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Hadkhale K, Atosuo J, Putus T. Groundwater radon exposure and risk of lung cancer: A population-based study in Finland. Front Oncol 2022; 12:935687. [PMID: 36185272 PMCID: PMC9520750 DOI: 10.3389/fonc.2022.935687] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 08/23/2022] [Indexed: 11/13/2022] Open
Abstract
Naturally occurring radioactive elements can be found in groundwater and exposure to such elements is associated with an increased risk of lung cancer. In this study, we aimed to observe the association between exposure to these radioactive elements in groundwater and the risk of lung cancer in selected regions in Finland. This is a population-based study from 1955 to 2019 in Finland. The exposed municipalities with their corresponding hospital districts were selected based on radon measurements at groundwater treatment plants. Lung cancer cases were obtained from the Finnish cancer registry. The 5-year incidence rates for lung cancer were calculated and a comparison was made between each of the hospital districts with radon exposure. More than 93,000 cases of lung cancer were reported in the radon-exposed regions over the examined period of 64 years. The highest number of cases was recorded in the Helsinki University hospital district and the least in the Southern Savo hospital district. Similarly, the lung cancer incidence rate was highest in Lapland and lowest in the Southern Savo hospital district. The number of daily smokers in the working-age population appears to have decreased in all the hospital districts from 2013 to 2018. A statistically significant increased risk of lung cancer was observed in the high radon-exposed hospital districts compared to those with lower exposure. Groundwater radon exposure is observed to be associated with an increased risk of lung cancer.
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Ollila H, Mäyränpää MI, Paavolainen L, Paajanen J, Välimäki K, Sutinen E, Wolff H, Räsänen J, Kallioniemi O, Myllärniemi M, Ilonen I, Pellinen T. Prognostic Role of Tumor Immune Microenvironment in Pleural Epithelioid Mesothelioma. Front Oncol 2022; 12:870352. [PMID: 35795056 PMCID: PMC9251441 DOI: 10.3389/fonc.2022.870352] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Accepted: 03/08/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundPleural mesothelioma (MPM) is an aggressive malignancy with an average patient survival of only 10 months. Interestingly, about 5%–10% of the patients survive remarkably longer. Prior studies have suggested that the tumor immune microenvironment (TIME) has potential prognostic value in MPM. We hypothesized that high-resolution single-cell spatial profiling of the TIME would make it possible to identify subpopulations of patients with long survival and identify immunophenotypes for the development of novel treatment strategies.MethodsWe used multiplexed fluorescence immunohistochemistry (mfIHC) and cell-based image analysis to define spatial TIME immunophenotypes in 69 patients with epithelioid MPM (20 patients surviving ≥ 36 months). Five mfIHC panels (altogether 21 antibodies) were used to classify tumor-associated stromal cells and different immune cell populations. Prognostic associations were evaluated using univariate and multivariable Cox regression, as well as combination risk models with area under receiver operating characteristic curve (AUROC) analyses.ResultsWe observed that type M2 pro-tumorigenic macrophages (CD163+pSTAT1−HLA-DRA1−) were independently associated with shorter survival, whereas granzyme B+ cells and CD11c+ cells were independently associated with longer survival. CD11c+ cells were the only immunophenotype increasing the AUROC (from 0.67 to 0.84) when added to clinical factors (age, gender, clinical stage, and grade).ConclusionHigh-resolution, deep profiling of TIME in MPM defined subgroups associated with both poor (M2 macrophages) and favorable (granzyme B/CD11c positivity) patient survival. CD11c positivity stood out as the most potential prognostic cell subtype adding prediction power to the clinical factors. These findings help to understand the critical determinants of TIME for risk and therapeutic stratification purposes in MPM.
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Affiliation(s)
- Hely Ollila
- Institute for Molecular Medicine Finland (FIMM), Helsinki Institute of Life Science (HiLIFE), University of Helsinki, Helsinki, Finland
- Individualized Drug Therapy Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Department of Pulmonary Medicine, Heart and Lung Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- *Correspondence: Hely Ollila,
| | - Mikko I. Mäyränpää
- Department of Pathology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Lassi Paavolainen
- Institute for Molecular Medicine Finland (FIMM), Helsinki Institute of Life Science (HiLIFE), University of Helsinki, Helsinki, Finland
| | - Juuso Paajanen
- Individualized Drug Therapy Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Department of Pulmonary Medicine, Heart and Lung Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Katja Välimäki
- Institute for Molecular Medicine Finland (FIMM), Helsinki Institute of Life Science (HiLIFE), University of Helsinki, Helsinki, Finland
| | - Eva Sutinen
- Individualized Drug Therapy Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Department of Pulmonary Medicine, Heart and Lung Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Henrik Wolff
- Department of Pathology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Laboratory of Pathology, Finnish Institute of Occupational Health, Helsinki, Finland
| | - Jari Räsänen
- Department of General Thoracic and Esophageal Surgery, Heart and Lung Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Olli Kallioniemi
- Institute for Molecular Medicine Finland (FIMM), Helsinki Institute of Life Science (HiLIFE), University of Helsinki, Helsinki, Finland
| | - Marjukka Myllärniemi
- Individualized Drug Therapy Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Department of Pulmonary Medicine, Heart and Lung Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Ilkka Ilonen
- Individualized Drug Therapy Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Department of General Thoracic and Esophageal Surgery, Heart and Lung Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Teijo Pellinen
- Institute for Molecular Medicine Finland (FIMM), Helsinki Institute of Life Science (HiLIFE), University of Helsinki, Helsinki, Finland
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Ollila H, Paajanen J, Wolff H, Ilonen I, Sutinen E, Välimäki K, Östman A, Anttila S, Kettunen E, Räsänen J, Kallioniemi O, Myllärniemi M, Mäyränpää MI, Pellinen T. High tumor cell platelet-derived growth factor receptor beta expression is associated with shorter survival in malignant pleural epithelioid mesothelioma. J Pathol Clin Res 2021; 7:482-494. [PMID: 33955203 PMCID: PMC8363931 DOI: 10.1002/cjp2.218] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Revised: 03/10/2021] [Accepted: 04/01/2021] [Indexed: 11/11/2022]
Abstract
Malignant pleural mesothelioma (MPM) has a rich stromal component containing mesenchymal fibroblasts. However, the properties and interplay of MPM tumor cells and their surrounding stromal fibroblasts are poorly characterized. Our objective was to spatially profile known mesenchymal markers in both tumor cells and associated fibroblasts and correlate their expression with patient survival. The primary study cohort consisted of 74 MPM patients, including 16 patients who survived at least 60 months. We analyzed location-specific tissue expression of seven fibroblast markers in clinical samples using multiplexed fluorescence immunohistochemistry (mfIHC) and digital image analysis. Effect on survival was assessed using Cox regression analyses. The outcome measurement was all-cause mortality. Univariate analysis revealed that high expression of secreted protein acidic and cysteine rich (SPARC) and fibroblast activation protein in stromal cells was associated with shorter survival. Importantly, high expression of platelet-derived growth factor receptor beta (PDGFRB) in tumor cells, but not in stromal cells, was associated with shorter survival (hazard ratio [HR] = 1.02, p < 0.001). A multivariable survival analysis adjusted for clinical parameters and stromal mfIHC markers revealed that tumor cell PDGFRB and stromal SPARC remained independently associated with survival (HR = 1.01, 95% confidence interval [CI] = 1.00-1.03 and HR = 1.05, 95% CI = 1.00-1.11, respectively). The prognostic effect of PDGFRB was validated with an artificial intelligence-based analysis method and further externally validated in another cohort of 117 MPM patients. In external validation, high tumor cell PDGFRB expression associated with shorter survival, especially in the epithelioid subtype. Our findings suggest PDGFRB and SPARC as potential markers for risk stratification and as targets for therapy.
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Affiliation(s)
- Hely Ollila
- Institute for Molecular Medicine Finland (FIMM), Helsinki Institute of Life Science (HiLIFE)University of HelsinkiHelsinkiFinland
- Individualized Drug Therapy Research Program, Faculty of MedicineUniversity of HelsinkiHelsinkiFinland
- Department of Pulmonary MedicineHeart and Lung Center, University of Helsinki and Helsinki University HospitalHelsinkiFinland
| | - Juuso Paajanen
- Individualized Drug Therapy Research Program, Faculty of MedicineUniversity of HelsinkiHelsinkiFinland
- Department of Pulmonary MedicineHeart and Lung Center, University of Helsinki and Helsinki University HospitalHelsinkiFinland
| | - Henrik Wolff
- Laboratory of PathologyFinnish Institute of Occupational HealthHelsinkiFinland
- Department of PathologyUniversity of Helsinki and Helsinki University HospitalHelsinkiFinland
| | - Ilkka Ilonen
- Individualized Drug Therapy Research Program, Faculty of MedicineUniversity of HelsinkiHelsinkiFinland
- Department of General Thoracic and Esophageal SurgeryHeart and Lung Center, University of Helsinki and Helsinki University HospitalHelsinkiFinland
| | - Eva Sutinen
- Individualized Drug Therapy Research Program, Faculty of MedicineUniversity of HelsinkiHelsinkiFinland
- Department of Pulmonary MedicineHeart and Lung Center, University of Helsinki and Helsinki University HospitalHelsinkiFinland
| | - Katja Välimäki
- Institute for Molecular Medicine Finland (FIMM), Helsinki Institute of Life Science (HiLIFE)University of HelsinkiHelsinkiFinland
| | - Arne Östman
- Department of Oncology‐PathologyKarolinska InstitutetSolnaSweden
| | - Sisko Anttila
- Department of PathologyUniversity of Helsinki and Helsinki University HospitalHelsinkiFinland
| | - Eeva Kettunen
- Laboratory of PathologyFinnish Institute of Occupational HealthHelsinkiFinland
| | - Jari Räsänen
- Department of General Thoracic and Esophageal SurgeryHeart and Lung Center, University of Helsinki and Helsinki University HospitalHelsinkiFinland
| | - Olli Kallioniemi
- Institute for Molecular Medicine Finland (FIMM), Helsinki Institute of Life Science (HiLIFE)University of HelsinkiHelsinkiFinland
| | - Marjukka Myllärniemi
- Individualized Drug Therapy Research Program, Faculty of MedicineUniversity of HelsinkiHelsinkiFinland
- Department of Pulmonary MedicineHeart and Lung Center, University of Helsinki and Helsinki University HospitalHelsinkiFinland
| | - Mikko I Mäyränpää
- Department of PathologyUniversity of Helsinki and Helsinki University HospitalHelsinkiFinland
| | - Teijo Pellinen
- Institute for Molecular Medicine Finland (FIMM), Helsinki Institute of Life Science (HiLIFE)University of HelsinkiHelsinkiFinland
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Verkola M, Järvelä T, Järvinen A, Jokelainen P, Virtala A, Kinnunen PM, Heikinheimo A. Infection prevention and control practices of ambulatory veterinarians: A questionnaire study in Finland. Vet Med Sci 2021; 7:1059-1070. [PMID: 33645926 PMCID: PMC8294370 DOI: 10.1002/vms3.464] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 02/02/2021] [Accepted: 02/16/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Veterinarians face the risk of contracting zoonotic pathogens. Infection prevention and control (IPC) guidelines stress the importance of proper hand hygiene and personal protective equipment (PPE) to prevent transmission of these pathogens. OBJECTIVES We aimed to assess how ambulatory livestock and equine veterinarians follow IPC guidelines, when working on farms and in stables. METHODS We studied hygiene practices of livestock and equine ambulatory veterinarians (n = 129) in Finland. A web-based questionnaire was used to obtain demographic information and information regarding hand-hygiene facilities and practices, use and cleaning of PPE and cleaning of medical equipment. RESULTS According to 66.9% of the respondents, hand-washing facilities were often adequate on livestock farms, but only 21.4% reported that this was the case in stables (p < .001). While 75.0% reported washing their hands or using hand sanitizer always before moving on to the next farm, only 42.5% reported doing this before moving on to the next stables (p < .001). Universal protective coat or coverall use was more common in livestock practice than in equine practice (91.6% vs. 27.7%, p < .001). Stethoscope cleaning was reported to happen less frequently than once a week by 30.0% of the respondents. CONCLUSIONS Finnish veterinarians' self-reported IPC adherence was far from uniform. IPC was more commonly followed in ambulatory livestock practice perhaps facilitated by better hand-washing facilities on farms than in stables. The study suggests that education of veterinarians is still needed and that hand-washing facilities need to be improved even in a high-income country.
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Affiliation(s)
- Marie Verkola
- Faculty of Veterinary MedicineUniversity of HelsinkiHelsinkiFinland
| | - Terhi Järvelä
- Faculty of Veterinary MedicineUniversity of HelsinkiHelsinkiFinland
| | - Asko Järvinen
- Department of Infectious DiseasesInflammation CenterHelsinki University Central Hospital and University of HelsinkiHUSFinland
| | - Pikka Jokelainen
- Faculty of Veterinary MedicineUniversity of HelsinkiHelsinkiFinland
- Laboratory of ParasitologyDepartment of BacteriaInfectious Disease PreparednessStatens Serum InstitutCopenhagen SDenmark
| | | | | | - Annamari Heikinheimo
- Faculty of Veterinary MedicineUniversity of HelsinkiHelsinkiFinland
- Finnish Food AuthoritySeinäjokiFinland
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