medicine, New York, NY, USA
| | - Joanne F. Dorgan
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, USA
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18
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Fortner RT, Schock H, Jung S, Allen NE, Arslan AA, Brinton LA, Egleston BL, Falk RT, Gunter MJ, Helzlsouer KJ, Idahl A, Johnson TS, Kaaks R, Krogh V, Lundin E, Merritt MA, Navarro C, Onland-Moret NC, Palli D, Shu XO, Sluss PM, Staats PN, Trichopoulou A, Weiderpass E, Zeleniuch-Jacquotte A, Zheng W, Dorgan JF. Anti-Mullerian hormone and endometrial cancer: a multi-cohort study. Br J Cancer 2017; 117:1412-1418. [PMID: 28873086 PMCID: PMC5672934 DOI: 10.1038/bjc.2017.299] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Revised: 06/30/2017] [Accepted: 08/04/2017] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND The Mullerian ducts are the embryological precursors of the female reproductive tract, including the uterus; anti-Mullerian hormone (AMH) has a key role in the regulation of foetal sexual differentiation. Anti-Mullerian hormone inhibits endometrial tumour growth in experimental models by stimulating apoptosis and cell cycle arrest. To date, there are no prospective epidemiologic data on circulating AMH and endometrial cancer risk. METHODS We investigated this association among women premenopausal at blood collection in a multicohort study including participants from eight studies located in the United States, Europe, and China. We identified 329 endometrial cancer cases and 339 matched controls. Anti-Mullerian hormone concentrations in blood were quantified using an enzyme-linked immunosorbent assay. Conditional logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CI) across tertiles and for a doubling of AMH concentrations (ORlog2). Subgroup analyses were performed by ages at blood donation and diagnosis, oral contraceptive use, and tumour characteristics. RESULTS Anti-Mullerian hormone was not associated with the risk of endometrial cancer overall (ORlog2: 1.07 (0.99-1.17)), or with any of the examined subgroups. CONCLUSIONS Although experimental models implicate AMH in endometrial cancer growth inhibition, our findings do not support a role for circulating AMH in the aetiology of endometrial cancer.
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Affiliation(s)
- Renée T Fortner
- Division of Cancer Epidemiology, German Cancer Research Cancer, Heidelberg, Germany
| | - Helena Schock
- Division of Cancer Epidemiology, German Cancer Research Cancer, Heidelberg, Germany
| | - Seungyoun Jung
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Naomi E Allen
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Alan A Arslan
- Department of Obstetrics and Gynecology, New York University School of Medicine, New York, NY, USA
- Departments of Population Health and Environmental Medicine, New York University School of Medicine, New York University Perlmutter Cancer Center, New York, NY, USA
| | - Louise A Brinton
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | | | - Roni T Falk
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Marc J Gunter
- Nutrition and Metabolism Section, International Agency for Research on Cancer, Lyon, France
| | - Kathy J Helzlsouer
- Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD, USA
| | - Annika Idahl
- Department of Clinical Sciences, Obstetrics and Gynecology, Umeå University, Umeå, Sweden
| | - Theron S Johnson
- Division of Cancer Epidemiology, German Cancer Research Cancer, Heidelberg, Germany
| | - Rudolf Kaaks
- Division of Cancer Epidemiology, German Cancer Research Cancer, Heidelberg, Germany
| | - Vittorio Krogh
- Nutritional Epidemiology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Eva Lundin
- Department of Medical Biosciences and Pathology, Umeå University, Umeå, Sweden
| | - Melissa A Merritt
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Carmen Navarro
- Department of Epidemiology, Regional Health Council, IMIB-Arrixaca, Murcia, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Department of Health and Social Sciences, Universidad de Murcia, Murcia, Spain
| | - N Charlotte Onland-Moret
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Domenico Palli
- Cancer Risk Factors and Life-Style Epidemiology Unit, Cancer Research and Prevention Institute – ISPO, Florence, Italy
| | - Xiao-Ou Shu
- Department of Epidemiology, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Patrick M Sluss
- Department of Pathology, Harvard Medical School, Boston, MA, USA
| | - Paul N Staats
- Department of Pathology, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Antonia Trichopoulou
- Hellenic Health Foundation, Athens, Greece
- WHO Collaborating Center for Nutrition and Health, Unit of Nutritional Epidemiology and Nutrition in Public Health, Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Elisabete Weiderpass
- Department of Research, Group of Etiological Cancer Research, Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Genetic Epidemiology Group, Folkhälsan Research Center, Helsinki, Finland
- Department of Community Medicine, The Arctic University of Norway, Tromsø, Norway
| | - Anne Zeleniuch-Jacquotte
- Department of Population Health and Perlmutter Cancer Center, New York University School of Medicine, New York, NY, USA
| | - Wei Zheng
- Department of Epidemiology, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Joanne F Dorgan
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, USA
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19
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Kurtycz DFI, Staats PN, Chute DJ, Russell D, Pavelec D, Monaco SE, Friedlander MA, Wilbur DC, Nayar R. Bethesda Interobserver Reproducibility Study-2 (BIRST-2): Bethesda System 2014. J Am Soc Cytopathol 2017; 6:131-144. [PMID: 31043266 DOI: 10.1016/j.jasc.2017.03.003] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [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: 03/08/2017] [Accepted: 03/27/2017] [Indexed: 06/09/2023]
Abstract
INTRODUCTION In concert with the 2014 update to the Bethesda System for Reporting Cervical Cytology, a Web-based image interobserver study was performed to evaluate concordance with the "expert panel" interpretation, as was done during the Bethesda 2001 update. The aim was to identify cytomorphologic features and Bethesda reporting categories that represent sources of poor interobserver agreement and see how the trends compared to the first Bethesda Interobserver Reproducibility Study (BIRST). MATERIALS AND METHODS Participants were recruited online through national and international cytopathology professional societies. Study participants evaluated 84 previously unpublished web images chosen from the third Bethesda Atlas image set, prior to the release of the atlas. These images spanned all reporting categories and included typical and borderline cytomorphology. Demographic information was collected on level of training, practice patterns, and experience of the participants. Participation was restricted to those correctly answering 2 basic cytopathology questions, ensuring minimal knowledge of gynecologic cytopathology. RESULTS A total of 1290 unique individuals attempted access to this Web-based study and 833 correctly answered the two qualifying questions. Of these, 518 respondents completed the survey. Participant origin included: 59% United States, 41% international; 48% cytotechnologists, 41% pathologists, 5% fellows, and 6% other. Practice types were: 39% academic institutions, 29% private hospitals, and 16% commercial laboratories. Overall, the mean participant agreement with the exact Bethesda panel interpretation was 62.8%. The best agreement was found for negative for intraepithelial lesion or malignancy (NILM; 74%) and low-grade squamous intraepithelial lesion (LSIL; 86%) categories. Squamous cell carcinoma (SCC) (63%), high-grade squamous intraepithelial lesion (HSIL; 60%), atypical squamous cells of undetermined significance (ASC-US; 62%) and atypical squamous cells, cannot exclude high-grade squamous intraepithelial lesion (ASC-H; 60%) showed slightly lower concordance with the panel interpretations. Cervical glandular lesions were more problematic (33%). Anal samples performed similarly to their gynecologic counterparts. There was similar diagnostic agreement across participant certifications and practice type (academic versus non-academic). Performance was higher for United States and other North America-based participants (P = 0.0104). This significance may be attributed to a language bias, as the survey was only offered in English. CONCLUSIONS Similar to the BIRST-1 study conducted in 2001, the most important factor for diagnostic agreement by cytotechnologists, pathologists, and trainees was the a priori difficulty of an image rather than participant training, certification, or experience. Participants showed better general diagnostic agreement with the expert panel interpretations of the material in BIRST-2 than in BIRST-1. Agreement was highest for Bethesda categories of NILM, LSIL, HSIL, and SCC. Concordance for even the borderline ASC-US and ASC-H categories exhibited remarkable improvement in the BIRST-2.
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Affiliation(s)
- Daniel F I Kurtycz
- Department of Pathology and Laboratory Medicine and the Wisconsin State Laboratory of Hygiene, University of Wisconsin-Madison, Madison, Wisconsin.
| | - Paul N Staats
- Department of Pathology, University of Maryland School of Medicine, Baltimore, Maryland
| | - Deborah J Chute
- Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, Ohio
| | - Donna Russell
- Department of Pathology and Laboratory Medicine, University of Rochester, Rochester, New York
| | - Derek Pavelec
- Department of Pathology and Laboratory Medicine and the Wisconsin State Laboratory of Hygiene, University of Wisconsin-Madison, Madison, Wisconsin
| | - Sara E Monaco
- Department of Pathology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Maria A Friedlander
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - David C Wilbur
- Harvard University and Massachusetts General Hospital, Boston, Massachusetts
| | - Ritu Nayar
- Department of Pathology, Northwestern University, Chicago, Illinois
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20
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Jung S, Allen N, Arslan AA, Baglietto L, Brinton LA, Egleston BL, Falk R, Fortner RT, Helzlsouer KJ, Idahl A, Kaaks R, Lundin E, Merritt M, Onland-Moret C, Rinaldi S, Sánchez MJ, Sieri S, Schock H, Shu XO, Sluss PM, Staats PN, Travis RC, Tjønneland A, Trichopoulou A, Tworoger S, Visvanathan K, Krogh V, Weiderpass E, Zeleniuch-Jacquotte A, Zheng W, Dorgan JF. Demographic, lifestyle, and other factors in relation to antimüllerian hormone levels in mostly late premenopausal women. Fertil Steril 2017; 107:1012-1022.e2. [PMID: 28366409 PMCID: PMC5426228 DOI: 10.1016/j.fertnstert.2017.02.105] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Revised: 02/09/2017] [Accepted: 02/20/2017] [Indexed: 01/09/2023]
Abstract
OBJECTIVE To identify reproductive, lifestyle, hormonal, and other correlates of circulating antimüllerian hormone (AMH) concentrations in mostly late premenopausal women. DESIGN Cross-sectional study. SETTING Not applicable. PATIENT(S) A total of 671 premenopausal women not known to have cancer. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) Concentrations of AMH were measured in a single laboratory using the picoAMH ELISA. Multivariable-adjusted median (and interquartile range) AMH concentrations were calculated using quantile regression for several potential correlates. RESULT(S) Older women had significantly lower AMH concentrations (≥40 [n = 444] vs. <35 years [n = 64], multivariable-adjusted median 0.73 ng/mL vs. 2.52 ng/mL). Concentrations of AMH were also significantly lower among women with earlier age at menarche (<12 [n = 96] vs. ≥14 years [n = 200]: 0.90 ng/mL vs. 1.12 ng/mL) and among current users of oral contraceptives (n = 27) compared with never or former users (n = 468) (0.36 ng/mL vs. 1.15 ng/mL). Race, body mass index, education, height, smoking status, parity, and menstrual cycle phase were not significantly associated with AMH concentrations. There were no significant associations between AMH concentrations and androgen or sex hormone-binding globulin concentrations or with factors related to blood collection (e.g., sample type, time, season, and year of blood collection). CONCLUSION(S) Among premenopausal women, lower AMH concentrations are associated with older age, a younger age at menarche, and currently using oral contraceptives, suggesting these factors are related to a lower number or decreased secretory activity of ovarian follicles.
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Affiliation(s)
- Seungyoun Jung
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland
| | - Naomi Allen
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Alan A Arslan
- Department of Obstetrics and Gynecology, New York University School of Medicine, New York, New York; Departments of Population Health and Environmental Medicine and Perlmuttr Cancer Center, New York University School of Medicine, New York, New York
| | - Laura Baglietto
- Cancer Epidemiology Centre, Cancer Council of Victoria, Melbourne, Victoria, Australia; Centre for Epidemiology and Biostatistics, School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Louise A Brinton
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland
| | | | - Roni Falk
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland
| | - Renée T Fortner
- Division of Cancer Epidemiology, German Cancer Research Cancer, Heidelberg, Germany
| | - Kathy J Helzlsouer
- Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, Maryland; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Annika Idahl
- Department of Clinical Sciences, Obstetrics and Gynecology, Umeå University, Umeå, Sweden
| | - Rudolph Kaaks
- Division of Cancer Epidemiology, German Cancer Research Cancer, Heidelberg, Germany
| | - Eva Lundin
- Department of Medical Biosciences, Pathology, and Public Health and Clinical Medicine: Nutritional Research, Umeå University, Umeå, Sweden
| | - Melissa Merritt
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
| | - Charlotte Onland-Moret
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Sabina Rinaldi
- International Agency for Research on Cancer, Lyon, France
| | - María-José Sánchez
- Escuela Andaluza de Salud Pública, Instituto de Investigación Biosanitaria ibs, GRANADA, Hospitales Universitarios de Granada/Universidad de Granada, Granada, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Sabina Sieri
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Helena Schock
- Division of Cancer Epidemiology, German Cancer Research Cancer, Heidelberg, Germany
| | - Xiao-Ou Shu
- Department of Epidemiology, Vanderbilt University School of Medicine, Nashville, Tennessee
| | - Patrick M Sluss
- Department of Pathology, Harvard Medical School, Boston, Massachusetts
| | - Paul N Staats
- Department of Pathology, University of Maryland School of Medicine, Baltimore, Maryland
| | - Ruth C Travis
- Cancer Epidemiology Unit, University of Oxford, Oxford, United Kingdom
| | | | - Antonia Trichopoulou
- Hellenic Health Foundation, Athens, Greece; World Health Organization Collaborating Center for Nutrition and Health, Unit of Nutritional Epidemiology and Nutrition in Public Health, Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens, Greece
| | - Shelley Tworoger
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Baltimore, Maryland; Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Kala Visvanathan
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Vittorio Krogh
- Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Elisabete Weiderpass
- Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, Tromsø, Norway; Department of Research, Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Genetic Epidemiology Group, Folkhälsan Research Center, Helsinki, Finland
| | - Anne Zeleniuch-Jacquotte
- Departments of Population Health and Environmental Medicine and Perlmuttr Cancer Center, New York University School of Medicine, New York, New York
| | - Wei Zheng
- Department of Epidemiology, Vanderbilt University School of Medicine, Nashville, Tennessee
| | - Joanne F Dorgan
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland.
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Balenga N, Azimzadeh P, Hogue JA, Staats PN, Shi Y, Koh J, Dressman H, Olson JA. Orphan Adhesion GPCR GPR64/ADGRG2 Is Overexpressed in Parathyroid Tumors and Attenuates Calcium-Sensing Receptor-Mediated Signaling. J Bone Miner Res 2017; 32:654-666. [PMID: 27760455 PMCID: PMC7211037 DOI: 10.1002/jbmr.3023] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [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: 03/24/2016] [Revised: 09/30/2016] [Accepted: 10/17/2016] [Indexed: 12/19/2022]
Abstract
Abnormal feedback of serum calcium to parathyroid hormone (PTH) secretion is the hallmark of primary hyperparathyroidism (PHPT). Although the molecular pathogenesis of parathyroid neoplasia in PHPT has been linked to abnormal expression of genes involved in cell growth (e.g., cyclin D1, retinoblastoma, and β-catenin), the molecular basis of abnormal calcium sensing by calcium-sensing receptor (CaSR) and PTH hypersecretion in PHPT are incompletely understood. Through gene expression profiling, we discovered that an orphan adhesion G protein-coupled receptor (GPCR), GPR64/ADGRG2, is expressed in human normal parathyroid glands and is overexpressed in parathyroid tumors from patients with PHPT. Using immunohistochemistry, Western blotting, and coimmunoprecipitation, we found that GPR64 is expressed on the cell surface of parathyroid cells, is overexpressed in parathyroid tumors, and physically interacts with the CaSR. By using reporter gene assay and GPCR second messenger readouts we identified Gαs, 3',5'-cyclic adenosine monophosphate (cAMP), protein kinase A, and cAMP response element binding protein (CREB) as the signaling cascade downstream of GPR64. Furthermore, we found that an N-terminally truncated human GPR64 is constitutively active and a 15-amino acid-long peptide C-terminal to the GPCR proteolysis site (GPS) of GPR64 activates this receptor. Functional characterization of GPR64 demonstrated its ability to increase PTH release from human parathyroid cells at a range of calcium concentrations. We discovered that the truncated constitutively active, but not the full-length GPR64 physically interacts with CaSR and attenuates the CaSR-mediated intracellular Ca2+ signaling and cAMP suppression in HEK293 cells. Our results indicate that GPR64 may be a physiologic regulator of PTH release that is dysregulated in parathyroid tumors, and suggest a role for GPR64 in pathologic calcium sensing in PHPT. © 2016 American Society for Bone and Mineral Research.
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Affiliation(s)
- Nariman Balenga
- Division of General & Oncologic Surgery, Department of Surgery, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Pedram Azimzadeh
- Division of General & Oncologic Surgery, Department of Surgery, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Joyce A Hogue
- Department of Surgery, Duke University Medical Center, Durham, NC, USA
| | - Paul N Staats
- Department of Pathology, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Yuhong Shi
- Division of General & Oncologic Surgery, Department of Surgery, University of Maryland School of Medicine, Baltimore, MD, USA
| | - James Koh
- Department of Surgery, Duke University Medical Center, Durham, NC, USA
| | - Holly Dressman
- Department of Molecular Genetics and Microbiology, Duke University, Durham, NC, USA
| | - John A Olson
- Division of General & Oncologic Surgery, Department of Surgery, University of Maryland School of Medicine, Baltimore, MD, USA
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Bhooshan N, Staats PN, Fulton AM, Feliciano JL, Edelman MJ. Prostaglandin E Receptor EP4 expression, survival and pattern of recurrence in locally advanced NSCLC. Lung Cancer 2016; 101:88-91. [PMID: 27794413 DOI: 10.1016/j.lungcan.2016.09.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2016] [Revised: 09/01/2016] [Accepted: 09/14/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND Elevated COX-2 expression has been correlated with inferior outcome in NSCLC. COX-2 catalyzes the transformation of arachidonate to PGE2. We and others have demonstrated that PGE2 induces proliferation and metastatic spread and immunosuppression through the G protein-coupled EP4 receptor. We hypothesized that EP4 expression on malignant cells would correlate with outcome and patterns of relapse after treatment of LANSCLC stage IIIA (7th edition, N2+). METHODS Tissue specimens from 41 pts treated for LANSC at UMGCC were obtained. A tissue microarray was prepared and examined for EP4 expression. Intensity of staining was scored semi-quantitatively as 0-4 in both the nuclear and cytoplasmic compartments by a pathologist blinded to the clinical data. RESULTS EP4 nuclear staining 0-1 vs. 2+ was associated with overall survival, (OS) (44.3 vs. 18 mo; HR=0.41, p=0.024) and numerically superior progression free survival (PFS) (16.4 vs. 10.2 mo, p=0.16). EP4 cytoplasmic staining did not correlate with OS (0-1 vs. 2+, 23.8 vs. 28.8 mo; HR=1.2, p=0.81). Relapse pattern (no relapse or local vs. systemic) did not correlate with EP nuclear staining (p=1.0, X2). CONCLUSIONS This is the first clinical study of EP4 expression in lung cancer. There was a significant correlation between OS and nuclear EP4 expression, indicating that this is a potential therapeutic target. Studies with AT-007, a specific inhibitor of EP4, are planned to commence this year.
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Affiliation(s)
- Neha Bhooshan
- University of Maryland Marlene and Stewart Greenebaum Cancer Center, 22 South Greene Street, Baltimore, MD, 21201, USA
| | - Paul N Staats
- University of Maryland Marlene and Stewart Greenebaum Cancer Center, 22 South Greene Street, Baltimore, MD, 21201, USA
| | - Amy M Fulton
- University of Maryland Marlene and Stewart Greenebaum Cancer Center, 22 South Greene Street, Baltimore, MD, 21201, USA; Baltimore Veterans Administration Medical Center, Baltimore, MD 21201, USA
| | - Josephine L Feliciano
- University of Maryland Marlene and Stewart Greenebaum Cancer Center, 22 South Greene Street, Baltimore, MD, 21201, USA
| | - Martin J Edelman
- University of Maryland Marlene and Stewart Greenebaum Cancer Center, 22 South Greene Street, Baltimore, MD, 21201, USA.
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Staats PN, Davey DD. Tips for surviving and thriving in the next accreditation system. Cancer Cytopathol 2016; 124:229-30. [PMID: 27078178 DOI: 10.1002/cncy.21691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Revised: 12/17/2015] [Accepted: 12/17/2015] [Indexed: 11/09/2022]
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24
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Subang MLL, Konig M, Staats PN, Lamos EM, Munir KM, Malek R. Third-Trimester Intraplacental Choriocarcinoma Presenting With Respiratory Failure and Hyperthyroidism. AACE Clin Case Rep 2016. [DOI: 10.4158/ep15852.cr] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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25
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Hamilton DC, Shih HH, Schubert RA, Michie SA, Staats PN, Kaplan DL, Fontaine MJ. A silk-based encapsulation platform for pancreatic islet transplantation improves islet function in vivo. J Tissue Eng Regen Med 2015; 11:887-895. [PMID: 25619945 DOI: 10.1002/term.1990] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2014] [Revised: 09/04/2014] [Accepted: 12/09/2014] [Indexed: 12/15/2022]
Abstract
The success of pancreatic islet (PI) transplantation is challenged by PI functional damage during the peritransplantation period. A silk-based encapsulation platform including mesenchymal stromal cells (MSCs) was evaluated for islet cell delivery in vivo. Islet equivalents (IEQs) were transplanted into the epididymal fat pads of mice with streptozotocin-induced diabetes. Three PI combinations were tested: (A) co-encapsulated in silk with MSCs; (b) encapsulated in silk alone; or (c) pelleted. Blood glucose levels were monitored and intraperitoneal glucose tolerance test (IPGTT) was performed upon return to euglycaemia. Grafts were removed for histology and cytokine content analysis. Mice with PI grafts in silk showed a prompt return to euglycaemia. IPGTT was significantly improved with PI in silk with MSCs, compared to PI in silk alone or pelleted. Both Th1 and Th2 cytokines were increased in PI grafts in silk, but Th1 cytokines were decreased significantly with PI and MSC co-encapsulation. Histological analysis showed osteogenesis and chondrogenesis in the silk grafts containing MSCs. Future studies will evaluate MSC stability and function in vivo and improve silk biocompatibility for applications in islet transplantation. Copyright © 2015 John Wiley & Sons, Ltd.
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Affiliation(s)
- Diana C Hamilton
- Department of Pathology, Stanford University School of Medicine, CA, USA
| | - Hank H Shih
- Department of Pathology, Stanford University School of Medicine, CA, USA
| | - Richard A Schubert
- Department of Pathology, Stanford University School of Medicine, CA, USA
| | - Sara A Michie
- Department of Pathology, Stanford University School of Medicine, CA, USA
| | - Paul N Staats
- Department of Pathology, University of Maryland School of Medicine, Baltimore, MD, USA
| | - David L Kaplan
- Department of Bioengineering, Tufts University, Medford, MA, USA
| | - Magali J Fontaine
- Department of Pathology, Stanford University School of Medicine, CA, USA.,Department of Pathology, University of Maryland School of Medicine, Baltimore, MD, USA
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Heath JE, Goicochea LB, Staats PN. Biliary stent-related alterations can be distinguished from adenocarcinoma on bile duct brushings using a limited number of cytologic features. J Am Soc Cytopathol 2015; 4:282-289. [PMID: 31051766 DOI: 10.1016/j.jasc.2015.06.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2014] [Revised: 06/21/2015] [Accepted: 06/22/2015] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Although it is widely accepted that cytologic alterations secondary to a biliary stent can be difficult to distinguish from adenocarcinoma in pancreatobiliary exfoliative cytology, no systematic study has been undertaken to identify the cytologic features that best distinguish these entities. MATERIALS AND METHODS A training set of 29 bile duct brushings (14 with biliary stents, originally classified as atypical or suspicious, with >6 months of benign clinical follow-up; and 15 diagnosed as adenocarcinoma with histologic confirmation) was evaluated for the following: nuclear enlargement, nuclear contour, nuclear overlap, chromatin distribution, nuclear-cytoplasmic ratio, anisonucleosis, macronucleoli, mitoses, acute inflammation, disorganization, necrosis, cell borders, single atypical cells, and 2 distinct cell populations. A distinct validation set of 31 equivocal stented brushings-13 later diagnosed with carcinoma and 18 with ≥6 months of benign follow-up-were similarly evaluated. Cases were categorized as benign or malignant using a scoring algorithm based on statistically significant features. RESULTS Five features achieved statistical significance: atypical single cells (P = 0.0001), 2 distinct cell populations (P = 0.0007), and anisonucleosis (P = 0.0422) favored malignancy; distinct cell borders (P = 0.0018) and acute inflammation (P = 0.0035) favored benign. The algorithm correctly classified 12 of 14 benign and 15 of 15 malignant cases in the training set and 16 of 18 benign and 7 of 13 malignant cases in the validation set. CONCLUSIONS Most bile duct brushings from patients with biliary stents could be definitively and correctly classified as either benign or malignant using 5 morphologic features: single atypical cells, binary cell population, anisonucleosis, distinct cell borders, and acute inflammation.
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Affiliation(s)
- Jonathon E Heath
- Department of Pathology, University of Maryland School of Medicine, 22 South Greene Street, Baltimore, Maryland
| | - Lindsay B Goicochea
- Department of Pathology, University of Maryland School of Medicine, 22 South Greene Street, Baltimore, Maryland
| | - Paul N Staats
- Department of Pathology, University of Maryland School of Medicine, 22 South Greene Street, Baltimore, Maryland.
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27
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Bhatnagar R, Drachenberg C, Staats PN. Renal tubular epithelial clusters in voided urine: a potential diagnostic pitfall in renal transplant patients. J Am Soc Cytopathol 2014; 3:96-102. [PMID: 31051708 DOI: 10.1016/j.jasc.2013.12.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2013] [Accepted: 12/09/2013] [Indexed: 06/09/2023]
Abstract
INTRODUCTION Urine cytology is often used to screen for polyomavirus in renal transplant patients. There are qualitative cytologic differences between urine from transplant and nontransplant patients, particularly the presence of epithelial cell clusters, that can pose diagnostic difficulty. MATERIALS AND METHODS Voided urine cytology specimens from 100 renal transplant patients and 100 nontransplant patients were reviewed for cell clusters. Immunocytochemistry for renal cell carcinoma marker (RCC) and cytokeratin 7 was performed on 10 recent specimens. Clinical data was reviewed with a focus on evidence of graft dysfunction or malignancy. RESULTS Eighteen patients (18%) in the renal transplant group and no nontransplanted patients (0%) exhibited cell clusters with characteristic morphology: 3-dimensional cohesive groups; high nucleus-to-cytoplasm ratio; round, eccentrically placed nuclei with a prominent central nucleolus; and granular or vacuolated cytoplasm. Some had significant nuclear atypia. The groups were RCC-positive in 8 of 10 cases, and cytokeratin 7-positive in 6 of 10 cases, which is consistent with renal tubular epithelial clusters (RTECs). Clinical follow-up revealed that 88% (15 of 17) of those with RTECs developed graft dysfunction in a median of 65 days, compared with 6% (4 of 64) without RTECs (sensitivity 79%, specificity 97%, positive predictive value 88%, negative predictive value 94%). No patient developed a urinary tract malignancy. CONCLUSIONS RTECs are relatively common in urine cytology from transplant patients, but are rare in other urine specimens. Recognition is important as they can be mistaken for urothelial carcinoma or adenocarcinoma. There appears to be a strong association with later development of graft dysfunction. These cells are most likely evidence of renal tubular injury secondary to a variety of factors, including rejection.
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Affiliation(s)
| | - Cinthia Drachenberg
- Department of Pathology, University of Maryland School of Medicine, 22 South Greene Street, Baltimore, Maryland
| | - Paul N Staats
- Department of Pathology, University of Maryland School of Medicine, 22 South Greene Street, Baltimore, Maryland.
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28
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Fung AD, Collins JA, Campassi C, Ioffe OB, Staats PN. Performance characteristics of ultrasound-guided fine-needle aspiration of axillary lymph nodes for metastatic breast cancer employing rapid on-site evaluation of adequacy: analysis of 136 cases and review of the literature. Cancer Cytopathol 2013; 122:282-91. [PMID: 24353146 DOI: 10.1002/cncy.21384] [Citation(s) in RCA: 25] [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: 10/07/2013] [Revised: 10/31/2013] [Accepted: 11/04/2013] [Indexed: 01/27/2023]
Abstract
BACKGROUND It has been demonstrated that axillary ultrasound-guided fine-needle aspiration (US-FNA) has excellent positive predictive value for the axillary lymph node status of patients with breast cancer before surgery or neoadjuvant therapy and, thus, can obviate the need for sentinel lymph node biopsy in FNA-positive patients. However, US-FNA has only moderate sensitivity, in part because of the collection of nondiagnostic or equivocal specimens. Rapid on-site evaluation for adequacy (ROSE) can improve definitive diagnosis rates but has not been well characterized in this setting. METHODS One hundred thirty-three patients with breast carcinoma were identified who underwent 136 US-FNAs of axillary lymph nodes, all with ROSE, and the results were correlated with the diagnosis on a subsequent surgical procedure. RESULTS The adequacy rate was 95.6% (130 of 136 FNAs), and a definitive diagnosis was made in 91.2% (124 of 136 FNAs). Among definite diagnoses, sensitivity was 75%, specificity was 100%, the positive predictive value was 100%, and the negative predictive value was 79%. Sources of false-negative and potential false-positive diagnoses were evaluated among these cases and in the literature. CONCLUSIONS Small metastasis size is the most common cause of false-negative results, whereas interpretation errors by pathologists are quite rare. ROSE appears to improve adequacy and definitive diagnosis rates and, thus, can more accurately triage patients to appropriate care.
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Affiliation(s)
- Adele D Fung
- Department of Pathology, University of Maryland School of Medicine and University of Maryland Medical Center, Baltimore, Maryland
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29
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Alexiev BA, Papadimitriou JC, Chai TC, Ramos E, Staats PN, Drachenberg CB. Polyomavirus (BK)-associated pleomorphic giant cell carcinoma of the urinary bladder: a case report. Pathol Res Pract 2013; 209:255-9. [DOI: 10.1016/j.prp.2013.01.008] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2012] [Revised: 12/11/2012] [Accepted: 01/30/2013] [Indexed: 01/21/2023]
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30
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Alexiev BA, Staats PN. Erdheim-Chester disease with prominent pericardial effusion. Diagn Cytopathol 2013; 42:530-4. [DOI: 10.1002/dc.22957] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2012] [Accepted: 01/01/2013] [Indexed: 12/29/2022]
Affiliation(s)
- Borislav A. Alexiev
- Department of Pathology; University of Maryland Medical Center; Baltimore Maryland
| | - Paul N. Staats
- Department of Pathology; University of Maryland Medical Center; Baltimore Maryland
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31
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Richard HM, McMillan A, Staats PN, d'Othee BJ. Real-time MR Imaging Guidance for Percutaneous Core Biopsy of US- and CT-negative Lesion. J Vasc Interv Radiol 2012; 23:1539-42. [DOI: 10.1016/j.jvir.2012.07.024] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2012] [Revised: 07/24/2012] [Accepted: 07/26/2012] [Indexed: 11/26/2022] Open
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Sabatine MS, Jaffer FA, Staats PN, Stone JR. Case records of the Massachusetts General Hospital. Case 28-2010. A 32-year-old woman, 3 weeks post partum, with substernal chest pain. N Engl J Med 2010; 363:1164-73. [PMID: 20843252 DOI: 10.1056/nejmcpc1000966] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Marc S Sabatine
- Division of Cardiovascular Medicine, Brigham and Women’s Hospital, and Department of Medicine, Harvard Medical School, Boston, USA
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33
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Sabin TD, Jednacz JA, Staats PN. Case records of the Massachusetts General Hospital. Case 26-2008. A 26-year-old woman with headache and behavioral changes. N Engl J Med 2008; 359:842-53. [PMID: 18716302 DOI: 10.1056/nejmcpc0804644] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Thomas D Sabin
- Department of Neurology, Tufts Medical Center, Boston, USA
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Abstract
Vaginal adenocarcinoma is the second most common primary cancer of the vagina, yet there has been very little study of most subtypes other than clear cell carcinoma. We reviewed 18 cases of primary vaginal endometrioid adenocarcinoma, in our experience the second most common subtype. The patients ranged from 45 to 81 years of age (mean 60). Most presented with vaginal bleeding, and had had a prior hysterectomy. Five had a history of unopposed estrogen therapy but none had a history of intrauterine diethylstilbestrol exposure. The tumors were at the vaginal apex in 10 cases, in the posterior wall in 3, the lateral wall in 3, and the anterior wall in 1. On microscopic examination, each of the tumors had a pure or predominant component of typical endometrioid adenocarcinoma. There was squamous metaplasia in 4 cases, mucinous metaplasia in 4, and prominent nonvillous papillae in 2. The tumors were grade 1 of 3 in 4 cases, grade 2 in 13, and grade 3 in 1. Eleven cases were FIGO stage I, 5 stage II, and 2 stage IV. Vaginal endometriosis was identified in 14 cases, and is important in indicating a primary vaginal tumor, rather than secondary spread from the endometrium. Other subtypes of adenocarcinoma (such as serous when the tumor has a papillary pattern) and atypical forms of endometriosis, including polypoid endometriosis, are the most common other differential diagnostic considerations. The prognosis seems to be good in low-stage patients, with 11 patients alive and well and 2 alive with recurrent disease.
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Affiliation(s)
- Paul N Staats
- Department of Pathology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USA.
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35
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Staats PN, Jumbelic MI, Dignan CR. Death by compaction in a garbage truck. J Forensic Sci 2002; 47:1065-6. [PMID: 12353548] [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: 02/26/2023]
Abstract
We report on two deaths by compaction in a garbage truck that recently occurred in this county. In both cases, the victim apparently climbed into a recycling dumpster to sleep, and was emptied with the contents of the receptacle into a garbage truck. Subsequent compaction of the victim with the load led to death. We also discuss several similar fatalities that have been reported to the U.S. Consumer Product Safety Commission.
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36
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Kristal BS, Staats PN, Shestopalov AI. Biochemical characterization of the mitochondrial permeability transition in isolated forebrain mitochondria. Dev Neurosci 2000; 22:376-83. [PMID: 11111153 DOI: 10.1159/000017463] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Induction of the mitochondrial permeability transition (PT) has been proposed to contribute to neuronal cell death. Nearly all studies of the biochemistry of PT induction, however, have been conducted in isolated liver mitochondria. To better understand PT induction in brain mitochondria, we used Ficoll gradients to purify nonsynaptosomal mitochondria from the forebrains of male Fischer 344 rats. Incubation of these mitochondria with Ca(2+) was associated with a loss of absorbance. Inorganic phosphate enhanced this loss of absorbance, and the PT inhibitor cyclosporin A reduced it, especially in conjunction with ADP. These findings suggest that Ca(2+)-mediated loss of absorbance resulted from PT induction. Na(+), which enhances mitochondrial Ca(2+) efflux, but stimulates mitochondrial free radical production, had no effect on PT induction. These data confirm the existence of tissue-specific differences in the nature of PT induction.
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Affiliation(s)
- B S Kristal
- Dementia Research Service, Burke Medical Research Institute, White Plains, NY 10605, USA.
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