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Banceu CM, Gurzu S, Satala CB, Ghiga D, Neamtu MH, Voth V, Liebrich M, Suciu H. Histopathological Gap in Aortic Diseases: A Prospective Analysis. Int J Mol Sci 2023; 24:15470. [PMID: 37895149 PMCID: PMC10607681 DOI: 10.3390/ijms242015470] [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: 09/04/2023] [Revised: 10/08/2023] [Accepted: 10/16/2023] [Indexed: 10/29/2023] Open
Abstract
Aortic dissection (AD) is a critical cardiovascular condition with the potential for devastating consequences. This study evaluated the histological changes in the aorta wall in patients with AD and aortic aneurysm (AA) who received surgical aortic replacement. Histopathological data showed that modifications of the media layer (p = 0.0197), myxomatous aspect (p = 0.0001), and subendothelial layer degeneration (p = 0.0107) were more frequently seen in AA versus AD samples. Patients with AA were approximately twice as likely to develop histological changes than those with AD (p = 0.0037). Patients with moderate or severe medial degeneration had a higher chance of developing AD (p = 0.0001). Because the histopathological score proved to be a predictor of both in-hospital and overall mortality, its evaluation should become the standard of care in any patients who undergo aortic replacement. Individualized postoperative management might be influenced by the histopathological aspect of the aortic layer.
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Affiliation(s)
- Cosmin Marian Banceu
- I.O.S.U.D., George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 540139 Targu Mures, Romania;
- Department of Surgery M3, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 540139 Targu Mures, Romania;
- Emergency Institute for Cardiovascular Diseases and Transplantation Targu Mures, 540136 Targu Mures, Romania
| | - Simona Gurzu
- Department of Pathology, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 540139 Targu Mures, Romania;
- Research Center for Oncopathology and Translational Medicine (CCOMT), George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 540142 Targu Mures, Romania
- Romanian Academy of Medical Sciences, 030167 Bucharest, Romania
| | - Catalin-Bogdan Satala
- Department of Pathology, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 540139 Targu Mures, Romania;
| | - Dana Ghiga
- Department of Medical Scientific Research Methodology, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 540139 Targu Mures, Romania;
| | - Mihai Halic Neamtu
- Swiss Federal Institute of Forest, Snow and Landscape Research WSL, 8903 Birmensdorf, Switzerland;
- Institute of Environmental Engineering, ETH Zurich, 8039 Zurich, Switzerland
| | - Vladimir Voth
- Sana Cardiac Surgery, Herdweg 2, 70174 Stuttgart, Germany; (V.V.); (M.L.)
| | - Markus Liebrich
- Sana Cardiac Surgery, Herdweg 2, 70174 Stuttgart, Germany; (V.V.); (M.L.)
| | - Horatiu Suciu
- Department of Surgery M3, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 540139 Targu Mures, Romania;
- Emergency Institute for Cardiovascular Diseases and Transplantation Targu Mures, 540136 Targu Mures, Romania
- Romanian Academy of Medical Sciences, 030167 Bucharest, Romania
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Făgărășan A, Gurzu S, Satala CB, Hagău AC. The Importance of Aortic Valve Bicuspid Phenotype in Valvular Evolution in Pediatric Patients: A Case Report and Literature Mini-Review. Int J Mol Sci 2023; 24:14027. [PMID: 37762329 PMCID: PMC10531046 DOI: 10.3390/ijms241814027] [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: 07/24/2023] [Revised: 09/09/2023] [Accepted: 09/11/2023] [Indexed: 09/29/2023] Open
Abstract
Bicuspid aortic valve (BAV) is the most commonly encountered congenital malformation in the pediatric population, associated with aortic leaflet degeneration and aortopathy. However, studies on BAV and its complications in children are limited. We present the case of a 16-year-old with type 1B BAV with a raphe with fusion between the right and non-coronary cusps who exhibited severe aortic stenosis, regurgitation, and progressive dilatation of the ascending aorta. Surgical intervention, including aortic valve and aortic root replacement, was performed due to the patient's deteriorating condition. Histopathological examination revealed degenerative changes and calcifications in the aortic valve and mucoid fibrosis in the ascending aorta. The results are consistent with BAV patients being predisposed to aortic stenosis and regurgitation due to increased mechanical stress and hemodynamic abnormalities. Although more common in adults and a rare complication in pediatric patients, calcification was previously observed concurrently with rapid valve degeneration in our daily practice. Further studies are needed to improve our understanding of the mechanisms underlying BAV-related complications and refine treatment strategies for pediatric patients.
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Affiliation(s)
- Amalia Făgărășan
- Department of Pediatrics III, Faculty of Medicine, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Targu Mures, 540136 Targu Mures, Romania
- Department of Pediatric Cardiology, Emergency Institute for Cardiovascular Diseases and Transplantation of Târgu Mureș, 540136 Targu Mures, Romania
| | - Simona Gurzu
- Department of Pathology, Clinical County Emergency Hospital, 540136 Targu Mures, Romania
- Department of Pathology, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Targu Mures, 540142 Targu Mures, Romania
| | - Catalin-Bogdan Satala
- Department of Pathology, Clinical County Emergency Hospital, 540136 Targu Mures, Romania
- Department of Pathology, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Targu Mures, 540142 Targu Mures, Romania
| | - Asmaa Carla Hagău
- Department of Pediatric Cardiology, Emergency Institute for Cardiovascular Diseases and Transplantation of Târgu Mureș, 540136 Targu Mures, Romania
- Doctoral School of Medicine and Pharmacy, I.O.S.U.D., George Emil Palade University of Medicine, Pharmacy, Science and Technology of Targu Mures, 540136 Targu Mures, Romania
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Bereczki-Temistocle D, Jung I, Gurzu S, Kovacs Z, Chiciudean R, Ormenisan A, Banias L. HPV disrupt the cytoskeleton in oral squamous cell carcinomas from non-oropharyngeal sites via the E-cadherin/Mena/SMA pathway. Pathol Res Pract 2023; 249:154723. [PMID: 37544131 DOI: 10.1016/j.prp.2023.154723] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 07/19/2023] [Accepted: 07/26/2023] [Indexed: 08/08/2023]
Abstract
In this paper, we aimed to evaluate the mechanism of actin cytoskeleton disruption, in oral squamous cell carcinoma (OSCC). A total of 43 patients with surgically resected OSCCs located in non-oropharyngeal regions were randomly selected. The expression of E-cadherin, β-catenin, smooth muscle actin (SMA), Mena, maspin, V-set and immunoglobulin domain containing 1 (VSIG1), β human chorionic gonadotropin (βhCG), and angiotensin-converting enzyme (ACE) was assessed via immunohistochemistry (IHC) and evaluated in association with the prevalence of high-risk human papillomavirus (HPV). Mena positivity (n = 30; 69.77%) was more frequent in poorly differentiated OSCC of the tongue and lips with high-risk HPV viral DNA and a lymph node ratio (LNR) ≤ 2.5. Loss of E-cadherin was more prevalent among poorly differentiated stage pT4N1 tumors with an LNR ≤ 2.5 and perineural invasion. These cases were classified as SMA-high tumors. Independent negative prognostic factors included high Mena expression, loss of E-cadherin, high SMA expression, and the presence of high-risk HPV. No VSIG1 positivity was observed. In conclusion, in non-oropharyngeal OSCC, cytoskeleton activity might be driven by the Mena/E-cadherin/SMA axis, reflecting active epithelial-mesenchymal interaction. High Mena intensity is an indicator of poorly differentiated carcinomas with high-risk HPV and unfavorable prognosis.
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Affiliation(s)
- Despina Bereczki-Temistocle
- Department of Pathology, George Emil Palade University of Medicine, Pharmacy, Science and Technology, Targu-Mures, Romania; Department of Oral and Maxillo-Facial Surgery, George Emil Palade University of Medicine, Pharmacy, Science and Technology, Targu-Mures, Romania
| | - Ioan Jung
- Department of Pathology, George Emil Palade University of Medicine, Pharmacy, Science and Technology, Targu-Mures, Romania
| | - Simona Gurzu
- Department of Pathology, George Emil Palade University of Medicine, Pharmacy, Science and Technology, Targu-Mures, Romania; Research Center of Oncopathology and Translational Medicine (CCOMT), George Emil Palade University of Medicine, Pharmacy, Science and Technology, Targu-Mures, Romania.
| | - Zsolt Kovacs
- Research Center of Oncopathology and Translational Medicine (CCOMT), George Emil Palade University of Medicine, Pharmacy, Science and Technology, Targu-Mures, Romania; Department of Biochemistry, George Emil Palade University of Medicine, Pharmacy, Science and Technology, Targu-Mures, Romania
| | - Rebeca Chiciudean
- Department of Pathology, George Emil Palade University of Medicine, Pharmacy, Science and Technology, Targu-Mures, Romania
| | - Alina Ormenisan
- Department of Oral and Maxillo-Facial Surgery, George Emil Palade University of Medicine, Pharmacy, Science and Technology, Targu-Mures, Romania
| | - Laura Banias
- Department of Pathology, George Emil Palade University of Medicine, Pharmacy, Science and Technology, Targu-Mures, Romania
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Lupu VV, Beşer ÖF, Gurzu S, Stefanescu G, Starcea IM, Adam Raileanu A, Popp A, Lupu A. Pediatric Gastroenterology Research. Life (Basel) 2023; 13:1810. [PMID: 37763214 PMCID: PMC10532566 DOI: 10.3390/life13091810] [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] [Received: 07/17/2023] [Revised: 08/09/2023] [Accepted: 08/23/2023] [Indexed: 09/29/2023] Open
Abstract
For several decades, before the 19th century, pediatric pathology was considered to be an annex of adult pathology and treated as a secondary matter in medical practice [...].
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Affiliation(s)
- Vasile Valeriu Lupu
- Department of Pediatrics, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Ömer Faruk Beşer
- Department of Pediatric Gastroenterology, Hepatology, and Nutrition, Cerrahpasa Medical Faculty, Istanbul University Cerrahpasa, Istanbul 34776, Turkey
| | - Simona Gurzu
- Department of Pathology, George Emil Palade University of Medicine, Pharmacy, Science and Technology, 540012 Targu Mures, Romania
| | - Gabriela Stefanescu
- Department of Gastroenterology, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Iuliana Magdalena Starcea
- Department of Pediatrics, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Anca Adam Raileanu
- Department of Pediatrics, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Alina Popp
- Department of Pediatrics, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Ancuta Lupu
- Department of Pediatrics, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
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Stefan-van Staden RI, Bratei AA, Ilie-Mihai RM, Gheorghe DC, Tuchiu BM, Gurzu S. Bioanalysis of MMR and KRAS - a key factor in diagnosis of colorectal cancer. RSC Adv 2023; 13:24086-24092. [PMID: 37577090 PMCID: PMC10415748 DOI: 10.1039/d3ra04260j] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Accepted: 08/06/2023] [Indexed: 08/15/2023] Open
Abstract
Two miniaturized electrochemical devices were designed for the simultaneous bioanalysis of MMR (MLH1, MSH2, MSH6, PMS2), and of KRAS in whole blood, urine, saliva, and tumoral tissues. The devices comprised besides the electronic part of the potentiostat a combined 3D stochastic microsensor (combined microplatform) with the sensing part based on the modification of graphene decorated with nitrogen, sulfur and boron (NSB-EGR) modified with two types of frutafit: FTEX and FHD. For the assay of MSH2, MSH6, KRAS, and PMS2 higher sensitivities were recorded when the microdevice based on FHD was used, while for the assay of MLH1 the best sensitivity was achieved by using the microdevice based on FTEX. While the limits of quantification for MLH1, MSH2, and PMS2 were not influenced by the modifier, the microdevice based on FHD provided the lowest limit of quantification for KRAS, the microdevice based on FTEX provided the lowest limit of quantification for MSH6. The validation tests performed proved that recoveries of MLH1, MSH2, MSH6, PMS2, and of KRAS in whole blood, urine, saliva, and tumoral tissues higher than 98.50% with RSD (%) values lower than 0.10% were recorded.
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Affiliation(s)
- Raluca-Ioana Stefan-van Staden
- Laboratory of Electrochemistry and PATLAB, National Institute of Research for Electrochemistry and Condensed Matter 202 Splaiul Independentei Str. 060021 Bucharest-6 Romania +40213163113 +40751507779
- Faculty of Chemical Engineering and Biotechnologies, Politehnica University of Bucharest Bucharest Romania
| | - Alexandru Adrian Bratei
- Laboratory of Electrochemistry and PATLAB, National Institute of Research for Electrochemistry and Condensed Matter 202 Splaiul Independentei Str. 060021 Bucharest-6 Romania +40213163113 +40751507779
- Faculty of Chemical Engineering and Biotechnologies, Politehnica University of Bucharest Bucharest Romania
- Department of Pathology, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology Targu-Mures Romania
| | - Ruxandra-Maria Ilie-Mihai
- Laboratory of Electrochemistry and PATLAB, National Institute of Research for Electrochemistry and Condensed Matter 202 Splaiul Independentei Str. 060021 Bucharest-6 Romania +40213163113 +40751507779
| | - Damaris-Cristina Gheorghe
- Laboratory of Electrochemistry and PATLAB, National Institute of Research for Electrochemistry and Condensed Matter 202 Splaiul Independentei Str. 060021 Bucharest-6 Romania +40213163113 +40751507779
| | - Bianca Maria Tuchiu
- Laboratory of Electrochemistry and PATLAB, National Institute of Research for Electrochemistry and Condensed Matter 202 Splaiul Independentei Str. 060021 Bucharest-6 Romania +40213163113 +40751507779
| | - Simona Gurzu
- Department of Pathology, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology Targu-Mures Romania
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Fülöp AC, Serac G, Gurzu S. Detection of Hepatic Metastasis in Colorectal Cancer: A Comparative Case Report of 18F-FDG PET-CT and Diffusion-Weighted MRI with a b Value of 1000. J Belg Soc Radiol 2023; 107:52. [PMID: 37457674 PMCID: PMC10348067 DOI: 10.5334/jbsr.3186] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 06/19/2023] [Indexed: 07/18/2023] Open
Abstract
Detection of hepatic metastasis from colorectal cancer remains a clinical challenge. In this case report, we present a 66-year-old male patient with a rectal carcinoma who underwent 18F-FDG PET-CT for staging, which revealed one hepatic metastasis. Abdominal magnetic resonance imaging (MRI) with diffusion-weighted sequence with a b value of 1000 was performed, which identified a second metastasis of the liver. Teaching Point This case report illustrates that, in some patients, diffusion-weighted MRI with a b value of 1000 might be a more sensitive technique for detecting small hepatic metastases than 18F-FDG PET-CT.
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Affiliation(s)
- Andrei-Cristian Fülöp
- Department of Radiology and Imaging, George Emil Palade University of Medicine, Pharmacy, Science and Technology, Targu Mures, Romania
| | - Gabriel Serac
- Department of Surgery, George Emil Palade University of Medicine, Pharmacy, Science and Technology, Targu Mures, Romania
| | - Simona Gurzu
- Department of Pathology, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology, Targu Mures, Romania
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Gurzu S. Molecular Diagnostics, Pathology and Biomarkers of Gastrointestinal Neoplasms. Int J Mol Sci 2023; 24:11136. [PMID: 37446314 DOI: 10.3390/ijms241311136] [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] [Received: 06/27/2023] [Accepted: 07/03/2023] [Indexed: 07/15/2023] Open
Abstract
This Special Issue aims to highlight the advances made regarding the molecular profile of digestive system tumors in experimental and clinical studies [...].
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Affiliation(s)
- Simona Gurzu
- Department of Pathology, George Emil Palade University of Medicine, Pharmacy, Science and Technology, 38 Gheorghe Marinescu Street, 540139 Targu Mures, Romania
- Research Center of Oncopathology and Transdisciplinary Research (CCOMT), George Emil Palade University of Medicine, Pharmacy, Science and Technology, 540139 Targu Mures, Romania
- Romanian Academy of Medical Sciences, 540139 Targu Mures, Romania
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Manirakiza F, Yamada H, Iwashita Y, Ishino K, Ishikawa R, Kovacs Z, Osvath E, Nzitakera A, Gurzu S, Sugimura H. TP53 mutations in Romanian patients with colorectal cancer. Genes Environ 2023; 45:20. [PMID: 37391803 DOI: 10.1186/s41021-023-00277-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 06/05/2023] [Indexed: 07/02/2023] Open
Abstract
BACKGROUND Colorectal cancer (CRC) has been ranked as the second most deadly cancer and the third most diagnosed cancer cases for the year 2020. Specifically for Romania, the number of CRC-related deaths in 2019 was estimated at 6307 people, with a standardized mortality rate of 33.8 per 100,000 inhabitants. Although the tumor protein 53 (TP53) gene is intensively studied, there are few data on TP53 mutations in Romanian CRC. Furthermore, since genetic alterations may show geographical differences, our study aimed to analyze the clinical status and TP53 somatic variation in Romanian CRC patients. SUBJECTS AND METHODS DNA from 40 randomly selected cases of CRC was extracted from formalin-fixed paraffin-embedded tissues and sequenced using direct Sanger sequencing techniques, and variants were annotated according to the recommendations of the Human Genome Variation Society. Novel variants were analyzed using MutationTaster2021 to predict their effects. RESULTS The mean age was 63.6 years (range 33-85 years) with a male to female ratio of 2.3. More than 45% (18/40) had an advanced cancer stage (≥ stage III). Mutations were found in 21/40 cases (52.5%), with one case having two mutations, giving a total of twenty-two mutations in the TP53 coding DNA. These mutations include 3 (13.6%) insertion-deletion mutations, two of which are novel frameshift mutations: c.165delT (in exon 4) and c.928_935dup (in exon 9), both of which are predicted to lead to nonsense-mediated mRNA decay and are classified as deleterious. The remaining 19 (86.36%) were substitution mutations: 1 nonsense and 18 (81.8%) missense mutations, with G > A (n = 7/19; 36.8%) and C > T (n = 6/19; 31.5%) transitions being the most common. The G > T transversion was found in 21.05% (4/19) of the substitution mutations. CONCLUSION We have described two novel frameshift mutations in TP53. The discovery of novel mutations following the efforts of The Cancer Genome Atlas and other large-scale cancer genome sequencing projects may be further evidence of the heterogeneous nature of mutations in cancer and may indicate that the identification of carcinogenic mutations is not yet saturated. Further sequencing is therefore needed, especially in less studied populations. Importantly, consideration of their geographical environment will shed light on population-specific carcinogenesis.
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Affiliation(s)
- Felix Manirakiza
- Department of Tumor Pathology, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-Ku, Shizuoka, 431-3192, Japan
- Department of Pathology, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, P.O. Box 3286, Kigali, Rwanda
| | - Hidetaka Yamada
- Department of Tumor Pathology, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-Ku, Shizuoka, 431-3192, Japan
| | - Yuji Iwashita
- Department of Tumor Pathology, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-Ku, Shizuoka, 431-3192, Japan
| | - Keiko Ishino
- Department of Tumor Pathology, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-Ku, Shizuoka, 431-3192, Japan
| | - Rei Ishikawa
- Department of Tumor Pathology, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-Ku, Shizuoka, 431-3192, Japan
| | - Zsolt Kovacs
- Research Center of Oncopathology and Translational Research (CCOMT), George Emil Palade University of Medicine, Pharmacy, Science and Technology, Targu-Mures, 540139, Romania
| | - Eva Osvath
- Department of Pathology, George Emil Palade University of Medicine, Pharmacy, Science and Technology, Targu-Mures, 540139, Romania
| | - Augustin Nzitakera
- Department of Tumor Pathology, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-Ku, Shizuoka, 431-3192, Japan
- Department of Biomedical Laboratory Sciences, School of Health Sciences, College of Medicine and Health Sciences, University of Rwanda, P.O. Box 3286, Kigali, Rwanda
| | - Simona Gurzu
- Research Center of Oncopathology and Translational Research (CCOMT), George Emil Palade University of Medicine, Pharmacy, Science and Technology, Targu-Mures, 540139, Romania
- Department of Pathology, George Emil Palade University of Medicine, Pharmacy, Science and Technology, Targu-Mures, 540139, Romania
| | - Haruhiko Sugimura
- Department of Tumor Pathology, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-Ku, Shizuoka, 431-3192, Japan.
- Sasaki Institute, Sasaki Foundation, 2-2, Kanda Surugadai, Chiyoda-ku, Tokyo, 101-0062, Japan.
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Satala CB, Kovacs Z, Bara T, Jung I, Gurzu S. Signet-Ring Cell Squamous Cell Carcinoma: A Biphenotypic Neoplasm of the Gastro-Esophageal Junction with Uncertain Biological Potential: Case Report and Literature Review. Int J Mol Sci 2023; 24:ijms24119535. [PMID: 37298485 DOI: 10.3390/ijms24119535] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 05/27/2023] [Accepted: 05/28/2023] [Indexed: 06/12/2023] Open
Abstract
The signet-ring cell variant of squamous cell carcinoma (SCC) is an extremely rare histological subtype, with only 24 cases (including the present case) reported in the Medline database: 15 affecting the external surface of the body, 3 in the lung, 2 affecting the uterine cervix, 1 involving the gingiva, another one affecting the esophagus and the present case that is the first reported at the gastro-esophageal junction (GEJ). In one case, the location of the lesion was not mentioned. A 59-year-old male patient underwent segmental eso-gastrectomy for carcinoma of the GEJ. The microscopic examination showed a pT3N1-staged SCC composed of solid nests admixed in over 30% of the tumor, with cells having eccentrically located nuclei and clear vacuolated cytoplasm. The signet-ring cells did not show mucinous secretion and were positive for keratin 5/6 and vimentin, with nuclear expression of β-catenin and Sox2 and focal membrane positivity for E-cadherin. Based on these features, the case was considered a signet-ring SCC with epithelial-mesenchymal transition. Thirty-one months after surgery, the patient was disease-free, with no local recurrence and no known distant metastases. In SCC, a signet-ring cell component might be an indicator of the dedifferentiation of tumor cells towards a mesenchymal molecular subtype.
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Affiliation(s)
- Catalin Bogdan Satala
- Department of Pathology, George Emil Palade University of Medicine, Pharmacy, Science and Technology, 540012 Targu Mures, Romania
- Department of Pathology, Clinical County Emergency Hospital, 540136 Targu Mures, Romania
| | - Zsolt Kovacs
- Department of Pathology, George Emil Palade University of Medicine, Pharmacy, Science and Technology, 540012 Targu Mures, Romania
- Department of Pathology, Clinical County Emergency Hospital, 540136 Targu Mures, Romania
- Research Center for Oncopathology and Translational Medicine (CCOMT), George Emil Palade University of Medicine, Pharmacy, Science and Technology, 540136 Targu Mures, Romania
| | - Tivadar Bara
- Department of General Surgery, Clinical County Emergency Hospital, 540136 Targu Mures, Romania
| | - Ioan Jung
- Department of Pathology, George Emil Palade University of Medicine, Pharmacy, Science and Technology, 540012 Targu Mures, Romania
| | - Simona Gurzu
- Department of Pathology, George Emil Palade University of Medicine, Pharmacy, Science and Technology, 540012 Targu Mures, Romania
- Department of Pathology, Clinical County Emergency Hospital, 540136 Targu Mures, Romania
- Research Center for Oncopathology and Translational Medicine (CCOMT), George Emil Palade University of Medicine, Pharmacy, Science and Technology, 540136 Targu Mures, Romania
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Satala CB, Jung I, Gurzu S. Mucin-Phenotype and Expression of the Protein V-Set and Immunoglobulin Domain Containing 1 (VSIG1): New Insights into Gastric Carcinogenesis. Int J Mol Sci 2023; 24:ijms24108697. [PMID: 37240039 DOI: 10.3390/ijms24108697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 05/07/2023] [Accepted: 05/11/2023] [Indexed: 05/28/2023] Open
Abstract
In gastric cancer (GC), intestinal metaplasia (IM) is a common precursor lesion, but its relationship to the MUC2/MUC5AC/CDX2 axis is not completely understood. Although V-set and immunoglobulin domain containing 1 (VSIG1) is supposed to be a specific marker for gastric mucosa and GC, respectively, no data about its relationship with IM or mucin phenotype have been published. The aim of our study was to explore the possible linkage between IM and these four molecules. The clinicopathological features of 60 randomly selected GCs were examined in association with VSIG1, MUC2, MUC5AC and CDX2. Two online database platforms were also used to establish the transcription factors (TFs) network involved in MUC2/MUC5AC/CDX2 cascade. IM was more frequently encountered in females (11/16 cases) and in patients below 60 years old (10/16 cases). Poorly differentiated (G3) carcinomas tended to show a loss of CDX2 (27/33 cases) but not of MUC2 and MUC5AC. MUC5AC and CDX2 were lost in parallel with the depth of invasion of the pT4 stage (28/35 and 29/35 cases), while an advanced Dukes-MAC-like stage was only correlated with CDX2 and VSIG1 loss (20/37 and 30/37 cases). VSIG1 was directly correlated with MUC5AC (p = 0.04) as an indicator of gastric phenotype. MUC2-negative cases showed a propensity towards lymphatic invasion (37/40 cases) and distant metastases, while CDX2-negative cases tended to associate with hematogenous dissemination (30/40 cases). Regarding the molecular network, only 3 of the 19 TFs involved in this carcinogenic cascade (SP1, RELA, NFKB1) interacted with all targeted genes. In GC, VSIG1 can be considered an indicator of gastric phenotype carcinomas, where carcinogenesis is mainly driven by MUC5AC. Although infrequently encountered in GC, CDX2 positivity might indicate a locally advanced stage and risk for vascular invasion, especially in tumors developed against the background of IM. The loss of VSIG1 indicates a risk for lymph node metastases.
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Affiliation(s)
- Catalin-Bogdan Satala
- Department of Pathology, George Emil Palade University of Medicine, Pharmacy, Science and Technology, 540142 Targu Mures, Romania
- Department of Pathology, Clinical County Emergency Hospital, 540136 Targu Mures, Romania
| | - Ioan Jung
- Department of Pathology, George Emil Palade University of Medicine, Pharmacy, Science and Technology, 540142 Targu Mures, Romania
| | - Simona Gurzu
- Department of Pathology, George Emil Palade University of Medicine, Pharmacy, Science and Technology, 540142 Targu Mures, Romania
- Department of Pathology, Clinical County Emergency Hospital, 540136 Targu Mures, Romania
- Research Center for Oncopathology and Translational Medicine (CCOMT), George Emil Palade University of Medicine, Pharmacy, Science and Technology, 540136 Targu Mures, Romania
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Natsume H, Szczepaniak K, Yamada H, Iwashita Y, Gędek M, Šuto J, Kasajima R, Manirakiza F, Nzitakera A, Ishikawa R, Rutaganda E, Ngabonziza F, Seminega B, Kamali P, Dusabejambo V, Rugwizangoga B, Nobuhito N, Wang Y, Miyagi Y, Gurzu S, Sugimura H. Abstract 2609: Non-CpG sites preference in G:C>A:T transition of TP53 in gastric cancer of Eastern Europe (Poland, Romania and Hungary) compared to East Asian countries (China and Japan) : gastric cancer in the world, mutation spectrum revisited. Cancer Res 2023. [DOI: 10.1158/1538-7445.am2023-2609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2023]
Abstract
Abstract
Aim: Mutation spectrum of TP53 in gastric cancer (GC) has been investigated world-widely, but a comparison of mutation spectrum among GCs from various regions in the world are still sparsely documented. In order to identify the difference of TP53 mutation spectrum in GCs in Eastern Europe and in East Asia, we sequenced TP53 in GCs from Eastern Europe, Lujiang (China), and Yokohama, Kanagawa (Japan) and identified the feature of TP53 mutations of GC in these regions.
Subjects and Method: In total, 689 tissue samples of GC were analyzed: 288 samples from East European populations (25 from Hungary, 71 from Poland and 192 from Romania), 268 from Yokohama, Kanagawa, Japan and 133 from Lujiang, Anhui province, China. DNA was extracted from FFPE tissue of Chinese, East European cases; and from frozen tissue of Japanese GCs. PCR products were direct-sequenced by Sanger method, and in ambiguous cases, PCR product was cloned and up to 8 clones were sequenced. We used No. NC_000017.11(hg38) as the reference sequence of TP53. Mutation patterns were categorized into nine groups: six base substitutions, insertion, deletion and deletion-insertion. Within G:C>A:T mutations the mutations in CpG and non-CpG sites were divided. Furthermore, 40 cases of Rwanda GC were compared in the world for mutation spectrum. The Cancer Genome Atlas data (TCGA, ver.R20, July, 2019) having somatic mutation list of GCs from Whites, Asians, and other ethnicities were used as a reference for our data.
Results: The most frequent base substitutions were G:C>A:T transition in all the areas investigated. The G:C>A:T transition in non-CpG sites were prominent in East European GCs, compared with Asian ones. Mutation pattern from TCGA data revealed the same trend between GCs from White (TCGA category) vs Asian countries. Chinese and Japanese GCs showed higher ratio of G:C>A:T transition in CpG sites and A:T>G:C mutation was more prevalent in Asian countries.
Conclusion: The divergence in mutation spectrum of GC in different areas in the world may reflect various pathogeneses and etiologies of GC, region to region. Diversified mutation spectrum in GC in Eastern Europe may suggest GC in Europe has different carcinogenic pathway of those from Asia. Whether the Rwanda pattern belong to Asian or East European would be interesting.
Citation Format: Hiroko Natsume, Kinga Szczepaniak, Hidetaka Yamada, Yuji Iwashita, Marta Gędek, Jelena Šuto, Rika Kasajima, Felix Manirakiza, Augustin Nzitakera, Rei Ishikawa, Eric Rutaganda, François Ngabonziza, Benoit Seminega, Placide Kamali, Vincent Dusabejambo, Belson Rugwizangoga, Nobuhito Nobuhito, Yaping Wang, Yohei Miyagi, Simona Gurzu, Haruhiko Sugimura. Non-CpG sites preference in G:C>A:T transition of TP53 in gastric cancer of Eastern Europe (Poland, Romania and Hungary) compared to East Asian countries (China and Japan) : gastric cancer in the world, mutation spectrum revisited [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 2609.
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Affiliation(s)
- Hiroko Natsume
- 1Hamamatsu University School of Medicine, Hamamatsu, Japan
| | | | | | - Yuji Iwashita
- 1Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Marta Gędek
- 3Medical University of Lublin, Lublin, Poland
| | - Jelena Šuto
- 4Clinical Hospital Centre Split, Split, Croatia
| | - Rika Kasajima
- 5Kanagawa Cancer Center Research Institute, Yokohama, Japan
| | | | | | - Rei Ishikawa
- 1Hamamatsu University School of Medicine, Hamamatsu, Japan
| | | | | | | | | | | | | | | | - Yaping Wang
- 7Nanjing University School of Medicine, Nanjing, China
| | - Yohei Miyagi
- 5Kanagawa Cancer Center Research Institute, Yokohama, Japan
| | - Simona Gurzu
- 8George Emil Palade University of Medicine, Pharmacy, Sciences and Technology, Targu Mures, Targu Mures, Romania
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12
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Natsume H, Szczepaniak K, Yamada H, Iwashita Y, Gędek M, Šuto J, Ishino K, Kasajima R, Matsuda T, Manirakiza F, Nzitakera A, Wu Y, Xiao N, He Q, Guo W, Cai Z, Ohta T, Szekely T, Kadar Z, Sekiyama A, Oshima T, Yoshikawa T, Tsuburaya A, Kurono N, Wang Y, Miyagi Y, Gurzu S, Sugimura H. Non-CpG sites preference in G:C > A:T transition of TP53 in gastric cancer of Eastern Europe (Poland, Romania and Hungary) compared to East Asian countries (China and Japan). Genes Environ 2023; 45:1. [PMID: 36600315 DOI: 10.1186/s41021-022-00257-y] [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: 07/07/2022] [Accepted: 11/23/2022] [Indexed: 01/05/2023] Open
Abstract
AIM Mutation spectrum of TP53 in gastric cancer (GC) has been investigated world-widely, but a comparison of mutation spectrum among GCs from various regions in the world are still sparsely documented. In order to identify the difference of TP53 mutation spectrum in GCs in Eastern Europe and in East Asia, we sequenced TP53 in GCs from Eastern Europe, Lujiang (China), and Yokohama, Kanagawa (Japan) and identified the feature of TP53 mutations of GC in these regions. SUBJECTS AND METHOD In total, 689 tissue samples of GC were analyzed: 288 samples from East European populations (25 from Hungary, 71 from Poland and 192 from Romania), 268 from Yokohama, Kanagawa, Japan and 133 from Lujiang, Anhui province, China. DNA was extracted from FFPE tissue of Chinese, East European cases; and from frozen tissue of Japanese GCs. PCR products were direct-sequenced by Sanger method, and in ambiguous cases, PCR product was cloned and up to 8 clones were sequenced. We used No. NC_000017.11(hg38) as the reference sequence of TP53. Mutation patterns were categorized into nine groups: six base substitutions, insertion, deletion and deletion-insertion. Within G:C > A:T mutations the mutations in CpG and non-CpG sites were divided. The Cancer Genome Atlas data (TCGA, ver.R20, July, 2019) having somatic mutation list of GCs from Whites, Asians, and other ethnicities were used as a reference for our data. RESULTS The most frequent base substitutions were G:C > A:T transition in all the areas investigated. The G:C > A:T transition in non-CpG sites were prominent in East European GCs, compared with Asian ones. Mutation pattern from TCGA data revealed the same trend between GCs from White (TCGA category) vs Asian countries. Chinese and Japanese GCs showed higher ratio of G:C > A:T transition in CpG sites and A:T > G:C mutation was more prevalent in Asian countries. CONCLUSION The divergence in mutation spectrum of GC in different areas in the world may reflect various pathogeneses and etiologies of GC, region to region. Diversified mutation spectrum in GC in Eastern Europe may suggest GC in Europe has different carcinogenic pathway of those from Asia.
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Affiliation(s)
- Hiroko Natsume
- Department of Tumor Pathology, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higasi-ku, Hamamatsu, Shizuoka, 431-3192, Japan
| | - Kinga Szczepaniak
- Department of Tumor Pathology, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higasi-ku, Hamamatsu, Shizuoka, 431-3192, Japan.,Medical University of Warsaw, 1B Banacha Street, Warsaw, Poland
| | - Hidetaka Yamada
- Department of Tumor Pathology, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higasi-ku, Hamamatsu, Shizuoka, 431-3192, Japan.
| | - Yuji Iwashita
- Department of Tumor Pathology, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higasi-ku, Hamamatsu, Shizuoka, 431-3192, Japan
| | - Marta Gędek
- Department of Tumor Pathology, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higasi-ku, Hamamatsu, Shizuoka, 431-3192, Japan.,Medical University of Lublin, ul. Radziwiłłowska 11, wew, 5647, Lublin, Poland
| | - Jelena Šuto
- Department of Tumor Pathology, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higasi-ku, Hamamatsu, Shizuoka, 431-3192, Japan.,Department of Oncology, Clinical Hospital Centre Split, Split, Croatia
| | - Keiko Ishino
- Department of Tumor Pathology, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higasi-ku, Hamamatsu, Shizuoka, 431-3192, Japan
| | - Rika Kasajima
- The Center for Cancer Genome Medicine, Kanagawa Cancer Center, 2-3-2 Nakao, Asahi-ku, Yokohama, Kanagawa, 241-8515, Japan.,Molecular Pathology and Genetics Division, Kanagawa Cancer Center Research Institute, 2-3-2 Nakao, Asahi-ku, Yokohama, 241-8515, Japan
| | - Tomonari Matsuda
- Research Center for Environmental Quality Management, Kyoto University, 1-2 Yumihama, Otsu, Shiga, 520-0811, Japan
| | - Felix Manirakiza
- Department of Tumor Pathology, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higasi-ku, Hamamatsu, Shizuoka, 431-3192, Japan
| | - Augustin Nzitakera
- Department of Tumor Pathology, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higasi-ku, Hamamatsu, Shizuoka, 431-3192, Japan
| | - Yijia Wu
- Lujiang People Hospital, 32 Wenmingzhong Road, Lujiang, Hefei, 231501, China
| | - Nong Xiao
- Jiangsu Key Laboratory of Molecular Medicine, Nanjing University School of Medicine, Nanjing, 210093, China
| | - Qiong He
- Department of Pathology, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, 210003, China
| | - Wenwen Guo
- Jiangsu Key Laboratory of Molecular Medicine, Nanjing University School of Medicine, Nanjing, 210093, China.,Department of Pathology, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, 210003, China
| | - Zhenming Cai
- Jiangsu Key Laboratory of Molecular Medicine, Nanjing University School of Medicine, Nanjing, 210093, China.,Department of Immunology, Key Laboratory of Immune Microenvironment and Diseases, Nanjing Medical University, Nanjing, 211166, China
| | - Tsutomu Ohta
- Department of Tumor Pathology, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higasi-ku, Hamamatsu, Shizuoka, 431-3192, Japan.,Department of Physical Therapy, Faculty of Health and Medical Sciences, Tokoha University, 1230 Miyakoda-cho, Kita-ku, Hamamatsu, Shizuoka, 431-2102, Japan
| | - Tıberiu Szekely
- Department of Pathology, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology, Targu Mures, Ghe Marinescu 38 Street, 540139, Targu Mures, Romania.,Department of Oncology, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology, Targu Mures, Ghe Marinescu 38 Street, 540139, Targu Mures, Romania
| | - Zoltan Kadar
- Department of Oncology, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology, Targu Mures, Ghe Marinescu 38 Street, 540139, Targu Mures, Romania
| | - Akiko Sekiyama
- Department of Clinical Laboratory, Kanagawa Cancer Center, 2-3-2 Nakao, Asahi-ku, Yokohama, Kanagawa, 241-8515, Japan
| | - Takashi Oshima
- Department of Gastrointestinal Surgery, Kanagawa Cancer Center, 2-3-2 Nakao, Asahi-ku, Yokohama, Kanagawa, 241-8515, Japan
| | - Takaki Yoshikawa
- Department of Gastric Surgery, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Akira Tsuburaya
- Department of Surgery, Ozawa Hospital, 1-1-17, Honcho, Odawara, Kanagawa, 250-0012, Japan
| | - Nobuhito Kurono
- Department of Chemistry, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu, Shizuoka, 431-3192, Japan
| | - Yaping Wang
- Jiangsu Key Laboratory of Molecular Medicine, Nanjing University School of Medicine, Nanjing, 210093, China.
| | - Yohei Miyagi
- Molecular Pathology and Genetics Division, Kanagawa Cancer Center Research Institute, 2-3-2 Nakao, Asahi-ku, Yokohama, 241-8515, Japan.
| | - Simona Gurzu
- Department of Pathology, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology, Targu Mures, Ghe Marinescu 38 Street, 540139, Targu Mures, Romania.
| | - Haruhiko Sugimura
- Department of Tumor Pathology, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higasi-ku, Hamamatsu, Shizuoka, 431-3192, Japan. .,Sasaki Foundation Sasaki Institute, 2-2, KandaSurugadai, Chiyoda-ku, Tokyo, 101-0062, Japan.
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Bereczki-Temistocle DL, Gurzu S, Ioan I, Vlad GM, Beresescu G, Ormenisan A. Successful Closure of an Oro-Antral Communication, after Three Previously Failed Attempts, Using Bichat Fat Pad Flap: A Case Report. World J Plast Surg 2023; 12:90-94. [PMID: 37220572 PMCID: PMC10200079 DOI: 10.52547/wjps.12.1.90] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 04/30/2023] [Indexed: 05/25/2023] Open
Abstract
An oro-antral communication represents an abnormal connection between the oral cavity and the maxillary sinus. It occurs most often after tooth extractions, improper implant placement or incorrect management of the sinus lifts. Surgical repair is challenging and most practitioners usually choose the buccal advancement flap, the palatal flap and in some cases the buccal fat pad flap to close the defect. We present a 43 year-old female of a large oro-antral communication and associated chronic sinusitis which was succesfully manged by surgery. Previous interventions including 2 buccal advancement flaps, and a double layer closure using Collagen membrane and buccal advancement flap were unsuccesful. The stepwise intervention consisted on the complete cleaning of the sinus, using the Caldwell Luc technique, followed by the closure of the oro-antral communication using Bichat fat pad flap. The particular aspect was the proper integration of the buccal fat pad flap, after 3 failed attempts, without dehiscence or any other complications. The buccal fat pad flap can be succesfully used for closure of lage oro-antral communications, even when previous methods have failed and local tissue is of poor quality.
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Affiliation(s)
- Despina Luciana Bereczki-Temistocle
- Department of Oral and Maxillo-Facial Surgery, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 540142 Targu Mures, Romania
- IOSUD ´´G. E. Palade´´ University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 540142 Targu Mures, Romania
| | - Simona Gurzu
- Department of Morphopatology George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 540142 Targu Mures, Romania
| | - Ioan Ioan
- Department of Morphopatology George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 540142 Targu Mures, Romania
| | - Golu Mihai Vlad
- Department of Oral and Maxillo-Facial Surgery, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 540142 Targu Mures, Romania
- IOSUD ´´G. E. Palade´´ University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 540142 Targu Mures, Romania
| | - Gabriela Beresescu
- Department of Tooth and Arch Morphology, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Targu Mures, 540142 Targu Mures, Romania
| | - Alina Ormenisan
- Department of Oral and Maxillo-Facial Surgery, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 540142 Targu Mures, Romania
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Wagner A, Gurzu S, Barresi V, Jiang Y. Editorial: Detection and characterization of gastrointestinal (early) cancer. Front Oncol 2022; 12:1089612. [DOI: 10.3389/fonc.2022.1089612] [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] [Received: 11/04/2022] [Accepted: 11/10/2022] [Indexed: 11/22/2022] Open
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Bereczki-Temistocle DL, Gurzu S, Jung I, Cosarca A, Beresescu G, Golu V, Petrovan C, Ormenisan A. Selecting the Best Surgical Treatment Methods in Oro-Antral Communications. Int J Environ Res Public Health 2022; 19:ijerph192114543. [PMID: 36361422 PMCID: PMC9658250 DOI: 10.3390/ijerph192114543] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 11/02/2022] [Accepted: 11/03/2022] [Indexed: 05/31/2023]
Abstract
INTRODUCTION an oro-antral communication is defined as a permanent pathological connection between the maxillary sinus and the septic oral cavity. Several flaps can be used for the closure (buccal flap, palatal flap, combination techniques) but relapses occur often in case of a large defects and underlying general conditions. Bichat fad pad flap is a multipotent pedicled fatty tissue that is easily accessible from the oral cavity that can be used for the closure of medium-sized defects, even in immunocompromised patients due to its stem cell capacity. MATERIALS AND METHODS the medical information of the patients diagnosed with oro-antral communications who were admitted and treated in the Oral and Maxillo-Facial Clinic Targu Mures, between 2013 and 2020 were analyzed. A database containing general information, reported causes, associated diseases, surgical methods used during admission, and relapses, was created. The information was statistically processed. The written consent and ethical approval were obtained. RESULTS the study shows that from a total of 140 cases, 72 were treated using buccal advancement flap, 49 using Bichat fat pad flap, and 19 using palatal flaps. The dimensions of the communications ranged between 0.3 cm and 1.5 cm. Several statistically significant results could be found when comparing the surgical methods. Of the 72 patients treated with buccal advancement flaps, 25 presented relapses as opposed to the patients treated with Bichat fat pad flaps who showed no complications, p < 0.05. Analysing this aspect further, all large defects (10 cases) ranging from 0.6 cm to 1.5 cm treated with advancement buccal flaps (Rehrmann flaps) showed relapses (p < 0.05). Considering the general conditions, out of 7 patients who received radiotherapy 4 presented relapses, as opposed to the healthy patients, p < 0.05. Regarding the reintervention for the relapsed cases, the majority of the cases treated a second time with buccal advancement flap (5 out of 7 cases) failed as opposed to the Bichat fat pad flap with no further relapses (p < 0.05). CONCLUSIONS the most frequently used surgical treatment is the buccal flap, which also has the highest relapse rate. Both primary treatment with Bichat fat-pad flap and re-treatment of relapses using this flap have had 100% success rates, even in patients with general associated conditions, in contrast with patients treated by using the buccal flap. The dimensions of the oro-antral communication and general conditions are crucial factors for the success of the surgical treatment.
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Affiliation(s)
- Despina Luciana Bereczki-Temistocle
- Department of Oral and Maxillo-Facial, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 540142 Targu Mures, Romania
| | - Simona Gurzu
- Department of Morphopatology, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 540142 Targu Mures, Romania
| | - Ioan Jung
- Department of Morphopatology, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 540142 Targu Mures, Romania
| | - Adina Cosarca
- Department of Oral and Maxillo-Facial, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 540142 Targu Mures, Romania
| | - Gabriela Beresescu
- Department of Tooth and Arch Morphology, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Targu Mures, 540142 Targu Mures, Romania
| | - Vlad Golu
- Department of Oral and Maxillo-Facial, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 540142 Targu Mures, Romania
| | - Cecilia Petrovan
- Department of Oral and Maxillo-Facial, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 540142 Targu Mures, Romania
| | - Alina Ormenisan
- Department of Oral and Maxillo-Facial, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 540142 Targu Mures, Romania
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Gurzu S, Kovacs Z, Patrichi A, Jung I. 57P V-set and immunoglobulin domain containing 1 (VSIG1): Gene vs protein expression in colorectal cancer tissue samples. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.10.089] [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: 12/07/2022] Open
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Banias L, Chiciudean R, Jung I, Petrovan C, Kovacs Z, Gurzu S. 59P Prognostic impact of HPV status evaluation in head and neck squamous cell carcinomas. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.09.060] [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: 11/24/2022] Open
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Satala CB, Jung I, Kovacs Z, Stefan-Van Staden RI, Molnar C, Bara T, Patrichi AI, Gurzu S. V-set and immunoglobulin domain containing 1 (VSIG1) as an emerging target for epithelial-mesenchymal transition of gastric cancer. Sci Rep 2022; 12:16241. [PMID: 36171238 PMCID: PMC9519899 DOI: 10.1038/s41598-022-19883-1] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 09/06/2022] [Indexed: 11/09/2022] Open
Abstract
V-set and Immunoglobulin domain containing 1 (VSIG1) is a cell–cell adhesion molecule which role in the genesis and evolution of gastric cancer (GC) is not understood. Only three Medline-indexed papers have focused on the role of VSIG1 in GC. The clinicopathological features of 94 GCs were examined in association with immunohistochemical (IHC) patterns of VSIG1, E-cadherin, and β-catenin which were assessed in the tumor core (central) vs. invasive edge. Cases were classified depending on the VSIG1 expression: membrane/membrane in both core and invasive front; null/negative staining in both core and invasive front; and cases with translocational patterns: membrane core/cytoplasmic buds and cytoplasmic core/null buds. Most of the tumors showed null pattern (n = 54). Cases with translocational patterns (n = 20) were GCs with a high lymph node ratio value (≥ 0.26) and advanced Dukes-MAC-like stage. Of the 20 total cases, 9 showed membrane-to-nuclear translocation of β-catenin and loss of E-cadherin, as indicators of epithelial–mesenchymal transition. All cases with membrane/membrane pattern (n = 20) involved the distal stomach. The poorest overall survival was registered in patients with subcellular translocation of VSIG1, compared to those with either membrane/membrane or null patterns (p = 0.002). In GC, VSIG1 acts as an adhesion membrane protein but its membrane-cytoplasmic translocation can be an indicator of epithelial–mesenchymal transition due to cytoplasmic VSIG1-mediated activation of canonical Wnt/β-catenin signaling pathway.
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Affiliation(s)
- Catalin-Bogdan Satala
- Department of Pathology, George Emil Palade University of Medicine, Pharmacy, Science and Technology, Targu Mures, Romania
| | - Ioan Jung
- Department of Pathology, George Emil Palade University of Medicine, Pharmacy, Science and Technology, Targu Mures, Romania
| | - Zsolt Kovacs
- Department of Biochemistry, George Emil Palade University of Medicine, Pharmacy, Science and Technology, Targu Mures, Romania
| | | | - Calin Molnar
- Department of Surgery, George Emil Palade University of Medicine, Pharmacy, Science and Technology, Targu Mures, Romania
| | - Tivadar Bara
- Department of Surgery, George Emil Palade University of Medicine, Pharmacy, Science and Technology, Targu Mures, Romania
| | - Andrei-Ionut Patrichi
- Department of Pathology, George Emil Palade University of Medicine, Pharmacy, Science and Technology, Targu Mures, Romania.,Research Center for Oncopathology and Translational Medicine (CCOMT), George Emil Palade University of Medicine, Pharmacy, Science and Technology, Targu Mures, Romania
| | - Simona Gurzu
- Department of Pathology, George Emil Palade University of Medicine, Pharmacy, Science and Technology, Targu Mures, Romania. .,Research Center for Oncopathology and Translational Medicine (CCOMT), George Emil Palade University of Medicine, Pharmacy, Science and Technology, Targu Mures, Romania.
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Banias L, Jung I, Chiciudean R, Gurzu S. From Dukes-MAC Staging System to Molecular Classification: Evolving Concepts in Colorectal Cancer. Int J Mol Sci 2022; 23:ijms23169455. [PMID: 36012726 PMCID: PMC9409470 DOI: 10.3390/ijms23169455] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 08/12/2022] [Accepted: 08/18/2022] [Indexed: 11/21/2022] Open
Abstract
This historical review aimed to summarize the main changes that colorectal carcinoma (CRC) staging systems suffered over time, starting from the creation of the classical Duke’s classification, modified Astler–Coller staging, internationally used TNM (T—primary tumor, N—regional lymph nodes’ status, M—distant metastases) staging system, and ending with molecular classifications and epithelial–mesenchymal transition (EMT) concept. Besides currently used staging parameters, this paper briefly presents the author’s contribution in creating an immunohistochemical (IHC)-based molecular classification of CRC. It refers to the identification of three molecular groups of CRCs (epithelial, mesenchymal and hybrid) based on the IHC markers E-cadherin, β-catenin, maspin, and vimentin. Maspin is a novel IHC antibody helpful for tumor budding assessment, which role depends on its subcellular localization (cytoplasm vs. nuclei). The long road of updating the staging criteria for CRC has not come to an end. The newest prognostic biomarkers, aimed to be included in the molecular classifications, exert predictive roles, and become more and more important for targeted therapy decisions.
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Affiliation(s)
- Laura Banias
- Department of Pathology, George Emil Palade University of Medicine, Pharmacy, Science and Technology, 38 Gheorghe Marinescu Street, 540139 Targu Mures, Romania
| | - Ioan Jung
- Department of Pathology, George Emil Palade University of Medicine, Pharmacy, Science and Technology, 38 Gheorghe Marinescu Street, 540139 Targu Mures, Romania
| | - Rebeca Chiciudean
- Department of Pathology, George Emil Palade University of Medicine, Pharmacy, Science and Technology, 38 Gheorghe Marinescu Street, 540139 Targu Mures, Romania
- Correspondence: ; Tel.: +40-745-673550; Fax: +40-265-210407
| | - Simona Gurzu
- Department of Pathology, George Emil Palade University of Medicine, Pharmacy, Science and Technology, 38 Gheorghe Marinescu Street, 540139 Targu Mures, Romania
- Research Center of Oncopathology and Transdisciplinary Research (CCOMT), George Emil Palade University of Medicine, Pharmacy, Science and Technology, 540136 Targu Mures, Romania
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20
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Opris CE, Suciu H, Banias L, Banceu CM, Opris C, Harpa M, Ispas M, Gurzu S. Staphylococcus-induced proliferative glomerulonephritis and cerebral hemorrhage - fatal complications in a young female with postpartum cardiomyopathy and an implanted left ventricular assist device: a case report and review of the literature. Acta Chir Belg 2022; 122:225-232. [PMID: 35075982 DOI: 10.1080/00015458.2022.2033928] [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] [Indexed: 02/08/2023]
Abstract
Background: The continuous-flow left ventricular assist device (CF-LVAD) is used to save the lives of patients in the final stage of congestive heart failure, replacing the pump function of the left ventricle. Although quality of life increases significantly, CF-LVAD-related complications might prove fatal, as in the case presented in this paper.Methods: A 20-year-old female, during her second pregnancy, presented with signs of heart failure. Emergency caesarean section was necessary to save the baby, but peripartum cardiomyopathy developed in the mother. The use of an implantable cardioverter-defibrillator (ICD) was necessary 5 years later. As the clinical progression was unfavorable under medical treatment, with the patient reaching INTERMACS (Interagency Registry for Mechanically Assisted Circulatory Support) Profile 1 (refractory cardiogenic shock), the treatment of choice was the implantation of a CF-LVAD.Results: After 3 years of follow-up (at the age of 28), the patient presented with a positive hemoculture for Staphylococcus aureus. Prolonged antibiotic therapy and attentive follow-up was prescribed. Although an effective antiplatelet and anticoagulant treatment was applied, and despite therapeutic values of prothrombin time and international normalized ratio (INR), the patient died as result of a fatal cerebral hemorrhage. The autopsy also revealed septic emboli, disseminated intravascular coagulation, and focal proliferative glomerulonephritis.Conclusions: Although the benefits of CF-LVAD are significant, bleeding episodes can be severe and LVAD-associated infection can trigger glomerular injury and increase mortality.
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Affiliation(s)
- Carmen Elena Opris
- Department of Adult and Children Cardiovascular Recovery, Emergency Institute for Cardio-Vascular Diseases and Transplantation, Targu Mures, Romania
- Department of Pathology, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology, Targu Mures Romania
| | - Horatiu Suciu
- Department of Adult and Children Cardiovascular Recovery, Emergency Institute for Cardio-Vascular Diseases and Transplantation, Targu Mures, Romania
- Department of Surgery, Emil Palade University of Medicine, Pharmacy, Sciences and Technology, George, Targu Mures Romania
| | - Laura Banias
- Department of Pathology, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology, Targu Mures Romania
| | - Cosmin Marian Banceu
- Department of Adult and Children Cardiovascular Recovery, Emergency Institute for Cardio-Vascular Diseases and Transplantation, Targu Mures, Romania
- Department of Surgery, Emil Palade University of Medicine, Pharmacy, Sciences and Technology, George, Targu Mures Romania
| | - Cosmin Opris
- Department of Adult and Children Cardiovascular Recovery, Emergency Institute for Cardio-Vascular Diseases and Transplantation, Targu Mures, Romania
| | - Marius Harpa
- Department of Adult and Children Cardiovascular Recovery, Emergency Institute for Cardio-Vascular Diseases and Transplantation, Targu Mures, Romania
- Department of Surgery, Emil Palade University of Medicine, Pharmacy, Sciences and Technology, George, Targu Mures Romania
| | - Mihaela Ispas
- Department of Adult and Children Cardiovascular Recovery, Emergency Institute for Cardio-Vascular Diseases and Transplantation, Targu Mures, Romania
| | - Simona Gurzu
- Department of Pathology, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology, Targu Mures Romania
- Research Center of Oncopathology and Translational Medicine, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology, Targu Mures, Romania
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21
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Lazar AE, Gurzu S, Kovecsi A, Perian M, Cordos B, Gherghinescu MC, Enache LS. Cardio Protective Effects of Lipid Emulsion against Ropivacaine-Induced Local Anesthetic Systemic Toxicity—An Experimental Study. J Clin Med 2022; 11:jcm11102784. [PMID: 35628910 PMCID: PMC9142945 DOI: 10.3390/jcm11102784] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Revised: 05/04/2022] [Accepted: 05/13/2022] [Indexed: 11/16/2022] Open
Abstract
Inadvertent intravascular injection of local anesthetics (LA) during regional anesthesia causes Local Anesthetic Systemic Toxicity (LAST). Theories of lipid rescue in the case of LAST proved that the administration of lipids in LAST has beneficial effects. One possible mechanism of action is based on the lipophilic properties of LA which allow plasma-free LA to be bound by the molecules of Lipid Emulsion (LE). The association LA–LE is shuttled towards organs such as liver and the kidneys, and the half-life of LA is shortened. The main objective of this experimental study was to assess the possible cardio-prophylactic effect of LE administration before the induction of LAST by intravenous administration of Ropivacaine. This was an experimental, interventional, prospective, and non-randomized study. The subjects were divided into groups and received, under general anesthesia, LE 20% first 0.3–0.4 mL, followed by 0.1 mL Ropivacaine 2 mg/mL, or Ropivacaine alone. At the end of the experiment, the subjects were sacrificed, and tissue samples of kidney, heart and liver were harvested for histopathological examination. LE, when administered as prophylaxis in Ropivacaine-induced LAST, had protective cardiac effects in rats. The LE known side effects were not produced if the substance was administered in the low doses used for LAST prophylaxis.
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Affiliation(s)
- Alexandra Elena Lazar
- Department of Anesthesiology, Emergency Clinical County Hospital, University of Medicine, Science and Technology “George Emil Palade”, 540136 Tirgu Mures, Romania;
| | - Simona Gurzu
- Department of Morphopathology, Emergency Clinical County Hospital, University of Medicine, Science and Technology “George Emil Palade”, 540136 Tirgu Mures, Romania;
- Correspondence:
| | - Attila Kovecsi
- Department of Morphopathology, Emergency Clinical County Hospital, University of Medicine, Science and Technology “George Emil Palade”, 540136 Tirgu Mures, Romania;
| | - Marcel Perian
- Department of Physiology, University of Medicine, Science and Technology “George Emil Palade”, 540136 Tirgu Mures, Romania;
| | - Bogdan Cordos
- Veterinary Experimental Base, University of Medicine, Science and Technology “George Emil Palade”, 540136 Tirgu Mures, Romania;
| | - Mircea Constantin Gherghinescu
- Department of Surgery, Emergency Clinical County Hospital, University of Medicine, Science and Technology “George Emil Palade”, 540136 Tirgu Mures, Romania;
| | - Liviu Sorin Enache
- Emergency Clinical County Hospital Tirgu Mures, University “Dimitrie Cantemir”, 540136 Tirgu Mures, Romania;
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22
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Gurzu S, Burlacu D, Sánta R, Jung I, Slevin M, Fulop E. Case Report: Coexistence of generalized arterial calcification of infancy (GACI) and maternal infections with cytomegalovirus and Toxoplasma gondii-unexpected fatal complication in a newborn. Front Pediatr 2022; 10:922379. [PMID: 36061401 PMCID: PMC9434010 DOI: 10.3389/fped.2022.922379] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Accepted: 06/15/2022] [Indexed: 11/13/2022] Open
Abstract
Generalized arterial calcification of infancy (GACI) is an extremely rare autosomal recessive condition characterized by the storage of calcium at the level of internal elastic membrane of arteries. The main consequences are intimal fibrous thickening and arterial occlusion. We present the case of a preterm male infant, born from an improperly dispensed pregnancy. At birth, the newborn presented generalized edema and hypotonia, and abolished heart sounds, without response to stimulation. Despite the mechanical ventilation, the infant died 2 h after birth. The death was clinically presumed to be related to the maternal infection with cytomegalovirus (CMV) and Toxoplasma gondii. The infant's mother affirmed the history of 6 previous miscarriages and a non-consanguineous marriage. At autopsy, microscopic examination showed generalized vasculitis secondary to minimal calcification of the large and medium-sized vessels of the lungs, liver, and tongue. These findings supported the diagnosis of GACI. Hydrothorax, non-infective ascites, and necrosis of the brain parenchyma were also associated. The premature infant died due to tonsillar herniation associated with decreased vessel compliance and refractory pulmonary hypertension thus leading to congestive cardiac failure. CMV was not detected on histopathological assessment nor were signs of any other infections. To the best of our knowledge, this is the first case of GACI occurring in a baby from a mother co-infected with CMV and T. gondii.
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Affiliation(s)
- Simona Gurzu
- Department of Pathology, George Emil Palade University of Medicine, Pharmacy, Science and Technology, Târgu Mureş, Romania.,Department of Pathology, Clinical County Emergency Hospital, Târgu Mureş, Romania.,Research Center in Oncology and Translational Medicine (CCOMT), University of Medicine, Pharmacy, Science and Technology, Târgu Mureş, Romania
| | - Diana Burlacu
- Department of Pathology, George Emil Palade University of Medicine, Pharmacy, Science and Technology, Târgu Mureş, Romania.,Department of Pathology, Clinical County Emergency Hospital, Târgu Mureş, Romania
| | - Réka Sánta
- Department of Pediatrics and Neonatology, Clinical County Emergency Hospital, Târgu Mureş, Romania.,Department of Pediatrics, George Emil Palade University of Medicine, Pharmacy, Science and Technology, Târgu Mureş, Romania
| | - Ioan Jung
- Department of Pathology, George Emil Palade University of Medicine, Pharmacy, Science and Technology, Târgu Mureş, Romania
| | - Mark Slevin
- Doctoral School, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu Mures, Târgu Mures, Romania
| | - Emöke Fulop
- Department of Pathology, Clinical County Emergency Hospital, Târgu Mureş, Romania
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23
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Botoncea M, Voidazan S, Orsolya M, Butiurca VO, Gurzu S, Molnar C, Molnar CV. Perioperative complications and short-term outcomes of sacrocolpopexy using self-adhesive mesh. Ann Ital Chir 2022; 92:349-354. [PMID: 34807004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
BACKGROUND AND OBJECTIVES The aim of this study was to investigate the perioperative complications and short-term outcomes of patients who underwent sacrocolpopexy using a self-adhesive mesh. MATERIALS AND METHODS This is a prospective, monocentric study conducted between October 2019 and December 2020. We included 20 consecutive patients on whom sacrocolpopexy using the Parietex ProGripTM Self-Fixating Mesh (Medtronic, Minneapolis, MN, USA) was performed. The patients' demographics, operative data, perioperative complications, and functional and anatomical outcomes were assessed. RESULTS A total of 20 patients were included in this study. The objective cure rate was 95%, and the subjective cure rate was 94.12%. The failure of the surgery was defined as the recurrence of pelvic organ prolapse (POP) ≥ grade II. The preoperative POP quantification classifications were as follows: grade I: 0%; grade II: 70%; grade III: 30%; and grade IV: 0%. There were no mesh-related complications or other intraoperative complications. The postoperative complications included two urinary tract infections, two incisional hernias, and a prolapse recurrence. The mean operative time was 154 ± 37.04 minutes, and the mean hospital stay time was 7 ± 1.12 days. CONCLUSIONS The present study found that the use of the Parietex ProGripTM Self-Fixating Mesh in abdominal sacrocolpopexy was not associated with greater rates of complications. KEY WORDS Pelvic organ prolapse, Sacrocolpopexy, Self-fixating mesh.
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24
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Simu P, Jung I, Banias L, Fulop ZZ, Bara T, Simu I, Andone S, Staden RISV, Satala CB, Halmaciu I, Gurzu S. In-House Validated Map of Lymph Node Stations in a Prospective Cohort of Colorectal Cancer: A Tool for a Better Preoperative Staging. J Oncol 2022; 2022:1788004. [PMID: 35345517 PMCID: PMC8957432 DOI: 10.1155/2022/1788004] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Revised: 02/06/2022] [Accepted: 03/07/2022] [Indexed: 02/05/2023]
Abstract
Preoperative staging of colorectal cancer (CRC) based on imaging techniques such as computed tomography (CT) or magnetic resonance imaging (MRI) is crucial for identification and then removal of the positive lymph nodes (LNs). The aim of this study was to evaluate the correlation between preoperatively seen morphologic criteria (number, size, shape, structure, borders, or enhancement patterns) and histopathological features of LNs using an in-house validated map of nodal stations. A total of 112 patients with CRC that underwent surgery were preoperatively evaluated by CT scans. The locoregional, intermediate, and central LNs were CT-mapped and then removed during open laparotomy and examined under microscope. The analysis of correlations was interpreted using the suspicious-to-positive ratio (SPR) parameter. The greatest correlation was found in tumors located in the sigmoid colon, descending colon and middle rectum; SPR value was 1.12, 1.18, and 1.26, respectively. SPR proved to be 0.59 for cases of the transverse colon. Regarding the enhancement type, the dotted pattern was mostly correlated with metastatic LNs (OR: 7.84; p < 0.0001), while the homogenous pattern proved a reliable indicator of nonmetastatic LNs (OR: 1.99; p < 0.05). A total of 1809 LNs were harvested, with a median value of 15 ± 1.34 LNs/case. Transdisciplinary approach of CRC focused on pre-, intra-, and postoperatively mapping of LNs might increase the accuracy of detecting metastasized nodes for tumors of the distal colon and middle rectum but not for those of the transverse colon. In addition to morphologic criteria, the enhancement pattern of LNs can be used as a predictor of nodal involvement improving the CT-based preoperative staging.
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Affiliation(s)
- Patricia Simu
- 1Department of Radiology and Imaging, Clinical County Emergency Hospital, Targu Mures, Romania
- 2Department of Pathology, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology, Targu Mures, Romania
| | - Ioan Jung
- 2Department of Pathology, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology, Targu Mures, Romania
| | - Laura Banias
- 2Department of Pathology, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology, Targu Mures, Romania
| | - Zsolt Zoltan Fulop
- 3Department of Surgery, George Emil Palade University of Medicine, Pharmacy, Science and Technology, Targu Mures, Romania
| | - Tivadar Bara
- 3Department of Surgery, George Emil Palade University of Medicine, Pharmacy, Science and Technology, Targu Mures, Romania
| | - Iunius Simu
- 1Department of Radiology and Imaging, Clinical County Emergency Hospital, Targu Mures, Romania
| | - Sebastian Andone
- 4Department of Neurology, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology, Targu Mures, Romania
| | - Raluca Ioana Stefan-van Staden
- 5Laboratory of Electrochemistry and PATLAB, National Institute of Research for Electrochemistry and Condensed Matter, Bucharest, Romania
| | - Catalin Bogdan Satala
- 2Department of Pathology, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology, Targu Mures, Romania
| | - Ioana Halmaciu
- 1Department of Radiology and Imaging, Clinical County Emergency Hospital, Targu Mures, Romania
- 6Department of Anatomy, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology, Targu Mures, Romania
| | - Simona Gurzu
- 2Department of Pathology, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology, Targu Mures, Romania
- 7Research Center of Oncopathology and Transdisciplinary Research, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology, Targu Mures, Romania
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Beleaua MA, Jung I, Braicu C, Milutin D, Gurzu S. Relevance of BRAF Subcellular Localization and Its Interaction with KRAS and KIT Mutations in Skin Melanoma. Int J Mol Sci 2021; 22:11918. [PMID: 34769348 PMCID: PMC8584522 DOI: 10.3390/ijms222111918] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 10/31/2021] [Accepted: 11/01/2021] [Indexed: 11/16/2022] Open
Abstract
Although skin melanoma (SKM) represents only one-quarter of newly diagnosed skin malignant tumors, it presents a high mortality rate. Hence, new prognostic and therapeutic tools need to be developed. This study focused on investigating the prognostic value of the subcellular expression of BRAF, KRAS, and KIT in SKM in correlation with their gene-encoding interactions. In silico analysis of the abovementioned gene interactions, along with their mRNA expression, was conducted, and the results were validated at the protein level using immunohistochemical (IHC) stains. For IHC expression, the encoded protein expressions were checked on 96 consecutive SKMs and 30 nevi. The UALCAN database showed no prognostic value for the mRNA expression level of KRAS and BRAF and demonstrated a longer survival for patients with low mRNA expression of KIT in SKMs. IHC examinations of SKMs confirmed the UALCAN data and showed that KIT expression was inversely correlated with ulceration, Breslow index, mitotic rate, and pT stage. KRAS expression was also found to be inversely correlated with ulceration and perineural invasion. When the subcellular expression of BRAF protein was recorded (nuclear vs. cytoplasmatic vs. mixed nucleus + cytoplasm), a direct correlation was emphasized between nuclear positivity and lymphovascular or perineural invasion. The independent prognostic value was demonstrated for mixed expression of the BRAF protein in SKM. BRAF cytoplasmic predominance, in association with KIT's IHC positivity, was more frequently observed in early-stage nonulcerated SKMs, which displayed a low mitotic rate and a late death event. The present study firstly verified the possible prognostic value of BRAF subcellular localization in SKMs. A low mRNA expression or IHC cytoplasmic positivity for KIT and BRAF might be used as a positive prognostic parameter of SKM. SKM's BRAF nuclear positivity needs to be evaluated in further studies as a possible indicator of perineural and lymphovascular invasion.
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Affiliation(s)
- Marius-Alexandru Beleaua
- Department of Pathology, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology, 38 Gheorghe Marinescu Street, 540139 Targu Mures, Romania;
- Department of Pathology, Clinical County Emergency Hospital, 540139 Targu Mures, Romania; (I.J.); (D.M.)
| | - Ioan Jung
- Department of Pathology, Clinical County Emergency Hospital, 540139 Targu Mures, Romania; (I.J.); (D.M.)
| | - Cornelia Braicu
- Research Center for Functional Genomics, Biomedicine and Translational Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, 400337 Cluj-Napoca, Romania;
- Research Center for Oncopathology and Translational Medicine (CCOMT), George Emil Palade University of Medicine, Pharmacy, Sciences and Technology, 540139 Targu Mures, Romania
| | - Doina Milutin
- Department of Pathology, Clinical County Emergency Hospital, 540139 Targu Mures, Romania; (I.J.); (D.M.)
| | - Simona Gurzu
- Department of Pathology, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology, 38 Gheorghe Marinescu Street, 540139 Targu Mures, Romania;
- Department of Pathology, Clinical County Emergency Hospital, 540139 Targu Mures, Romania; (I.J.); (D.M.)
- Research Center for Oncopathology and Translational Medicine (CCOMT), George Emil Palade University of Medicine, Pharmacy, Sciences and Technology, 540139 Targu Mures, Romania
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Gurzu S, Sugimura H, Szederjesi J, Szodorai R, Braicu C, Kobori L, Fodor D, Jung I. Interaction between cadherins, vimentin, and V-set and immunoglobulin domain containing 1 in gastric-type hepatocellular carcinoma. Histochem Cell Biol 2021; 156:377-390. [PMID: 34170400 DOI: 10.1007/s00418-021-02006-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [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] [Accepted: 06/08/2021] [Indexed: 02/08/2023]
Abstract
In hepatocellular carcinomas (HCCs), the role of the cell surface protein V-set and immunoglobulin domain containing 1 (VSIG1), which is known as a specific marker of the gastric mucosa and testis, has not yet been determined. We examined VSIG1 immunohistochemical (IHC) expression in 105 consecutive samples provided by HCC patients, along with the IHC expression of three of the biomarkers known to be involved in the epithelial-mesenchymal transition (EMT): vimentin (VIM), and E- and N-cadherin (encoded by CDH1 and CDH2 genes). IHC subcellular localization of thyroid transcription factor 1 (TTF1), in which nuclear-to-cytoplasmic translocation is known to cause a lineage shift from lung to gastric-type adenocarcinoma, was also checked. The obtained data were validated using the miRNET program. In the examined HCC samples, VSIG1 expression was observed in the cytoplasm of normal hepatocytes and downregulated in 47 of the 105 HCCs (44.76%). In 29 cases (27.62%), VSIG1 was co-expressed with cytoplasmic TTF1. VSIG1 expression was positively correlated with both E-cadherin and N-cadherin and negatively correlated with VIM (p < 0.0001). The VSIG1+/E-cadherin+/N-cadherin-/VIM phenotype was seen in 13 cases (12.4%) and was characteristic of well-differentiated (G1/2) carcinomas diagnosed in pT1/2 stages. Like pulmonary carcinomas, simultaneous cytoplasmic positivity of HCC cells for VSIG1 and TTF1 may be a potential indicator of a lineage shift from conventional to gastric-type HCC. The E-cadherin/VSIG1 complex can help suppress tumor growth by limiting HCC dedifferentiation. The miRNET-based interaction between VSIG1/VIM/CDH1/CDH2 genes might be interconnected by miR-200b-3p, a central regulator of EMT which also targets VIM and VSIG1.
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Affiliation(s)
- Simona Gurzu
- Department of Pathology, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology, 38 Gheorghe Marinescu Street, 530149, Targu-Mures, Romania.
- Research Center for Oncopathology and Translational Medicine, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology, Targu-Mures, Romania.
| | - Haruhiko Sugimura
- Department of Tumor Pathology, Hamamatsu University School of Medicine, Hamamatsu, Japan.
| | - Janos Szederjesi
- Department of Anesthesiology and Intensive Care, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology, Targu-Mures, Romania
| | - Rita Szodorai
- Department of Pathology, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology, 38 Gheorghe Marinescu Street, 530149, Targu-Mures, Romania
| | - Cornelia Braicu
- Research Center for Functional Genomics, Biomedicine and Translational Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Laszlo Kobori
- Department of Transplantation and Surgery, Semmelweis University, Budapest, Hungary
| | - Decebal Fodor
- Department of Pathology, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology, 38 Gheorghe Marinescu Street, 530149, Targu-Mures, Romania
- Department of Anatomy and Embryology, Emil Palade University of Medicine, Pharmacy, Sciences and Technology, Targu Mures, Romania
| | - Ioan Jung
- Department of Pathology, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology, 38 Gheorghe Marinescu Street, 530149, Targu-Mures, Romania
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Satala CB, Bara TJ, Jung I, Tudorache V, Gurzu S. Chylous Ascites, Unusual Association with Ductal Pancreatic Adenocarcinoma with Plasmacytoid Morphology: A Case Report and Literature Review. Surg J (N Y) 2021; 7:e158-e162. [PMID: 34295975 PMCID: PMC8289679 DOI: 10.1055/s-0041-1728651] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 02/17/2021] [Indexed: 11/24/2022] Open
Abstract
Chylous ascites represents a relatively uncommon condition. In this paper, we present a case of chyloperitoneum associated with pancreatic ductal adenocarcinoma (PDAC) and a review of literature regarding chylous ascites. A 76-year-old male patient was admitted in emergency department with acute abdomen. A pancreatic cancer was suspected. Subtotal spleno-pancreatectomy, for a nodular mass infiltrating the mild and distal portion of the pancreas, was necessary. During surgical intervention in the peritoneal cavity, a moderate quantity of whitish and thick consistency fluid with milk-like appearance was observed to be accumulated. After examination of the fluid, chyloperitoneum was diagnosed. The histologic examination showed a PDAC, with multiple emboli in lymph vessels, with tumor cells with plasmacytoid morphology, diagnosed as lymphangiosis carcinomatosa. The patient died at 3 weeks after surgical intervention. In patients with pancreatic cancer and chylous ascites, suspicion of tumor-related blockage of the lymphatic flow should be suspected. Prognosis of PDAC should be evaluated not only based on the number of lymph node metastases, but also considering the number of lymph vessels with tumor emboli and the architecture of tumor cells. This is the first reported case of a PDAC with plasmacytoid morphology of lymphangiosis carcinomatosa.
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Affiliation(s)
- Catalin Bogdan Satala
- Department of Pathology, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology, Targu-Mures, Romania
| | - Tivadar Jr. Bara
- Department of Surgery, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology, Targu-Mures, Romania
| | - Ioan Jung
- Department of Pathology, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology, Targu-Mures, Romania
| | - Vlad Tudorache
- Department of Gynecology, Clinical County Hospital, Targu-Mures, Romania
| | - Simona Gurzu
- Department of Pathology, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology, Targu-Mures, Romania
- Research Center for Oncopathology and Translational Medicine, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology, Targu-Mures, Romania
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Beleaua MA, Jung I, Braicu C, Milutin D, Gurzu S. SOX11, SOX10 and MITF Gene Interaction: A Possible Diagnostic Tool in Malignant Melanoma. Life (Basel) 2021; 11:life11040281. [PMID: 33801642 PMCID: PMC8065671 DOI: 10.3390/life11040281] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 03/22/2021] [Accepted: 03/24/2021] [Indexed: 12/24/2022] Open
Abstract
Malignant melanoma (MM) is a highly heterogenic tumor whose histological diagnosis might be difficult. This study aimed to investigate the diagnostic and prognostic utility of the conventional pan-melanoma cocktail members (HMB-45, melan-A and tyrosinase), in conjunction with SOX10 and SOX11 immunohistochemical (IHC) expression. In 105 consecutive cases of MMs and 44 of naevi, the IHC examination was performed using the five-abovementioned markers, along with microphthalmia transcription factor (MITF), S100, and Ki67. Correlation with the clinicopathological factors and a long-term follow-up was also done. Survival analysis was performed with Kaplan–Meier curves and compared with TCGA public datasets. None of the 44 naevi expressed SOX11, but its positivity was seen in 52 MMs (49.52%), being directly correlated with lymphovascular invasion, the Ki67 index, and SOX10 expression. HMB-45, SOX10, and tyrosinase, but not melan-A, proved to differentiate the naevi from MMs successfully, with high specificity. Triple MITF/SOX10/SOX11 co-expression was seen in 9 out of 15 negative conventional pan-melanoma-cocktail cases. The independent prognostic value was proved for the conventional pan-melanoma cocktail (triple positivity for HMB-45, melan-A, and tyrosinase) and, independently for HMB-45 and tyrosinase, but not for melan-A, SOX10, or SOX11. As consequence, to differentiate MMs from benign naevi, melan-A should be substituted by SOX10 in the conventional cocktail. Although the conventional pan-melanoma cocktail, along with S100 can be used for the identification of melanocytic origin of tumor cells and predicting prognosis of MMs, the conventional-adapted cocktail (triple positivity for HMB-45, SOX10, and tyrosinase) has a slightly higher diagnostic specificity. SOX11 can be added to identify the aggressive MMs with risk for lymphatic dissemination and the presence of circulating tumor cells.
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Affiliation(s)
- Marius-Alexandru Beleaua
- Department of Pathology, Clinical County Emergency Hospital, Targu-Mures, Romania, 540139 Targu Mures, Romania; (M.-A.B.); (D.M.)
- Department of Pathology, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology, 38 Gheorghe Marinescu Street, 540139 Targu Mures, Romania;
| | - Ioan Jung
- Department of Pathology, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology, 38 Gheorghe Marinescu Street, 540139 Targu Mures, Romania;
| | - Cornelia Braicu
- Research Center for Functional Genomics, Biomedicine and Translational Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, 400337 Cluj-Napoca, Romania;
- Research Center (CCAMF), George Emil Palade University of Medicine, Pharmacy, Sciences and Technology, 540139 Targu Mures, Romania
| | - Doina Milutin
- Department of Pathology, Clinical County Emergency Hospital, Targu-Mures, Romania, 540139 Targu Mures, Romania; (M.-A.B.); (D.M.)
| | - Simona Gurzu
- Department of Pathology, Clinical County Emergency Hospital, Targu-Mures, Romania, 540139 Targu Mures, Romania; (M.-A.B.); (D.M.)
- Department of Pathology, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology, 38 Gheorghe Marinescu Street, 540139 Targu Mures, Romania;
- Research Center (CCAMF), George Emil Palade University of Medicine, Pharmacy, Sciences and Technology, 540139 Targu Mures, Romania
- Correspondence: ; Tel.: +40-745-673550; Fax: +40-265-210407
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Gurzu S, Jung I, Borz C, Patrichi A, Yamada H, Sugimura H. Sporadic Multifocal Gastrinoma Mimicking a Duodenal GIST, in a Patient with MEN1 Gene Polymorphism D418D: an Unusual Case Report. J Gastrointest Cancer 2021; 52:351-354. [PMID: 32705580 DOI: 10.1007/s12029-020-00461-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- Simona Gurzu
- Department of Pathology, University of Medicine, Pharmacy, Sciences and Technology, George Emil Palade, 38 Ghe Marinescu Street, 540139, Targu-Mures, Romania.
- Department of Pathology, Clinical County Emergency Hospital, George Emil Palade, Targu-Mures, Romania.
- Department of Pathology, Research Center of the University of Medicine, Pharmacy, Sciences and Technology, George Emil Palade, Targu-Mures, Romania.
| | - Ioan Jung
- Department of Pathology, University of Medicine, Pharmacy, Sciences and Technology, George Emil Palade, 38 Ghe Marinescu Street, 540139, Targu-Mures, Romania
| | - Cristian Borz
- Department of Surgery, University of Medicine, Pharmacy, Sciences and Technology, George Emil Palade, Targu-Mures, Romania
| | - Andrei Patrichi
- Department of Pathology, Clinical County Emergency Hospital, George Emil Palade, Targu-Mures, Romania
| | - Hidetaka Yamada
- Department of Tumor Pathology, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Haruhiko Sugimura
- Department of Tumor Pathology, Hamamatsu University School of Medicine, Hamamatsu, Japan
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Satala CB, Jung I, Kobori L, Kovacs Z, Fodor D, Szodorai R, Gurzu S. Benefits of the 8th American Joint Committee on Cancer System for Hepatocellular Carcinoma Staging. J Gastrointest Cancer 2021; 52:243-248. [PMID: 32173767 DOI: 10.1007/s12029-020-00394-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [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] [Indexed: 02/05/2023]
Abstract
PURPOSE We aimed to emphasize the prognostic impact of differences included in the 8th versus the previous 7th edition of AJCC (American Joint Committee on Cancer) Cancer Staging manual for hepatocellular carcinoma (HCC). METHODS A number of 87 consecutive HCCs were retrospectively evaluated and staged, using the 7th and 8th edition of AJCC staging systems. The clinicopathological parameters were correlated with the overall survival rate. No preoperative chemotherapy was received by any of the patients. RESULTS According to the 7th edition of AJCC manual, 52 of the 87 cases were staged as pT2 and 35 as pT1. After restaging, according to the 8th edition, 23 of the 52 pT2 cases were understaged as pT1b, and the rest of the 29 remained as pT2. Regarding the 35 HCCs classified as pT1, using 7th edition, all of them were restaged as pT1a. Compared to the 7th staging system, using the 8th edition of AJCC manual, the percentage of pT2 tumors significantly decreased, from 59.77 to 33.33%. The patient's gender, age, tumor focality, and grade of differentiation did not prove to have any prognostic value. Regarding pT stage, it does not influence the overall survival rate, independently from the used staging system. CONCLUSION The staging criteria, in the most recent edition of AJCC, are simplified and allowed tumor understaging. These changes do not have independent prognostic value. The prognostic impact of pT understaging should be evaluated in larger cohorts.
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Affiliation(s)
- Catalin Bogdan Satala
- Department of Pathology, Emil Palade University of Medicine, Pharmacy, Sciences and Technology, 38 Gheorghe Marinescu Street, 530149, Targu-Mures, Romania
- Department of Pathology, Clinical County Emergency Hospital, Targu-Mures, Romania
| | - Ioan Jung
- Department of Pathology, Emil Palade University of Medicine, Pharmacy, Sciences and Technology, 38 Gheorghe Marinescu Street, 530149, Targu-Mures, Romania
| | - Laszlo Kobori
- Department of Transplantation and Surgery, Semmelweis University, Budapest, Hungary
| | - Zsolt Kovacs
- Department of Pathology, Clinical County Emergency Hospital, Targu-Mures, Romania
| | - Decebal Fodor
- Department of Pathology, Clinical County Emergency Hospital, Targu-Mures, Romania
- Department of Anatomy and Embryology, Emil Palade University of Medicine, Pharmacy, Sciences and Technology, Targu-Mures, Romania
| | - Rita Szodorai
- Department of Pathology, Emil Palade University of Medicine, Pharmacy, Sciences and Technology, 38 Gheorghe Marinescu Street, 530149, Targu-Mures, Romania
| | - Simona Gurzu
- Department of Pathology, Emil Palade University of Medicine, Pharmacy, Sciences and Technology, 38 Gheorghe Marinescu Street, 530149, Targu-Mures, Romania.
- Department of Pathology, Clinical County Emergency Hospital, Targu-Mures, Romania.
- Department of Pathology, Research Center (CCAMF) of the Emil Palade University of Medicine, Pharmacy, Sciences and Technology, Targu-Mures, Romania.
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Simu P, Jung I, Banias L, Kovacs Z, Fulop ZZ, Bara T, Simu I, Gurzu S. Synchronous Colorectal Cancer: Improving Accuracy of Detection and Analyzing Molecular Heterogeneity-The Main Keys for Optimal Approach. Diagnostics (Basel) 2021; 11:diagnostics11020314. [PMID: 33671994 PMCID: PMC7919277 DOI: 10.3390/diagnostics11020314] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Revised: 02/04/2021] [Accepted: 02/11/2021] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND In patients with synchronous colorectal cancer (SCRC), understanding the underlying molecular behavior of such cases is mandatory for designing individualized therapy. The aim of this paper is to highlight the importance of transdisciplinary evaluation of the pre- and post-operative assessment of patients with SCRCs, from imaging to molecular investigations. METHODS Six patients with SCRCs presented with two carcinomas each. In addition to the microsatellite status (MSS), the epithelial mesenchymal transition was checked in each tumor using the biomarkers β-catenin and E-cadherin, same as KRAS and BRAF mutations. RESULTS In two of the patients, the second tumor was missed at endoscopy, but diagnosed by a subsequent computed-tomography-scan (CT-scan). From the six patients, a total of 11 adenocarcinomas (ADKs) and one squamous cell carcinoma (SCC) were analyzed. All the examined carcinomas were BRAF-wildtype microsatellite stable tumors with an epithelial histological subtype. In two of the six cases, KRAS gene status showed discordance between the two synchronous tumors, with mutations in the index tumors and wildtype status in the companion ones. CONCLUSIONS Preoperative CT-scans can be useful for detection of synchronous tumors which may be missed by colonoscopy. Where synchronous tumors are identified, therapy should be based on the molecular profile of the indexed tumors.
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Affiliation(s)
- Patricia Simu
- Department of Radiology and Imaging, ‘George Emil Palade’ University of Medicine, Pharmacy, Sciences and Technology, 530149 Targu Mures, Romania; (P.S.); (I.S.)
- Department of Pathology, ‘George Emil Palade’ University of Medicine, Pharmacy, Sciences and Technology, 530149 Targu Mures, Romania; (I.J.); (L.B.)
| | - Ioan Jung
- Department of Pathology, ‘George Emil Palade’ University of Medicine, Pharmacy, Sciences and Technology, 530149 Targu Mures, Romania; (I.J.); (L.B.)
| | - Laura Banias
- Department of Pathology, ‘George Emil Palade’ University of Medicine, Pharmacy, Sciences and Technology, 530149 Targu Mures, Romania; (I.J.); (L.B.)
- Department of Pathology, Clinical County Emergency Hospital, 530150 Targu Mures, Romania;
| | - Zsolt Kovacs
- Department of Pathology, Clinical County Emergency Hospital, 530150 Targu Mures, Romania;
- Department of Biochemistry, ‘George Emil Palade’ University of Medicine, Pharmacy, Sciences and Technology, 530149 Targu Mures, Romania
| | - Zsolt Zoltan Fulop
- Department of Surgery, ‘George Emil Palade’ University of Medicine, Pharmacy, Sciences and Technology, 530149 Targu Mures, Romania; (Z.Z.F.); (T.B.)
| | - Tivadar Bara
- Department of Surgery, ‘George Emil Palade’ University of Medicine, Pharmacy, Sciences and Technology, 530149 Targu Mures, Romania; (Z.Z.F.); (T.B.)
| | - Iunius Simu
- Department of Radiology and Imaging, ‘George Emil Palade’ University of Medicine, Pharmacy, Sciences and Technology, 530149 Targu Mures, Romania; (P.S.); (I.S.)
| | - Simona Gurzu
- Department of Pathology, ‘George Emil Palade’ University of Medicine, Pharmacy, Sciences and Technology, 530149 Targu Mures, Romania; (I.J.); (L.B.)
- Department of Pathology, Clinical County Emergency Hospital, 530150 Targu Mures, Romania;
- Research Center (CCAMF), ‘George Emil Palade’ University of Medicine, Pharmacy, Sciences and Technology, 540139 Targu Mures, Romania
- Correspondence: ; Tel.: +40-745-673550; Fax: +40-265-210407
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Gurzu S, Jung I. Subcellular Expression of Maspin in Colorectal Cancer: Friend or Foe. Cancers (Basel) 2021; 13:cancers13030366. [PMID: 33498377 PMCID: PMC7864036 DOI: 10.3390/cancers13030366] [Citation(s) in RCA: 10] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Revised: 01/12/2021] [Accepted: 01/19/2021] [Indexed: 02/05/2023] Open
Abstract
In this review the authors aimed to emphasize the practical value of nuclear expression of the mammary serine protease inhibitor (maspin), also known as serpin B5 protein, in colorectal carcinoma (CRC), from pre-malignant disorders to carcinogenesis and metastasis. As the role of maspin is controversial and not yet understood, the present update highlights the latest data revealed by literature which were filtrated through the daily experience of the authors, which was gained at microscopic examination of maspin expression in CRCs and other tumors for daily diagnosis. Data regarding the subcellular localization of maspin, in correlation with the microsatellite status, grade of tumor dedifferentiation, and epithelial-mesenchymal transition (EMT) phenomenon of the tumor buds were presented with details. An original observation refers to the maspin capacity to mark the tumor cells which are "at the point of budding" that were previously considered as having "hybrid EMT phenotype". It refers to the transitional status of tumor cell that is between "epithelial status" and "mesenchymal status". The second original hypothesis highlights the possible role of maspin in dysregulating the intestinal microbiota, in patients with idiopathic inflammatory bowel diseases (IBD) and inducing IBD-related CRC. The dynamic process of budding and EMT of tumor buds, possible mediated by maspin, needs further investigation and validation in many human CRC samples. The histological and molecular data reveal that synthesis of maspin-based therapeutics might represent a novel individualized therapeutic strategy for patients with CRC.
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Affiliation(s)
- Simona Gurzu
- Correspondence: ; Tel.: +40-7-4567-3550; Fax: +40-2-6521-0407
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Gurzu S, Satala CB, Melit LE, Streinu-Cercel A, Otelea D, Capalna B, Puiac CI, Szederjesi J, Jung I. Hallazgos similares al COVID-19 en un caso fatal de neumonía intersticial descamativa asociada con glomerulonefritis por IgA en una niña de 13 meses de edad. Kompass Neumol 2021. [PMCID: PMC8089446 DOI: 10.1159/000516149] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
En la era del COVID-19, es usual sospechar que cualquier paciente con síndrome respiratorio agudo grave (SARS) esté asociado con una infección por SARS-CoV-2. El objetivo de este artículo es presentar un caso de neumonía similar al COVID, con evolución fatal. Los aspectos clínicos se correlacionan con los hallazgos en la autopsia y se discuten en el contexto de los datos más recientes en la literatura médica. Una niña de 13 meses de edad ingresó a la sala de emergencias con dificultad respiratoria aguda y opacidades pulmonares bilaterales con apariencia de vidrio molido, además del pulmón izquierdo casi completamente opacificado. El estado de la paciente se deterioró súbitamente, y se confirmó la muerte 3 h después de la admisión. En la autopsia se diagnosticó neumonía intersticial descamativa grave, y se asoció con glomerulonefritis por IgA, un hallazgo poco usual. No se detectó infección por SARS-CoV-2 en el parénquima pulmonar mediante RT-PCR. Éste es un caso muy inusual de deterioro rápido de un infante con neumonía intersticial descamativa (NID) idiopática y afectación multiorgánica. Con base en tinciones inmunohistoquímicas, proponemos la hipótesis de que, en la NID, las membranas hialinas surgen de neumocitos descamados necrotizantes. En la era de COVID-19, tales casos son extremadamente difíciles de diagnosticar, y pueden semejar las lesiones pulmonares inducidas por el SARS-CoV-2. Esta pauta de formación de membrana hialina podría explicar la falta de respuesta a la terapia con oxígeno. El presente caso resalta la importancia de la autopsia en estos casos complicados.
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Affiliation(s)
- Simona Gurzu
- Departamento de Patología, Universidad George Emil Palade de Medicina, Farmacia, Ciencias y Tecnología, Targu-Mures, Rumania
- Departamento de Patología, Hospital de Emergencias Clínicas del Condado, Targu-Mures, Rumania
- Departmento de Microscopía, Centro de Investigación de la Universidad de Medicina, Farmacia, Ciencias y Tecnología, Targu-Mures, Rumania
- * Simona Gurzu,
| | - Catalin-Bogdan Satala
- Departamento de Patología, Universidad George Emil Palade de Medicina, Farmacia, Ciencias y Tecnología, Targu-Mures, Rumania
- Departamento de Patología, Hospital de Emergencias Clínicas del Condado, Targu-Mures, Rumania
| | - Lorena Elena Melit
- Departamento de Pediatría, Hospital de Emergencias Clínicas del Condado, Targu-Mures, Rumania
- Departamento de Pediatría, Universidad George Emil Palade de Medicina, Farmacia, Ciencias y Tecnología, Targu-Mures, Rumania
| | | | - Dan Otelea
- Instituto Nacional para Enfermedades Infecciosas «Matei Bals», Bucarest, Rumania
| | - Brandusa Capalna
- Departamento de Pediatría, Hospital de Emergencias Clínicas del Condado, Targu-Mures, Rumania
| | - Claudiu Ioan Puiac
- Departamento de Cuidados Intensivos, Universidad George Emil Palade de Medicina, Farmacia, Ciencias y Tecnología, Targu-Mures, Rumania
| | - Janos Szederjesi
- Departamento de Cuidados Intensivos, Universidad George Emil Palade de Medicina, Farmacia, Ciencias y Tecnología, Targu-Mures, Rumania
| | - Ioan Jung
- Departamento de Patología, Universidad George Emil Palade de Medicina, Farmacia, Ciencias y Tecnología, Targu-Mures, Rumania
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Fülöp ZZ, Fülöp RL, Gurzu S, Bara T, Tímár J, Drágus E, Jung I. Prognostic Impact of the Neutrophil-to-Lymphocyte and Lymphocyte-to-Monocyte Ratio, in Patients with Rectal Cancer: A Retrospective Study of 1052 Patients. J Pers Med 2020; 10:jpm10040173. [PMID: 33081102 PMCID: PMC7712240 DOI: 10.3390/jpm10040173] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 10/13/2020] [Accepted: 10/14/2020] [Indexed: 02/05/2023] Open
Abstract
Despite the description of several new prognostic markers, colorectal cancer still represents the third most frequent cause of cancer-related death. As immunotherapy is considered a therapeutic alternative in such patients, neutrophil-to-lymphocyte (NLR) and lymphocyte-to-monocyte ratio (LMR) are hypothesized to provide reliable prognostic information. A retrospective study was conducted on 1052 patients operated on during 2013-2019 in two clinical hospitals from Hungary and Romania. Inclusion criteria targeted patients over 18 years old, diagnosed with rectal cancer, with preoperatively defined NLR and LMR. The overall survival rate, along with clinical and histopathological data, was evaluated. Overall survival was significantly associated with increased NLR (p = 0.03) and decreased LMR (p = 0.04), with cut-off values of 3.11 and 3.39, respectively. The two parameters were inversely correlated (p < 0.0001). There was no statistically significant association between tumor stage and NLR or LMR (p = 0.30, p = 0.06, respectively). The total mesorectal excision was especially obtained in cases with low NLR (p = 0.0005) and high LMR (p = 0.0009) values. A significant association was also seen between preoperative chemoradiotherapy and high NLR (p = 0.0001) and low LMR (p = 0.0001). In patients with rectal cancer, the preoperative values of NLR and LMR can be used as independent prognostic parameters. An NLR value of ≥3.11 can be used to indicate the response to preoperative chemoradiotherapy, but a low chance of sphincter preservation or obtaining a complete TME. Higher values of NLR and lower values of LMR require a more attentive preoperative evaluation of the mesorectum.
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Affiliation(s)
- Zsolt Zoltán Fülöp
- Department of Surgery, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology, 540139 Targu Mures, Romania; (Z.Z.F.); (R.L.F.); (T.B.J.)
| | - Réka Linda Fülöp
- Department of Surgery, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology, 540139 Targu Mures, Romania; (Z.Z.F.); (R.L.F.); (T.B.J.)
| | - Simona Gurzu
- Department of Pathology, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology, 38 Gheorghe Marinescu Street, 540139 Targu Mures, Romania;
- Research Center (CCAMF), George Emil Palade University of Medicine, Pharmacy, Sciences and Technology, 540139 Targu Mures, Romania
- Correspondence: ; Tel.: +40-745-673550; Fax: +40-265-210407
| | - Tivadar Bara
- Department of Surgery, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology, 540139 Targu Mures, Romania; (Z.Z.F.); (R.L.F.); (T.B.J.)
| | - József Tímár
- Second Department of Pathology, National Institute of Oncology, Faculty of Medicine, Semmelweis University, H-1085 Budapest, Hungary;
| | - Emőke Drágus
- Department of Urology, Clinical County Hospital, 540167 Targu Mures, Romania;
| | - Ioan Jung
- Department of Pathology, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology, 38 Gheorghe Marinescu Street, 540139 Targu Mures, Romania;
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Satală CB, Jung I, Bara TJ, Simu P, Simu I, Vlad M, Szodorai R, Gurzu S. Primary rhabdomyosarcoma: An extremely rare and aggressive variant of male breast cancer. World J Clin Cases 2020; 8:4466-4474. [PMID: 33083405 PMCID: PMC7559662 DOI: 10.12998/wjcc.v8.i19.4466] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Revised: 07/28/2020] [Accepted: 09/04/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Rhabdomyosarcoma (RMS) of the breast, a mesenchymal neoplasm with skeletal muscle differentiation, is an extremely rare tumour in males, with less than 30 cases published in English-language literature. We report on the first case of a male breast RMS, with an unusual ectomesenchymal/neuroectodermal component.
CASE SUMMARY A 55-year-old, previously healthy male, underwent a radical left mastectomy for an ulcerated tumour mass, occupying the breast and left anterior thoracic wall. The biopsy specimen indicated the presence of a tumour with neural origins, namely a peripheral neuroectodermal tumour (PNET). The surgical specimens identified two components. The rhabdomyosarcomatous component (over 70%) was represented by large pleomorphic cells with positivity for desmin, sarcomeric actin and myogenin. The PNET-like ectomesenchymal component, which was admixed with the RMS cells, and was also revealed during the preoperative biopsy, consisted of small cells which expressed neurofilament, neuron specific enolase and CD99. The microscopic examination, along with the immunohistochemical profile, allowed the diagnosis of an RMS, with unusual ectomesenchymal differentiation. The patient refused the postoperative oncologic therapy and died three months after surgery.
CONCLUSION In patients with RMS of the breast, the PNET-like ectomesenchymal component increases the diagnosis difficulty, especially in biopsy specimens. This differentiation can be immunohistochemically proven and might highlight the possible development of high-grade sarcoma of the breast from remnants of the embryological ectodermal layer.
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Affiliation(s)
- Cătălin Bogdan Satală
- Department of Pathology, Clinical County Emergency Hospital, Tirgu Mures 540139, Romania
| | - Ioan Jung
- Department of Pathology, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology, Targu Mures 530149, Romania
| | - Tivadar Jr Bara
- Department of Surgery, Clinical County Emergency Hospital, Targu Mures 540136, Romania
| | - Patricia Simu
- Department of Radiology, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology, Targu Mures 530149, Romania
| | - Iunius Simu
- Department of Radiology, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology, Targu Mures 530149, Romania
| | - Madalina Vlad
- Department of Pathology, Clinical County Emergency Hospital, Targu Mures 540136, Romania
| | - Rita Szodorai
- Department of Pathology, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology, Targu Mures 530149, Romania
| | - Simona Gurzu
- Department of Pathology, Clinical County Emergency Hospital, Targu Mures 540136, Romania
- Department of Pathology, George Emil Palade University of Medicine, Pharmacy, Science and Technology, Targu Mures 530149, Romania
- Research Center (CCAMF), University of Medicine, Pharmacy, Sciences and Technology, Targu Mures 540139, Romania
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Gurzu S, Jung I, Sugimura H, Stefan-van Staden RI, Yamada H, Natsume H, Iwashita Y, Szodorai R, Szederjesi J. Maspin subcellular expression in wild-type and mutant TP53 gastric cancers. World J Gastrointest Oncol 2020; 12:741-755. [PMID: 32864042 PMCID: PMC7428795 DOI: 10.4251/wjgo.v12.i7.741] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 04/06/2020] [Accepted: 05/27/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Although the role of p53 in the evolution and prognosis of gastric cancer (GC) has been extensively examined, the exact mechanism of action is incompletely understood. In the last years, p53-target genes were supposed to be involved in the p53 pathway. One of them is the tumor-suppressor gene Maspin, which codifies the protein with the same name. Maspin activity depends on its subcellular localization. To our knowledge, the possible role of TP53 gene in Maspin subcellular localization, in GC cells, has not yet been studied in a large number of human samples.
AIM To evaluate the possible role of wild-type and mutated p53 in Maspin subcellular localization.
METHODS The present study included 266 consecutive patients with GC in which TP53 gene status, and mutations in exons 2 to 11, respectively, were analyzed and correlated with immunohistochemical expression of p53 and Maspin.
RESULTS None of the 266 cases showed mutations in exon 9. The rate of TP53 mutations was 33.83%. The mutation rate was slightly higher in distally-located GCs, with a lower degree (≤ 5 buds/ high power fields) of dyscohesivity (P < 0.01). The wild-type cases had a longer survival, compared with mutant GCs, especially in patients without lymph node metastases, despite the high depth of tumor infiltration (P = 0.01). The Dukes-MAC-like staging system was proved to have the most significant independent prognostic value (P < 0.01). The statistical correlations proved that TP53 gene mutations in exon 7 might induce knockdown of Maspin, but wild-type p53 can partially restore nuclear Maspin expression and decrease the metastatic potential of gastric adenocarcinoma cells.
CONCLUSION Downregulated Maspin might be induced by mutations in exon 7 of the TP53 gene but wild-type p53 can partially restore nuclear Maspin expression. These findings should be proved in experimental studies.
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Affiliation(s)
- Simona Gurzu
- Department of Pathology, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology, Targu Mureș 540139, Mureș, Romania
- Research Center, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology, Targu Mureș 540139, Mureș, Romania
| | - Ioan Jung
- Department of Pathology, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology, Targu Mureș 540139, Mureș, Romania
| | - Haruhiko Sugimura
- Department of Tumor Pathology, Hamamatsu University School of Medicine, Hamamatsu 431-3192, Japan
| | | | - Hidetaka Yamada
- Department of Tumor Pathology, Hamamatsu University School of Medicine, Hamamatsu 431-3192, Japan
| | - Hiroko Natsume
- Department of Tumor Pathology, Hamamatsu University School of Medicine, Hamamatsu 431-3192, Japan
| | - Yuji Iwashita
- Department of Tumor Pathology, Hamamatsu University School of Medicine, Hamamatsu 431-3192, Japan
| | - Rita Szodorai
- Department of Pathology, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology, Targu Mureș 540139, Mureș, Romania
| | - Janos Szederjesi
- Intensive Care Unit, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology, Targu Mureș 540139, Mureș, Romania
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Fulop ZZ, Gurzu S, Jung I, Simu P, Banias L, Fulop E, Dragus E, Bara TJ. Cystic low-grade collecting duct renal carcinoma with liver compression — A challenging diagnosis and therapy: A case report. World J Gastrointest Surg 2020; 12:298-306. [PMID: 32774768 PMCID: PMC7385511 DOI: 10.4240/wjgs.v12.i6.298] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 04/06/2020] [Accepted: 05/12/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND A collecting duct carcinoma is a very rare, malignant renal epithelial tumor. Distant metastases are present in one third of cases at the time of diagnosis. It is known to have a poor prognosis.
CASE SUMMARY A 42-year-old male was sent to our surgery clinic for removal of a 119.2 mm × 108.3 mm encapsulated cystic mass, which was localized in the 8th segment of the right liver lobe. The lesion was first identified on ultrasonography. A computed tomography scan confirmed the presence of a Bosniak type III cystic lesion, which affected the liver and convexity of the right kidney. Surgical intervention involved a right nephrectomy, with removal of the cystic mass. The patient was mobilized on the first postoperative day and was discharged after 7 d. The histological and immunohistochemical examination revealed a low-grade collecting duct renal carcinoma, which is a rare variant of papillary carcinoma, with low malignant potential. The patient did not receive chemotherapy and after 21 mo of follow-up, a radiological examination and laboratory analyses showed normal aspects. No relapse or other complications were reported.
CONCLUSION To manage renal tumors properly, a correct histopathological diagnosis is crucial, as is early diagnosis and correct surgical treatment.
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Affiliation(s)
- Zsolt Zoltan Fulop
- Department of Surgery, George Emil Palade University of Medicine, Pharmacy, Science and Technology, Targu Mures 540139, Romania
| | - Simona Gurzu
- Department of Pathology, George Emil Palade University of Medicine, Pharmacy, Science and Technology, Targu Mures 540139, Romania
- Department of Pathology, Clinical County Emergency Hospital, Targu Mures 540067, Romania
| | - Ioan Jung
- Department of Pathology, George Emil Palade University of Medicine, Pharmacy, Science and Technology, Targu Mures 540139, Romania
| | - Patricia Simu
- Department of Radiology, George Emil Palade University of Medicine, Pharmacy, Science and Technology, Targu Mures 540139, Romania
| | - Laura Banias
- Department of Pathology, George Emil Palade University of Medicine, Pharmacy, Science and Technology, Targu Mures 540139, Romania
| | - Emoke Fulop
- Department of Pathology, Clinical County Emergency Hospital, Targu Mures 540067, Romania
| | - Emoke Dragus
- Department of Urology, Clinical County Hospital, Targu Mures 540167, Romania
| | - Tivadar Jr Bara
- Department of Surgery, George Emil Palade University of Medicine, Pharmacy, Science and Technology, Targu Mures 540139, Romania
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Stefan-van Staden RI, Ilie-Mihai RM, Gurzu S. Simultaneous Determination of Carcinoembryonic Antigen (CEA), Carbohydrate Antigen 19-9 (CA19-9), and Serum Protein p53 in Biological Samples with Protoporphyrin IX (PIX) Used for Recognition by Stochastic Microsensors. ANAL LETT 2020. [DOI: 10.1080/00032719.2020.1747480] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- Raluca-Ioana Stefan-van Staden
- Laboratory of Electrochemistry and PATLAB, National Institute of Research for Electrochemistry and Condensed Matter, Bucharest, Romania
- Faculty of Applied Chemistry and Material Science, Politehnica University of Bucharest, Bucharest, Romania
| | - Ruxandra-Maria Ilie-Mihai
- Laboratory of Electrochemistry and PATLAB, National Institute of Research for Electrochemistry and Condensed Matter, Bucharest, Romania
- Faculty of Applied Chemistry and Material Science, Politehnica University of Bucharest, Bucharest, Romania
| | - Simona Gurzu
- Department of Pathology, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology, Targu-Mures, Romania
- Department of Pathology, Clinical County Emergency Hospital, Targu-Mures, Romania
- Department of Pathology, Research Center (CCAMF), Targu-Mures, Romania
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Bara T, Gurzu S, Borz C, Muresan M, Jung I, Fulop Z, Bara T. Retromuscular mesh and hernial sac technique in the reconstruction of 139 cases of large median incisional hernias: one institution's experience. Hernia 2020; 24:99-105. [PMID: 30806887 DOI: 10.1007/s10029-019-01915-x] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Accepted: 02/19/2019] [Indexed: 02/05/2023]
Abstract
PURPOSE Incisional hernia is the most common complication of laparotomy. Postoperative parietal defects tend to relapse, even after the most optimal surgical methods. The aim of this study was to present the effectiveness of an adapted retromuscular technique with prolene mesh and a hernial sac, in patients with large incisional median hernias. The reported results were obtained by our team after more than 15 years of experience. METHODS This retrospective study included 139 consecutive cases of large median incisional hernias operated on using a retromuscular mesh and hernial sac technique. The cross-sectional diameter of incisional hernias was larger than 10 cm, being classified in the W3 group, according to the European Hernia Society classification. RESULTS The study included 83 females (59.71%) and 56 males (40.29%) with a median age of 62.4 ± 16.6 years and an average body mass index of 32.4 ± 7.6 kg. The hernia was supraumbilically located in 54 cases, subumbilically in 61 cases, and supra- and subumbilically in 24 cases. Postoperative complications were recorded in eight cases (5.75%): one case with a hematoma in the right abdominal muscle sheath; five cases with supra-aponeurotic seromas; two cases with skin necrosis and one with a mesh infection. Recurrence occurred in seven cases (5.03%): four cases in the first 2 years postoperatively and three cases in the third year after surgery. CONCLUSIONS The retromuscular technique with prolene mesh and a hernial sac is an effective method of restoring the integrity of the abdominal wall in large median incisional hernias with low rates of morbidity and recurrence.
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Affiliation(s)
- T Bara
- Department of Surgery, University of Medicine, Pharmacy, Sciences and Technology, Tirgu Mures, Romania
| | - S Gurzu
- Department of Pathology, University of Medicine, Pharmacy, Sciences and Technology, 38 Gheorghe Marinescu Street, 540139, Tîrgu Mureş, Romania.
- Advanced Medical and Pharmaceutical Research Center (CCAMF), University of Medicine, Pharmacy, Sciences and Technology, Tirgu Mures, Romania.
| | - C Borz
- Department of Surgery, University of Medicine, Pharmacy, Sciences and Technology, Tirgu Mures, Romania
| | - M Muresan
- Department of Surgery, University of Medicine, Pharmacy, Sciences and Technology, Tirgu Mures, Romania
| | - I Jung
- Department of Pathology, University of Medicine, Pharmacy, Sciences and Technology, 38 Gheorghe Marinescu Street, 540139, Tîrgu Mureş, Romania
| | - Z Fulop
- Department of Surgery, University of Medicine, Pharmacy, Sciences and Technology, Tirgu Mures, Romania
- Department of Pathology, University of Medicine, Pharmacy, Sciences and Technology, 38 Gheorghe Marinescu Street, 540139, Tîrgu Mureş, Romania
| | - T Bara
- Department of Surgery, University of Medicine, Pharmacy, Sciences and Technology, Tirgu Mures, Romania
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Banias L, Jung I, Bara T, Fulop Z, Simu P, Simu I, Satala C, Gurzu S. Immunohistochemical-based molecular subtyping of colorectal carcinoma using maspin and markers of epithelial-mesenchymal transition. Oncol Lett 2020; 19:1487-1495. [PMID: 31966075 PMCID: PMC6956164 DOI: 10.3892/ol.2019.11228] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Accepted: 11/15/2019] [Indexed: 02/07/2023] Open
Abstract
The aim of the present study was to classify colorectal carcinoma (CRC) into molecular subtypes, based on immunohistochemical (IHC) assessments. A total of 112 CRC samples were molecularly classified based on the expression levels of epithelial-mesenchymal transition (EMT)-associated IHC markers. A total of three molecular subtypes were defined: Epithelial, membrane positivity for E-cadherin and β-catenin, negative for vimentin; mesenchymal, E-cadherin-negative, nuclear β-catenin- and vimentin-positive; and hybrid cases, epithelial tumor core and mesenchymal tumor buds. Most of the cases were diagnosed as moderately differentiated adenocarcinoma (n=89; 79.46%). The majority of cases (n=100; 89.28%) exhibited a mismatch repair proficient status (microsatellite stable CRCs). A predominance of epithelial-type (n=51; 45.54%) and hybrid CRCs (n=47; 41.96%) was observed, whereas a few cases (n=14; 12.50%) were classified as mesenchymal-type CRCs. This molecular classification was associated with pathological stage (P<0.01), pT stage (P=0.04), pN stage (P<0.01), the grade of tumor budding (P=0.04), and maspin expression in both the tumor core (P=0.04) and the invasion front (P<0.01). The mesenchymal-type cases predominantly exhibited lymph node metastases, high-grade budding and a tendency towards maspin nuclear predominance. All epithelial-type cases with maspin-only expression (n=18) were non-metastatic. Patients with CRC of the epithelial subtype and those with a lymph node ratio (LNR) ≤0.15 presented the best overall survival, followed by those with hybrid and mesenchymal subtypes. Nuclear maspin positivity was more frequent in cases with a high-budding degree compared with those with a low-budding degree (P=0.03). The EMT-associated molecular classification of CRCs may be used to identify the most aggressive CRCs, which show a mesenchymal phenotype, high-budding degree, maspin nuclear positivity and lymph node metastases. The pN stage, LNR and budding degree of patients, which can be evaluated with maspin expression, remain the most important prognostic factors.
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Affiliation(s)
- Laura Banias
- Department of Pathology, University of Medicine, Pharmacy, Sciences and Technology, ‘George Emil Palade’, 540139 Targu-Mures, Romania
| | - Ioan Jung
- Department of Pathology, University of Medicine, Pharmacy, Sciences and Technology, ‘George Emil Palade’, 540139 Targu-Mures, Romania
| | - Tivadar Bara
- Department of Surgery, University of Medicine, Pharmacy, Sciences and Technology, ‘George Emil Palade’, 540139 Targu-Mures, Romania
| | - Zsolt Fulop
- Department of Surgery, University of Medicine, Pharmacy, Sciences and Technology, ‘George Emil Palade’, 540139 Targu-Mures, Romania
| | - Patricia Simu
- Department of Radiology, University of Medicine, Pharmacy, Sciences and Technology, ‘George Emil Palade’, 540139 Targu-Mures, Romania
| | - Iunius Simu
- Department of Radiology, University of Medicine, Pharmacy, Sciences and Technology, ‘George Emil Palade’, 540139 Targu-Mures, Romania
| | - Catalin Satala
- Department of Pathology, University of Medicine, Pharmacy, Sciences and Technology, ‘George Emil Palade’, 540139 Targu-Mures, Romania
| | - Simona Gurzu
- Department of Pathology, University of Medicine, Pharmacy, Sciences and Technology, ‘George Emil Palade’, 540139 Targu-Mures, Romania
- Research Center (CCAMF)-Microscopy Laboratory, University of Medicine, Pharmacy, Sciences and Technology, ‘George Emil Palade’, 540139 Targu-Mures, Romania
- Correspondence to: Professor Simona Gurzu, Department of Pathology, University of Medicine, Pharmacy, Sciences and Technology, ‘George Emil Palade’, 38 Ghe Marinescu Street, 540139 Targu-Mures, Romania, E-mail:
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Satala CB, Jung I, Stefan-van Staden RI, Kovacs Z, Molnar C, Bara T, Fulop ZZ, Gurzu S. HER2 Heterogeneity in Gastric Cancer: A Comparative Study, Using Two Commercial Antibodies. J Oncol 2020; 2020:8860174. [PMID: 33144857 PMCID: PMC7596543 DOI: 10.1155/2020/8860174] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 10/08/2020] [Accepted: 10/12/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Although amplification of the gene encoding human epidermal growth factor receptor 2 (HER2) is used as an indicator for response to trastuzumab, the reported response rate is low, and few patients with gastric cancer (GC) benefit from this individualized therapy. The aim of this study was to examine the expression of c-erbB-2 oncoprotein (HER2), in GC samples, using two commercial immunohistochemical (IHC) antibodies, and to validate the results by checking HER2 gene amplification by fluorescence in situ hybridization (FISH). METHODS We assessed the IHC expression of HER2 using the polyclonal antibody from Dako and CB11 clone from Leica, in 93 consecutive cases of GC samples. In all of the cases, FISH analysis was also performed using the BOND-MAX platform. RESULTS No significant difference was observed between the two HER2 antibodies. Of the 93 cases, 22.58% demonstrated at least focal and 1+ HER2 positivity. Seven cases (7.53%) exhibited 3+ expression, and another 7 carcinomas (7.53%) were equivocal (2+). HER2 amplification was seen in 11 cases (11.83%), 10 of which were differentiated adenocarcinomas. In 5 of the cases, 2-5 sections were examined, which proved the extremely high intratumorally/intraglandular heterogeneity. FISH heterogeneity was higher in cases with only 2+ positivity on IHC assessment, compared with those showing at least one small focus of 3+ overexpression. HER2 amplification proved to be an independent negative prognostic factor. CONCLUSIONS Due to the highly heterogeneous aspect of GC, at least 3-4 slides should be assessed by IHC, before considering a tumor to be HER2-negative. In cases with small 3+ foci representing less than 5% of tumor and in equivocal (2+) cases, FISH analysis remains the gold standard method.
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Affiliation(s)
- Catalin Bogdan Satala
- 1Department of Pathology, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology, Targu-Mures, Romania
- 2Department of Pathology, Clinical County Emergency Hospital, Targu-Mures, Romania
| | - Ioan Jung
- 1Department of Pathology, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology, Targu-Mures, Romania
| | - Raluca Ioana Stefan-van Staden
- 3Laboratory of Electrochemistry and PATLAB, National Institute of Research for Electrochemistry and Condensed Matter, Bucharest, Romania
| | - Zsolt Kovacs
- 4Department of Pathology, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology, Tirgu-Mures, Romania
| | - Calin Molnar
- 5Department of Surgery, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology, Tirgu-Mures, Romania
- 6Department of Surgery, Clinical County Emergency Hospital, Targu-Mures, Romania
| | - Tivadar Bara
- 6Department of Surgery, Clinical County Emergency Hospital, Targu-Mures, Romania
| | - Zsolt Zoltan Fulop
- 5Department of Surgery, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology, Tirgu-Mures, Romania
- 6Department of Surgery, Clinical County Emergency Hospital, Targu-Mures, Romania
| | - Simona Gurzu
- 1Department of Pathology, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology, Targu-Mures, Romania
- 2Department of Pathology, Clinical County Emergency Hospital, Targu-Mures, Romania
- 7Department of Pathology, Research Center (CCAMF), Tirgu-Mures, Romania
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Botoncea M, Molnar C, Mărginean C, Martha O, Gurzu S, Butiurca VO, Andrei BS, Molnar CV. Parietex ProGrip™ Self-Fixating Mesh in Surgical Treatment of Pelvic Organ Prolapse. Chirurgia (Bucur) 2020; 115:650-655. [PMID: 33138902 DOI: 10.21614/chirurgia.115.5.650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/01/2020] [Indexed: 02/05/2023]
Abstract
Introduction: Advanced pelvic organ prolapse is a public health problem, and its treatment can be difficult, requiring a multidisciplinary approach. Aim: The main objective of this article is to describe particular aspects of the use of Parietex ProGrip trade; Self-Fixating Mesh for abdominal sacrocolpopexy or sacrocervicopexy. The secondary objective is to present the initial results of the use of these self-fixating meshes. Results: Ten successive patients with a POP of grade 2 or higher have benefited from this procedure. No complications or recurrences of prolapse were detected at 1, 3 and 6 months postoperatively. The mean operative time was 102Â+-25.84 minutes. The mean length of hospital stay was 6.7Â+-0.67 days. Conclusions: The results of this surgical procedure demonstrate that Parietex ProGrip trade; Self- Fixating Mesh can be used without complications and with good postoperative results. The main advantage of using this mesh is that it does not require other fastening means. The lack of rejection reaction or foreign body pathology encourages the implementation of this surgical procedure. Further study is needed to consolidate these results.
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Opriş EC, Suciu H, Jung I, Satală CB, Al Hussein H, Harpa MM, Bănceu CM, Gurzu S. Mesangioproliferative glomerulonephritis with extracapillary crescents - unexpected fatal complication in a 17-year-old patient with implanted left ventricular assist device. Rom J Morphol Embryol 2020; 61:535-544. [PMID: 33544806 PMCID: PMC7864293 DOI: 10.47162/rjme.61.2.24] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The continuous flow left ventricular assist device (cf-LVAD) is the life-saving solution for patients with end-stage global heart failure. We present the case of a young patient with biventricular dilated cardiomyopathy, who had a cf-LVAD implantation and died as result of progressive renal failure. In the first year after implantation, he suffered repeated strokes and episodes of pneumonia with Klebsiella pneumoniae and Escherichia coli. The patient had hypertension, which was kept under control with angiotensin-converting enzyme (ACE) inhibitors and beta-blockers. After multiple bleeding episodes, the patient died at 21 months after the LVAD implant. At autopsy, parenchymatous brain hemorrhage was found to be associated with pulmonary hemorrhages. The unexpected features related to mesangioproliferative and extracapillary glomerulonephritis, with focal glomerulosclerosis. The proliferated parietal cells of Bowman’s capsule proved to express cluster of differentiation 44 (CD44), whereas remnant podocytes and mesangial cells showed Wilms tumor 1 (WT1) positivity. Since CD44 might be involved in fibrogenesis, but ACE inhibitors can exert a protective role against glomerular deterioration, we performed a synthesis of literature data which enabled us to propose a hypothesis with a potential clinical impact. We conclude that, in patients with LVAD implants, high blood pressure and high serum level of angiotensin II, the association between ACE inhibitors and anti-CD44 agents might exert glomerular protection and increase the survival time. Experimental studies are necessary to support our hypothesis and to explain the mechanism of possible glomerulopathy installed after LVAD implant.
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Affiliation(s)
- Elena Carmen Opriş
- Department of Pathology, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu Mureş, Romania;
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Gurzu S, Satala CB, Melit LE, Streinu-Cercel A, Otelea D, Capalna B, Puiac CI, Szederjesi J, Jung I. COVID-19 Like Findings in a Fatal Case of Idiopathic Desquamative Interstitial Pneumonia Associated With IgA Glomerulonephritis in a 13-Month-Old Child. Front Pediatr 2020; 8:586666. [PMID: 33262964 PMCID: PMC7686237 DOI: 10.3389/fped.2020.586666] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 10/21/2020] [Indexed: 12/19/2022] Open
Abstract
In the COVID-19 era, patients with severe acute respiratory syndrome (SARS) are suspected to be associated with SARS-CoV-2 infection. The aim of this paper is to present a case with COVID-like pneumonia, with fatal evolution. The clinical aspects were correlated with the autopsy findings and discussed on the background of the most recent data from the medical literature. A 13-month-old girl was admitted to the emergency room with acute severe shortness of breath and pulmonary bilateral ground-glass opacities and an almost complete opacified left lung. The patient suddenly deteriorated, and death was confirmed 3 h after admission. At autopsy, severe desquamative interstitial pneumonia was diagnosed and was associated with an unusual IgA glomerulonephritis. No SARS-CoV-2 infection was detected in the lung parenchyma by RT- PCR. This is a very unusual case of rapid deterioration of an infant with idiopathic desquamative interstitial pneumonia (IDP) and multiorgan involvement. Based on immunohistochemical stains, we hypothesize that, in IDP, the hyaline membranes arise from necrotizing desquamated pneumocytes. In the COVID-19 era, such cases are extremely difficult to diagnose; they can mimic SARS-CoV-2-induced lung injuries. This pattern of hyaline membrane formation might explain the poor response to oxygen therapy. The present case highlights the importance of autopsy in such challenging cases.
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Affiliation(s)
- Simona Gurzu
- Department of Pathology, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology, Targu-Mures, Romania.,Department of Pathology, Clinical County Emergency Hospital, Targu-Mures, Romania.,Department of Microscopy, Research Center of the University of Medicine, Pharmacy, Sciences and Technology, Targu-Mures, Romania
| | - Catalin Bogdan Satala
- Department of Pathology, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology, Targu-Mures, Romania.,Department of Pathology, Clinical County Emergency Hospital, Targu-Mures, Romania
| | - Lorena Elena Melit
- Department of Pediatrics, Clinical County Emergency Hospital, Targu-Mures, Romania.,Department of Pediatrics, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology, Targu-Mures, Romania
| | | | - Dan Otelea
- National Institute for Infectious Diseases "Matei Bals", Bucharest, Romania
| | - Brandusa Capalna
- Department of Pediatrics, Clinical County Emergency Hospital, Targu-Mures, Romania
| | - Claudiu Ioan Puiac
- Department of Intensive Care, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology, Targu-Mures, Romania
| | - Janos Szederjesi
- Department of Intensive Care, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology, Targu-Mures, Romania
| | - Ioan Jung
- Department of Pathology, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology, Targu-Mures, Romania
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Kovacs Z, Jung I, Szalman K, Banias L, Bara TJ, Gurzu S. Interaction of arylsulfatases A and B with maspin: A possible explanation for dysregulation of tumor cell metabolism and invasive potential of colorectal cancer. World J Clin Cases 2019; 7:3990-4003. [PMID: 31832401 PMCID: PMC6906558 DOI: 10.12998/wjcc.v7.i23.3990] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Revised: 10/31/2019] [Accepted: 11/15/2019] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Although it has been shown that arylsulfatases are lost in colorectal cancer (CRC) cell lines, their exact role in the carcinogenesis and behavior of this cancer was not elucidated. No data about the correlation between serum and immunohistochemical (IHC) level of arylsulfatases (ARSA, ARSB) in patients with CRC were published yet.
AIM To evaluate the possible prognostic value of ARSA and/or ARSB in CRC, at circulating and protein levels.
METHODS The present study included 45 consecutive patients who were prospectively diagnosed with CRC. For IHC stains (protein expression) ARSA, ARSB and maspin expression were quantified. For these markers, cytoplasmic expression was taken into account. For gene expression study, circulating mRNA was isolated from all patients, before surgery. A group of 45 healthy patients without inflammatory or tumor pathologies was used as control group. Reverse transcription and Taqman Gene Expression Array were used for ARSB gene expression.
RESULTS The preoperative circulating RNA level of the ARSB gene was significantly decreased in patients with CRC (RQ < 1), compared with the control group (RQ > 1). A more significant decrease (RQ < 0.5) occurred in ulcero-infiltrative maspin-positive adenocarcinomas, with a higher degree of tumor budding, diagnosed in locally advanced stages (pT3/4). ARSA/maspin immunopositivity indicated a higher risk for lymph node metastasis, while triple positivity for maspin/ARSA/ARSB and ARSB gene expression level < 0.5 were indicators of CRC aggressive behavior, independent of lymph node status.
CONCLUSION The significant independent negative prognostic factors of CRC are the ulcero-infiltrative aspect, high budding degree, triple positivity for maspin, ARSA and ARSB, and low ARSB gene expression.
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Affiliation(s)
- Zsolt Kovacs
- Department of Pathology, University of Medicine, Pharmacy, Sciences and Technology “George Emil Palade”, Targu Mures 530149, Romania
| | - Ioan Jung
- Department of Pathology, University of Medicine, Pharmacy, Sciences and Technology “George Emil Palade”, Targu Mures 530149, Romania
| | - Krisztina Szalman
- Department of Internal Medicine, University of Medicine, Pharmacy, Sciences and Technology “George Emil Palade”, Targu Mures 530149, Romania
| | - Laura Banias
- Department of Pathology, University of Medicine, Pharmacy, Sciences and Technology “George Emil Palade”, Targu Mures 530149, Romania
| | - Tivadar Jr Bara
- Department of Surgery, University of Medicine, Pharmacy, Science and Technology “George Emil Palade”, Tirgu Mures 530149, Romania
| | - Simona Gurzu
- Department of Pathology, University of Medicine, Pharmacy, Sciences and Technology “George Emil Palade”, Targu Mures 530149, Romania
- Research Center (CCAMF), University of Medicine, Pharmacy, Sciences and Technology, Targu Mures 540139, Romania
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Gurzu S, Fetyko A, Bara T, Banias L, Butiurca VO, Bara T, Tudorache V, Jung I. Gastrointestinal mixed adenoneuroendocrine carcinoma (MANEC): An immunohistochemistry study of 13 microsatellite stable cases. Pathol Res Pract 2019; 215:152697. [PMID: 31704155 DOI: 10.1016/j.prp.2019.152697] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 10/16/2019] [Accepted: 10/17/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND Mixed adenoneuroendocrine carcinoma (MANEC) is currently included in the category of neuroendocrine carcinomas but the therapeutically management is not yet defined. AIMS To present the immunohistochemical (IHC) features of the epithelial mesenchymal transition (EMT) of MANEC. MATERIALS AND METHODS The clinicopathological features of 13 consecutive cases of MANEC (6 gastric and 7 colorectal) were correlated with the IHC expression of the biomarkers E-cadherin, β-catenin, N-cadherin, vimentin, maspin, CD44 and S100. In all of the cases open surgery was performed. RESULTS All of the cases showed microsatellite stable status, expressed E-cadherin and membrane β-catenin in both components (neuroendocrine and adenocarcinoma) and were negative for N-cadherin, vimentin and S-100. The colorectal MANECs were negative for maspin. In gastric MANECs, maspin showed cytoplasm positivity in the neuroendocrine component and nuclear translocation in the adenocarcinoma cells. CD44 was positive in all of the cases, in both components. No tumor buddings were identified. Three of the 13 patients survived for at least 32 months, all of them showing lymphatic emboli but not lymph node metastases. Pure neuroendocrine lymph node metastases were seen in only four of the cases: one from stomach, two of the ascending colon and two cases of the upper rectum. CONCLUSIONS Gastrointestinal MANEC is a microsatellite stable tumor with nodular growth, which components might originate from a CD44-positive stem-like precursor cell. Lymph node status remains the most reliable prognostic parameter and agressivity seems to not be influenced by tumor budding degree or EMT-related features. The histologic aspect of metastatic component (neuroendocrine versus adenocarcinoma) should be included in the histopathological reports and might be used for establishing the proper-targeted therapy of MANEC.
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Affiliation(s)
- Simona Gurzu
- Department of Pathology, University of Medicine, Pharmacy, Sciences and Technology, George Emil Palade, Tirgu-Mures, Romania; Department of Pathology, Clinical County Emergency Hospital, Tirgu-Mures, Romania; Department of Pathology, Research Center of the University of Medicine, Pharmacy, Sciences and Technology, George Emil Palade, Tirgu-Mures, Romania.
| | - Annamaria Fetyko
- Department of Pathology, Clinical County Emergency Hospital, Tirgu-Mures, Romania
| | - Tivadar Bara
- Department of Surgery, University of Medicine, Pharmacy, Sciences and Technology, George Emil Palade, Tirgu-Mures, Romania
| | - Laura Banias
- Department of Pathology, University of Medicine, Pharmacy, Sciences and Technology, George Emil Palade, Tirgu-Mures, Romania
| | - Vlad Olimpiu Butiurca
- Department of Surgery, University of Medicine, Pharmacy, Sciences and Technology, George Emil Palade, Tirgu-Mures, Romania
| | - Tivadar Bara
- Department of Surgery, University of Medicine, Pharmacy, Sciences and Technology, George Emil Palade, Tirgu-Mures, Romania
| | - Vlad Tudorache
- Department of Pathology, University of Medicine, Pharmacy, Sciences and Technology, George Emil Palade, Tirgu-Mures, Romania
| | - Ioan Jung
- Department of Pathology, University of Medicine, Pharmacy, Sciences and Technology, George Emil Palade, Tirgu-Mures, Romania
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Butiurca VO, Molnar C, Constantin C, Botoncea M, Bud TI, Kovacs Z, Satala C, Gurzu S. Long Term Results of Modified Intersphincteric Resections for Low Rectal Cancer: A Single Center Experience. Medicina (Kaunas) 2019; 55:medicina55120764. [PMID: 31795439 PMCID: PMC6955682 DOI: 10.3390/medicina55120764] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2019] [Revised: 11/25/2019] [Accepted: 11/27/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND AND OBJECTIVES The objective of this article is to evaluate the long-term oncological and functional outcomes following modified intersphincteric resections (ISR) for low rectal cancer. The modified technique consisted of the abandonment of colonic J-pouches, transverse coloplasty, or defunctioning temporary stoma in favor of a direct handsewn coloanal anastomosis (CAA). MATERIAL AND METHODS Sixty consecutive patients with type II and III (juxta-anal or intra-anal) low rectal tumors underwent modified ISR by the same surgical team and were followed for a period of five years. Functional outcomes using the Wexner Score, postoperative complications, recurrence rates, morbidity, and mortality rates were assessed. RESULTS The five-year survival rate was 93.3% with a disease-free interval at three years of 98%. Morbidity was 15% (n = 9) consisting of intestinal wall necrosis (n = 6), stenosis (n = 2), and sacral metastasis (n = 1). The Wexner score values were, at 1 year, 8.5 (range, 4-13); at three years 7.2 (range, 2-11); and at 5 years 6.7 (range, 2-12). A second surgery was needed in only one case that showed postoperative transmural necrosis of the colonic wall. CONCLUSIONS In highly selected patients with type II or III low rectal tumors and proper preoperative imaging staging, ISR might be a viable alternative to other techniques such as abdominoperineal resection and low anterior resection, both from a functional and an oncological perspective.
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Affiliation(s)
- Vlad-Olimpiu Butiurca
- First Department of Surgery, University of Medicine, Pharmacy, Science and Technology ‘George Emil Palade’, 540139 Târgu-Mureș, Romania; (V.-O.B.); (C.C.); (M.B.)
- Clinic of Vascular Surgery, Emergency County Hospital, 540139 Târgu-Mureș, Romania;
| | - Călin Molnar
- First Department of Surgery, University of Medicine, Pharmacy, Science and Technology ‘George Emil Palade’, 540139 Târgu-Mureș, Romania; (V.-O.B.); (C.C.); (M.B.)
- Correspondence: ; Tel.: +40-07-2224-1281
| | - Copotoiu Constantin
- First Department of Surgery, University of Medicine, Pharmacy, Science and Technology ‘George Emil Palade’, 540139 Târgu-Mureș, Romania; (V.-O.B.); (C.C.); (M.B.)
| | - Marian Botoncea
- First Department of Surgery, University of Medicine, Pharmacy, Science and Technology ‘George Emil Palade’, 540139 Târgu-Mureș, Romania; (V.-O.B.); (C.C.); (M.B.)
| | - Teodor Ioan Bud
- Clinic of Vascular Surgery, Emergency County Hospital, 540139 Târgu-Mureș, Romania;
| | - Zsolt Kovacs
- Department of Pathology, Emergency County Hospital, 540136 Târgu-Mureș, Romania; (Z.K.); (C.S.)
| | - Cătălin Satala
- Department of Pathology, Emergency County Hospital, 540136 Târgu-Mureș, Romania; (Z.K.); (C.S.)
| | - Simona Gurzu
- Department of Pathology, University of Medicine, Pharmacy, Science and Technology, 540139 Târgu-Mureș, Romania;
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Gurzu S, Sugimura H, Van Staden R, Yamada H, Jung I. The importance of p53 signaling pathway in the evolution of gastric cancer. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz413.039] [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: 11/12/2022] Open
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Jung I, Banias L, Bara T, Kovacs Z, Fulop Z, Simu P, Simu I, Gurzu S. Epithelial-mesenchymal transition of tumour buds: A histopathological parameter with potential implication in oncological therapy of colorectal carcinoma. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz413.092] [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: 11/14/2022] Open
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Banceu C, Gurzu S, Harpa M, Brinzaniuc K, Ispas M, Bud V, Kovacs J, Pop M, Ciorba M, Hessein HA, Suciu H. Therapeutic Management of Trauma-related Acute Pancreatitis in a Heart Transplant Recipient. Rev Chim 2019. [DOI: 10.37358/rc.19.9.7496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Acute pancreatitis is a very mortal disease, mortality that increases even more in patients with cardiac transplantation. Medical-surgical management of acute pancreatitis in transplanted patients can make the difference between life and death. The aim of this paper was to highlight the severity of this pathology especially because the patient is immunosuppressed after cardiac transplant. A case of 36-year-old man, known with heart transplant, immunosuppressive treatment and chronic renal frailer, who arrived to Emergency Department, with severe abdominal pain and abdominal distention which started after a traumatic accident. Investigations revealed acute pancreatitis that needed three surgeries for acute necrotic hemorrhagic pancreatitis, acute bleeding, left subphrenic abscess and intensive care therapy. With favorable postoperative evolution, patient is discharged 60 days later He�s follow up reveled no gastrointestinal or cardiac complication with an improved quality of life.
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