1
|
Dorca E, Velasco A, Varela M, Gatius S, Villatoro S, Fullana N, Cuevas D, Vaquero M, Birnbaum A, Neumann K, Matias-Guiu X. Validation of Modaplex POLE mutation assay in endometrial carcinoma. Virchows Arch 2023; 483:787-794. [PMID: 37874375 DOI: 10.1007/s00428-023-03636-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 08/11/2023] [Accepted: 08/24/2023] [Indexed: 10/25/2023]
Abstract
The TCGA-based molecular classification of endometrial cancer has emerged as an important tool to stratify patients according to prognosis. A simplified scheme has been proposed, by using immunohistochemistry for p53, MSH6, and PMS2 and a molecular test for POLE mutations (NGS or Sanger sequencing, techniques that are not available in many centers worldwide). In this study, we validate a novel method that allows simultaneous analysis of multiple pathogenic POLE mutations. The Modaplex technology integrates polymerase chain reaction and capillary electrophoresis. The design of this study encompassed 4 different steps: (1) a retrospective-pilot phase, with 80 tumors, balancing the four molecular subgroups. (2) A retrospective phase of 25 tumors obtained between 2016 and 2020, and 30 tumors obtained between 2000 and 2015. (3) An inter-laboratory corssavalidation step with 19 cases (belonging to phases 1 and 2). (4) A prospective cohort of 123 tumors, of unknown POLE status, with simultaneous validation by Sanger sequencing. A total of 258 samples were analyzed. In the first and second phases, the test showed positive/negative predictive values of 100%, by correctly identifying POLE mutation status in 79/79 and 55/55 cases. Phase 3 showed 100% of inter-laboratory consistency. Phase 4 showed 16 positive samples out of the 123 prospective cases. Overall, the test has revealed sensitivity and specificity of 100%, identifying a total of 47 POLE-mutated tumors. We have shown that this technique allows faster and easier identification of multiple pathogenic POLE mutations with high robustness and confidence when comparing to other tests such as Sanger sequencing.
Collapse
Affiliation(s)
- Eduard Dorca
- Pathology Department, Hospital Universitari de Bellvitge, Universitat de Barcelona, IDIBELL, Feixa Llarga SN, 08907, L'Hospitalet de Llobregat, Spain
| | - Ana Velasco
- Pathology Department, Hospital Universitari Arnau de Vilanova, Universitat de Lleida, IRBLleida, CIBERONC, Av Rovira Roure 80, 25198, Lleida, Spain
| | - Mar Varela
- Pathology Department, Hospital Universitari de Bellvitge, Universitat de Barcelona, IDIBELL, Feixa Llarga SN, 08907, L'Hospitalet de Llobregat, Spain
| | - Sonia Gatius
- Pathology Department, Hospital Universitari Arnau de Vilanova, Universitat de Lleida, IRBLleida, CIBERONC, Av Rovira Roure 80, 25198, Lleida, Spain
| | - Sergio Villatoro
- Pathology Department, Hospital Universitari de Bellvitge, Universitat de Barcelona, IDIBELL, Feixa Llarga SN, 08907, L'Hospitalet de Llobregat, Spain
| | - Neus Fullana
- Pathology Department, Hospital Universitari de Bellvitge, Universitat de Barcelona, IDIBELL, Feixa Llarga SN, 08907, L'Hospitalet de Llobregat, Spain
| | - Dolors Cuevas
- Pathology Department, Hospital Universitari Arnau de Vilanova, Universitat de Lleida, IRBLleida, CIBERONC, Av Rovira Roure 80, 25198, Lleida, Spain
| | - Marta Vaquero
- Pathology Department, Hospital Universitari Arnau de Vilanova, Universitat de Lleida, IRBLleida, CIBERONC, Av Rovira Roure 80, 25198, Lleida, Spain
| | - Astrid Birnbaum
- Städtisches Klinikum Dessau Institut für Pathologie, Dessau-Roßlau, Germany
| | - Karsten Neumann
- Städtisches Klinikum Dessau Institut für Pathologie, Dessau-Roßlau, Germany
| | - Xavier Matias-Guiu
- Pathology Department, Hospital Universitari de Bellvitge, Universitat de Barcelona, IDIBELL, Feixa Llarga SN, 08907, L'Hospitalet de Llobregat, Spain.
- Pathology Department, Hospital Universitari Arnau de Vilanova, Universitat de Lleida, IRBLleida, CIBERONC, Av Rovira Roure 80, 25198, Lleida, Spain.
| |
Collapse
|
2
|
Costas L, Onieva I, Pelegrina B, Marin F, Carmona Á, López-Querol M, Frias-Gomez J, Peremiquel-Trillas P, Martínez JM, Dorca E, Brunet J, Pineda M, Ponce J, Matias-Guiu X, de Sanjosé S, Bosch FX, Alemany L, Paytubi S. Evaluation of Somatic Mutations in Urine Samples as a Noninvasive Method for the Detection and Molecular Classification of Endometrial Cancer. Clin Cancer Res 2023; 29:3681-3690. [PMID: 37439797 DOI: 10.1158/1078-0432.ccr-23-0367] [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] [Received: 02/09/2023] [Revised: 04/19/2023] [Accepted: 07/10/2023] [Indexed: 07/14/2023]
Abstract
PURPOSE Current diagnostic methods for endometrial cancer lack specificity, leading to many women undergoing invasive procedures. The aim of this study was to evaluate somatic mutations in urine to accurately discriminate patients with endometrial cancer from controls. EXPERIMENTAL DESIGN Overall, 72 samples were analyzed using next-generation sequencing (NGS) with molecular identifiers targeting 47 genes. We evaluated urine supernatant samples from women with endometrial cancer (n = 19) and age-matched controls (n = 20). Cell pellets from urine and plasma samples from seven cases were sequenced; further, we also evaluated paired tumor samples from all cases. Finally, immunohistochemical markers for molecular profiling were evaluated in all tumor samples. RESULTS Overall, we were able to identify mutations in DNA from urine supernatant samples in 100% of endometrial cancers. In contrast, only one control (5%) showed variants at a variant allele frequency (VAF) ≥ 2% in the urine supernatant samples. The molecular classification obtained by using tumor samples and urine samples showed good agreement. Analyses in paired samples revealed a higher number of mutations and VAF in urine supernatants than in urine cell pellets and blood samples. CONCLUSIONS Evaluation of somatic mutations using urine samples may offer a user-friendly and reliable tool for endometrial cancer detection and molecular classification. The diagnostic performance for endometrial cancer detection was very high, and cases could be molecularly classified using these noninvasive and self-collected samples. Additional multicenter evaluations using larger sample sizes are needed to validate the results and understand the potential of urine samples for the early detection and prognosis of endometrial cancer.
Collapse
Affiliation(s)
- Laura Costas
- Cancer Epidemiology Research Programme, Catalan Institute of Oncology, IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health - CIBERESP, Carlos III Institute of Health, Madrid, Spain
| | - Irene Onieva
- Cancer Epidemiology Research Programme, Catalan Institute of Oncology, IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
- Faculty of Medicine, University of Barcelona, Barcelona, Spain
| | - Beatriz Pelegrina
- Cancer Epidemiology Research Programme, Catalan Institute of Oncology, IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health - CIBERESP, Carlos III Institute of Health, Madrid, Spain
| | - Fátima Marin
- Consortium for Biomedical Research in Cancer - CIBERONC, Carlos III Institute of Health, Madrid, Spain
- Hereditary Cancer Program, Catalan Institute of Oncology, IDIBELL, ONCOBELL Program, L'Hospitalet, Barcelona, Spain
| | | | - Marta López-Querol
- Cancer Epidemiology Research Programme, Catalan Institute of Oncology, IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Jon Frias-Gomez
- Cancer Epidemiology Research Programme, Catalan Institute of Oncology, IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health - CIBERESP, Carlos III Institute of Health, Madrid, Spain
- Faculty of Medicine, University of Barcelona, Barcelona, Spain
| | - Paula Peremiquel-Trillas
- Cancer Epidemiology Research Programme, Catalan Institute of Oncology, IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health - CIBERESP, Carlos III Institute of Health, Madrid, Spain
- Faculty of Medicine, University of Barcelona, Barcelona, Spain
| | - José Manuel Martínez
- Faculty of Medicine, University of Barcelona, Barcelona, Spain
- Department of Gynecology, Hospital Universitari de Bellvitge, IDIBELL, Hospitalet de Llobregat, Barcelona, Spain
| | - Eduard Dorca
- Department of Pathology, Hospital Universitari de Bellvitge, IDIBELL, Hospitalet de Llobregat, Barcelona, Spain
| | - Joan Brunet
- Consortium for Biomedical Research in Cancer - CIBERONC, Carlos III Institute of Health, Madrid, Spain
- Hereditary Cancer Program, Catalan Institute of Oncology, IDIBELL, ONCOBELL Program, L'Hospitalet, Barcelona, Spain
- Hereditary Cancer Program, Catalan Institute of Oncology, IDIBGI, Girona, Spain
- Medical Oncology Department, Catalan Institute of Oncology, Doctor Josep Trueta Girona University Hospital, Girona, Spain
| | - Marta Pineda
- Consortium for Biomedical Research in Cancer - CIBERONC, Carlos III Institute of Health, Madrid, Spain
- Hereditary Cancer Program, Catalan Institute of Oncology, IDIBELL, ONCOBELL Program, L'Hospitalet, Barcelona, Spain
| | - Jordi Ponce
- Department of Gynecology, Hospital Universitari de Bellvitge, IDIBELL, Hospitalet de Llobregat, Barcelona, Spain
| | - Xavier Matias-Guiu
- Consortium for Biomedical Research in Cancer - CIBERONC, Carlos III Institute of Health, Madrid, Spain
- Department of Pathology, Hospital Universitari de Bellvitge, IDIBELL, Hospitalet de Llobregat, Barcelona, Spain
| | | | - Francesc Xavier Bosch
- Cancer Epidemiology Research Programme, Catalan Institute of Oncology, IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health - CIBERESP, Carlos III Institute of Health, Madrid, Spain
- Universitat Oberta de Catalunya, Barcelona, Spain
| | - Laia Alemany
- Cancer Epidemiology Research Programme, Catalan Institute of Oncology, IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health - CIBERESP, Carlos III Institute of Health, Madrid, Spain
| | - Sonia Paytubi
- Cancer Epidemiology Research Programme, Catalan Institute of Oncology, IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health - CIBERESP, Carlos III Institute of Health, Madrid, Spain
| |
Collapse
|
3
|
Pelegrina B, Paytubi S, Marin F, Martínez JM, Carmona Á, Frias-Gomez J, Peremiquel-Trillas P, Dorca E, Zanca A, López-Querol M, Onieva I, Benavente Y, Barahona M, Fernandez-Gonzalez S, De Francisco J, Caño V, Vidal A, Pijuan L, Canet-Hermida J, Dueñas N, Brunet J, Pineda M, Matias-Guiu X, Ponce J, Bosch FX, De Sanjosé S, Alemany L, Costas L. Evaluation of somatic mutations in cervicovaginal samples as a non-invasive method for the detection and molecular classification of endometrial cancer. EBioMedicine 2023; 94:104716. [PMID: 37480623 PMCID: PMC10393602 DOI: 10.1016/j.ebiom.2023.104716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 06/30/2023] [Accepted: 06/30/2023] [Indexed: 07/24/2023] Open
Abstract
BACKGROUND The incidence of endometrial cancer is increasing worldwide. While delays in diagnosis reduce survival, case molecular misclassification might be associated with under- and over-treatment. The objective of this study was to evaluate genetic alterations to detect and molecularly classify cases of endometrial cancer using non-invasive samples. METHODS Consecutive patients with incident endometrial cancer (N = 139) and controls (N = 107) from a recent Spanish case-control study were included in this analysis. Overall, 339 cervicovaginal samples (out of which 228 were clinician-collected and 111 were self-collected) were analysed using a test based on next-generation sequencing (NGS), which targets 47 genes. Immunohistochemical markers were evaluated in 133 tumour samples. A total of 159 samples were used to train the detection algorithm and 180 samples were used for validation. FINDINGS Overall, 73% (N = 94 out of 129 clinician-collected samples, and N = 66 out of 90 self-collected samples) of endometrial cancer cases had detectable mutations in clinician-collected and self-collected samples, while the specificity was 80% (79/99) for clinician-collected samples and 90% (19/21) for self-collected samples. The molecular classifications obtained using tumour samples and non-invasive gynaecologic samples in our study showed moderate-to-good agreement. The molecular classification of cases of endometrial cancer into four groups using NGS of both clinician-collected and self-collected cervicovaginal samples yielded significant differences in disease-free survival. The cases with mutations in POLE had an excellent prognosis, whereas the cases with TP53 mutations had the poorest clinical outcome, which is consistent with the data on tumour samples. INTERPRETATION This study classified endometrial cancer cases into four molecular groups based on the analysis of cervicovaginal samples that showed significant differences in disease-free survival. The molecular classification of endometrial cancer in non-invasive samples may improve patient care and survival by indicating the early need for aggressive surgery, as well as reducing referrals to highly specialized hospitals in cancers with good prognosis. Validation in independent sets will confirm the potential for molecular classification in non-invasive samples. FUNDING This study was funded by a competitive grant from Instituto de Salud Carlos III through the projects PI19/01835, PI23/00790, and FI20/00031, CIBERESP CB06/02/0073 and CIBERONC CB16/12/00231, CB16/12/00234 (Co-funded by European Regional Development Fund. ERDF: A way to build Europe). Samples and data were provided by Biobank HUB-ICO-IDIBELL, integrated into the Spanish Biobank Network, and funded by the Instituto de Salud Carlos III (PT20/00171) and by Xarxa de Bancs de Tumors de Catalunya (XBTC) sponsored by Pla Director d'Oncologia de Catalunya. This work was supported in part by the AECC, Grupos estables (GCTRA18014MATI). It also counts with the support of the Secretariat for Universities and Research of the Department of Business and Knowledge of the Generalitat de Catalunya, and grants to support the activities of research groups 2021SGR01354 and 2021SGR1112.
Collapse
Affiliation(s)
- Beatriz Pelegrina
- Cancer Epidemiology Research Programme, Catalan Institute of Oncology, IDIBELL, Av Gran Vía 199-203, 08908, L'Hospitalet de Llobregat, Barcelona, Spain; Consortium for Biomedical Research in Epidemiology and Public Health - CIBERESP, Carlos III Institute of Health, Av. De Monforte de Lemos 5, 28029, Madrid, Spain
| | - Sonia Paytubi
- Cancer Epidemiology Research Programme, Catalan Institute of Oncology, IDIBELL, Av Gran Vía 199-203, 08908, L'Hospitalet de Llobregat, Barcelona, Spain; Consortium for Biomedical Research in Epidemiology and Public Health - CIBERESP, Carlos III Institute of Health, Av. De Monforte de Lemos 5, 28029, Madrid, Spain
| | - Fátima Marin
- Consortium for Biomedical Research in Cancer - CIBERONC, Carlos III Institute of Health, Av. De Monforte de Lemos 5, 28029, Madrid, Spain; Hereditary Cancer Program, Catalan Institute of Oncology, IDIBELL, ONCOBELL Program, L'Hospitalet, Barcelona, Spain
| | - José Manuel Martínez
- Department of Gynecology, Hospital Universitari de Bellvitge, IDIBELL, Hospitalet de Llobregat, Barcelona, Spain; Faculty of Medicine, University of Barcelona, Spain
| | | | - Jon Frias-Gomez
- Cancer Epidemiology Research Programme, Catalan Institute of Oncology, IDIBELL, Av Gran Vía 199-203, 08908, L'Hospitalet de Llobregat, Barcelona, Spain; Consortium for Biomedical Research in Epidemiology and Public Health - CIBERESP, Carlos III Institute of Health, Av. De Monforte de Lemos 5, 28029, Madrid, Spain; Faculty of Medicine, University of Barcelona, Spain
| | - Paula Peremiquel-Trillas
- Cancer Epidemiology Research Programme, Catalan Institute of Oncology, IDIBELL, Av Gran Vía 199-203, 08908, L'Hospitalet de Llobregat, Barcelona, Spain; Consortium for Biomedical Research in Epidemiology and Public Health - CIBERESP, Carlos III Institute of Health, Av. De Monforte de Lemos 5, 28029, Madrid, Spain; Faculty of Medicine, University of Barcelona, Spain
| | - Eduard Dorca
- Department of Pathology, Hospital Universitari de Bellvitge, IDIBELL, Hospitalet de Llobregat, Barcelona, Spain
| | - Alba Zanca
- Consortium for Biomedical Research in Cancer - CIBERONC, Carlos III Institute of Health, Av. De Monforte de Lemos 5, 28029, Madrid, Spain; Department of Pathology, Hospital Universitari de Bellvitge, IDIBELL, Hospitalet de Llobregat, Barcelona, Spain
| | - Marta López-Querol
- Cancer Epidemiology Research Programme, Catalan Institute of Oncology, IDIBELL, Av Gran Vía 199-203, 08908, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Irene Onieva
- Cancer Epidemiology Research Programme, Catalan Institute of Oncology, IDIBELL, Av Gran Vía 199-203, 08908, L'Hospitalet de Llobregat, Barcelona, Spain; Faculty of Medicine, University of Barcelona, Spain
| | - Yolanda Benavente
- Cancer Epidemiology Research Programme, Catalan Institute of Oncology, IDIBELL, Av Gran Vía 199-203, 08908, L'Hospitalet de Llobregat, Barcelona, Spain; Consortium for Biomedical Research in Epidemiology and Public Health - CIBERESP, Carlos III Institute of Health, Av. De Monforte de Lemos 5, 28029, Madrid, Spain
| | - Marc Barahona
- Department of Gynecology, Hospital Universitari de Bellvitge, IDIBELL, Hospitalet de Llobregat, Barcelona, Spain
| | - Sergi Fernandez-Gonzalez
- Department of Gynecology, Hospital Universitari de Bellvitge, IDIBELL, Hospitalet de Llobregat, Barcelona, Spain
| | - Javier De Francisco
- Department of Anesthesiology, Hospital Universitari de Bellvitge, IDIBELL, Hospitalet de Llobregat, Barcelona, Spain
| | - Víctor Caño
- Department of Anesthesiology, Hospital Universitari de Bellvitge, IDIBELL, Hospitalet de Llobregat, Barcelona, Spain
| | - August Vidal
- Consortium for Biomedical Research in Cancer - CIBERONC, Carlos III Institute of Health, Av. De Monforte de Lemos 5, 28029, Madrid, Spain; Department of Pathology, Hospital Universitari de Bellvitge, IDIBELL, Hospitalet de Llobregat, Barcelona, Spain
| | - Lara Pijuan
- Consortium for Biomedical Research in Cancer - CIBERONC, Carlos III Institute of Health, Av. De Monforte de Lemos 5, 28029, Madrid, Spain; Department of Pathology, Hospital Universitari de Bellvitge, IDIBELL, Hospitalet de Llobregat, Barcelona, Spain
| | - Júlia Canet-Hermida
- Consortium for Biomedical Research in Cancer - CIBERONC, Carlos III Institute of Health, Av. De Monforte de Lemos 5, 28029, Madrid, Spain; Hereditary Cancer Program, Catalan Institute of Oncology, IDIBELL, ONCOBELL Program, L'Hospitalet, Barcelona, Spain
| | - Núria Dueñas
- Consortium for Biomedical Research in Cancer - CIBERONC, Carlos III Institute of Health, Av. De Monforte de Lemos 5, 28029, Madrid, Spain; Hereditary Cancer Program, Catalan Institute of Oncology, IDIBELL, ONCOBELL Program, L'Hospitalet, Barcelona, Spain
| | - Joan Brunet
- Consortium for Biomedical Research in Cancer - CIBERONC, Carlos III Institute of Health, Av. De Monforte de Lemos 5, 28029, Madrid, Spain; Hereditary Cancer Program, Catalan Institute of Oncology, IDIBELL, ONCOBELL Program, L'Hospitalet, Barcelona, Spain; Hereditary Cancer Program, Catalan Institute of Oncology, IDIBGI, Girona, Spain; Medical Oncology Department, Catalan Institute of Oncology, Doctor Josep Trueta Girona University Hospital, Girona, Spain
| | - Marta Pineda
- Consortium for Biomedical Research in Cancer - CIBERONC, Carlos III Institute of Health, Av. De Monforte de Lemos 5, 28029, Madrid, Spain; Hereditary Cancer Program, Catalan Institute of Oncology, IDIBELL, ONCOBELL Program, L'Hospitalet, Barcelona, Spain
| | - Xavier Matias-Guiu
- Consortium for Biomedical Research in Cancer - CIBERONC, Carlos III Institute of Health, Av. De Monforte de Lemos 5, 28029, Madrid, Spain; Department of Pathology, Hospital Universitari de Bellvitge, IDIBELL, Hospitalet de Llobregat, Barcelona, Spain
| | - Jordi Ponce
- Department of Gynecology, Hospital Universitari de Bellvitge, IDIBELL, Hospitalet de Llobregat, Barcelona, Spain
| | - Francesc Xavier Bosch
- Cancer Epidemiology Research Programme, Catalan Institute of Oncology, IDIBELL, Av Gran Vía 199-203, 08908, L'Hospitalet de Llobregat, Barcelona, Spain; Consortium for Biomedical Research in Epidemiology and Public Health - CIBERESP, Carlos III Institute of Health, Av. De Monforte de Lemos 5, 28029, Madrid, Spain; Universitat Oberta de Catalunya, Barcelona, Spain
| | - Silvia De Sanjosé
- Consortium for Biomedical Research in Epidemiology and Public Health - CIBERESP, Carlos III Institute of Health, Av. De Monforte de Lemos 5, 28029, Madrid, Spain; Consultant, National Cancer Institute, Bethesda, MD, 20814, USA; ISGlobal, Barcelona, Spain
| | - Laia Alemany
- Cancer Epidemiology Research Programme, Catalan Institute of Oncology, IDIBELL, Av Gran Vía 199-203, 08908, L'Hospitalet de Llobregat, Barcelona, Spain; Consortium for Biomedical Research in Epidemiology and Public Health - CIBERESP, Carlos III Institute of Health, Av. De Monforte de Lemos 5, 28029, Madrid, Spain; Faculty of Medicine, University of Barcelona, Spain
| | - Laura Costas
- Cancer Epidemiology Research Programme, Catalan Institute of Oncology, IDIBELL, Av Gran Vía 199-203, 08908, L'Hospitalet de Llobregat, Barcelona, Spain; Consortium for Biomedical Research in Epidemiology and Public Health - CIBERESP, Carlos III Institute of Health, Av. De Monforte de Lemos 5, 28029, Madrid, Spain; Faculty of Medicine, University of Barcelona, Spain.
| |
Collapse
|
4
|
Devis‐Jauregui L, Vidal A, Plata‐Peña L, Santacana M, García‐Mulero S, Bonifaci N, Noguera‐Delgado E, Ruiz N, Gil M, Dorca E, Llobet FJ, Coll‐Iglesias L, Gassner K, Martinez‐Iniesta M, Rodriguez‐Barrueco R, Barahona M, Marti L, Viñals F, Ponce J, Sanz‐Pamplona R, Piulats JM, Vivancos A, Matias‐Guiu X, Villanueva A, Llobet‐Navas D. Generation and Integrated Analysis of Advanced Patient-Derived Orthoxenograft Models (PDOX) for the Rational Assessment of Targeted Therapies in Endometrial Cancer. Adv Sci (Weinh) 2022; 10:e2204211. [PMID: 36373729 PMCID: PMC9811454 DOI: 10.1002/advs.202204211] [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] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 10/18/2022] [Indexed: 05/19/2023]
Abstract
Clinical management of endometrial cancer (EC) is handicapped by the limited availability of second line treatments and bona fide molecular biomarkers to predict recurrence. These limitations have hampered the treatment of these patients, whose survival rates have not improved over the last four decades. The advent of coordinated studies such as The Cancer Genome Atlas Uterine Corpus Endometrial Carcinoma (TCGA_UCEC) has partially solved this issue, but the lack of proper experimental systems still represents a bottleneck that precludes translational studies from successful clinical testing in EC patients. Within this context, the first study reporting the generation of a collection of endometrioid-EC-patient-derived orthoxenograft (PDOX) mouse models is presented that is believed to overcome these experimental constraints and pave the way toward state-of-the-art precision medicine in EC. The collection of primary tumors and derived PDOXs is characterized through an integrative approach based on transcriptomics, mutational profiles, and morphological analysis; and it is demonstrated that EC tumors engrafted in the mouse uterus retain the main molecular and morphological features from analogous tumor donors. Finally, the molecular properties of these tumors are harnessed to assess the therapeutic potential of trastuzumab, a human epidermal growth factor receptor 2 (HER2) inhibitor with growing interest in EC, using patient-derived organotypic multicellular tumor spheroids and in vivo experiments.
Collapse
|
5
|
Nogué C, Chong AS, Grau E, Han H, Dorca E, Roca C, Mosquera JL, lazaro C, Foulkes WD, Brunet J, Polo BR. Abstract 1549: The tumorigenesis model in DGCR8 associated schwannomatosis. Cancer Res 2022. [DOI: 10.1158/1538-7445.am2022-1549] [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
Purpose: Schwannomatosis is an inherited disorder that affects Schwann cells from peripheral nerves. It is diagnosed when multiple schwannomas occur in the absence of bilateral vestibular schwannomas. The two main genes associated with this disorder are SMARCB1 and LZTR1 both on chromosome 22q (Chrm22q). Somatic inactivation of NF2, downstream of SMARCB1, is observed in most schwannomas. The accepted model of schwannomatosis involves multiple hits over three steps to inactivate LZTR1 or SMARCB1 together with NF2. Following this pattern, most of the LZTR1/SMARCB1-schwannomas acquire a somatic loss of Chrm22 (thus deleting the three genes) and a somatic mutation affecting the remaining wild-type NF2 copy on the GPV allele. Several studies have postulated the plausible existence of other susceptibility genes predisposing to schwannomatosis and the likelihood of those being localized in Chrm22q. Last year we identified a GPV in the microprocessor DGCR8 (c.1552G>A; p.E518K) located in the Chrm22q11 region, as responsible for a familial form of schwannomatosis and multinodular goiter (Rivera et al JCI, 2020). Our goal is to clarify the role of DGCR8 as a novel tumor susceptibility gene and the tumorigenic mechanisms that lead to DGCR8-schwannomatosis.
Methods: We searched for patients affected of schwannoma and thyroid tumors. By whole exome sequencing we identified the same DGCR8 (c.1552G>A; p.E518K) variant in one patient. We then collected a total of 13 DGCR8-schwannomas from carriers. Eleven tumors were subjected to WES and two tumors were subjected to a NGS targeted panel covering all known schwannoma genes in Chrm22q.
Results: We report the second case of a patient with peripheral schwannomatosis and thyroid alterations caused by the germline pathogenic variant E518K in DGCR8. Loss of Chrm22q was seen in all 13 tumors analyzed. While all tumors had at least one alteration of NF2, 4 tumors had no somatic mutations on the retained (not deleted) allele (30.8%). Given that DGCR8 localizes 5’ of LZTR1, the second step (LOH) leads to the deletion of DGCR8 and the three bona fide schwannoma genes (LZTR1, SMARCB1 and NF2) adding up to a total of 6 hits in a 3-step model. Suggesting that the path to tumorigenesis driven by DGCR8 requires the loss of the wild type allele of Chrm22q and in more than two thirds of the tumors a complete inactivation of NF2 occurs.
Conclusion: Our findings highlight DGCR8 as a schwannomatosis gene mapping to the Chrm22 cluster of tumor suppressors that cooperate to promote tumorigenesis in Schwann cell and pinpoints an important role of miRNA regulation in this process.
Citation Format: Clara Nogué, Anne-Sophie Chong, Elia Grau, HyeRim Han, Eduard Dorca, Carla Roca, Jose Luis Mosquera, Conxi lazaro, William D. Foulkes, Joan Brunet, Bárbara Rivera Polo. The tumorigenesis model in DGCR8 associated schwannomatosis [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 1549.
Collapse
Affiliation(s)
- Clara Nogué
- 1IDIBELL, L´Hospitalet de Llobregat, Barcelona, Spain
| | | | - Elia Grau
- 1IDIBELL, L´Hospitalet de Llobregat, Barcelona, Spain
| | - HyeRim Han
- 1IDIBELL, L´Hospitalet de Llobregat, Barcelona, Spain
| | - Eduard Dorca
- 3Hospital de Bellvitge, L´Hospitalet de Llobregat, Barcelona, Spain
| | - Carla Roca
- 1IDIBELL, L´Hospitalet de Llobregat, Barcelona, Spain
| | | | - Conxi lazaro
- 1IDIBELL, L´Hospitalet de Llobregat, Barcelona, Spain
| | | | - Joan Brunet
- 4Instituto Catalán de Oncología, L´Hospitalet de Llobregat, Barcelona, Spain
| | | |
Collapse
|
6
|
Aliagas E, Alay A, Martínez-Iniesta M, Hernández-Madrigal M, Cordero D, Gausachs M, Pros E, Saigí M, Busacca S, Sharkley AJ, Dawson A, Palmero R, Ruffinelli JC, Padrones S, Aso S, Escobar I, Ramos R, Llatjós R, Vidal A, Dorca E, Varela M, Sánchez-Céspedes M, Fennell D, Muñoz-Pinedo C, Villanueva A, Solé X, Nadal E. Efficacy of CDK4/6 inhibitors in preclinical models of malignant pleural mesothelioma. Br J Cancer 2021; 125:1365-1376. [PMID: 34588615 PMCID: PMC8576019 DOI: 10.1038/s41416-021-01547-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Revised: 08/06/2021] [Accepted: 09/03/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND There is no effective therapy for patients with malignant pleural mesothelioma (MPM) who progressed to platinum-based chemotherapy and immunotherapy. METHODS We aimed to investigate the antitumor activity of CDK4/6 inhibitors using in vitro and in vivo preclinical models of MPM. RESULTS Based on publicly available transcriptomic data of MPM, patients with CDK4 or CDK6 overexpression had shorter overall survival. Treatment with abemaciclib or palbociclib at 100 nM significantly decreased cell proliferation in all cell models evaluated. Both CDK4/6 inhibitors significantly induced G1 cell cycle arrest, thereby increasing cell senescence and increased the expression of interferon signalling pathway and tumour antigen presentation process in culture models of MPM. In vivo preclinical studies showed that palbociclib significantly reduced tumour growth and prolonged overall survival using distinct xenograft models of MPM implanted in athymic mice. CONCLUSIONS Treatment of MPM with CDK4/6 inhibitors decreased cell proliferation, mainly by promoting cell cycle arrest at G1 and by induction of cell senescence. Our preclinical studies provide evidence for evaluating CDK4/6 inhibitors in the clinic for the treatment of MPM.
Collapse
Affiliation(s)
- Elisabet Aliagas
- grid.418284.30000 0004 0427 2257Preclinical and Experimental Research in Thoracic Tumors (PrETT) group. Oncobell Program. Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat (Barcelona), Barcelona, Spain
| | - Ania Alay
- grid.418284.30000 0004 0427 2257Preclinical and Experimental Research in Thoracic Tumors (PrETT) group. Oncobell Program. Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat (Barcelona), Barcelona, Spain ,grid.418701.b0000 0001 2097 8389Unit of Bioinformatics for Precision Oncology, Catalan Institute of Oncology (ICO), L’Hospitalet de Llobregat (Barcelona), Barcelona, Spain
| | - Maria Martínez-Iniesta
- grid.418284.30000 0004 0427 2257Chemoresistance group. Oncobell Program, Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat (Barcelona), Barcelona, Spain
| | - Miguel Hernández-Madrigal
- grid.418284.30000 0004 0427 2257Preclinical and Experimental Research in Thoracic Tumors (PrETT) group. Oncobell Program. Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat (Barcelona), Barcelona, Spain
| | - David Cordero
- grid.418284.30000 0004 0427 2257Preclinical and Experimental Research in Thoracic Tumors (PrETT) group. Oncobell Program. Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat (Barcelona), Barcelona, Spain ,grid.418701.b0000 0001 2097 8389Unit of Bioinformatics for Precision Oncology, Catalan Institute of Oncology (ICO), L’Hospitalet de Llobregat (Barcelona), Barcelona, Spain ,grid.466571.70000 0004 1756 6246Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Barcelona, Spain
| | - Mireia Gausachs
- grid.418284.30000 0004 0427 2257Preclinical and Experimental Research in Thoracic Tumors (PrETT) group. Oncobell Program. Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat (Barcelona), Barcelona, Spain
| | - Eva Pros
- grid.429289.cCancer Genetics Group, Josep Carreras Leukaemia Research Institute (IJC), Badalona, Badalona Barcelona, Spain
| | - Maria Saigí
- grid.429289.cCancer Genetics Group, Josep Carreras Leukaemia Research Institute (IJC), Badalona, Badalona Barcelona, Spain
| | - Sara Busacca
- grid.9918.90000 0004 1936 8411Department of Genetics and Genome Biology, Leicester Cancer Research Centre, University of Leicester, Leicester, UK
| | - Annabel J. Sharkley
- grid.11835.3e0000 0004 1936 9262University of Sheffield Teaching Hospitals, Sheffield, UK
| | - Alan Dawson
- grid.412925.90000 0004 0400 6581Department of Thoracic Surgery, Glenfield Hospital, Leicester, UK
| | - Ramón Palmero
- grid.418284.30000 0004 0427 2257Preclinical and Experimental Research in Thoracic Tumors (PrETT) group. Oncobell Program. Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat (Barcelona), Barcelona, Spain ,grid.418701.b0000 0001 2097 8389Department of Medical Oncology, Catalan Institute of Oncology, L’Hospitalet de Llobregat (Barcelona), Barcelona, Spain
| | - José C. Ruffinelli
- grid.418701.b0000 0001 2097 8389Department of Medical Oncology, Catalan Institute of Oncology, L’Hospitalet de Llobregat (Barcelona), Barcelona, Spain
| | - Susana Padrones
- grid.411129.e0000 0000 8836 0780Department of Respiratory Medicine, Hospital Universitari de Bellvitge, L’Hospitalet de Llobregat (Barcelona), Barcelona, Spain
| | - Samantha Aso
- grid.411129.e0000 0000 8836 0780Department of Respiratory Medicine, Hospital Universitari de Bellvitge, L’Hospitalet de Llobregat (Barcelona), Barcelona, Spain
| | - Ignacio Escobar
- grid.411129.e0000 0000 8836 0780Department of Thoracic Surgery, Hospital Universitari de Bellvitge, L’Hospitalet de Llobregat (Barcelona), Barcelona, Spain
| | - Ricard Ramos
- grid.411129.e0000 0000 8836 0780Department of Thoracic Surgery, Hospital Universitari de Bellvitge, L’Hospitalet de Llobregat (Barcelona), Barcelona, Spain
| | - Roger Llatjós
- grid.411129.e0000 0000 8836 0780Department of Pathology, Hospital Universitari de Bellvitge, L’Hospitalet de Llobregat (Barcelona), Barcelona, Spain
| | - August Vidal
- grid.411129.e0000 0000 8836 0780Department of Pathology, Hospital Universitari de Bellvitge, L’Hospitalet de Llobregat (Barcelona), Barcelona, Spain
| | - Eduard Dorca
- grid.411129.e0000 0000 8836 0780Department of Pathology, Hospital Universitari de Bellvitge, L’Hospitalet de Llobregat (Barcelona), Barcelona, Spain
| | - Mar Varela
- grid.411129.e0000 0000 8836 0780Department of Pathology, Hospital Universitari de Bellvitge, L’Hospitalet de Llobregat (Barcelona), Barcelona, Spain
| | - Montse Sánchez-Céspedes
- grid.429289.cCancer Genetics Group, Josep Carreras Leukaemia Research Institute (IJC), Badalona, Badalona Barcelona, Spain
| | - Dean Fennell
- grid.9918.90000 0004 1936 8411Department of Genetics and Genome Biology, Leicester Cancer Research Centre, University of Leicester, Leicester, UK ,grid.9918.90000 0004 1936 8411Mesothelioma Research Programme, Department of Genetics and Genome Biology, University of Leicester, Leicester, UK
| | - Cristina Muñoz-Pinedo
- grid.418284.30000 0004 0427 2257Preclinical and Experimental Research in Thoracic Tumors (PrETT) group. Oncobell Program. Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat (Barcelona), Barcelona, Spain
| | - Alberto Villanueva
- grid.418284.30000 0004 0427 2257Chemoresistance group. Oncobell Program, Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat (Barcelona), Barcelona, Spain
| | - Xavi Solé
- grid.418284.30000 0004 0427 2257Preclinical and Experimental Research in Thoracic Tumors (PrETT) group. Oncobell Program. Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat (Barcelona), Barcelona, Spain ,grid.418701.b0000 0001 2097 8389Unit of Bioinformatics for Precision Oncology, Catalan Institute of Oncology (ICO), L’Hospitalet de Llobregat (Barcelona), Barcelona, Spain ,grid.466571.70000 0004 1756 6246Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Barcelona, Spain
| | - Ernest Nadal
- grid.418284.30000 0004 0427 2257Preclinical and Experimental Research in Thoracic Tumors (PrETT) group. Oncobell Program. Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat (Barcelona), Barcelona, Spain ,grid.418701.b0000 0001 2097 8389Department of Medical Oncology, Catalan Institute of Oncology, L’Hospitalet de Llobregat (Barcelona), Barcelona, Spain ,grid.5841.80000 0004 1937 0247Department of Clinical Sciences, School of Medicine and Health Sciences, Universitat de Barcelona, L’Hospitalet del Llobregat (Barcelona), Campus Bellvitge, Barcelona, Spain
| |
Collapse
|
7
|
Dorca-Arévalo J, Dorca E, Torrejón-Escribano B, Blanch M, Martín-Satué M, Blasi J. Lung endothelial cells are sensitive to epsilon toxin from Clostridium perfringens. Vet Res 2020; 51:27. [PMID: 32093740 PMCID: PMC7041264 DOI: 10.1186/s13567-020-00748-2] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Accepted: 01/22/2020] [Indexed: 11/12/2022] Open
Abstract
The pore-forming protein epsilon toxin (Etx) from Clostridium perfringens produces acute perivascular edema affecting several organs, especially the brain and lungs. Despite the toxin evident effect on microvasculature and endothelial cells, the underlying molecular and cellular mechanisms remain obscure. Moreover, no Etx-sensitive endothelial cell model has been identified to date. Here, we characterize the mouse lung endothelial cell line 1G11 as an Etx-sensitive cell line and compare it with the well-characterized Etx-sensitive Madin-Darby canine kidney epithelial cell line. Several experimental approaches, including morphological and cytotoxic assays, clearly demonstrate that the 1G11 cell line is highly sensitive to Etx and show the specific binding, oligomerization, and pore-forming activity of the toxin in these cells. Recently, the myelin and lymphocyte (MAL) protein has been postulated as a putative receptor for Etx. Here, we show the presence of Mal mRNA in the 1G11 cell line and the presence of the MAL protein in the endothelium of some mouse lung vessels, supporting the hypothesis that this protein is a key element in the Etx intoxication pathway. The existence of an Etx-sensitive cell line of endothelial origin would help shed light on the cellular and molecular mechanisms underlying Etx-induced edema and its consequences.
Collapse
Affiliation(s)
- Jonatan Dorca-Arévalo
- Department of Pathology and Experimental Therapeutics, Faculty of Medicine and Health Sciences, Campus of Bellvitge, University of Barcelona, Hospitalet de Llobregat, Barcelona, Spain. .,Biomedical Research Institute of Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain. .,Institute of Neurosciences, University of Barcelona, 08035, Barcelona, Spain.
| | - Eduard Dorca
- Pathology Service, Bellvitge University Hospital, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Benjamín Torrejón-Escribano
- Department of Pathology and Experimental Therapeutics, Faculty of Medicine and Health Sciences, Campus of Bellvitge, University of Barcelona, Hospitalet de Llobregat, Barcelona, Spain.,Centres Científics i Tecnològics, Universitat de Barcelona, Campus Bellvitge, Barcelona, Spain
| | - Marta Blanch
- Department of Pathology and Experimental Therapeutics, Faculty of Medicine and Health Sciences, Campus of Bellvitge, University of Barcelona, Hospitalet de Llobregat, Barcelona, Spain.,Biomedical Research Institute of Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain.,Institute of Neurosciences, University of Barcelona, 08035, Barcelona, Spain
| | - Mireia Martín-Satué
- Department of Pathology and Experimental Therapeutics, Faculty of Medicine and Health Sciences, Campus of Bellvitge, University of Barcelona, Hospitalet de Llobregat, Barcelona, Spain.,Biomedical Research Institute of Bellvitge (IDIBELL), Oncobell Program, CIBERONC, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Juan Blasi
- Department of Pathology and Experimental Therapeutics, Faculty of Medicine and Health Sciences, Campus of Bellvitge, University of Barcelona, Hospitalet de Llobregat, Barcelona, Spain.,Biomedical Research Institute of Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain.,Institute of Neurosciences, University of Barcelona, 08035, Barcelona, Spain
| |
Collapse
|
8
|
Soler T, Dorca E, Fernandez-Calvo D, Bosch J, Petit A, Taco M, Guerra E, Zanca A, Baixeras N, Perez Tapia L, Ortega R, Perez-Sidelnikova D, Fernandez Montoli M, Tena G, Matias-Guiu X. Diagnosis of fibroepithelial lesions and Pyllodes tumors by core biopsy: Correlation with the surgical specimen. Eur J Cancer 2018. [DOI: 10.1016/s0959-8049(18)30697-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: 10/17/2022]
|
9
|
Blasi M, Blasi J, Miguel-Pérez MI, Domingo T, Dorca E, García M, Pérez A. Anatomical and Histological Study of Foetal Fascias. J Bodyw Mov Ther 2012. [DOI: 10.1016/j.jbmt.2012.01.010] [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: 10/27/2022]
|
10
|
Tapiz A, Narberhaus B, Ugarte A, Dorca E. [Recurrent aseptic meningitis associated with dural vascular malformation]. Rev Neurol 2000; 30:1099-100. [PMID: 10904960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
|
11
|
Tapiz A, Dorca E, Force L, Aranda M. [Vertical transmission of HIV treated with zidovudine in county hospitals in Catalonia]. Med Clin (Barc) 1999; 113:357. [PMID: 10562932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
|
12
|
Tapiz A, Vilá-Parrot T, Gatell S, Dorca E, Barrios J. [Infrequent forms of meningococcal infections]. Rev Clin Esp 1997; 197:658-9. [PMID: 9411577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
|
13
|
Tapiz A, Vila D, Valdés V, Dorca E, Badal J, Marcos JM. [Cryptococcosis with exclusive cutaneous presentation in a patient with AIDS]. Rev Clin Esp 1994; 194:689-91. [PMID: 7984797] [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: 01/28/2023]
Abstract
We report an exclusively cutaneous case of cryptococcosis, which is exceptional. He was a 33 years old patient with the acquired immunodeficiency syndrome who presented with an ulcer-necrotic lesion at the nasal wings with a long and torpid evolution. Finally, culture and biopsy were diagnostic of cryptococcosis. We ruled out affection of other organs and the cryptococcal antigen was negative in serum and cerebrospinal fluid. The patient was treated with fluconazole and had a good clinical course. Its emphasized the scarcity of this form of presentation as well as the lack of specificity of its lesions and the necessity of ruling out other locations once the fungus is isolated in the skin. Diagnosis is simple through skin biopsy and culture. Its important to determine the cryptococcal antigen. We comment on the current approaches to treatment during acute and maintenance phases, after the appearance of the new imidazolic compounds such as fluconazole.
Collapse
Affiliation(s)
- A Tapiz
- Servicio de Medicina Interna, Hospital General de Manresa
| | | | | | | | | | | |
Collapse
|
14
|
Carratalá J, Dorca E, Bolao F, Mañá J, Niubó R, Fernández Nogués F. [Giant cell arteritis: clinical study and iatrogenesis by corticoids in 45 patients]. Rev Clin Esp 1988; 182:22-5. [PMID: 3375510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
|
15
|
Carratalá J, Bolao F, Dorca E. [Treatment with gamma globulin in thrombotic thrombocytopenic purpura]. Med Clin (Barc) 1987; 88:788. [PMID: 2441213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
|
16
|
de Celis G, Martínez-Brotóns F, Pintó J, Dorca E. [Thrombocytopenia associated with the prophylactic use of heparin]. Med Clin (Barc) 1984; 83:86-7. [PMID: 6471949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
|
17
|
Bene M, Radu H, Dorca E, Bene T. [Cleidocranial dysostosis, considerations in connection with a clinical case]. Kinderarztl Prax 1968; 36:217-24. [PMID: 5717018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
|