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Agarwal G, Sattavan S, Kumar A, Agrawal V, Chanthar V, Mayilvaghanan S, Chand G, Mishra A. P051 Cost-efficacy Analysis of Use of Frozen Section Histology for Margin Assessment During Breast Conservation Surgery in Breast Cancer Patients. Breast 2023. [DOI: 10.1016/s0960-9776(23)00170-4] [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: 03/18/2023] Open
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Agrawal V, Das G, Singla LD, Shukla S, Maharana BR, Jayraw AK, Shakya M, Jatav GP. Bovine cerebral theileriosis: first molecular report in cross bred cattle calf in India. J Parasit Dis 2023; 47:113-117. [PMID: 36910325 PMCID: PMC9998821 DOI: 10.1007/s12639-022-01544-9] [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: 08/10/2022] [Accepted: 10/20/2022] [Indexed: 11/05/2022] Open
Abstract
Bovine tropical theileriosis caused by Theileria annulata, is a serious constraint to Indian dairy industry with more fatal infections in exotic cattle and substantial losses to cross-bred and indigenous zebu cattle. The present communication is to place on record the first report of molecular based confirmed case of cerebral theileriosis caused by T. annulata coupled with its morphological detection, clinical manifestations, haematological alterations and therapeutic management in a cross bred cattle calf from India. After preparation of peripheral thin blood smear from cross bred cattle calf at the site of collection and fixation with methanol, blood sample brought to Department of Veterinary Parasitology, College of Veterinary Science and A.H, Jabalpur and stained by standard protocol for Giemsa staining. Genomic DNA was isolated from the collected blood sample using QIAamp® DNA blood mini kit following the manufacturer's recommendations and PCR was performed. The cross bred cow calf revealed high rise in temperature (105.5°F), increased heart rate, labored breathing with seromucous nasal discharge, enlargement of prescapular lymph node and animal exhibited tonic clonic convulsions in response to any sudden noise. Giemsa stained thin blood smear revealed intraerythrocytic piroplasm and Koch'sblue bodies of T. annulata within the cytoplasm of lymphocytes. The species of Theileria was confirmed by molecular amplification of genomic DNA as T. annulata.
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Affiliation(s)
- V. Agrawal
- Department of Veterinary Parasitology, College of Veterinary Science and Animal Husbandry, Mhow, Indore, M.P. India
- Nanaji Deshmukh Veterinary Science University, Jabalpur, M.P. India
| | - G. Das
- Nanaji Deshmukh Veterinary Science University, Jabalpur, M.P. India
- Department of Veterinary Parasitology, College of Veterinary Science and Animal Husbandry, Jabalpur, India
| | - L. D. Singla
- Department of Veterinary Parasitology, College of Veterinary Science, Guru Angad Dev Veterinary and Animal Sciences University, Ludhiana, 141004 India
| | - S. Shukla
- Nanaji Deshmukh Veterinary Science University, Jabalpur, M.P. India
- Department of Veterinary Pathology, College of Veterinary Science and Animal Husbandry, Mhow, Indore, India
| | - B. R. Maharana
- Referral Veterinary Diagnostic and Extension Centre (RVDEC), Lala Lajpat Rai University of Veterinary and Animal Sciences (LUVAS), Uchani, Karnal, Haryana India
| | - A. K. Jayraw
- Department of Veterinary Parasitology, College of Veterinary Science and Animal Husbandry, Mhow, Indore, M.P. India
- Nanaji Deshmukh Veterinary Science University, Jabalpur, M.P. India
| | - M. Shakya
- Department of Veterinary Parasitology, College of Veterinary Science and Animal Husbandry, Mhow, Indore, M.P. India
- Nanaji Deshmukh Veterinary Science University, Jabalpur, M.P. India
| | - G. P. Jatav
- Nanaji Deshmukh Veterinary Science University, Jabalpur, M.P. India
- Department of Veterinary Pathology, College of Veterinary Science and Animal Husbandry, Mhow, Indore, India
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Yadav B, Prasad N, Agrawal V, Jain M, Agarwal V. WCN23-0779 Inflammatory interstitial fibrosis and tubular atrophy is associated with intragraft Granzyme-B+ immune cell infiltration and phosphoSMAD-3+ mediated signaling in renal transplant recipients. Kidney Int Rep 2023. [DOI: 10.1016/j.ekir.2023.02.903] [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: 03/22/2023] Open
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KAMTHAN S, Agrawal V, Singh S, Prasad N, Agarwal V. WCN23-1127 CIRCULATING MICROPARTICLES, URINARY SOLUBLE CD163 AND CD163+ M2 MACROPHAGE TISSUE INFILTRATION IN ANTIBODY-MEDIATED RENAL ALLOGRAFT REJECTION. Kidney Int Rep 2023. [DOI: 10.1016/j.ekir.2023.02.929] [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: 03/22/2023] Open
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Agrawal V, Colbert KR, Kumar S, Dharanya , Bhat RV. Papillary Carcinoma of Thyroglossal Duct Cyst- A Diagnostic and Therapeutic Conundrum. Kathmandu Univ Med J (KUMJ) 2023; 21:106-109. [PMID: 37800438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/07/2023]
Abstract
Thyroglossal duct cysts (TGDC) are the most common congenital midline neck mass. It accounts for 70% of congenital neck masses in children and 7% in the general population. Untreated, Thyroglossal duct cyst may transform into a thyroid carcinoma in less than 1% of cases. A 47 year old female patient presented with complaints of swelling on the anterior aspect of neck for 1 year which was progressively increasing in size. Smears from needle aspiration revealed features suspicious of Papillary carcinoma of thyroid which was confirmed as on histopathology. Thyroid gland and the adjacent lymph nodes were free of the tumour on Computed Tomography (CT). Thyroglossal duct cysts undergoing neoplastic change is more common among women. Though sistrunk's procedure is widely accepted as a primary management, the role of total thyroidectomy with radioiodine therapy still remains a controversy due to contrasting opinions available in the literature.
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Affiliation(s)
- V Agrawal
- Department of Pathology, Indira Gandhi Medical College and Research Institute, Vazhudavur Road, Kathirkamam, Puducherry, India
| | - K R Colbert
- Department of ENT, Indira Gandhi Medical College and Research Institute, Vazhudavur Road, Kathirkamam, Puducherry, India
| | - S Kumar
- Department of ENT, Indira Gandhi Medical College and Research Institute, Vazhudavur Road, Kathirkamam, Puducherry, India
| | - - Dharanya
- Department of ENT, Indira Gandhi Medical College and Research Institute, Vazhudavur Road, Kathirkamam, Puducherry, India
| | - R V Bhat
- Department of Pathology, Indira Gandhi Medical College and Research Institute, Vazhudavur Road, Kathirkamam, Puducherry, India
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Joshi U, Subedi R, Nepal G, Gyawali S, Agrawal V, Poudyal BS, Bhatt VR, D'Angelo CR. EFFICACY OF AUTOLOGOUS STEM CELL TRANSPLANTATION IN ADULT BURKITT/BURKITT-LIKE LYMPHOMA: A SYSTEMATIC REVIEW. Exp Oncol 2022; 44:190-197. [PMID: 36325697 DOI: 10.32471/exp-oncology.2312-8852.vol-44-no-3.18599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
BACKGROUND Burkitt and Burkitt like lymphoma (BL/BLL) are highly proliferative germinal or post-germinal B cell tumors. Few studies have evaluated the impact of autologous stem cell transplantation (ASCT) on disease outcomes. AIM We performed a systematic review to analyze the efficacy of ASCT as frontline consolidation and for treatment of relapsed/refractory cases in adult BL/BLL. MATERIALS AND METHODS Eligible studies with clear outcome measures on the efficacy of ASCT in adult patients with BL/BLL were identified through systematic search. The overall survival (OS), progression-free survival (PFS), complete response (CR), partial response (PR), and progression/relapse were used to assess the efficacy. RESULTS For patients who underwent ASCT in first CR, 5-year PFS and OS ranged between 70-78% and 70-83% respectively. For relapsed/refractory disease, 5-year PFS and OS were 27% and 31%, respectively. Patients undergoing ASCT for chemoresistant disease fared poorly with 3-year OS of 7% vs 37% for chemosensitive disease (p ≤ 0.00001). The overall response rate to ASCT for patients transplanted in first CR ranged between 71% and 93% and was 37% for patients who were transplanted in disease status other than first CR. Disease progression/relapse was observed in 16-29% of the patients transplanted in first CR, and 55% to 60% in relapsed disease. CONCLUSION We found insufficient evidence to support ASCT over chemotherapy alone in the first remission for adult BL/BLL. Evidence supports guidelines recommending ASCT for chemosensitive disease but suggests there is no benefit to ASCT for chemoresistant disease.
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Affiliation(s)
- U Joshi
- Department of Internal Medicine, Rochester General Hospital, Rochester, NY 14621, USA
| | - R Subedi
- Department of Internal Medicine, Unity Hospital - Rochester Regional Health, Rochester, NY 14626, USA
| | - G Nepal
- Department of Internal Medicine, Tribhuvan University Teaching Hospital, Institute of Medicine, Kathmandu 44600, Nepal
| | - S Gyawali
- Department of Internal Medicine, Sukraraj Tropical and Infectious Disease Hospital, Kathmandu 44600, Nepal
| | - V Agrawal
- Department of Internal Medicine, Tribhuvan University Teaching Hospital, Institute of Medicine, Kathmandu 44600, Nepal
| | - B S Poudyal
- Clinical Hematology and Bone Marrow Transplant Unit, Civil Service Hospital, Kathmandu 44600, Nepal
| | - V R Bhatt
- Department of Internal Medicine, Division of Hematology-Oncology, University of Nebraska Medical Center, Omaha, NE 68198, USA
- Fred and Pamela Buffett Cancer Center, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Ch R D'Angelo
- Department of Internal Medicine, Division of Hematology-Oncology, University of Nebraska Medical Center, Omaha, NE 68198, USA
- Fred and Pamela Buffett Cancer Center, University of Nebraska Medical Center, Omaha, NE 68198, USA
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Singh R, Singh UP, Agrawal V, Garg M. Epithelial-to-mesenchymal transition based diagnostic and prognostic signature markers in non-muscle invasive and muscle invasive bladder cancer patients. Mol Biol Rep 2022; 49:7541-7556. [PMID: 35593896 DOI: 10.1007/s11033-022-07563-2] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Accepted: 05/04/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Diagnostic and prognostic significance of epithelial-to-mesenchymal transition (EMT) associated biomarkers are evaluated in a cohort of NMIBC (non-muscle invasive bladder cancer) and MIBC (muscle invasive bladder cancer) patients. METHODS AND RESULTS Real-time quantitative polymerase chain reaction (RT-qPCR) and immunohistochemical (IHC) staining were carried out in 100 tumor specimens (59 NMIBC and 41 MIBC). The expressions of the epithelial marker, mesenchymal markers and EMT-activating transcription factors (EMT-ATFs) were determined at transcriptome and protein level followed by their statistical associations with clinicohistopathological variables of the patients. Transcriptomic expression analysis showed statistical relevance of tumor stage with increased Twist and Zeb-1; tumor type with reduced E-cadherin and increased Snail; and smoking/tobacco chewing status (S/TC) of patients with increased N-cadherin and Snail in NMIBC patients. Tumor grade with reduced message E-cadherin, gain of N-cadherin, Snail, Twist and Zeb-1; patients' age with reduced E-cadherin and Twist gain; and tumor type with increased message N-cadherin exhibited associations in MIBC patients. Protein expression analysis identified statistical relevance of tumor grade with nuclear gain of Snail and Twist; and nuclear gain of Slug with S/TC status of NMIBC patients. Novel gain of membranous Vimentin deduced association with patients' age in MIBC patients. Survival analysis identified novel Vimentin as the positive predictor of short progression free survival (PFS) and short overall survival (OS) in MIBC patients. Study established altered EMT profile as the independent negative predictor of short recurrence free survival (RFS) in NMIBC patients and positive predictor of short PFS and OS in MIBC patients. CONCLUSIONS EMT associated biomarkers could provide diagnostic and prognostic risk stratification and hence could be of importance in the clinical management of bladder cancer patients.
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Affiliation(s)
- R Singh
- Department of Biochemistry, University of Lucknow, Lucknow, 226007, India
| | - U P Singh
- Department of Urology and Renal Transplantation, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, 226014, India
| | - V Agrawal
- Department of Pathology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, 226014, India
| | - M Garg
- Department of Biochemistry, University of Lucknow, Lucknow, 226007, India.
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Agrawal V, Paulose R, Arya R, Rajak G, Giri A, Bijanu A, Sanghi SK, Mishra D, N P, Khare AK, Parmar V, Khan MA, Bhisikar A, Srivastava AK, Thankaraj Salammal S. Green conversion of hazardous red mud into diagnostic X-ray shielding tiles. J Hazard Mater 2022; 424:127507. [PMID: 34879512 DOI: 10.1016/j.jhazmat.2021.127507] [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] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 09/30/2021] [Accepted: 10/11/2021] [Indexed: 06/13/2023]
Abstract
Red mud is a solid hazardous alumina industrial waste, which is rich in iron, titanium, aluminum, silicon, calcium, etc. The red mud contains 30-60% of hematite, which is suitable for shielding high energy X- and gamma rays. So, the iron rich red mud was converted into diagnostic X-ray shielding tiles through ceramic route by adding a certain weight percentage of BaSO4 and binders (kaolin clay or sodium hexametaphosphate) with it. The kaolin clay tile possess sufficient impact strength (failure point is 852 mm for 19 mm steel ball) and flexural strength of ~25 N/mm2, which is suitable for wall applications. The 10.3 mm and 14.7 mm thick red mud:BaSO4:kaolin clay tile possess the attenuation equivalent to 2 mm and 2.3 mm lead at 125 kVp and 140 kVp, respectively. No heavy elements were found to leach out except chromium and arsenic from the sintered tiles. However, the leaching of Cr (0.6 ppm) and As (0.015 ppm) was found to be well below the permissible limit. These tiles can be used in the X-ray diagnosis, CT scanner, bone densitometry, and cath labs instead of toxic lead sheet and thereby to protect the operating personnel, public, and environment from radiation hazards.
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Affiliation(s)
- Varsha Agrawal
- CSIR-Advanced Materials and Processes Research Institute (CSIR-AMPRI), Bhopal, Madhya Pradesh, India; Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, India
| | - Rini Paulose
- CSIR-Advanced Materials and Processes Research Institute (CSIR-AMPRI), Bhopal, Madhya Pradesh, India
| | - Rahul Arya
- CSIR-Advanced Materials and Processes Research Institute (CSIR-AMPRI), Bhopal, Madhya Pradesh, India; Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, India
| | - Gaurav Rajak
- CSIR-Advanced Materials and Processes Research Institute (CSIR-AMPRI), Bhopal, Madhya Pradesh, India; Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, India
| | - Abhishek Giri
- CSIR-Advanced Materials and Processes Research Institute (CSIR-AMPRI), Bhopal, Madhya Pradesh, India
| | - Abhijit Bijanu
- CSIR-Advanced Materials and Processes Research Institute (CSIR-AMPRI), Bhopal, Madhya Pradesh, India; Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, India
| | - Sunil K Sanghi
- CSIR-Advanced Materials and Processes Research Institute (CSIR-AMPRI), Bhopal, Madhya Pradesh, India
| | - Deepti Mishra
- CSIR-Advanced Materials and Processes Research Institute (CSIR-AMPRI), Bhopal, Madhya Pradesh, India; Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, India
| | - Prasanth N
- CSIR-Advanced Materials and Processes Research Institute (CSIR-AMPRI), Bhopal, Madhya Pradesh, India
| | - Anup Kumar Khare
- CSIR-Advanced Materials and Processes Research Institute (CSIR-AMPRI), Bhopal, Madhya Pradesh, India
| | - Varsha Parmar
- CSIR-Advanced Materials and Processes Research Institute (CSIR-AMPRI), Bhopal, Madhya Pradesh, India; Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, India
| | - Mohammed Akram Khan
- CSIR-Advanced Materials and Processes Research Institute (CSIR-AMPRI), Bhopal, Madhya Pradesh, India; Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, India
| | - Abhay Bhisikar
- Raja Ramanna Centre for Advanced Technology (RRCAT), Indore, India
| | - Avanish Kumar Srivastava
- CSIR-Advanced Materials and Processes Research Institute (CSIR-AMPRI), Bhopal, Madhya Pradesh, India; Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, India
| | - Shabi Thankaraj Salammal
- CSIR-Advanced Materials and Processes Research Institute (CSIR-AMPRI), Bhopal, Madhya Pradesh, India; Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, India.
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Agrawal V, Ma X, Kang J, Hu J, Barbieri C, Nagar H. Trends And Disparities In The Diagnosis And Initial Management Of High-Risk Prostate Cancer In The United States. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.443] [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: 10/23/2022]
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Agrawal V, Kaylor K, Fenton-Kerimian M, Golden E, Kang J, Ng J, Formenti S. Feasibility of Hypo-fractionated Radiation Therapy to the Breast and Nodal Stations after Neo-Adjuvant Systemic Therapy and Surgery (NCT02917421). Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.1166] [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: 11/27/2022]
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Agrawal V, Nagar H, Formenti S, Kang J. Phase I Trial Of MRI-Linac Based Stereotactic Body Radiation Therapy With Simultaneous Integrated Boost For Localized Prostate Cancer (NCT03664193). Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.413] [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: 10/23/2022]
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Venkataraman S, Murari M, Agrawal V, Pandey R, Aggarwal A. Simple And Cost-Effective Classics Are Back- Revisiting The Role Of Urine Microscopic Analysis For Assessing Severity Of Renal Involvement In Lupus Nephritis. Am J Clin Pathol 2020. [DOI: 10.1093/ajcp/aqaa161.187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Casestudy
Urinalysis is important to assess disease activity in Lupus nephritis (LN). Hematuria, pyuria, cellular/granular casts and proteinuria are scored separately for assessing renal activity in SLEDAI. However, pyuria is not specific, and could indicate infection. We studied the correlation of microscopic urinalysis and degree of lymphocyturia with histological ISN/RPS 2018 class of LN.
Methods
Pre-biopsy urine was collected in 76 LN patients. The urine sediment was analyzed using light and phase- contrast microscope. Smear stained with supravital stain Sternheimer Malbin, was assessed semi-quantitatively for lymphocytes (per HPF). Renal biopsy was classified into proliferative (Class III/IV ± V)[N=64] and non-proliferative LN (Class I, II, V, VI) [N=12].
Results
48 patients had active urinary sediment. Cellular and/or granular casts were identified only in proliferativeLN (n=15/64; 23.4%). Hematuria (Range 0-65/HPF) was seen in 45 patients. Dysmorphic RBCs were identified in proliferative (n=17/41; mean 9.9 RBCs/HPF) and were absent in non-proliferative LN (mean 1.4 RBCs/HPF). 20 of the 34 patients with pyuria showed predominant lymphocytes. Lymphocyturia (Range 0-20/HPF) was significantly higher in proliferative LN (Mean 4.6/HPF) as compared to non-proliferative LN (Mean 1.5/HPF). Degree of pyuria or proteinuria had no correlation with biopsy class or activity. Lymphocyturia and hematuria showed correlation with biopsy activity index (r=0.30 and 0.39; p<0.05 and <0.001 respectively). A cut-off of average 6 RBCs/HPF or 5 lymphocytes/HPF could correctly identify proliferative LN with 100% specificity (p<0.001; AUC 0.72 and 0.74 respectively, combined AUC 0.81) and sensitivity of 0.42 and 0.36 respectively.
Conclusion
Although renal biopsy is the gold standard for assessment of renal lesions in LN, urine lymphocytes ≥5 and RBCs ≥6/HPF have a high specificity to differentiate proliferative and non-proliferative LN. This may be especially important in patients having comorbidities contraindicating a renal biopsy. Defining urine sediments using lymphocytes can increase the specificity of clinical activity indices.
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Affiliation(s)
- S Venkataraman
- Department of Pathology, Sanjay Gandhi Postgraduate Institute for Medical Sciences, Lucknow, India, Lucknow, Uttar Pradesh, INDIA
| | - M Murari
- Department of Pathology, Sanjay Gandhi Postgraduate Institute for Medical Sciences, Lucknow, India, Lucknow, Uttar Pradesh, INDIA
| | - V Agrawal
- Department of Pathology, Sanjay Gandhi Postgraduate Institute for Medical Sciences, Lucknow, India, Lucknow, Uttar Pradesh, INDIA
| | - R Pandey
- Department of Pathology, Sanjay Gandhi Postgraduate Institute for Medical Sciences, Lucknow, India, Lucknow, Uttar Pradesh, INDIA
| | - A Aggarwal
- Department of Clinical Immunology and Rheumatology, Sanjay Gandhi Postgraduate Institute for Medical Sciences, Lucknow, India, Lucknow, INDIA
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Affiliation(s)
- V Agrawal
- Division of Pediatric Surgery, Department of Surgery, Jabalpur, India
| | - D Sharma
- Department of Surgery, Netaji Subhash Chandra Bose Medical College and Hospitals, Jabalpur, India
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Mishra BK, Banerjee BD, Agrawal V, Madhu SV. Association of PPARγ gene expression with postprandial hypertriglyceridaemia and risk of type 2 diabetes mellitus. Endocrine 2020; 68:549-556. [PMID: 32180115 DOI: 10.1007/s12020-020-02257-w] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Accepted: 03/03/2020] [Indexed: 12/15/2022]
Abstract
PURPOSE Peroxisome proliferator-activated receptor γ (PPARγ) gene is strongly associated with type 2 diabetes mellitus, as well as postprandial lipemia, and plays an important role in Wnt dependent adipogenesis in subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT). We aimed to study the expression of PPARγ gene in SAT and VAT to find out its correlation with postprandial hypertriglyceredemia and glucose intolerance. METHODS Thirty subjects who were scheduled to undergo abdominal surgery were recruited in three groups (n = 10 in NGT, n = 10 in prediabetes, and n = 10 in T2DM). A standardized oral fat challenge was performed. Anthropometry, plasma glucose, HbA1c, and fasting serum insulin were also measured. SAT and VATs were collected during surgery for PPARγ gene expression studies by real-time PCR. RESULTS PPARγ gene expression was 5.5-fold lower in T2DM and 1.7-fold lower in prediabetes as compared with NGT subjects in VAT. There was a significant negative correlation of expression of PPARγ gene in VAT {Tgauc (r = -0.57, p < 0.007), Peak Tg (r = -0.51, p < 0.01)} as well as in subcutaneous adipose tissue {Tgauc (r = -0.45, p < 0.02)} with PPTg responses measures. CONCLUSION Reduced adipocyte expression of PPARγ gene and the resultant postprandial hypertriglyceredemia is associated with greater risk of diabetes and prediabetes.
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Affiliation(s)
- B K Mishra
- Department of Endocrinology, University College of Medical Sciences, University of Delhi, Delhi, India
| | - B D Banerjee
- Department of Biochemistry, University College of Medical Sciences, University of Delhi, Delhi, India
| | - V Agrawal
- Department of Surgery, University College of Medical Sciences, University of Delhi, Delhi, India
| | - S V Madhu
- Department of Endocrinology, University College of Medical Sciences, University of Delhi, Delhi, India.
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Kaul A, Agrawal V, Bhaduaria D, Agrawal V, Prasad N, Gupta A, Sharma RK. Vasculitis and vasculopathy in Lupus Nephritis: Clinical variability, outcome, and new insight into treatment. Saudi J Kidney Dis Transpl 2019; 28:415-424. [PMID: 28352031 DOI: 10.4103/1319-2442.202777] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
More than 50% of patients with systemic lupus erythematosus (SLE) have renal involvement at presentation or during their illness. Lupus nephritis (LN) encompasses several patterns of renal disease, including glomerular, tubulointerstitial, and vascular pathologies. The presence and significance of renal vascular lesions (VLs) are often overlooked. VLs in LN are not rare with an incidence of 10%-40% on renal biopsies from various studies and their presence is often labeled as poor prognostic markers. The current treatment protocol for LN is mainly based on the glomerular pathology, and no guidelines/consensus exists for treatment of LN with VLs. We describe the clinical presentation, course, response to therapy, and outcomes in five patients with SLE with histological evidence of renal VLs.
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Affiliation(s)
- A Kaul
- Department of Nephrology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - V Agrawal
- Department of Pathology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - D Bhaduaria
- Department of Nephrology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Vikas Agrawal
- Department of Immunology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Narayan Prasad
- Department of Nephrology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Amit Gupta
- Department of Nephrology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - R K Sharma
- Department of Nephrology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
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Huang Y, Agrawal V, Su M, Cherkasov A, Zhou Y. 143 Molecular targeting of the DNA binding domain of TOX protein results in selective inhibition of cutaneous T cell lymphoma cells. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.03.219] [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: 11/30/2022]
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Agarwal G, Sonthineni C, Mohindra N, Jain N, Neyaz Z, Agrawal V, Krishnani N, Maylivahnan S, Mishra A, Lal P. Abstract P1-15-11: Predicting pathological complete response (pCR) to neoadjuvant chemotherapy (NACT) based on pre- and post-NACT digital mammography and digital breast tomosynthesis findings. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p1-15-11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: In invasive breast cancer patients being treated with neoadjuvant chemotherapy (NACT), achieving pathological complete response (pCR) is a useful goal of treatment. Monitoring response to NACT and predicting pCR is helpful in planning further therapy and providing robust prognostic information. Digital mammography (DM) and additional digital breast tomosynthesis (DBT) features are important tell-tales of tumor characteristics and behaviour. Following NACT, the mammographic features- both DM and DBT- of responding tumors can vary considerably. In this prospective study, we correlated the DM and DBT features of pre-NACT and post-NACT mammograms to investigate if these can reliably predict pCR to NACT.
Methods: Following approval by institutional ethics committee, starting January 2016, 200 consecutive invasive breast carcinoma patients (mean age 51.2 years, all palpable breast masses) undergoing diagnostic breast imaging had their DM and DBT reviewed by two radiologists independently, who were blinded of the cyto/histology and the original DM and DBT reporting. Of these, 47 patients who were treated with NACT and had pre- and post-NACT DM and DBT were recruited. After a core-biopsy, radio-opaque marker(s) were placed in tumor core/margin. The pre- and post-NACT DM and DBT findings were compared and correlated with the extent of response of the primary breast tumor to NACT. DM and DBT characteristics predictive of (in-breast) pCR of index breast lesion were identified.
Results: Of the 47 patients who underwent NACT, 44 received both anthracycline and taxane, and 3 received only an anthracycline based combination chemotherapy. Twelve patients underwent breast conservative surgery and the remaining underwent mastectomy. pCR was seen in 17 (36.2%) patients based on the surgical specimen histology. On clinical examination, 19 (40.4%) patients had clinical complete response (cCR) of the breast tumor, 11 (64.7%) of whom had pCR as well. Five patients had radiological complete response (rCR, no breast lesion visualised on post-NACT imaging)- 2 patients on DM alone, 2 patients on DBT alone, and one patient on both DM and DBT. Radio-opaque clips had some obscuring effects in 3 of these 5 patients, especially on DBT, in form of reduced visibility of breast lesion on DBT, c.w. corresponding DM images. All 5 patients with rCR had pCR (sensitivity=29.4%, specificity=100%), in contrast to only 11 (57.9%) patients with cCR having pCR. Patients with pCR had benign appearing (forced Bi-RADS 2 and 3) lesions on mammography more commonly on DM (p<0.001) than on DBT (p=0.042) (41.2% vs 23.5%). Post NACT lesion morphology varied significantly between patients with and without pCR on DM (p=0.038) but not on DBT (p=0.182). Pre-NACT forced Bi-RADS score, lesion morphology or margin characteristics on DM and DBT did not vary significantly amongst patients with and without pCR.
Conclusions: Post-NACT DM and DBT features can predict pCR with high specificity but with low sensitivity. Pre-NACT DM and DBT features did not reliably predict response to NACT, and pCR in this study. DM may be better than DBT for assessing response to NACT in the presence of radio-opaque markers/clips.
Citation Format: Agarwal G, Sonthineni C, Mohindra N, Jain N, Neyaz Z, Agrawal V, Krishnani N, Maylivahnan S, Mishra A, Lal P. Predicting pathological complete response (pCR) to neoadjuvant chemotherapy (NACT) based on pre- and post-NACT digital mammography and digital breast tomosynthesis findings [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P1-15-11.
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Affiliation(s)
- G Agarwal
- SGPGIMS, Lucknow, Uttar Pradesh, India
| | | | | | - N Jain
- SGPGIMS, Lucknow, Uttar Pradesh, India
| | - Z Neyaz
- SGPGIMS, Lucknow, Uttar Pradesh, India
| | - V Agrawal
- SGPGIMS, Lucknow, Uttar Pradesh, India
| | | | | | - A Mishra
- SGPGIMS, Lucknow, Uttar Pradesh, India
| | - P Lal
- SGPGIMS, Lucknow, Uttar Pradesh, India
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Agrawal V, Ma X, Kang J, Nagar H. Delayed Radiation Therapy is Associated with Improved Overall Survival in Node Positive Prostate Cancer Treated with Androgen Deprivation Therapy. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.368] [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: 10/28/2022]
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Agrawal V, Bharti N. Alterations in Expression of Cell Surface and Cell Cycle Signaling Molecules in Recurrent Nonmuscle Invasive Bladder Cancers: A Tissue Microarray Expression Analysis. J Glob Oncol 2018. [DOI: 10.1200/jgo.18.60400] [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: 11/20/2022] Open
Abstract
Background: Nonmuscle invasive bladder cancers (NMIBC) are one of the most common urological cancers having a high risk of recurrence and progression. Recurrent tumors may acquire certain molecular alterations responsible for progression of the tumors. Identification of these alterations is important to understand the pathobiology and guide further management. Aim: We studied the differences in expression of cell surface proteins and cell cycle signaling molecules in primary and recurrent NMIBC by immunohistochemistry (IHC) on tissue microarrays (TMA). Methods: Using FFPE tissue, TMA of 82 tumors (40 primary NMIBC and 47 recurrences) were constructed. IHC for growth factor receptors [epidermal growth factor receptor (EGFR), HER2/neu and FGFR3], cell adhesion molecules (E-cadherin and beta-catenin) and cell cycle pathway molecules (p53, p21/WAF1/Cip1 and Ki-67 proliferation index) was performed. A semiquantitative H-score (Histo-score; range 0-300) was calculated according to the intensity (0, negative; 1, weak; 2, moderate; and 3, strong) and percentage of cells stained. < 10% cells showing nuclear p21 expression was considered p21-loss. The differences in expression between the primary and recurrent tumors were analyzed using paired t test. Results: The mean age at presentation was 65.3 ± 13.6 years with a male predominance (n=36). The mean time to recurrence was 33.4 months (range 3-109). Progression in grade and/or stage was seen in 30 (75%) tumors. Time to recurrence was shorter in primary tumors with ≥ 5% Ki-67 proliferation index. There was no significant difference in expression of cell surface proteins between primary and recurrent tumors. Significant p21 loss was seen in recurrent tumors ( P = 0.03) and significantly correlated with loss of surface beta-catenin and nuclear p53 positivity ( P = 0.002). Ki-67 index was higher in recurrent tumors and also correlated with p53 positivity ( P = 0.007). Conclusion: We found no significant differences in expression of cell surface molecules in primary nonmuscle invasive bladder cancers and their recurrences. However, there were significant alterations in expression of molecules of cell cycle signaling pathway and cellular proliferation in recurrent tumors suggesting the role of cell cycle regulators as promising targets in these cancers.
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Agrawal V, Agrawal S, Agrawal U, Kshirsagar A, Patil V. A Study of Serum Cholinesterase Activity with Clinical Correlation in Patients with Acute Organophosphorous Poisoning. J Med Res 2018. [DOI: 10.31254/jmr.2018.4505] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Abstract
BACKGROUND With increasing graft survival, post-transplant immunoglobulin A nephropathy (IgAN) has emerged as an important cause of chronic graft dysfunction in renal allograft recipients. We studied the clinico-pathological features of post-transplant IgAN regardless of the primary disease. The aim was to study the usefulness of the Oxford classification in predicting survival. METHODS Indication graft biopsy specimens (n = 915) were received during a 10-year period; 27 biopsy specimens from 22 patients were diagnosed as IgAN. RESULTS Post-transplant IgAN was seen in 2.6% of biopsy specimens. Mean time to occurrence was 71.6 ± 47.6 months (range, 6.8 months to 16 years), occurring most commonly 4 to 8 years after transplant. Associated rejection was present in 4 biopsies; 72.7% (16/22), 91% (20/22), and 31.8% (7/22) presented with rise in serum creatinine, proteinuria, and hematuria, respectively. Four (21%) patients had nephrotic range proteinuria. Mesangial hypercelullarity (M1), endocapillary hypercelullarity (E1), segmental glomerulosclerosis (S1), and tubulo-interstitial fibrosis (T1-2) was present in 36.6%, 22.7%, 54.5%, and 31.8% biopsies, respectively. The most frequent Haas class was III (n = 7; 29.1%), followed by classes IV and I (n = 5; 20.8% each). The 2- and 5-year graft survival rates were 75% and 56%, respectively. High serum creatinine, low estimated glomerular filtration rate, E1 and T lesions, and degree of interstitial inflammation predicted graft survival. Interestingly, percentage (>25%) of segmentally sclerosed glomeruli and not S1 correlated with graft outcome. CONCLUSIONS The Oxford MEST scheme is useful in predicting graft survival in post-transplant IgAN. The degree of interstitial inflammation is also an important feature for determining graft outcomes in post-transplant IgAN.
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Affiliation(s)
- V Agrawal
- Department of Pathology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.
| | - A Singh
- Department of Pathology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - A Kaul
- Department of Nephrology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - R Verma
- Department of Pathology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - M Jain
- Department of Pathology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - R Pandey
- Department of Pathology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
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Agrawal V, Cheung YH, Keswarpu P, Somlo G, Abu-Khalaf M, Sikov W, Varadan V, Harris L, Dimitrova N. Abstract P2-05-06: Not presented. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p2-05-06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
This abstract was not presented at the symposium.
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Affiliation(s)
- V Agrawal
- Philips Research North America, Cambridge, MA; Philips Genomics, Valhalla, NY; City of Hope National Medical Center, Duarte, CA; Yale Comprehensive Cancer Center, New Haven, CT; Women and Infants Hospital, Providence, RI; Case Western Reserve University, Cleveland, OH; National Institute of Health, Bethesda, MD
| | - YH Cheung
- Philips Research North America, Cambridge, MA; Philips Genomics, Valhalla, NY; City of Hope National Medical Center, Duarte, CA; Yale Comprehensive Cancer Center, New Haven, CT; Women and Infants Hospital, Providence, RI; Case Western Reserve University, Cleveland, OH; National Institute of Health, Bethesda, MD
| | - P Keswarpu
- Philips Research North America, Cambridge, MA; Philips Genomics, Valhalla, NY; City of Hope National Medical Center, Duarte, CA; Yale Comprehensive Cancer Center, New Haven, CT; Women and Infants Hospital, Providence, RI; Case Western Reserve University, Cleveland, OH; National Institute of Health, Bethesda, MD
| | - G Somlo
- Philips Research North America, Cambridge, MA; Philips Genomics, Valhalla, NY; City of Hope National Medical Center, Duarte, CA; Yale Comprehensive Cancer Center, New Haven, CT; Women and Infants Hospital, Providence, RI; Case Western Reserve University, Cleveland, OH; National Institute of Health, Bethesda, MD
| | - M Abu-Khalaf
- Philips Research North America, Cambridge, MA; Philips Genomics, Valhalla, NY; City of Hope National Medical Center, Duarte, CA; Yale Comprehensive Cancer Center, New Haven, CT; Women and Infants Hospital, Providence, RI; Case Western Reserve University, Cleveland, OH; National Institute of Health, Bethesda, MD
| | - W Sikov
- Philips Research North America, Cambridge, MA; Philips Genomics, Valhalla, NY; City of Hope National Medical Center, Duarte, CA; Yale Comprehensive Cancer Center, New Haven, CT; Women and Infants Hospital, Providence, RI; Case Western Reserve University, Cleveland, OH; National Institute of Health, Bethesda, MD
| | - V Varadan
- Philips Research North America, Cambridge, MA; Philips Genomics, Valhalla, NY; City of Hope National Medical Center, Duarte, CA; Yale Comprehensive Cancer Center, New Haven, CT; Women and Infants Hospital, Providence, RI; Case Western Reserve University, Cleveland, OH; National Institute of Health, Bethesda, MD
| | - L Harris
- Philips Research North America, Cambridge, MA; Philips Genomics, Valhalla, NY; City of Hope National Medical Center, Duarte, CA; Yale Comprehensive Cancer Center, New Haven, CT; Women and Infants Hospital, Providence, RI; Case Western Reserve University, Cleveland, OH; National Institute of Health, Bethesda, MD
| | - N Dimitrova
- Philips Research North America, Cambridge, MA; Philips Genomics, Valhalla, NY; City of Hope National Medical Center, Duarte, CA; Yale Comprehensive Cancer Center, New Haven, CT; Women and Infants Hospital, Providence, RI; Case Western Reserve University, Cleveland, OH; National Institute of Health, Bethesda, MD
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Singh R, Mandhani A, Agrawal V, Garg M. Positive Correlation between Matrix Metalloproteinases and Epithelial-to-Mesenchymal Transition and its Association with Clinical Outcome in Bladder Cancer Patients. Cancer Microenviron 2018; 11:23-39. [PMID: 29349669 DOI: 10.1007/s12307-017-0199-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Accepted: 10/10/2017] [Indexed: 12/21/2022]
Abstract
Involvement of matrix metalloproteinases (MMPs) in the pathogenesis of urothelial carcinoma elects them to be sensitive marker for clinical and prognostic implications. MMPs regulate tumor growth and invasion by inducing epithelial-to-mesenchymal transition (EMT) which is characterized by the complex reprogramming of epithelial cells and ultimately bring about major changes in the structural organization of bladder urothelium. The present study has been undertaken to evaluate the clinical relevance of MMPs in two distinct types of bladder cancer disease. Expression analysis of MMPs namely MMP-2, MMP-7, MMP-9 and EMT markers including epithelial marker, E-cadherin; mesenchymal markers, N-cadherin and Vimentin; and EMT-activating transcriptional factors (EMT-ATFs), Snail, Slug, Twist and Zeb was done in 64 cases of bladder tumor tissues [{Non-muscle invasive bladder cancer (NMIBC): 35 cases} and {Muscle invasive bladder cancer (MIBC): 29 cases}] by real-time quantitative polymerase chain reaction (RT-qPCR). Immunohistochemistry (IHC) staining was done in matched bladder tumor tissues to evaluate the protein expression and localization of E-cadherin, N-cadherin, Vimentin, Snail, and Slug. Our data showed overexpression of MMP-2, MMP-7 and MMP-9 at transcriptome level in 32.8%, 25% and 37.5% bladder tumor cases respectively. These tumor tissues were examined for higher expression of mesenchymal markers (N-cadherin and Vimentin) at mRNA and protein level and exhibited statistical association with tumor stage and tumor grade (p = 0.02, p = 0.04, Mann-Whitney test). Significant statistical correlation in tumor tissues with overexpressed MMPs has also been observed between gain of transcriptional factors and weak expression of E-cadherin with tumor stage, grade, gender, presence of hematuria and smoking history of the patients. Gene expression patterns of EMT markers in bladder tumors with overexpressed MMPs and their significant association with clinical profile validate the important role of MMPs in the pathogenesis of urothelial carcinoma of bladder (UCB). Increased expression of specific MMPs may affect several downstream EMT programs and thus may improve its diagnostic and prognostic utility in clinical setting.
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Affiliation(s)
- R Singh
- Department of Biochemistry, Lucknow University, Lucknow, 226007, India
| | - A Mandhani
- Uro-Oncology and Minimally Invasive Surgery, Fortis Escorts Kidney & Urology, New Delhi, India
| | - V Agrawal
- Department of Pathology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, 226014, India
| | - Minal Garg
- Department of Biochemistry, Lucknow University, Lucknow, 226007, India.
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Bankhead-Kendall B, Gutierrez T, Murry J, Holland D, Agrawal V, Almahmoud K, Pearcy C, Truitt MS. Antibiotics and open fractures of the lower extremity: less is more. Eur J Trauma Emerg Surg 2017; 45:125-129. [DOI: 10.1007/s00068-017-0847-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Accepted: 09/25/2017] [Indexed: 10/18/2022]
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25
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Prajapati R, Subramanian G, Jain D, Lohia B, Agrawal V, Shankar O, Chaudhary A, Bansal K. Coronary angiographic pattern in young (≤35 years) acute myocardial infarction patients. Indian Heart J 2017. [DOI: 10.1016/j.ihj.2017.09.183] [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: 11/30/2022] Open
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26
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Ohri S, Agrawal V, Kasliwal R. 26A hit that was a miss- a STEMI with a twist. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx495.26] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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27
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Allseits E, Lučarević J, Gailey R, Agrawal V, Gaunaurd I, Bennett C. The development and concurrent validity of a real-time algorithm for temporal gait analysis using inertial measurement units. J Biomech 2017; 55:27-33. [DOI: 10.1016/j.jbiomech.2017.02.016] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Revised: 02/08/2017] [Accepted: 02/11/2017] [Indexed: 11/28/2022]
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Agarwal G, Sonthineni C, Sabaretnam M, Chand G, Mishra A, Agarwal A, Verma A, Mishra S, Agrawal V, Lal P. Frozen section histology of margins facilitates one-step safe & cost-effective breast conservation surgery. Breast 2017. [DOI: 10.1016/s0960-9776(17)30348-x] [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: 10/20/2022] Open
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29
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Agrawal V, Zhong M, Huang W, Kewarpu P, Dimitrova N, Fallon JT. Abstract P1-05-29: Genomic variants in 5 male breast cancers using whole exome sequencing. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p1-05-29] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
This abstract was not presented at the symposium.
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Affiliation(s)
- V Agrawal
- Philips Research North America; New York Medical College/Westchester Medical Centre; Philips Healthcare
| | - M Zhong
- Philips Research North America; New York Medical College/Westchester Medical Centre; Philips Healthcare
| | - W Huang
- Philips Research North America; New York Medical College/Westchester Medical Centre; Philips Healthcare
| | - P Kewarpu
- Philips Research North America; New York Medical College/Westchester Medical Centre; Philips Healthcare
| | - N Dimitrova
- Philips Research North America; New York Medical College/Westchester Medical Centre; Philips Healthcare
| | - JT Fallon
- Philips Research North America; New York Medical College/Westchester Medical Centre; Philips Healthcare
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30
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Agarwal G, Sonthineni C, Maylivahanan S, Chand G, Mishra A, Agarwal A, Verma AK, Mishra SK, Agrawal V, Krishnani N, Lal P. Abstract P1-11-07: Frozen section histology evaluation of surgical margins helps perform single step oncologically safe and cost-effective breast conservation surgery. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p1-11-07] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
This abstract was withdrawn by the authors.
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Affiliation(s)
- G Agarwal
- Endocrine & Breast Surgery, SGPGIMS, Lucknow, UP, India; Pathology, SGPGIMS, Lucknow, UP, India; Radiotherapy, SGPGIMS, Lucknow, UP, India
| | - C Sonthineni
- Endocrine & Breast Surgery, SGPGIMS, Lucknow, UP, India; Pathology, SGPGIMS, Lucknow, UP, India; Radiotherapy, SGPGIMS, Lucknow, UP, India
| | - S Maylivahanan
- Endocrine & Breast Surgery, SGPGIMS, Lucknow, UP, India; Pathology, SGPGIMS, Lucknow, UP, India; Radiotherapy, SGPGIMS, Lucknow, UP, India
| | - G Chand
- Endocrine & Breast Surgery, SGPGIMS, Lucknow, UP, India; Pathology, SGPGIMS, Lucknow, UP, India; Radiotherapy, SGPGIMS, Lucknow, UP, India
| | - A Mishra
- Endocrine & Breast Surgery, SGPGIMS, Lucknow, UP, India; Pathology, SGPGIMS, Lucknow, UP, India; Radiotherapy, SGPGIMS, Lucknow, UP, India
| | - A Agarwal
- Endocrine & Breast Surgery, SGPGIMS, Lucknow, UP, India; Pathology, SGPGIMS, Lucknow, UP, India; Radiotherapy, SGPGIMS, Lucknow, UP, India
| | - AK Verma
- Endocrine & Breast Surgery, SGPGIMS, Lucknow, UP, India; Pathology, SGPGIMS, Lucknow, UP, India; Radiotherapy, SGPGIMS, Lucknow, UP, India
| | - SK Mishra
- Endocrine & Breast Surgery, SGPGIMS, Lucknow, UP, India; Pathology, SGPGIMS, Lucknow, UP, India; Radiotherapy, SGPGIMS, Lucknow, UP, India
| | - V Agrawal
- Endocrine & Breast Surgery, SGPGIMS, Lucknow, UP, India; Pathology, SGPGIMS, Lucknow, UP, India; Radiotherapy, SGPGIMS, Lucknow, UP, India
| | - N Krishnani
- Endocrine & Breast Surgery, SGPGIMS, Lucknow, UP, India; Pathology, SGPGIMS, Lucknow, UP, India; Radiotherapy, SGPGIMS, Lucknow, UP, India
| | - P Lal
- Endocrine & Breast Surgery, SGPGIMS, Lucknow, UP, India; Pathology, SGPGIMS, Lucknow, UP, India; Radiotherapy, SGPGIMS, Lucknow, UP, India
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Phatak S, Chaurasia S, Mishra SK, Gupta R, Agrawal V, Aggarwal A, Misra R. Urinary B cell activating factor (BAFF) and a proliferation-inducing ligand (APRIL): potential biomarkers of active lupus nephritis. Clin Exp Immunol 2016; 187:376-382. [PMID: 27804111 DOI: 10.1111/cei.12894] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/27/2016] [Indexed: 12/23/2022] Open
Abstract
B cell activating factor (BAFF) and a proliferation-inducing ligand (APRIL) help in B cell activation, maintenance and plasma cell survival. B cell infiltration has been demonstrated in kidneys of patients with lupus nephritis (LN). Serum levels of BAFF and APRIL have shown inconsistent relationships with lupus disease activity. We evaluated urinary levels of BAFF and APRIL as biomarker for LN. Thirty-six patients with proliferative lupus nephritis (AN), 10 with active lupus without nephritis (AL) and 15 healthy controls (HC) were studied. APRIL and BAFF levels were measured in both serum and urine using enzyme-linked immunosorbent assay (ELISA). Urine levels were normalized for urinary creatinine excretion. Urine levels were correlated with conventional disease activity markers and histology. Levels were reassessed in 20 AN patients at 6 months after treatment with cyclophosphamide. Urinary APRIL (uAPRIL) and BAFF (uBAFF) levels were raised significantly in AN. uAPRIL, but not uBAFF, correlated moderately with renal Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) in AN (r = 0·36, P < 0·05). On receiver operator curve (ROC) analysis, uBAFF and uAPRIL showed an area under the curve (AUC) of 0·825 and 0·781, respectively, in differentiating between nephritis and non-nephritis, which performed better than low C3, C4 and raised anti-dsDNA antibodies. There was no correlation of serum levels with uBAFF (r = 0·187, P = 0·261) and uAPRIL (r = 0·114, P = 0·494). uAPRIL levels reduced after treatment (mean 125 pg/mg to 36 pg/mg, P < 0·05). uBAFF levels reduced in 16 responders while two of four non-responders had increase in levels. Thus, uBAFF and uAPRIL are potential biomarkers of proliferative lupus nephritis.
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Affiliation(s)
- S Phatak
- Department of Clinical Immunology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - S Chaurasia
- Department of Clinical Immunology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - S K Mishra
- Department of Clinical Immunology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - R Gupta
- Department of Clinical Immunology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - V Agrawal
- Department of Pathology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - A Aggarwal
- Department of Clinical Immunology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - R Misra
- Department of Clinical Immunology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
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Agrawal V, Amos JD. The association between illicit drug use and infectious complications among trauma patients. Eur J Clin Microbiol Infect Dis 2016; 36:447-450. [PMID: 27785636 DOI: 10.1007/s10096-016-2815-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Accepted: 10/12/2016] [Indexed: 12/16/2022]
Abstract
Management of patients with traumatic injury is a complex endeavor requiring a concerted effort of multi-organ stabilization and prevention of septic shock. Given that traumatic injury is frequently mediated by illicit drug use, which has previously been associated with immune suppression, it is hypothesized that infectious complications may occur more prevalently in this patient population. In this study, we evaluate the incidence of infectious complications in trauma patients who screened positive for illicit drug abuse. The national trauma databank was queried for all patients who underwent laboratory evaluation for drug use between 2002 and 2009 and between 2013 and 2014. Patient demographics, clinical outcomes (injury severity score [ISS], intensive care unit length of stay [ILOS], hospital length of stay [HLOS], mortality, risk-adjusted ILOS [rILOS] or HLOS [rHLOS]) and infectious complications (pneumonia, superficial surgical site infection, organ space infection, deep space surgical site infection and urinary tract infection) were attained. Out of 5,564,821 incidents, 525,052 admissions met the inclusion criteria. Patients were 41 ± 19 years of age and 72 % were male. Patients positive for drug use were 1.1-fold more likely to develop pneumonia, 1.2-fold more likely to develop superficial site infection, and 1.3-fold more likely to develop organ space infection. No statistically significant variations in ILOS, HLOS, rILOS, rHLOS or mortality were noted. Traumatic patients who screen positive for illicit drug use are more likely to develop infectious complications. Therefore, vigilance and appropriate preventative measures should be considered in this unique group of patients.
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Affiliation(s)
- V Agrawal
- Methodist Health System, Clinical Research Institute, Pavilion III, Suite 168, 1411 N. Beckley Avenue, Dallas, TX, 75203, USA.
| | - J D Amos
- Associates in Surgical Acute Care, Methodist Dallas Medical Center, Dallas, TX, 75208, USA
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Coroller T, Agrawal V, Narayan V, Grossmann P, Hou Y, Lee S, Mak R, Aerts H. Radiomics Predict Pathological Response in Non-Small Cell Lung Cancer. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.2095] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Coroller T, Agrawal V, Narayan V, Lee S, Mak R, Aerts H. TU-D-207B-06: Pathological Response Prediction by Radiomic Data From Primary and Lymph Nodes in NSCLC. Med Phys 2016. [DOI: 10.1118/1.4957514] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Huynh E, Coroller T, Narayan V, Agrawal V, Romano J, Franco I, Hou Y, Mak R, Aerts H. SU-F-R-52: A Comparison of the Performance of Radiomic Features From Free Breathing and 4DCT Scans in Predicting Disease Recurrence in Lung Cancer SBRT Patients. Med Phys 2016. [DOI: 10.1118/1.4955823] [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: 11/07/2022] Open
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Huynh E, Coroller T, Narayan V, Agrawal V, Hou Y, Romano J, Franco I, Mak R, Aerts H. SU-F-R-53: CT-Based Radiomics Analysis of Non-Small Cell Lung Cancer Patients Treated with Stereotactic Body Radiation Therapy. Med Phys 2016. [DOI: 10.1118/1.4955824] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Agarwal G, Gambhir S, Lal P, Rajan S, Krishnani N, Mishra A, SabaRetnam M, Agarwal A, Chand G, Verma AK, Mishra SK, Kumari N, Agrawal V, Kheruka SC. Abstract P3-01-06: Sentinel lymph node biopsy after NACT: Results of a validation study in large/locally advanced breast cancer patients. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-p3-01-06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background:
Sentinel lymph node biopsy (SLNB) is the current standard of care for surgical staging of clinically node negative axilla (N0) early breast cancer patients undergoing primary surgery. SLN- identification rate (IR) of 90% and SLN- false negative rate (FNR) of 10% are considered minimum acceptable indices for SLNB. Its role in staging axillae in patients undergoing post-NACT surgery is somewhat unclear. In India, and most low-and-middle income countries, large operable breast cancers (LOBC) and locally advanced breast cancers (LABC) constitute a large proportion of breast cancer patients treated. These patients are usually are treated with NACT, followed by surgery and radiation therapy. In a prospective validation SLNB study, we investigated the accuracy of SLNB in staging post-NACT N0 axilla in a patient cohort that were LOBC or LABC at the time of initial presentation.
Methods:
Hundred consenting non-inflammatory LOBC/LABC patients (mean age 49.3+8.6; index stage T3,N0-1=21; T4b,N0-1=33; T1-3,N2a=24; T4b,N2a=22) who were N0 after NACT at time of surgery (Breast conservation surgery in 19, Mastectomy in 81) were included. Majority had Infiltrating ductal carcinoma (n=87), and grade II/III tumors (n=93); 45 were hormone receptor positive (+), 29 had HR negative (-) HER2(+); and 26 had triple negative breast cancer on IHC sub-typing. Commonest NACT regimen used was Anthracycline followed by taxanes in 83. SLNB was performed using low-cost methylene-blue and 99mTc-Antimony-colloid, which were produced in-house using well standardized protocols, with clearance of the institutional ethics committee. Irrespective of the SLN histology, a complete axillary dissection (ALND) was carried out in all. SLN-IR and SLN-FNR were calculated, comparing the histological status of the SLN and the ALND specimen. Factors predicting non-identified SLN and false negative SLN were evaluated in uni-variate and multi-variate analysis.
Results:
With a combination of methylene blue dye and radiopharmaceutical, the SLN-IR was 81%. Mean number of SLN removed was 2.4+/-1.02. Mean number of nodes removed at ALND was 13.3+/-2.2. SLN-IR varied significantly (p<0.05) per index stage, and were- 90.4% in T3,N0-1; 84.4% in T4b,N0-1; 83.3% in T1-3,N2a; and 63.6% in T4bN2a. The FNR was 17.3% for the whole cohort. FNR varied significantly (p<0.05) per index stage, and were- 8.3% in T3,N0-1; 14.9% in T4b,N0-1; 22.2% in T1-3,N2a; and 30% in T4bN2a. Factors found predictive of non-identified SLN were tumor stage T4b, nodal stage N2a, extra-nodal spread, and LVI. Factors found predictive of FNR SLN were tumor stage T4b, nodal stage N2a, and extra-nodal spread.
Conclusions:
Considering SLN-IR of 90% and SLN-FNR of 10% as acceptable standards, SLNB in post-NACT N0 patients undergoing surgery was not found robust in staging the axilla, with the exception of patients with index stage T3,N0-1 who had SLN-IR of 90.4% and SLN-FNR of 8.3%. Patients with (pre-NACT) skin involvement(T4b), matted axillary nodes(N2a) and LVI are fraught with high-risk of non-identification and false-negative SLNB.
Citation Format: Agarwal G, Gambhir S, Lal P, Rajan S, Krishnani N, Mishra A, SabaRetnam M, Agarwal A, Chand G, Verma AK, Mishra SK, Kumari N, Agrawal V, Kheruka SC. Sentinel lymph node biopsy after NACT: Results of a validation study in large/locally advanced breast cancer patients. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P3-01-06.
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Affiliation(s)
- G Agarwal
- Endocrine & Breast Surgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, UP, India; Nuclear Medicine, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, UP, India; Radiotherapy, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, UP, India; Pathology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, UP, India
| | - S Gambhir
- Endocrine & Breast Surgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, UP, India; Nuclear Medicine, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, UP, India; Radiotherapy, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, UP, India; Pathology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, UP, India
| | - P Lal
- Endocrine & Breast Surgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, UP, India; Nuclear Medicine, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, UP, India; Radiotherapy, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, UP, India; Pathology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, UP, India
| | - S Rajan
- Endocrine & Breast Surgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, UP, India; Nuclear Medicine, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, UP, India; Radiotherapy, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, UP, India; Pathology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, UP, India
| | - N Krishnani
- Endocrine & Breast Surgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, UP, India; Nuclear Medicine, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, UP, India; Radiotherapy, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, UP, India; Pathology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, UP, India
| | - A Mishra
- Endocrine & Breast Surgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, UP, India; Nuclear Medicine, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, UP, India; Radiotherapy, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, UP, India; Pathology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, UP, India
| | - M SabaRetnam
- Endocrine & Breast Surgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, UP, India; Nuclear Medicine, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, UP, India; Radiotherapy, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, UP, India; Pathology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, UP, India
| | - A Agarwal
- Endocrine & Breast Surgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, UP, India; Nuclear Medicine, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, UP, India; Radiotherapy, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, UP, India; Pathology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, UP, India
| | - G Chand
- Endocrine & Breast Surgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, UP, India; Nuclear Medicine, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, UP, India; Radiotherapy, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, UP, India; Pathology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, UP, India
| | - AK Verma
- Endocrine & Breast Surgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, UP, India; Nuclear Medicine, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, UP, India; Radiotherapy, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, UP, India; Pathology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, UP, India
| | - SK Mishra
- Endocrine & Breast Surgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, UP, India; Nuclear Medicine, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, UP, India; Radiotherapy, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, UP, India; Pathology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, UP, India
| | - N Kumari
- Endocrine & Breast Surgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, UP, India; Nuclear Medicine, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, UP, India; Radiotherapy, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, UP, India; Pathology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, UP, India
| | - V Agrawal
- Endocrine & Breast Surgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, UP, India; Nuclear Medicine, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, UP, India; Radiotherapy, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, UP, India; Pathology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, UP, India
| | - SC Kheruka
- Endocrine & Breast Surgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, UP, India; Nuclear Medicine, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, UP, India; Radiotherapy, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, UP, India; Pathology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, UP, India
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Agrawal V, Varadan V, Banerjee N, Miskimen K, Vadodkar A, Abu-Khalaf M, Sikov W, Harris L, Dimitrova N. Abstract P6-03-08: Novel recurrent lncRNA fusions detected in breast cancer using RNA-Seq technology in a neoadjuvant setting. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-p6-03-08] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Recent discoveries of recurrent and targetable gene fusions in breast cancer suggest the need to characterize the functional significance of such genomic aberrations within larger cohorts. We quantified fusion transcript expression in patient samples using RNASeq to identify recurrent gene fusion events in breast cancer as well as study the fusions post-brief exposure to mono-therapy.
Methods: We sequenced transcriptomes of core biopsy RNA from 130 breast tumors obtained from brief-exposure preoperative clinical trials BrUOG 211A/211B. HER2- patients were treated with brief exposure to bevacizumab (B) or nab-paclitaxel (nP) followed by treatment with B/nP/carboplatin while HER2+ patients received brief exposure to trastuzumab (T) or nP followed by T/nP/carboplatin. Paired-end sequencing on 75 baseline biopsies and 55 post-exposure biopsies using amplified total RNA yielded 55 million reads on average perlsample. Fusion transcript abundance was evaluated using 2 pipelines, TopHat-Fusion and deFuse, due to their complementary strategies in fusion detection. We eliminated gene-pseuodogene fusion pairs as likely false positives arising due to alignment artifacts. Fusions that met 1 or more of the following 3 criteria were considered high confidence:
i) Called by both deFuse and TopHat. ii) Called by deFuse with probability >95% iii) Called by TopHat with > 15 reads supporting the fusion.
Results: We identified high confidence gene fusions, detected by both TopHat and deFuse, in 73 of the 75 baseline biopsies with 16 fusions on average per sample. We looked for modulation of gene fusions upon brief exposure to therapy in 55 patients that had post exposure biopsy data and found that out of the 545 high confidence fusions detected across these patients, 62 (11.37%) of the fusions were found to be still present after the therapy exposure. For the recurrent fusion analyses, we considered the 75 baseline samples. We found a total of 1158 unique candidate fusions. Out of these, 116 (10%) were recurrent in more than 1 patient. After further filtering, we were able to narrow down to 9 (0.77%) fusions that were reliable since they were predicted by both the algorithms in different patients. 2 of these 9 fusions involved GAS5 as a partner gene. GAS5 have been studied to have a role in apoptosis and its down-regulation has been associated with cell proliferation, which makes it a very interesting fusion candidate.
Conclusions: We find that gene fusions in breast cancer are highly heterogeneous but are enriched with cancer-related pathway genes. This is the first study to report 2 novel gene-lincRNA fusion transcripts: MDN1-GAS5 and GABRB3-GAS5. Both these fusions are called in the baseline & post-therapy for atleast 1 patient (different patients each). GAS5 has been found as participating in a fusion in B-cell lymphoma. We are currently in the process of validating the fusion calls using qRT-PCR. The heterogeneity of detected fusions suggests that multiple mechanisms could underlie the selective advantage of tumor cells expressing fusion transcripts. The brief-exposure preoperative paradigm provides a unique opportunity to evaluate modulation of fusion transcripts that can shed light on their functional importance.
Citation Format: Agrawal V, Varadan V, Banerjee N, Miskimen K, Vadodkar A, Abu-Khalaf M, Sikov W, Harris L, Dimitrova N. Novel recurrent lncRNA fusions detected in breast cancer using RNA-Seq technology in a neoadjuvant setting. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P6-03-08.
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Affiliation(s)
- V Agrawal
- Philips Research North America, Briarcliff Manor, NY; Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH; Yale Comprehensive Cancer Center, New Haven, CT; Warren Alpert Medical School of Brown University, Providence, RI; Seidman Cancer Center, University Hospitals, Cleveland, OH
| | - V Varadan
- Philips Research North America, Briarcliff Manor, NY; Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH; Yale Comprehensive Cancer Center, New Haven, CT; Warren Alpert Medical School of Brown University, Providence, RI; Seidman Cancer Center, University Hospitals, Cleveland, OH
| | - N Banerjee
- Philips Research North America, Briarcliff Manor, NY; Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH; Yale Comprehensive Cancer Center, New Haven, CT; Warren Alpert Medical School of Brown University, Providence, RI; Seidman Cancer Center, University Hospitals, Cleveland, OH
| | - K Miskimen
- Philips Research North America, Briarcliff Manor, NY; Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH; Yale Comprehensive Cancer Center, New Haven, CT; Warren Alpert Medical School of Brown University, Providence, RI; Seidman Cancer Center, University Hospitals, Cleveland, OH
| | - A Vadodkar
- Philips Research North America, Briarcliff Manor, NY; Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH; Yale Comprehensive Cancer Center, New Haven, CT; Warren Alpert Medical School of Brown University, Providence, RI; Seidman Cancer Center, University Hospitals, Cleveland, OH
| | - M Abu-Khalaf
- Philips Research North America, Briarcliff Manor, NY; Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH; Yale Comprehensive Cancer Center, New Haven, CT; Warren Alpert Medical School of Brown University, Providence, RI; Seidman Cancer Center, University Hospitals, Cleveland, OH
| | - W Sikov
- Philips Research North America, Briarcliff Manor, NY; Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH; Yale Comprehensive Cancer Center, New Haven, CT; Warren Alpert Medical School of Brown University, Providence, RI; Seidman Cancer Center, University Hospitals, Cleveland, OH
| | - L Harris
- Philips Research North America, Briarcliff Manor, NY; Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH; Yale Comprehensive Cancer Center, New Haven, CT; Warren Alpert Medical School of Brown University, Providence, RI; Seidman Cancer Center, University Hospitals, Cleveland, OH
| | - N Dimitrova
- Philips Research North America, Briarcliff Manor, NY; Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH; Yale Comprehensive Cancer Center, New Haven, CT; Warren Alpert Medical School of Brown University, Providence, RI; Seidman Cancer Center, University Hospitals, Cleveland, OH
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Gupta A, Agrawal V, Kaul A, Verma R, Pandey R. Anti-glomerular basement membrane crescentic glomerulonephritis: A report from India and review of literature. Indian J Nephrol 2016; 26:335-339. [PMID: 27795626 PMCID: PMC5015510 DOI: 10.4103/0971-4065.172227] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Anti-glomerular basement membrane (anti-GBM) disease is an autoimmune disease that most commonly presents as rapidly progressive glomerulonephritis with or without pulmonary involvement. It is characterized by the presence of antibodies directed to antigenic targets within glomerular and alveolar basement membranes. This study was performed to evaluate the clinicopathological features and outcome in anti-GBM crescentic glomerulonephritis (CrGN) at a tertiary care center in North India over a period of 9 years (January 2004 to December 2012). A diagnosis of anti-GBM CrGN was made in the presence of >50% crescents, linear deposits of IgG along GBM, and raised serum anti-GBM antibody titer. Of 215 cases of CrGN diagnosed during this period, 11 had anti-GBM CrGN. Anti-GBM CrGN was found at all ages but was most common in the third to fifth decade with no gender predilection (mean age 48 +/- 15 years, 13–67 years). Patients presented with a mean serum creatinine of 10.2 +/- 5.3 mg/dl and sub-nephrotic proteinuria. Pulmonary involvement was present in two patients. Myeloperoxidase-antineutrophil cytoplasmic antibody was positive in two (2/11) elderly patients. Follow-up was available in four patients for a range of 30-270 (mean 99.5 ± 114.5) days, two remained dialysis dependent while two died due to uremia and sepsis. Our findings show that anti-GBM disease is a rare cause of CrGN in India, accounting for only 5% of patients. It usually presents as a renal-limited disease and is associated with a poor renal outcome.
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Affiliation(s)
- A Gupta
- Department of Pathology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - V Agrawal
- Department of Pathology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - A Kaul
- Department of Nephrology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - R Verma
- Department of Pathology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - R Pandey
- Department of Pathology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
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Christenson ES, Teply B, Agrawal V, Illei P, Gurakar A, Kanakry JA. Human Herpesvirus 8-Related Primary Effusion Lymphoma After Liver Transplantation. Am J Transplant 2015; 15:2762-6. [PMID: 25988353 DOI: 10.1111/ajt.13321] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2015] [Revised: 03/17/2015] [Accepted: 03/18/2015] [Indexed: 01/25/2023]
Abstract
Primary effusion lymphoma is a rare subclass of non-Hodgkin lymphoma associated with human herpesvirus 8 infection and principally seen in human immunodeficiency virus-positive patients. We report on the case of a 72-year-old human immunodeficiency virus-negative male with a hepatic transplant 10 years prior, who presented with a symptomatic right-sided pleural effusion and was found to have primary effusion lymphoma by flow cytometric and cytopathologic examination. Immunohistochemistry of his lymphoma cells was positive for human herpesvirus 8. Both he and his donor had no identifiable risk factors for human herpesvirus 8 infection. The patient was intolerant of antiviral therapy and chemotherapy, dying 7 months after diagnosis. Posttransplant primary effusion lymphoma is exceedingly rare and carries a very poor prognosis. Individualized treatment strategies are necessary given the scant body of published literature with guidance based solely on case reports.
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Affiliation(s)
- E S Christenson
- Department of Medicine, Johns Hopkins University, Baltimore, MD
| | - B Teply
- Department of Oncology, Johns Hopkins University, Baltimore, MD
| | - V Agrawal
- Department of Medicine, Johns Hopkins University, Baltimore, MD
| | - P Illei
- Department of Pathology, Johns Hopkins University, Baltimore, MD
| | - A Gurakar
- Department of Medicine, Johns Hopkins University, Baltimore, MD
| | - J A Kanakry
- Department of Medicine, Johns Hopkins University, Baltimore, MD
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Agrawal V, Kaul A, Ranade RS, Sharma RK. Immunoglobulin A dominant membranoproliferative glomerulonephritis in an elderly man: A case report and review of the literature. Indian J Nephrol 2015; 25:168-70. [PMID: 26060367 PMCID: PMC4446922 DOI: 10.4103/0971-4065.145425] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Immunoglobulin A (IgA) dominant membranoproliferative glomerulonephritis (MPGN) is rare, described only as case reports. We report a rare case of an elderly man presenting with rapidly progressive renal failure and nephrotic range proteinuria with histological, immunofluorescence, and ultrastructural findings supporting a diagnosis of IgA dominant MPGN. Autoimmune disease, cryoglobulinemia and infection-associated glomerulonephritis were excluded. Remission was achieved within 3 months of treatment. This case highlights an uncommon diagnosis with a good response to therapy. The differential diagnosis of IgA nephropathy with MPGN-like pattern is discussed.
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Affiliation(s)
- V Agrawal
- Department of Pathology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - A Kaul
- Department of Nephrology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - R S Ranade
- Department of Pathology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - R K Sharma
- Department of Nephrology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
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Abstract
Chronic hyperglycemia and its associated metabolic products are key factors responsible for the development and progression of diabetic chronic kidney disease (CKD). Endocrinologists are tasked with detection and management of early CKD before patients need referral to a nephrologist for advanced CKD or dialysis evaluation. Primary care physicians are increasingly becoming aware of the importance of managing hyperglycemia to prevent or delay progression of CKD. Glycemic control is an integral part of preventing or slowing the advancement of CKD in patients with diabetes; however, not all glucose-lowering agents are suitable for this patient population. The availability of the latest information on treatment options may enable physicians to thwart advancement of serious renal complication in patients suffering from diabetes. This review presents clinical data that shed light on the risk/benefit profiles of three relatively new antidiabetes drug classes, the dipeptidyl peptidase-4 inhibitors, glucagon-like peptide-1 analogs, and sodium glucose co-transporter 2 inhibitors, particularly for patients with diabetic CKD, and summarizes the effects of these therapies on renal outcomes and glycemic control for endocrinologists and primary care physicians. Current recommendations for screening and diagnosis of CKD in patients with diabetes are also discussed.
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Affiliation(s)
- V Agrawal
- Division of Nephrology and Hypertension University of Vermont College of Medicine, 1 South Prospect Street, Burlington, VT 05401, USA.
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Vij M, Agrawal V, Kumar A, Pandey R. Evaluation of biologic potential and risk stratification for predicting disease-free survival after resection of primary gastrointestinal stromal tumor: A multivariate clinicopathological study. Indian J Cancer 2015; 52:351-7. [PMID: 26905135 DOI: 10.4103/0019-509x.176689] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Kumar B, Lal H, Agrawal V, Agrawal V, Upadhyaya V. 454. Abdominal pseudotumour in children: Difficult to diagnose and treat. Eur J Surg Oncol 2014. [DOI: 10.1016/j.ejso.2014.08.442] [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: 11/16/2022] Open
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Varadan V, Agrawal V, Kamalakaran S, Banerjee N, Miskimen K, Vadodkar A, Abu-Khalaf M, Sikov W, Harris LN, Dimitrova N. Abstract P4-04-07: Heterogeneous gene fusions detected by RNASeq show enrichment of insulin signaling pathway genes in breast cancer. Cancer Res 2013. [DOI: 10.1158/0008-5472.sabcs13-p4-04-07] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Recent discoveries of recurrent and targetable gene fusions in breast cancer suggest the need to characterize the functional significance of such genomic aberrations within larger cohorts. We quantify fusion transcript expression in patient samples using RNASeq and evaluate their functional significance using biological pathway enrichment analysis.
Methods: We sequenced transcriptomes of core biopsy RNA from 97 breast tumors obtained from brief-exposure preoperative clinical trials BrUOG 211A/211B. HER2- patients were treated with brief exposure to bevacizumab (B) or nab-paclitaxel (nP) followed by treatment with B/nP/carboplatin while HER2+ patients received brief exposure to trastuzumab (T) or nP followed by T/nP/carboplatin. Paired-end sequencing on 55 baseline biopsies and 42 post-exposure biopsies using amplified total RNA yielded 55 million reads on average per sample. We assigned RNASeq-based PAM50 subtypes for each of the samples using standard methodology. Fusion transcript abundance was evaluated using two independent pipelines, TopHat and deFuse, due to their complementary strategies in fusion detection. We eliminated fusions of genes with their respective pseudogenes as likely false positives arising due to alignment artifacts. TopHat fusion calls with total supporting reads ≥10 and deFuse calls with probability of fusion ≥0.7 were considered reliable.
Results: We identified high confidence gene fusions, detected by both TopHat and deFuse, in 30 of the 55 baseline biopsies (54.4%), with 3.3 fusions on average per sample and a maximum of 10. Fusions were predominantly associated with chromosomal aberrations (75%), with putative deletions responsible for 32% of fusions and translocations responsible for 43%. We find a high level of fusion transcript heterogeneity within breast cancers, detecting a total of 80 fusions across the 30 samples with only three fusions recurrent in two samples with high expression in each: MDN1-GAS5 in two basal breast cancers, KRAS-GRIP1 and ITPR2-CCDC91 in two LumB cancers. Several cancer-related genes were found to be fusion partners: AKT3-SMYD3, CREB1-PPP1R1C, FLOT2-TOP2A and FOXC1-ARID1B. Pathway analysis of the fusion genes at baseline revealed enrichment of proteasome (p = 0.000752), tight junction (p = 0.027), insulin signaling (p = 0.0284) and melanogenesis (p = 0.05) pathways after multiple testing correction (FDR≤0.25). We looked for modulation of gene fusions upon brief exposure to therapy in 18 patients and found a majority of the baseline fusion transcripts to be present post-brief exposure in 44% of the patients, irrespective of therapy regimen.
Conclusions: We find that gene fusions in breast cancer are highly heterogeneous but are enriched with cancer-related pathway genes. This is the first study to report a novel gene-lincRNA fusion transcript (MDN1-GAS5). We are currently validating the fusion calls using qRT-PCR. The heterogeneity of detected fusions suggests that multiple mechanisms could underlie the selective advantage of tumor cells expressing fusion transcripts. The brief-exposure preoperative paradigm provides a unique opportunity to evaluate modulation of fusion transcripts that can shed light on their functional importance.
Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P4-04-07.
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Affiliation(s)
- V Varadan
- Philips Research North America, Briarcliff Manor, NY; Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH; Yale Comprehensive Cancer Center, New Haven, CT; Warren Alpert Medical School of Brown University, Providence, RI; Seidman Cancer Center, University Hospitals, Cleveland, OH
| | - V Agrawal
- Philips Research North America, Briarcliff Manor, NY; Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH; Yale Comprehensive Cancer Center, New Haven, CT; Warren Alpert Medical School of Brown University, Providence, RI; Seidman Cancer Center, University Hospitals, Cleveland, OH
| | - S Kamalakaran
- Philips Research North America, Briarcliff Manor, NY; Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH; Yale Comprehensive Cancer Center, New Haven, CT; Warren Alpert Medical School of Brown University, Providence, RI; Seidman Cancer Center, University Hospitals, Cleveland, OH
| | - N Banerjee
- Philips Research North America, Briarcliff Manor, NY; Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH; Yale Comprehensive Cancer Center, New Haven, CT; Warren Alpert Medical School of Brown University, Providence, RI; Seidman Cancer Center, University Hospitals, Cleveland, OH
| | - K Miskimen
- Philips Research North America, Briarcliff Manor, NY; Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH; Yale Comprehensive Cancer Center, New Haven, CT; Warren Alpert Medical School of Brown University, Providence, RI; Seidman Cancer Center, University Hospitals, Cleveland, OH
| | - A Vadodkar
- Philips Research North America, Briarcliff Manor, NY; Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH; Yale Comprehensive Cancer Center, New Haven, CT; Warren Alpert Medical School of Brown University, Providence, RI; Seidman Cancer Center, University Hospitals, Cleveland, OH
| | - M Abu-Khalaf
- Philips Research North America, Briarcliff Manor, NY; Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH; Yale Comprehensive Cancer Center, New Haven, CT; Warren Alpert Medical School of Brown University, Providence, RI; Seidman Cancer Center, University Hospitals, Cleveland, OH
| | - W Sikov
- Philips Research North America, Briarcliff Manor, NY; Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH; Yale Comprehensive Cancer Center, New Haven, CT; Warren Alpert Medical School of Brown University, Providence, RI; Seidman Cancer Center, University Hospitals, Cleveland, OH
| | - LN Harris
- Philips Research North America, Briarcliff Manor, NY; Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH; Yale Comprehensive Cancer Center, New Haven, CT; Warren Alpert Medical School of Brown University, Providence, RI; Seidman Cancer Center, University Hospitals, Cleveland, OH
| | - N Dimitrova
- Philips Research North America, Briarcliff Manor, NY; Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH; Yale Comprehensive Cancer Center, New Haven, CT; Warren Alpert Medical School of Brown University, Providence, RI; Seidman Cancer Center, University Hospitals, Cleveland, OH
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Agrawal RP, Tantia P, Jain S, Agrawal R, Agrawal V. Camel milk: a possible boon for type 1 diabetic patients. Cell Mol Biol (Noisy-le-grand) 2013; 59:99-107. [PMID: 24200025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2012] [Accepted: 05/14/2013] [Indexed: 06/02/2023]
Abstract
Poor nutrition in utero and in early life combined with over nutrition in later life may also play a role in epidemic of diabetes. The efficacy of camel milk consumption as an adjunct to routine diabetic management in type 1 diabetes is a approach showing new rays of hope to cope with this disorder by adding a food supplement with medicinal values. Research on the beneficial aspects of camel milk has been taking place in different corners of globe since last three decades. Continuous efforts to disclose the role of camel milk in diabetes has rendered it title of 'white gold'. Biochemical studies has revealed the components e.g. insulin like protein, lactoferrin, immunoglobulins are responsible for imparting camel milk the scientific weightage. In parallel, epidemiological surveys stating low prevalence of diabetes in communities consuming camel milk clearly indicate towards its hopeful role in maintaining hyperglycemia. This article shades light on camel milk production, composition, characteristics as well as it expresses positive effect of camel milk on blood glucose level, insulin dose, beta cell function. This review also compiles various epidemiological studies carried out to bring forth utility of camel milk suggesting it as a useful food supplement or alternative therapy for type 1 diabetic patients.
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Affiliation(s)
- R P Agrawal
- Diabetes Care & Research Centre S.P.Medical College, Bikaner Rajasthan India drrpagrawal@yahoo.co.in
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Vij M, Agrawal V, Kumar A, Pandey R. Cytomorphology of gastrointestinal stromal tumors and extra-gastrointestinal stromal tumors: A comprehensive morphologic study. J Cytol 2013; 30:8-12. [PMID: 23661933 PMCID: PMC3643373 DOI: 10.4103/0970-9371.107505] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND The term gastrointestinal stromal tumors (GIST) is used to refer to those mesenchymal neoplasms of the gastrointestinal tract (GIT) which express CD117, a c-kit proto-oncogene protein. AIMS To study the cytological features of GIST and extra-gastrointestinal stromal tumors (EGIST), to correlate them with histology and to determine cytological indicators of malignancy. MATERIALS AND METHODS Cytological smears from patients diagnosed as GIST/EGIST on histology were retrieved. From Jan 2000 to July 2010, 26 GIST (13 primary, 12 metastatic, one recurrent) and seven EGIST (5 primary, one metastatic, one recurrent) cytologic samples from 27 patients were identified. RESULTS The patients included 20 males and 7 females with a mean age of 50.6 years. Tumor sites included stomach (5), duodenum (5), ileum (2), ileocecal (1), rectum (1), liver (9), retroperitoneum (5), mesentery (1), subcutaneous nodule (1), supra-penile lump (1), ascitic (1) and pleural fluids (1). The smears were cellular with cohesive to loosely cohesive thinly spread irregularly outlined cell clusters held together by thin calibre vessels. The tumor cells were mild to moderately pleomorphic, spindle to epithelioid with variable chromatin pattern and variable cytoplasm. Cellular dyscohesion, nuclear pleomorphism, intranuclear pseudoinclusions, prominent nucleoli, mitosis and necrosis were more prominent in malignant, metastatic and recurrent tumors. CONCLUSIONS GISTs show a wide spectrum of cytological features and the presence of mitosis, necrosis and nuclear pleomorphism can help in prediction of malignant behavior. Further, cytology is a very useful screening modality in patients of GIST and EGIST to detect early recurrence and metastasis at follow-up.
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Affiliation(s)
- M Vij
- Department of Pathology, Global Hospitals and Health City, Chennai, Tamil Nadu, India
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Affiliation(s)
- P K Garg
- Department of Surgery, University College of Medical Sciences and Guru Teg Bahadur Hospital, University of Delhi, Delhi, India.
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