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White C, Reynolds S, Murphy K, Keegan H, Naik P, O'Brien R, Pilkington L, Sharkey Ochoa I, Glesson G, Russell N, Nuttall D, Tewari P, Wright F, O'Toole S, Sharp L, Flannelly G, O'Leary JJ, Martin CM. Performance of the HPV E6/E7 mRNA Aptima HPV assay combined with partial genotyping compared with the HPV DNA Cobas 4800 HPV test for use in primary screening: Results from the CERVIVA HPV primary screening study in Ireland. Int J Cancer 2024; 154:53-64. [PMID: 37632406 DOI: 10.1002/ijc.34685] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 06/06/2023] [Accepted: 06/12/2023] [Indexed: 08/28/2023]
Abstract
There are currently several validated HPV tests. However, longitudinal data which spans appropriate age ranges, as well as evaluation of potential screening algorithms are necessary for screening programmes choice of test. The objective of our study was to evaluate the performance of HPV mRNA and HPV DNA testing, including partial genotyping, in routine cervical screening. As part of the CERVIVA HPV Primary Screening Study, ThinPrep samples from 10 150 women were tested for HPV mRNA using the Aptima HPV assay and HPV DNA using the Cobas 4800 HPV test. HPV mRNA-positive women were further assessed with the Aptima genotyping assay for HPV 16/18/45. Baseline cytology and prospective follow-up data were collected. The performance of the two tests was examined over 42 months (to date). HPV mRNA demonstrated equivalent sensitivity to HPV DNA testing for detection of CIN2+ (93.2% [92.4-93.9] vs 92.8% [92.0-93.6], respectively) and CIN3+ (94.6% [93.8-95.3] vs 94.6% [93.8-95.3]). HPV mRNA testing had significantly higher specificity compared to HPV DNA for detection of CIN2+ (84.0% [83.5-84.5] vs 80.8% [80.2-81.4], respectively) and CIN3+ (88.44% [88.2-88.6] vs 85.62 [85.4-85.9]). The proportion of CIN2+ and CIN3+, over 3 years (42 months), in HPV-negative women was comparable for both RNA (0.20% and 0.10%) and DNA (0.22% and 0.11%). Genotyping data was comparable across both assay platforms. In the context of HPV primary screening HPV mRNA testing has potential to reduce triage tests and follow-up tests at 12 months compared to DNA testing, with no significant difference in detection of CIN2+ and CIN3+.
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Affiliation(s)
- Christine White
- TCD CERVIVA Molecular Pathology Laboratory, Trinity College Dublin, Dublin, Ireland
- Discipline of Histopathology, St. James' University Hospital, Trinity College Dublin, Dublin, Ireland
- The Coombe Hospital, Dublin 8, Ireland
| | - Stephen Reynolds
- TCD CERVIVA Molecular Pathology Laboratory, Trinity College Dublin, Dublin, Ireland
- The Coombe Hospital, Dublin 8, Ireland
| | - Katherine Murphy
- TCD CERVIVA Molecular Pathology Laboratory, Trinity College Dublin, Dublin, Ireland
| | - Helen Keegan
- TCD CERVIVA Molecular Pathology Laboratory, Trinity College Dublin, Dublin, Ireland
- The Coombe Hospital, Dublin 8, Ireland
| | - Padma Naik
- TCD CERVIVA Molecular Pathology Laboratory, Trinity College Dublin, Dublin, Ireland
- Discipline of Histopathology, St. James' University Hospital, Trinity College Dublin, Dublin, Ireland
- The Coombe Hospital, Dublin 8, Ireland
| | | | - Loretto Pilkington
- TCD CERVIVA Molecular Pathology Laboratory, Trinity College Dublin, Dublin, Ireland
| | - Imogen Sharkey Ochoa
- TCD CERVIVA Molecular Pathology Laboratory, Trinity College Dublin, Dublin, Ireland
| | - Grainne Glesson
- CervicalCheck, National Screening Service, Kings Inns House, Dublin 1, Ireland
| | - Noirin Russell
- CervicalCheck, National Screening Service, Kings Inns House, Dublin 1, Ireland
| | - David Nuttall
- TCD CERVIVA Molecular Pathology Laboratory, Trinity College Dublin, Dublin, Ireland
| | - Prerna Tewari
- TCD CERVIVA Molecular Pathology Laboratory, Trinity College Dublin, Dublin, Ireland
- Discipline of Histopathology, St. James' University Hospital, Trinity College Dublin, Dublin, Ireland
- Trinity St James Cancer Institute, Trinity College Dublin, Dublin, Ireland
| | - Fiona Wright
- CervicalCheck, National Screening Service, Kings Inns House, Dublin 1, Ireland
| | - Sharon O'Toole
- TCD CERVIVA Molecular Pathology Laboratory, Trinity College Dublin, Dublin, Ireland
- Discipline of Histopathology, St. James' University Hospital, Trinity College Dublin, Dublin, Ireland
- Trinity St James Cancer Institute, Trinity College Dublin, Dublin, Ireland
| | - Linda Sharp
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | | | - John J O'Leary
- TCD CERVIVA Molecular Pathology Laboratory, Trinity College Dublin, Dublin, Ireland
- Discipline of Histopathology, St. James' University Hospital, Trinity College Dublin, Dublin, Ireland
- The Coombe Hospital, Dublin 8, Ireland
- Trinity St James Cancer Institute, Trinity College Dublin, Dublin, Ireland
| | - Cara M Martin
- TCD CERVIVA Molecular Pathology Laboratory, Trinity College Dublin, Dublin, Ireland
- Discipline of Histopathology, St. James' University Hospital, Trinity College Dublin, Dublin, Ireland
- The Coombe Hospital, Dublin 8, Ireland
- Trinity St James Cancer Institute, Trinity College Dublin, Dublin, Ireland
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2
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Kelly TE, Spillane CL, Ward MP, Hokamp K, Huang Y, Tewari P, Martin CM, Norris LA, Mohamed BM, Bates M, Brooks R, Selemidis S, Brooks DA, Kamran W, Saadeh FA, O’Toole SA, O’Leary JJ. Plasminogen activator inhibitor 1 is associated with high-grade serous ovarian cancer metastasis and is reduced in patients who have received neoadjuvant chemotherapy. Front Cell Dev Biol 2023; 11:1150991. [PMID: 38143926 PMCID: PMC10740207 DOI: 10.3389/fcell.2023.1150991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 11/09/2023] [Indexed: 12/26/2023] Open
Abstract
Introduction: High-grade serous ovarian cancer (HGSOC) is the most prevalent and deadliest subtype of epithelial ovarian cancer (EOC), killing over 140,000 people annually. Morbidity and mortality are compounded by a lack of screening methods, and recurrence is common. Plasminogen-activator-inhibitor 1 (PAI-1, the protein product of SERPIN E1) is involved in hemostasis, extracellular matrix (ECM) remodeling, and tumor cell migration and invasion. Overexpression is associated with poor prognosis in EOC. Platelets significantly increase PAI-1 in cancer cells in vitro, and may contribute to the hematogenous metastasis of circulating tumor cells (CTCs). CTCs are viable tumor cells that intravasate and travel through the circulation-often aided by platelets - with the potential to form secondary metastases. Here, we provide evidence that PAI-1 is central to the platelet-cancer cell interactome, and plays a role in the metastatic cascade. Methods: SK-OV-3 cells where PAI-1 had been silenced, treated with healthy donor platelets, and treated with platelet-conditioned medium were used as an in vitro model of metastatic EOC. Gene expression analysis was performed using RNA-Seq data from untreated cells and cells treated with PAI-1 siRNA or negative control, each with and without platelets. Four cohorts of banked patient plasma samples (n = 239) were assayed for PAI-1 by ELISA. Treatment-naïve (TN) whole blood (WB) samples were evaluated for CTCs in conjunction with PAI-1 evaluation in matched plasma. Results and discussion: Significant phenotypic changes occurring when PAI-1 was silenced and when platelets were added to cells were reflected by RNA-seq data, with PAI-1 observed to be central to molecular mechanisms of EOC metastasis. Increased proliferation was observed in cells treated with platelets. Plasma PAI-1 significantly correlated with advanced disease in a TN cohort, and was significantly reduced in a neoadjuvant chemotherapy (NACT) cohort. PAI-1 demonstrated a trend towards significance in overall survival (OS) in the late-stage TN cohort, and correlation between PAI-1 and neutrophils in this cohort was significant. 72.7% (16/22) of TN patients with plasma PAI-1 levels higher than OS cutoff were CTC-positive. These data support a central role for PAI-1 in EOC metastasis, and highlight PAI-1's potential as a biomarker, prognostic indicator, or gauge of treatment response in HGSOC.
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Affiliation(s)
- Tanya E. Kelly
- Department of Histopathology and Morbid Anatomy, School of Medicine, Trinity College Dublin, Dublin, Ireland
- Trinity St James’s Cancer Institute, St. James’s Hospital, Dublin, Ireland
| | - Cathy L. Spillane
- Department of Histopathology and Morbid Anatomy, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Mark P. Ward
- Department of Histopathology and Morbid Anatomy, School of Medicine, Trinity College Dublin, Dublin, Ireland
- Trinity St James’s Cancer Institute, St. James’s Hospital, Dublin, Ireland
| | - Karsten Hokamp
- Smurfit Institute of Genetics, Trinity College Dublin, Dublin, Ireland
| | - Yanmei Huang
- Department of Histopathology and Morbid Anatomy, School of Medicine, Trinity College Dublin, Dublin, Ireland
- Trinity St James’s Cancer Institute, St. James’s Hospital, Dublin, Ireland
- School of Forensic Medicine, Xinxiang Medical University, Xinxiang, China
| | - Prerna Tewari
- Department of Histopathology and Morbid Anatomy, School of Medicine, Trinity College Dublin, Dublin, Ireland
- Trinity St James’s Cancer Institute, St. James’s Hospital, Dublin, Ireland
| | - Cara M. Martin
- Department of Histopathology and Morbid Anatomy, School of Medicine, Trinity College Dublin, Dublin, Ireland
- Trinity St James’s Cancer Institute, St. James’s Hospital, Dublin, Ireland
| | - Lucy A. Norris
- Trinity St James’s Cancer Institute, St. James’s Hospital, Dublin, Ireland
- Department of Obstetrics and Gynaecology, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Bashir M. Mohamed
- Department of Histopathology and Morbid Anatomy, School of Medicine, Trinity College Dublin, Dublin, Ireland
- Trinity St James’s Cancer Institute, St. James’s Hospital, Dublin, Ireland
| | - Mark Bates
- Department of Histopathology and Morbid Anatomy, School of Medicine, Trinity College Dublin, Dublin, Ireland
- Trinity St James’s Cancer Institute, St. James’s Hospital, Dublin, Ireland
| | - Robert Brooks
- Sansom Institute for Health Research, University of South Australia, Adelaide, Australia
| | - Stavros Selemidis
- School of Health and Biomedical Sciences, STEM College, Royal Melbourne Institute of Technology, Melbourne, VIC, Australia
| | - Douglas A. Brooks
- Sansom Institute for Health Research, University of South Australia, Adelaide, Australia
| | - Waseem Kamran
- Division of Gynaegological Oncology, St. James’ Hospital, Dublin, Ireland
| | - Feras Abu Saadeh
- Division of Gynaegological Oncology, St. James’ Hospital, Dublin, Ireland
| | - Sharon A. O’Toole
- Department of Histopathology and Morbid Anatomy, School of Medicine, Trinity College Dublin, Dublin, Ireland
- Trinity St James’s Cancer Institute, St. James’s Hospital, Dublin, Ireland
- Department of Obstetrics and Gynaecology, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - John J. O’Leary
- Department of Histopathology and Morbid Anatomy, School of Medicine, Trinity College Dublin, Dublin, Ireland
- Trinity St James’s Cancer Institute, St. James’s Hospital, Dublin, Ireland
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3
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Kumar T, Khanna N, Tewari P, Bharti S, Bhadani PP. FNA cytology of columnar cell variant of papillary thyroid carcinoma: A case report with review of literature. Cytopathology 2023; 34:617-621. [PMID: 37578037 DOI: 10.1111/cyt.13288] [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: 03/02/2023] [Revised: 07/07/2023] [Accepted: 07/28/2023] [Indexed: 08/15/2023]
Abstract
Cytological features such as papillary configuration, pseudostratification, and large rosette‐like clusters without any nuclear features of PTC hint at the CCVPTC diagnosis.The presence of papillary configuration, pseudostratification, and large rosette‐like clusters without any nuclear features of PTC hint at CCVPTC.
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Affiliation(s)
- Tarun Kumar
- Department of Pathology/Lab Medicine, All India Institute of Medical Sciences, Patna, Bihar, India
| | - Nisha Khanna
- Department of Pathology/Lab Medicine, All India Institute of Medical Sciences, Patna, Bihar, India
| | - Prerna Tewari
- Department of Pathology/Lab Medicine, All India Institute of Medical Sciences, Patna, Bihar, India
| | - Shreekant Bharti
- Department of Pathology/Lab Medicine, All India Institute of Medical Sciences, Patna, Bihar, India
| | - Punam Prasad Bhadani
- Department of Pathology/Lab Medicine, All India Institute of Medical Sciences, Patna, Bihar, India
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Sorvina A, Martini C, Prabhakaran S, Logan JM, S-Y Ung B, Moore C, Johnson IRD, Lazniewska J, Tewari P, Malone V, Brooks RD, Hickey SM, Caruso MC, Klebe S, Karageorgos L, O'Leary JJ, Delahunt B, Samaratunga H, Brooks DA. Appl1, Sortilin and Syndecan-1 immunohistochemistry on intraductal carcinoma of the prostate provides evidence of retrograde spread. Pathology 2023; 55:792-799. [PMID: 37422404 DOI: 10.1016/j.pathol.2023.05.004] [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: 02/02/2023] [Revised: 03/30/2023] [Accepted: 05/02/2023] [Indexed: 07/10/2023]
Abstract
The presence of intraductal carcinoma of the prostate (IDCP) correlates with late-stage disease and poor outcomes for patients with prostatic adenocarcinoma, but the accurate and reliable staging of disease severity remains challenging. Immunohistochemistry (IHC) has been utilised to overcome problems in assessing IDCP morphology, but the current markers have only demonstrated limited utility in characterising the complex biology of this lesion. In a retrospective study of a cohort of patients who had been diagnosed with IDCP, we utilised IHC on radical prostatectomy sections with a biomarker panel of Appl1, Sortilin and Syndecan-1, to interpret different architectural patterns and to explore the theory that IDCP occurs from retrograde spread of high-grade invasive prostatic adenocarcinoma. Cribriform IDCP displayed strong Appl1, Sortilin and Syndecan-1 labelling patterns, while solid IDCP architecture had high intensity Appl1 and Syndecan-1 labelling, but minimal Sortilin labelling. Notably, the expression pattern of the biomarker panel in regions of IDCP was similar to that of adjacent invasive prostatic adenocarcinoma, and also comparable to prostate cancer showing perineural and vascular invasion. The Appl1, Sortilin, and Syndecan-1 biomarker panel in IDCP provides evidence for the model of retrograde spread of invasive prostatic carcinoma into ducts/acini, and supports the inclusion of IDCP into the five-tier Gleason grading system.
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Affiliation(s)
- Alexandra Sorvina
- Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia
| | - Carmela Martini
- Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia.
| | - Sarita Prabhakaran
- Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia; Department of Anatomical Pathology, College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
| | - Jessica M Logan
- Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia
| | - Benjamin S-Y Ung
- Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia
| | - Courtney Moore
- Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia
| | - Ian R D Johnson
- Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia
| | - Joanna Lazniewska
- Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia
| | - Prerna Tewari
- Department of Histopathology, Trinity College Dublin, Dublin, Ireland
| | - Victoria Malone
- Department of Pathology, The Coombe Women and Infants University Hospital, Dublin, Ireland
| | - Robert D Brooks
- Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia
| | - Shane M Hickey
- Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia
| | - Maria C Caruso
- Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia
| | - Sonja Klebe
- Department of Anatomical Pathology, College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia; Department of Surgical Pathology, SA Pathology at Flinders Medical Centre, Adelaide, SA, Australia
| | - Litsa Karageorgos
- Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia
| | - John J O'Leary
- Department of Histopathology, Trinity College Dublin, Dublin, Ireland
| | - Brett Delahunt
- Malaghan Institute of Medical Research, Wellington, New Zealand
| | - Hemamali Samaratunga
- Aquesta Uropathology, Brisbane, Qld, Australia; University of Queensland, Brisbane, Qld, Australia
| | - Doug A Brooks
- Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia
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5
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Lazniewska J, Li KL, Johnson IRD, Sorvina A, Logan JM, Martini C, Moore C, Ung BSY, Karageorgos L, Hickey SM, Prabhakaran S, Heatlie JK, Brooks RD, Huzzell C, Warnock NI, Ward MP, Mohammed B, Tewari P, Martin C, O'Toole S, Edgerton LB, Bates M, Moretti P, Pitson SM, Selemidis S, Butler LM, O'Leary JJ, Brooks DA. Dynamic interplay between sortilin and syndecan-1 contributes to prostate cancer progression. Sci Rep 2023; 13:13489. [PMID: 37596305 PMCID: PMC10439187 DOI: 10.1038/s41598-023-40347-7] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 08/09/2023] [Indexed: 08/20/2023] Open
Abstract
Prostate cancer (PCa) development and progression relies on the programming of glucose and lipid metabolism, and this involves alterations in androgen receptor expression and signalling. Defining the molecular mechanism that underpins this metabolic programming will have direct significance for patients with PCa who have a poor prognosis. Here we show that there is a dynamic balance between sortilin and syndecan-1, that reports on different metabolic phenotypes. Using tissue microarrays, we demonstrated by immunohistochemistry that sortilin was highly expressed in low-grade cancer, while syndecan-1 was upregulated in high-grade disease. Mechanistic studies in prostate cell lines revealed that in androgen-sensitive LNCaP cells, sortilin enhanced glucose metabolism by regulating GLUT1 and GLUT4, while binding progranulin and lipoprotein lipase (LPL) to limit lipid metabolism. In contrast, in androgen-insensitive PC3 cells, syndecan-1 was upregulated, interacted with LPL and colocalised with β3 integrin to promote lipid metabolism. In addition, androgen-deprived LNCaP cells had decreased expression of sortilin and reduced glucose-metabolism, but increased syndecan-1 expression, facilitating interactions with LPL and possibly β3 integrin. We report a hitherto unappreciated molecular mechanism for PCa, which may have significance for disease progression and how androgen-deprivation therapy might promote castration-resistant PCa.
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Affiliation(s)
- Joanna Lazniewska
- Clinical and Health Sciences, University of South Australia, Adelaide, SA, 5000, Australia.
| | - Ka Lok Li
- Clinical and Health Sciences, University of South Australia, Adelaide, SA, 5000, Australia
| | - Ian R D Johnson
- Clinical and Health Sciences, University of South Australia, Adelaide, SA, 5000, Australia
| | - Alexandra Sorvina
- Clinical and Health Sciences, University of South Australia, Adelaide, SA, 5000, Australia
| | - Jessica M Logan
- Clinical and Health Sciences, University of South Australia, Adelaide, SA, 5000, Australia
| | - Carmela Martini
- Clinical and Health Sciences, University of South Australia, Adelaide, SA, 5000, Australia
| | - Courtney Moore
- Clinical and Health Sciences, University of South Australia, Adelaide, SA, 5000, Australia
| | - Ben S-Y Ung
- Clinical and Health Sciences, University of South Australia, Adelaide, SA, 5000, Australia
| | - Litsa Karageorgos
- Clinical and Health Sciences, University of South Australia, Adelaide, SA, 5000, Australia
| | - Shane M Hickey
- Clinical and Health Sciences, University of South Australia, Adelaide, SA, 5000, Australia
| | - Sarita Prabhakaran
- Clinical and Health Sciences, University of South Australia, Adelaide, SA, 5000, Australia
- Department of Anatomical Pathology, College of Medicine and Public Health, Flinders University, Bedford Park, SA, 5042, Australia
| | - Jessica K Heatlie
- Clinical and Health Sciences, University of South Australia, Adelaide, SA, 5000, Australia
| | - Robert D Brooks
- Clinical and Health Sciences, University of South Australia, Adelaide, SA, 5000, Australia
| | - Chelsea Huzzell
- Clinical and Health Sciences, University of South Australia, Adelaide, SA, 5000, Australia
| | - Nicholas I Warnock
- Centre for Cancer Biology, University of South Australia and SA Pathology, Adelaide, SA, 5000, Australia
| | - Mark P Ward
- Department of Histopathology, Trinity College Dublin, Dublin 8, Ireland
| | - Bashir Mohammed
- Department of Histopathology, Trinity College Dublin, Dublin 8, Ireland
| | - Prerna Tewari
- Department of Histopathology, Trinity College Dublin, Dublin 8, Ireland
| | - Cara Martin
- Department of Histopathology, Trinity College Dublin, Dublin 8, Ireland
| | - Sharon O'Toole
- Department of Histopathology, Trinity College Dublin, Dublin 8, Ireland
| | | | - Mark Bates
- Department of Histopathology, Trinity College Dublin, Dublin 8, Ireland
| | - Paul Moretti
- Centre for Cancer Biology, University of South Australia and SA Pathology, Adelaide, SA, 5000, Australia
| | - Stuart M Pitson
- Centre for Cancer Biology, University of South Australia and SA Pathology, Adelaide, SA, 5000, Australia
| | - Stavros Selemidis
- School of Health and Biomedical Sciences, STEM College, RMIT University, Bundoora, VIC, 3083, Australia
| | - Lisa M Butler
- South Australian ImmunoGENomics Cancer Institute and Freemasons Centre for Male Health and Wellbeing, University of Adelaide, Adelaide, SA, 5000, Australia
- Solid Tumour Program, Precision Cancer Medicine Theme, South Australian Health and Medical Research Institute, Adelaide, SA, 5000, Australia
| | - John J O'Leary
- Department of Histopathology, Trinity College Dublin, Dublin 8, Ireland
| | - Douglas A Brooks
- Clinical and Health Sciences, University of South Australia, Adelaide, SA, 5000, Australia.
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6
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Logan JM, Hopkins AM, Martini C, Sorvina A, Tewari P, Prabhakaran S, Huzzell C, Johnson IRD, Hickey SM, Ung BSY, Lazniewska J, Brooks RD, Moore CR, Caruso MC, Karageorgos L, Martin CM, O'Toole S, Bogue Edgerton L, Ward MP, Bates M, Selemidis S, Esterman A, Heffernan S, Keegan H, Ní Mhaolcatha S, O'Connor R, Malone V, Carter M, Ryan K, Clarke A, Brady N, Klebe S, Samaratunga H, Delahunt B, Sorich MJ, Moretti K, Butler LM, O'Leary JJ, Brooks DA. Prediction of Prostate Cancer Biochemical and Clinical Recurrence Is Improved by IHC-Assisted Grading Using Appl1, Sortilin and Syndecan-1. Cancers (Basel) 2023; 15:3215. [PMID: 37370825 DOI: 10.3390/cancers15123215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 06/09/2023] [Accepted: 06/14/2023] [Indexed: 06/29/2023] Open
Abstract
Gleason scoring is used within a five-tier risk stratification system to guide therapeutic decisions for patients with prostate cancer. This study aimed to compare the predictive performance of routine H&E or biomarker-assisted ISUP (International Society of Urological Pathology) grade grouping for assessing the risk of biochemical recurrence (BCR) and clinical recurrence (CR) in patients with prostate cancer. This retrospective study was an assessment of 114 men with prostate cancer who provided radical prostatectomy samples to the Australian Prostate Cancer Bioresource between 2006 and 2014. The prediction of CR was the primary outcome (median time to CR 79.8 months), and BCR was assessed as a secondary outcome (median time to BCR 41.7 months). The associations of (1) H&E ISUP grade groups and (2) modified ISUP grade groups informed by the Appl1, Sortilin and Syndecan-1 immunohistochemistry (IHC) labelling were modelled with BCR and CR using Cox proportional hazard approaches. IHC-assisted grading was more predictive than H&E for BCR (C-statistic 0.63 vs. 0.59) and CR (C-statistic 0.71 vs. 0.66). On adjusted analysis, IHC-assisted ISUP grading was independently associated with both outcome measures. IHC-assisted ISUP grading using the biomarker panel was an independent predictor of individual BCR and CR. Prospective studies are needed to further validate this biomarker technology and to define BCR and CR associations in real-world cohorts.
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Affiliation(s)
- Jessica M Logan
- Clinical and Health Sciences, University of South Australia, Bradley Building, City West Campus, North Terrace, Adelaide, SA 5000, Australia
| | - Ashley M Hopkins
- College of Medicine and Public Health, Flinders University, Flinders Drive, Bedford Park, Adelaide, SA 5042, Australia
| | - Carmela Martini
- Clinical and Health Sciences, University of South Australia, Bradley Building, City West Campus, North Terrace, Adelaide, SA 5000, Australia
| | - Alexandra Sorvina
- Clinical and Health Sciences, University of South Australia, Bradley Building, City West Campus, North Terrace, Adelaide, SA 5000, Australia
| | - Prerna Tewari
- Department of Histopathology, Trinity College Dublin, D02 PN40 Dublin, Ireland
| | - Sarita Prabhakaran
- Department of Anatomical Pathology, College of Medicine and Public Health, Flinders University, Adelaide, SA 5042, Australia
| | - Chelsea Huzzell
- Clinical and Health Sciences, University of South Australia, Bradley Building, City West Campus, North Terrace, Adelaide, SA 5000, Australia
| | - Ian R D Johnson
- Clinical and Health Sciences, University of South Australia, Bradley Building, City West Campus, North Terrace, Adelaide, SA 5000, Australia
| | - Shane M Hickey
- Clinical and Health Sciences, University of South Australia, Bradley Building, City West Campus, North Terrace, Adelaide, SA 5000, Australia
| | - Ben S-Y Ung
- Clinical and Health Sciences, University of South Australia, Bradley Building, City West Campus, North Terrace, Adelaide, SA 5000, Australia
| | - Joanna Lazniewska
- Clinical and Health Sciences, University of South Australia, Bradley Building, City West Campus, North Terrace, Adelaide, SA 5000, Australia
| | - Robert D Brooks
- Clinical and Health Sciences, University of South Australia, Bradley Building, City West Campus, North Terrace, Adelaide, SA 5000, Australia
| | - Courtney R Moore
- Clinical and Health Sciences, University of South Australia, Bradley Building, City West Campus, North Terrace, Adelaide, SA 5000, Australia
| | - Maria C Caruso
- Clinical and Health Sciences, University of South Australia, Bradley Building, City West Campus, North Terrace, Adelaide, SA 5000, Australia
| | - Litsa Karageorgos
- Clinical and Health Sciences, University of South Australia, Bradley Building, City West Campus, North Terrace, Adelaide, SA 5000, Australia
| | - Cara M Martin
- Department of Histopathology, Trinity College Dublin, D02 PN40 Dublin, Ireland
| | - Sharon O'Toole
- Department of Histopathology, Trinity College Dublin, D02 PN40 Dublin, Ireland
| | | | - Mark P Ward
- Department of Histopathology, Trinity College Dublin, D02 PN40 Dublin, Ireland
| | - Mark Bates
- Department of Histopathology, Trinity College Dublin, D02 PN40 Dublin, Ireland
| | - Stavros Selemidis
- School of Health and Biomedical Sciences, STEM College, RMIT University, Bundoora, Melbourne, VIC 3001, Australia
| | - Adrian Esterman
- Clinical and Health Sciences, University of South Australia, Bradley Building, City West Campus, North Terrace, Adelaide, SA 5000, Australia
| | - Sheena Heffernan
- Department of Pathology, The Coombe Women and Infants University Hospital, D08 XW7X Dublin, Ireland
| | - Helen Keegan
- Department of Histopathology, Trinity College Dublin, D02 PN40 Dublin, Ireland
| | - Sarah Ní Mhaolcatha
- Department of Pathology, The Coombe Women and Infants University Hospital, D08 XW7X Dublin, Ireland
| | - Roisin O'Connor
- Department of Pathology, The Coombe Women and Infants University Hospital, D08 XW7X Dublin, Ireland
| | - Victoria Malone
- Department of Pathology, The Coombe Women and Infants University Hospital, D08 XW7X Dublin, Ireland
| | - Marguerite Carter
- Department of Pathology, The Coombe Women and Infants University Hospital, D08 XW7X Dublin, Ireland
| | - Katie Ryan
- Department of Pathology, The Coombe Women and Infants University Hospital, D08 XW7X Dublin, Ireland
| | - Andres Clarke
- Department of Pathology, The Coombe Women and Infants University Hospital, D08 XW7X Dublin, Ireland
| | - Nathan Brady
- Department of Pathology, The Coombe Women and Infants University Hospital, D08 XW7X Dublin, Ireland
| | - Sonja Klebe
- Department of Anatomical Pathology, College of Medicine and Public Health, Flinders University, Adelaide, SA 5042, Australia
| | - Hemamali Samaratunga
- Aquesta Uropathology, The University of Queensland, Brisbane, QLD 4072, Australia
| | - Brett Delahunt
- Malaghan Institute of Medical Research, Wellington 6012, New Zealand
| | - Michael J Sorich
- College of Medicine and Public Health, Flinders University, Flinders Drive, Bedford Park, Adelaide, SA 5042, Australia
| | - Kim Moretti
- Discipline of Surgery, University of Adelaide, Adelaide, SA 5371, Australia
- Allied Health and Human Performance, University of South Australia, Adelaide, SA 5005, Australia
- Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC 3800, Australia
| | - Lisa M Butler
- South Australian ImmunoGENomics Cancer Institute and Freemasons Centre for Male Health and Wellbeing, University of Adelaide, Adelaide, SA 5005, Australia
- Solid Tumour Program, Precision Cancer Medicine Theme, South Australian Health and Medical Research Institute, Adelaide, SA 5000, Australia
| | - John J O'Leary
- Department of Histopathology, Trinity College Dublin, D02 PN40 Dublin, Ireland
| | - Douglas A Brooks
- Clinical and Health Sciences, University of South Australia, Bradley Building, City West Campus, North Terrace, Adelaide, SA 5000, Australia
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7
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Kumar T, Tewari P, Nigam JS, Bharti S, Surabhi, Sinha R, Bhadani PP. Cytohistological correlation and risk stratification of salivary gland lesions using the Milan System for Reporting Salivary Gland Cytopathology: A tertiary care centre experience. Cytopathology 2023; 34:225-231. [PMID: 36775661 DOI: 10.1111/cyt.13217] [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: 11/04/2022] [Revised: 01/28/2023] [Accepted: 02/01/2023] [Indexed: 02/14/2023]
Abstract
INTRODUCTION Salivary gland neoplasms account for approximately 5% of head and neck tumours. The cytomorphology of fine needle aspiration material helps determine the preoperative assessment and risk stratification. The Milan System for Reporting Salivary Gland Cytopathology (MSRSGC) was developed to improve communication between the laboratory and treatment provider. AIMS AND OBJECTIVE In the present study, we stratified all salivary gland lesions according to the MSRSGC and evaluated each category's concordance and risk of malignancy (ROM). MATERIALS AND METHODS This was a 5 year retrospective study. First, all cases were assigned to one of the six MSRSGC categories. Then, following cytohistological correlation, the concordance rates and ROM were calculated based on the final histopathology report. RESULTS A total of 354 cases were identified, with ages ranging from 2 to 88 years and the commonest age group was the 3rd to 4th decades. Categories I, II, III, IVA, IVB, V, and VI comprised 5.37% (19/354), 26.84% (95/354), 1.13% (04/354), 51.41% (182/354), 1.98% (07/354), 1.13% (04/354), and 12.15% (43/354) of the cases, respectively. The overall concordance rate between the cytological and histopathological diagnoses was 81.25% (65 out of 80 cases), with the sensitivity, specificity, positive predictive value, and negative predictive value at 43.48%, 96.49%, 83.33%, and 80.88%, respectively. CONCLUSION The MSRSGC provides a better objective and structured way to communicate with the health care provider. In our study, the overall concordance rate was observed in 62/80 cases, with maximum concordance seen in categories III, IVB, and V of the MSRSGC.
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Affiliation(s)
- Tarun Kumar
- Department of Pathology/Lab Medicine, All India Institute of Medical Sciences, Patna, India
| | - Prerna Tewari
- Department of Pathology/Lab Medicine, All India Institute of Medical Sciences, Patna, India
| | - Jitendra Singh Nigam
- Department of Pathology and Lab Medicine, All India Institute of Medical Sciences, Bibinagar, India
| | - Shreekant Bharti
- Department of Pathology/Lab Medicine, All India Institute of Medical Sciences, Patna, India
| | - Surabhi
- Department of Pathology/Lab Medicine, All India Institute of Medical Sciences, Patna, India
| | - Ruchi Sinha
- Department of Pathology/Lab Medicine, All India Institute of Medical Sciences, Patna, India
| | - Punam Prasad Bhadani
- Department of Pathology/Lab Medicine, All India Institute of Medical Sciences, Patna, India
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8
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Martini C, Logan JM, Sorvina A, Gordon C, Beck AR, S-Y Ung B, Caruso MC, Moore C, Hocking A, Johnson IRD, Li KL, Karageorgos L, Hopkins AM, Esterman AJ, Huzzell C, Brooks RD, Lazniewska J, Hickey SM, Bader C, Parkinson-Lawrence E, Weigert R, Sorich MJ, Tewari P, Martin C, O'Toole S, Bates M, Ward M, Mohammed B, Keegan H, Watson W, Prendergast S, Heffernan S, NiMhaolcatha S, O'Connor R, Malone V, Carter M, Ryan K, Brady N, Clarke A, Sokol F, Prabhakaran S, Stahl J, Klebe S, Samaratunga H, Delahunt B, Selemidis S, Moretti KL, Butler LM, O'Leary JJ, Brooks DA. Aberrant protein expression of Appl1, Sortilin and Syndecan-1 during the biological progression of prostate cancer. Pathology 2023; 55:40-51. [PMID: 36089417 DOI: 10.1016/j.pathol.2022.08.001] [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: 06/08/2022] [Revised: 07/19/2022] [Accepted: 08/01/2022] [Indexed: 01/27/2023]
Abstract
Diagnosis and assessment of patients with prostate cancer is dependent on accurate interpretation and grading of histopathology. However, morphology does not necessarily reflect the complex biological changes occurring in prostate cancer disease progression, and current biomarkers have demonstrated limited clinical utility in patient assessment. This study aimed to develop biomarkers that accurately define prostate cancer biology by distinguishing specific pathological features that enable reliable interpretation of pathology for accurate Gleason grading of patients. Online gene expression databases were interrogated and a pathogenic pathway for prostate cancer was identified. The protein expression of key genes in the pathway, including adaptor protein containing a pleckstrin homology (PH) domain, phosphotyrosine-binding (PTB) domain, and leucine zipper motif 1 (Appl1), Sortilin and Syndecan-1, was examined by immunohistochemistry (IHC) in a pilot study of 29 patients with prostate cancer, using monoclonal antibodies designed against unique epitopes. Appl1, Sortilin, and Syndecan-1 expression was first assessed in a tissue microarray cohort of 112 patient samples, demonstrating that the monoclonal antibodies clearly illustrate gland morphologies. To determine the impact of a novel IHC-assisted interpretation (the utility of Appl1, Sortilin, and Syndecan-1 labelling as a panel) of Gleason grading, versus standard haematoxylin and eosin (H&E) Gleason grade assignment, a radical prostatectomy sample cohort comprising 114 patients was assessed. In comparison to H&E, the utility of the biomarker panel reduced subjectivity in interpretation of prostate cancer tissue morphology and improved the reliability of pathology assessment, resulting in Gleason grade redistribution for 41% of patient samples. Importantly, for equivocal IHC-assisted labelling and H&E staining results, the cancer morphology interpretation could be more accurately applied upon re-review of the H&E tissue sections. This study addresses a key issue in the field of prostate cancer pathology by presenting a novel combination of three biomarkers and has the potential to transform clinical pathology practice by standardising the interpretation of the tissue morphology.
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Affiliation(s)
- Carmela Martini
- Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia.
| | - Jessica M Logan
- Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia
| | - Alexandra Sorvina
- Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia
| | - Colin Gordon
- Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia
| | - Andrew R Beck
- Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia
| | - Ben S-Y Ung
- Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia
| | - Maria C Caruso
- Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia
| | - Courtney Moore
- Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia
| | - Ashleigh Hocking
- Department of Anatomical Pathology, College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
| | - Ian R D Johnson
- Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia
| | - Ka Lok Li
- Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia
| | - Litsa Karageorgos
- Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia
| | - Ashley M Hopkins
- College of Medicine and Public Health, Flinders University, Flinders Drive, Bedford Park, Adelaide, SA, Australia
| | - Adrian J Esterman
- Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia
| | - Chelsea Huzzell
- Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia
| | - Robert D Brooks
- Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia
| | - Joanna Lazniewska
- Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia
| | - Shane M Hickey
- Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia
| | - Christie Bader
- Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia
| | | | - Roberto Weigert
- Center for Cancer Research, National Cancer Institute, Bethesda, MD, USA
| | - Michael J Sorich
- College of Medicine and Public Health, Flinders University, Flinders Drive, Bedford Park, Adelaide, SA, Australia
| | - Prerna Tewari
- Department of Histopathology, Trinity College Dublin, Dublin, Ireland
| | - Cara Martin
- Department of Histopathology, Trinity College Dublin, Dublin, Ireland
| | - Sharon O'Toole
- Department of Histopathology, Trinity College Dublin, Dublin, Ireland
| | - Mark Bates
- Department of Histopathology, Trinity College Dublin, Dublin, Ireland
| | - Mark Ward
- Department of Histopathology, Trinity College Dublin, Dublin, Ireland
| | - Bashir Mohammed
- Department of Histopathology, Trinity College Dublin, Dublin, Ireland
| | - Helen Keegan
- Department of Histopathology, Trinity College Dublin, Dublin, Ireland
| | - William Watson
- University College Dublin, School of Medicine, Conway Institute, University College Dublin, Dublin, Ireland
| | - Sophie Prendergast
- Department of Pathology, The Coombe Women and Infants University Hospital, Dublin, Ireland
| | - Sheena Heffernan
- Department of Pathology, The Coombe Women and Infants University Hospital, Dublin, Ireland
| | - Sarah NiMhaolcatha
- Department of Pathology, The Coombe Women and Infants University Hospital, Dublin, Ireland
| | - Roisin O'Connor
- Department of Pathology, The Coombe Women and Infants University Hospital, Dublin, Ireland
| | - Victoria Malone
- Department of Pathology, The Coombe Women and Infants University Hospital, Dublin, Ireland
| | - Marguerite Carter
- Department of Pathology, The Coombe Women and Infants University Hospital, Dublin, Ireland
| | - Katie Ryan
- Department of Pathology, The Coombe Women and Infants University Hospital, Dublin, Ireland
| | - Nathan Brady
- Department of Pathology, The Coombe Women and Infants University Hospital, Dublin, Ireland
| | - Andres Clarke
- Department of Pathology, The Coombe Women and Infants University Hospital, Dublin, Ireland
| | - Filip Sokol
- Department of Pathology, The Coombe Women and Infants University Hospital, Dublin, Ireland
| | - Sarita Prabhakaran
- Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia; Department of Anatomical Pathology, College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
| | - Jürgen Stahl
- Department of Cytopathology and Histopathology, Clinpath Pathology, Adelaide, SA, Australia
| | - Sonja Klebe
- Department of Anatomical Pathology, College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia; Department of Surgical Pathology, SA Pathology at Flinders Medical Centre, Adelaide, SA, Australia
| | | | - Brett Delahunt
- Department of Pathology and Molecular Medicine, Wellington School of Medicine and Health Sciences, University of Otago, Wellington, New Zealand
| | - Stavros Selemidis
- School of Health and Biomedical Sciences, STEM College, RMIT University, Bundoora, Melbourne, Vic, Australia
| | - Kim L Moretti
- Discipline of Surgery, University of Adelaide, Adelaide, SA, Australia; University of South Australia, Adelaide, SA, Australia; Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Vic, Australia
| | - Lisa M Butler
- South Australian ImmunoGENomics Cancer Institute and Freemasons Centre for Male Health and Wellbeing, University of Adelaide, Adelaide, SA, Australia; Solid Tumour Program, Precision Cancer Medicine Theme, South Australian Health and Medical Research Institute, Adelaide, SA, Australia
| | - John J O'Leary
- Department of Histopathology, Trinity College Dublin, Dublin, Ireland
| | - Douglas A Brooks
- Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia
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9
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Sharkey Ochoa I, O’Regan E, Toner M, Kay E, Faul P, O’Keane C, O’Connor R, Mullen D, Nur M, O’Murchu E, Barry-O’Crowley J, Kernan N, Tewari P, Keegan H, O’Toole S, Woods R, Kennedy S, Feeley K, Sharp L, Gheit T, Tommasino M, O’Leary JJ, Martin CM. The Role of HPV in Determining Treatment, Survival, and Prognosis of Head and Neck Squamous Cell Carcinoma. Cancers (Basel) 2022; 14:4321. [PMID: 36077856 PMCID: PMC9454666 DOI: 10.3390/cancers14174321] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 08/29/2022] [Accepted: 09/01/2022] [Indexed: 12/02/2022] Open
Abstract
Human papillomavirus (HPV) infection has been identified as a significant etiological agent in the development of head and neck squamous cell carcinoma (HNSCC). HPV's involvement has alluded to better survival and prognosis in patients and suggests that different treatment strategies may be appropriate for them. Only some data on the epidemiology of HPV infection in the oropharyngeal, oral cavity, and laryngeal SCC exists in Europe. Thus, this study was carried out to investigate HPV's impact on HNSCC patient outcomes in the Irish population, one of the largest studies of its kind using consistent HPV testing techniques. A total of 861 primary oropharyngeal, oral cavity, and laryngeal SCC (OPSCC, OSCC, LSCC) cases diagnosed between 1994 and 2013, identified through the National Cancer Registry of Ireland (NCRI), were obtained from hospitals across Ireland and tested for HPV DNA using Multiplex PCR Luminex technology based in and sanctioned by the International Agency for Research on Cancer (IARC). Both overall and cancer-specific survival were significantly improved amongst all HPV-positive patients together, though HPV status was only a significant predictor of survival in the oropharynx. Amongst HPV-positive patients in the oropharynx, surgery alone was associated with prolonged survival, alluding to the potential for de-escalation of treatment in HPV-related OPSCC in particular. Cumulatively, these findings highlight the need for continued investigation into treatment pathways for HPV-related OPSCC, the relevance of introducing boys into national HPV vaccination programs, and the relevance of the nona-valent Gardasil-9 vaccine to HNSCC prevention.
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Affiliation(s)
- Imogen Sharkey Ochoa
- TCD CERVIVA Molecular Pathology Laboratory, The Coombe Women and Infants University Hospital, D08 XW7X Dublin, Ireland
| | - Esther O’Regan
- Trinity St James Cancer Institute, Trinity College Dublin, D08 NHY1 Dublin, Ireland
- Discipline of Histopathology, St. James’ University Hospital, Trinity College Dublin, D08 NHY1 Dublin, Ireland
| | - Mary Toner
- Discipline of Histopathology, St. James’ University Hospital, Trinity College Dublin, D08 NHY1 Dublin, Ireland
| | - Elaine Kay
- Department of Pathology, Beaumont University Hospital, D09 V2N0 Dublin, Ireland
| | - Peter Faul
- Department of Pathology, University Hospital Limerick, V94 F858 Limerick, Ireland
| | - Connor O’Keane
- Department of Pathology, Mater University Hospital, D07 R2WY Dublin, Ireland
| | - Roisin O’Connor
- Discipline of Histopathology, St. James’ University Hospital, Trinity College Dublin, D08 NHY1 Dublin, Ireland
| | - Dorinda Mullen
- Discipline of Histopathology, St. James’ University Hospital, Trinity College Dublin, D08 NHY1 Dublin, Ireland
| | - Mataz Nur
- Discipline of Histopathology, St. James’ University Hospital, Trinity College Dublin, D08 NHY1 Dublin, Ireland
| | - Eamon O’Murchu
- National Cancer Registry of Ireland, T12 CDF7 Cork, Ireland
| | - Jacqui Barry-O’Crowley
- TCD CERVIVA Molecular Pathology Laboratory, The Coombe Women and Infants University Hospital, D08 XW7X Dublin, Ireland
| | - Niamh Kernan
- TCD CERVIVA Molecular Pathology Laboratory, The Coombe Women and Infants University Hospital, D08 XW7X Dublin, Ireland
| | - Prerna Tewari
- TCD CERVIVA Molecular Pathology Laboratory, The Coombe Women and Infants University Hospital, D08 XW7X Dublin, Ireland
| | - Helen Keegan
- TCD CERVIVA Molecular Pathology Laboratory, The Coombe Women and Infants University Hospital, D08 XW7X Dublin, Ireland
| | - Sharon O’Toole
- TCD CERVIVA Molecular Pathology Laboratory, The Coombe Women and Infants University Hospital, D08 XW7X Dublin, Ireland
- Trinity St James Cancer Institute, Trinity College Dublin, D08 NHY1 Dublin, Ireland
| | - Robbie Woods
- TCD CERVIVA Molecular Pathology Laboratory, The Coombe Women and Infants University Hospital, D08 XW7X Dublin, Ireland
| | - Susan Kennedy
- Department of Pathology, St Vincent’s University Hospital, D04 T6F4 Dublin, Ireland
| | - Kenneth Feeley
- Department of Pathology, University Hospital Kerry, V92 NX94 Tralee, Ireland
| | - Linda Sharp
- Faculty of Medical Sciences, Newcastle University, Newcastle NE1 7RU, UK
| | - Tarik Gheit
- Infections and Cancer Biology Laboratory, International Agency for Research on Cancer, 69008 Lyon, France
| | - Massimo Tommasino
- Dipartimento di Farmacia-Scienze del Farmaco, University of Bari, 70121 Bari, Italy
| | - John J. O’Leary
- TCD CERVIVA Molecular Pathology Laboratory, The Coombe Women and Infants University Hospital, D08 XW7X Dublin, Ireland
- Trinity St James Cancer Institute, Trinity College Dublin, D08 NHY1 Dublin, Ireland
- Discipline of Histopathology, St. James’ University Hospital, Trinity College Dublin, D08 NHY1 Dublin, Ireland
| | - Cara M. Martin
- TCD CERVIVA Molecular Pathology Laboratory, The Coombe Women and Infants University Hospital, D08 XW7X Dublin, Ireland
- Trinity St James Cancer Institute, Trinity College Dublin, D08 NHY1 Dublin, Ireland
- Discipline of Histopathology, St. James’ University Hospital, Trinity College Dublin, D08 NHY1 Dublin, Ireland
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10
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Kumar T, Tewari P, Khanna N, Surabhi, Bharti S, Sinha R, Bhadani PP. Cytomorphology of sebaceous carcinoma of the eyelid: A short series of three cases with literature review. Diagn Cytopathol 2022; 50:E361-E366. [PMID: 35932255 DOI: 10.1002/dc.25029] [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: 05/28/2022] [Accepted: 07/22/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND Ocular sebaceous carcinoma (OSC) is a malignant and potentially lethal sebaceous gland tumor. Clinically, it masquerades as other benign and less malignant lesions, resulting in a delay in diagnosis. METHODS In the present study, we sought to evaluate the cytomorphology of this aggressive neoplasm diagnosed by fine-needle aspiration cytology (FNAC) last year at our institute. RESULTS/FINDINGS We report three cases of OSC diagnosed on aspiration cytology showed a cellular smear composed of sheets, 3D clusters, papillaroid, and singly scattered polygonal tumor cells having centrally located hyperchromatic pleomorphic nuclei and multiple microvacuolations in the cytoplasm. Necrosis and crushing artifact were also identified. Special stains such as Oil Red O stain on air-dried smears showed positivity, confirming the presence of lipid globules. Subsequently, the Cytological impression of sebaceous carcinoma was confirmed on histopathology. CONCLUSIONS The article highlights the role of FNAC in the early and correct diagnosis of aggressive tumors and subsequent appropriate management to prevent recurrence and metastasis.
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Affiliation(s)
- Tarun Kumar
- Department of Pathology/Lab Medicine, All India Institute of Medical Science, Patna, India
| | - Prerna Tewari
- Department of Pathology/Lab Medicine, All India Institute of Medical Science, Patna, India
| | - Nisha Khanna
- Department of Pathology/Lab Medicine, All India Institute of Medical Science, Patna, India
| | - Surabhi
- Department of Pathology/Lab Medicine, All India Institute of Medical Science, Patna, India
| | - Shreekant Bharti
- Department of Pathology/Lab Medicine, All India Institute of Medical Science, Patna, India
| | - Ruchi Sinha
- Department of Pathology/Lab Medicine, All India Institute of Medical Science, Patna, India
| | - Punam Prasad Bhadani
- Department of Pathology/Lab Medicine, All India Institute of Medical Science, Patna, India
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11
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Traynor D, Duraipandian S, Bhatia R, Cuschieri K, Tewari P, Kearney P, D’Arcy T, O’Leary JJ, Martin CM, Lyng FM. Development and Validation of a Raman Spectroscopic Classification Model for Cervical Intraepithelial Neoplasia (CIN). Cancers (Basel) 2022; 14:cancers14071836. [PMID: 35406608 PMCID: PMC8997379 DOI: 10.3390/cancers14071836] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Accepted: 04/01/2022] [Indexed: 12/24/2022] Open
Abstract
Simple Summary There is an unmet clinical need for new methods to aid clinicians in the early detection of cervical cancer and precancer. Spectroscopic methods such as Raman spectroscopy can provide a rapid, label-free and nondestructive measurement of the biochemical fingerprint of cells, tissues and biofluids. This study aims to demonstrate the clinical utility of Raman spectroscopy for the identification of cervical precancer. Raman spectra were recorded from cervical smear samples (n = 662) and a classifier was developed based on histology. A classification accuracy of 91.3% was achieved in an independent blinded test set (n = 69), demonstrating the potential clinical utility of Raman spectroscopy. Abstract The mortality associated with cervical cancer can be reduced if detected at the precancer stage, but current methods are limited in terms of subjectivity, cost and time. Optical spectroscopic methods such as Raman spectroscopy can provide a rapid, label-free and nondestructive measurement of the biochemical fingerprint of a cell, tissue or biofluid. Previous studies have shown the potential of Raman spectroscopy for cervical cancer diagnosis, but most were pilot studies with small sample sizes. The aim of this study is to show the clinical utility of Raman spectroscopy for identifying cervical precancer in a large sample set with validation in an independent test set. Liquid-based cervical cytology samples (n = 662) (326 negative, 200 cervical intraepithelial neoplasia (CIN)1 and 136 CIN2+) were obtained as a training set. Raman spectra were recorded from single-cell nuclei and subjected to a partial least squares discriminant analysis (PLSDA). In addition, the PLSDA classification model was validated using a blinded independent test set (n = 69). A classification accuracy of 91.3% was achieved with only six of the blinded samples misclassified. This study showed the potential clinical utility of Raman spectroscopy with a good classification of negative, CIN1 and CIN2+ achieved in an independent test set.
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Affiliation(s)
- Damien Traynor
- Centre for Radiation and Environmental Science, FOCAS Research Institute, Technological University Dublin, D02 HW71 Dublin, Ireland; (D.T.); (S.D.)
- School of Physics & Clinical & Optometric Sciences, Technological University Dublin, Grangegorman, D07 XT95 Dublin, Ireland
| | - Shiyamala Duraipandian
- Centre for Radiation and Environmental Science, FOCAS Research Institute, Technological University Dublin, D02 HW71 Dublin, Ireland; (D.T.); (S.D.)
| | - Ramya Bhatia
- Scottish HPV Reference Laboratory, Department of Laboratory Medicine, NHS Lothian, 51 Little France Crescent, Edinburgh EH16 5SA, UK; (R.B.); (K.C.)
- HPV Research Group, Centre for Reproductive Health, Queens Medical Research Institute, University of Edinburgh, 47 Little France Crescent, Edinburgh EH16 4TJ, UK
| | - Kate Cuschieri
- Scottish HPV Reference Laboratory, Department of Laboratory Medicine, NHS Lothian, 51 Little France Crescent, Edinburgh EH16 5SA, UK; (R.B.); (K.C.)
- HPV Research Group, Centre for Reproductive Health, Queens Medical Research Institute, University of Edinburgh, 47 Little France Crescent, Edinburgh EH16 4TJ, UK
| | - Prerna Tewari
- Discipline of Histopathology, University of Dublin Trinity College, D08 NHY1 Dublin, Ireland; (P.T.); (P.K.); (J.J.O.); (C.M.M.)
- CERVIVA Molecular Pathology Research Laboratory, The Coombe Women and Infants University Hospital, D08 XW7X Dublin, Ireland
- The Trinity St. James’s Cancer Institute, D08 NHY1 Dublin, Ireland
| | - Padraig Kearney
- Discipline of Histopathology, University of Dublin Trinity College, D08 NHY1 Dublin, Ireland; (P.T.); (P.K.); (J.J.O.); (C.M.M.)
- CERVIVA Molecular Pathology Research Laboratory, The Coombe Women and Infants University Hospital, D08 XW7X Dublin, Ireland
| | - Tom D’Arcy
- Department of Obstetrics and Gynaecology, The Coombe Women and Infants University Hospital, D08 XW7X Dublin, Ireland;
| | - John J. O’Leary
- Discipline of Histopathology, University of Dublin Trinity College, D08 NHY1 Dublin, Ireland; (P.T.); (P.K.); (J.J.O.); (C.M.M.)
- CERVIVA Molecular Pathology Research Laboratory, The Coombe Women and Infants University Hospital, D08 XW7X Dublin, Ireland
- The Trinity St. James’s Cancer Institute, D08 NHY1 Dublin, Ireland
| | - Cara M. Martin
- Discipline of Histopathology, University of Dublin Trinity College, D08 NHY1 Dublin, Ireland; (P.T.); (P.K.); (J.J.O.); (C.M.M.)
- CERVIVA Molecular Pathology Research Laboratory, The Coombe Women and Infants University Hospital, D08 XW7X Dublin, Ireland
- The Trinity St. James’s Cancer Institute, D08 NHY1 Dublin, Ireland
| | - Fiona M. Lyng
- Centre for Radiation and Environmental Science, FOCAS Research Institute, Technological University Dublin, D02 HW71 Dublin, Ireland; (D.T.); (S.D.)
- School of Physics & Clinical & Optometric Sciences, Technological University Dublin, Grangegorman, D07 XT95 Dublin, Ireland
- Correspondence:
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12
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Tewari P, Kashdan E, Walsh C, Martin CM, Parnell AC, O'Leary JJ. Estimating the conditional probability of developing human papilloma virus related oropharyngeal cancer by combining machine learning and inverse Bayesian modelling. PLoS Comput Biol 2021; 17:e1009289. [PMID: 34415913 PMCID: PMC8409636 DOI: 10.1371/journal.pcbi.1009289] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 09/01/2021] [Accepted: 07/20/2021] [Indexed: 12/24/2022] Open
Abstract
The epidemic increase in the incidence of Human Papilloma Virus (HPV) related Oropharyngeal Squamous Cell Carcinomas (OPSCCs) in several countries worldwide represents a significant public health concern. Although gender neutral HPV vaccination programmes are expected to cause a reduction in the incidence rates of OPSCCs, these effects will not be evident in the foreseeable future. Secondary prevention strategies are currently not feasible due to an incomplete understanding of the natural history of oral HPV infections in OPSCCs. The key parameters that govern natural history models remain largely ill-defined for HPV related OPSCCs and cannot be easily inferred from experimental data. Mathematical models have been used to estimate some of these ill-defined parameters in cervical cancer, another HPV related cancer leading to successful implementation of cancer prevention strategies. We outline a "double-Bayesian" mathematical modelling approach, whereby, a Bayesian machine learning model first estimates the probability of an individual having an oral HPV infection, given OPSCC and other covariate information. The model is then inverted using Bayes' theorem to reverse the probability relationship. We use data from the Surveillance, Epidemiology, and End Results (SEER) cancer registry, SEER Head and Neck with HPV Database and the National Health and Nutrition Examination Surveys (NHANES), representing the adult population in the United States to derive our model. The model contains 8,106 OPSCC patients of which 73.0% had an oral HPV infection. When stratified by age, sex, marital status and race/ethnicity, the model estimated a higher conditional probability for developing OPSCCs given an oral HPV infection in non-Hispanic White males and females compared to other races/ethnicities. The proposed Bayesian model represents a proof-of-concept of a natural history model of HPV driven OPSCCs and outlines a strategy for estimating the conditional probability of an individual's risk of developing OPSCC following an oral HPV infection.
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Affiliation(s)
- Prerna Tewari
- Department Histopathology and Morbid Anatomy, Trinity College Dublin, Dublin, Ireland.,Molecular Pathology Research, Coombe Women & Infants University Hospital, Dublin, Ireland
| | - Eugene Kashdan
- School of Medicine, University College Dublin, Dublin, Ireland
| | - Cathal Walsh
- Department Mathematics and Statistics, University of Limerick, Limerick, Ireland
| | - Cara M Martin
- Department Histopathology and Morbid Anatomy, Trinity College Dublin, Dublin, Ireland.,Molecular Pathology Research, Coombe Women & Infants University Hospital, Dublin, Ireland
| | - Andrew C Parnell
- Hamilton Institute, Insight Centre for Data Analytics, Maynooth University, Kildare, Ireland
| | - John J O'Leary
- Department Histopathology and Morbid Anatomy, Trinity College Dublin, Dublin, Ireland.,Molecular Pathology Research, Coombe Women & Infants University Hospital, Dublin, Ireland
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13
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Nigam JS, Kumar T, Singh A, Tewari P, Pandey JK. Anorectal Melanoma-Brownish Black Mass Not Always a Hemorrhoid. J Gastrointest Cancer 2021; 53:825-829. [PMID: 34347246 DOI: 10.1007/s12029-021-00678-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/24/2021] [Indexed: 11/26/2022]
Abstract
The non-specific clinical symptoms of anorectal brownish-black mass do not help to differentiate colorectal cancer, hemorrhoids, rectal ulcers which result in a delayed diagnosis or lead to inadequate management of lethal anorectal melanoma. Primary malignant melanoma of the anorectal region is an uncommon tumor, constituting approximately 1% of anal canal tumors which may be misdiagnosed clinically as hemorrhoids. Because of aggressive behavior and poor prognosis, efficient and prompt diagnosis is required in these cases. We report 2 cases of this rare tumor.
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Affiliation(s)
- Jitendra Singh Nigam
- Department of Pathology and Lab Medicine, All India Institute of Medical Science, Bibinagar, Telangana, India.
| | - Tarun Kumar
- Department of Pathology / Lab Medicine, All India Institute of Medical Science, Patna, Bihar, India
| | - Avinash Singh
- Department of Pathology / Lab Medicine, All India Institute of Medical Science, Patna, Bihar, India
| | - Prerna Tewari
- Department of Pathology / Lab Medicine, All India Institute of Medical Science, Patna, Bihar, India
| | - Jagjit Kumar Pandey
- Department of Surgical Oncology, All India Institute of Medical Science, Patna, Bihar, India
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14
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Tewari P, Banka P, Kernan N, Reynolds S, White C, Pilkington L, O'Toole S, Sharp L, D'Arcy T, Murphy C, Comiskey C, Martin CM, O'Leary JJ. Prevalence and concordance of oral HPV infections with cervical HPV infections in women referred to colposcopy with abnormal cytology. J Oral Pathol Med 2021; 50:692-699. [PMID: 33733523 DOI: 10.1111/jop.13172] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Revised: 02/06/2021] [Accepted: 02/27/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Considering the shared aetiology of Human Papillomavirus infections in oropharyngeal and cervical cancers and the possible role for sexual transmission, several key aspects of the relationship between cervical and oral infections merit investigation, including prevalence of concomitant oral HPV infection and type-specific concordance with concurrent cervical infections. METHODS A cross-section study was performed on women referred to colposcopy clinics with cytological abnormalities and a cervical HPV infection. An oral rinse sample was taken from the participants at their baseline visit for HPV testing, and a demographic and risk factor questionnaire was also administered. HPV DNA testing was carried out on the Cobas 4800 platform and extended genotyping was carried out with the INNO-LiPA HPV Genotyping Extra II assay. HPV genotyping was also carried out on the concurrent cervical tissue samples on all women who had a positive oral HPV infection. RESULTS The prevalence of oral HPV infections was 10.0% (95%CI:5.9-13.7) in the study population. HPV18 was the most frequent genotype (7.0%). Concordant oral and cervical HPV infections were detected in 28.6% of women. Age (p = 0.005) and level of education (p = 0.02) were significantly associated with a prevalent oral HPV infection. CONCLUSION Concomitant oral HPV infections were present in 10.0% of women referred to colposcopy with a pre-existing cervical HPV infections and cytological abnormalities. Although mild type-specific concordance was observed between oral and cervical HPV infections, findings suggest that infections at these sites may not be independent of each other.
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Affiliation(s)
- Prerna Tewari
- Department of Histopathology, Trinity College Dublin, Dublin, Ireland.,Department of Molecular Pathology, Coombe Women & Infants University Hospital, Dublin, Ireland
| | - Prakashini Banka
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | - Niamh Kernan
- Department of Histopathology, Coombe Women & Infants University Hospital, Dublin, Ireland
| | - Stephen Reynolds
- Department of Histopathology, Trinity College Dublin, Dublin, Ireland.,Department of Molecular Pathology, Coombe Women & Infants University Hospital, Dublin, Ireland
| | - Christine White
- Department of Histopathology, Trinity College Dublin, Dublin, Ireland.,Department of Molecular Pathology, Coombe Women & Infants University Hospital, Dublin, Ireland
| | - Loretto Pilkington
- Department of Molecular Pathology, Coombe Women & Infants University Hospital, Dublin, Ireland
| | - Sharon O'Toole
- Department of Histopathology, Trinity College Dublin, Dublin, Ireland.,Department of Molecular Pathology, Coombe Women & Infants University Hospital, Dublin, Ireland
| | - Linda Sharp
- Newcastle University Centre for Cancer, Population Health Science Institute, Newcastle University, Newcastle, UK
| | - Tom D'Arcy
- Department of Obstetrics & Gynaecology, Coombe Women & Infants University Hospital, Dublin, Ireland
| | - Cliona Murphy
- Department of Obstetrics & Gynaecology, Tallaght University Hospital, Dublin, Ireland
| | - Catherine Comiskey
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | - Cara M Martin
- Department of Histopathology, Trinity College Dublin, Dublin, Ireland.,Department of Molecular Pathology, Coombe Women & Infants University Hospital, Dublin, Ireland
| | - John J O'Leary
- Department of Histopathology, Trinity College Dublin, Dublin, Ireland.,Department of Molecular Pathology, Coombe Women & Infants University Hospital, Dublin, Ireland
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15
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Nigam JS, Tewari P, Prasad T, Kumar T, Kumar A. Carcinoma Breast-Like Giant Complex Fibroadenoma: A Clinical Masquerade. Cureus 2021; 13:e12611. [PMID: 33585101 PMCID: PMC7872482 DOI: 10.7759/cureus.12611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Fibroadenoma (FA) is a benign, painless, solid breast tumor that commonly occurs in young adult females. The term complex FA is used when it is associated with any of the following: cyst >3 mm, epithelial calcifications, sclerosing adenosis, or papillary apocrine metaplasia. FAs of size more than 5 cm or weighing more than 500 g are considered as giant FAs. Giant FAs are rare, and because of hormonal sensitivity, they commonly occur in pregnant or lactating women. We report the case of a 26-year-old female with a large breast mass that was clinically as well as grossly masquerading as breast carcinoma and turned out to be a giant complex FA on microscopy.
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Affiliation(s)
- Jitendra S Nigam
- Pathology/Lab Medicine, All India Institute of Medical Sciences, Patna, IND
| | - Prerna Tewari
- Pathology/Lab Medicine, All India Institute of Medical Sciences, Patna, IND
| | - Tanya Prasad
- Pathology/Lab Medicine, All India Institute of Medical Sciences, Patna, IND
| | - Tarun Kumar
- Pathology/Lab Medicine, All India Institute of Medical Sciences, Patna, IND
| | - Anil Kumar
- Surgery, All India Institute of Medical Sciences, Patna, IND
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16
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Abstract
Papillary thyroid carcinoma (PTC) is one of the most common thyroid malignancy with various histologic variants. Acknowledging the correct histological variant of PTC helps to know about the tumor's nature and prognosis. The Warthin-like variant of papillary thyroid (WLPTC), a newly described histologic variant of PTC, is relatively uncommon. A 16-year-old female presented with complaints of painful thyroid swelling for two years. Fine needle aspiration cytology (FNAC) from the lobes showed lymphocytic thyroiditis features with Hurthle cell change. Sections from the left lobe revealed a diagnosis of a Warthin‑like variant of PTC without nodal metastasis. WLPTC is a rare variant having a favorable outcome due to the absence of lymph node metastasis, extra-thyroidal extension, and a low recurrence rate. The correct cytological and histomorphological features are of utmost importance to render the diagnosis of WLPTC for better management.
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Affiliation(s)
- Tarun Kumar
- Pathology, All India Institute of Medical Sciences, Patna, IND
| | | | - Prerna Tewari
- Pathology/Lab Medicine, All India Institute of Medical Sciences, Patna, IND
| | - Chandan K Jha
- Endocrine Surgery, All India Institute of Medical Sciences, Patna, IND
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17
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Tewari P, Nigam JS, Kumar T, Singh A, Pandey J. Ovarian Carcinoid Misinterpreted as Endometrioid Adenocarcinoma in Mature Cystic Teratoma. Cureus 2020; 12:e11948. [PMID: 33425527 PMCID: PMC7785500 DOI: 10.7759/cureus.11948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Mature cystic teratoma (MCT) is the most common benign germ cell tumor of the ovary and contains the different tissues that originate from the endoderm, mesoderm, and ectoderm. The monodermal teratoma has a component of only the germ layer. Ovarian carcinoid is rare and considered as a monodermal teratoma. We report a case of carcinoid tumor arising in MCT in a 60-year-old postmenopausal woman.
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Affiliation(s)
- Prerna Tewari
- Pathology and Laboratory Medicine, All India Institute of Medical Sciences, Patna, Patna, IND
| | - Jitendra S Nigam
- Pathology, All India Institute of Medical Sciences, Patna, Patna, IND
| | - Tarun Kumar
- Pathology, All India Institute of Medical Sciences, Patna, Patna, IND
| | - Avinash Singh
- Pathology and Laboratory Medicine, All India Institute of Medical Sciences, Patna, Patna, IND
| | - Jagjit Pandey
- Surgical Oncology, All India Institute of Medical Sciences, Patna, Patna, IND
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18
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White CM, Bakhiet S, Bates M, Ruttle C, Pilkington LJ, Keegan H, O'Toole SA, Sharp L, O'Kelly R, Tewari P, Flannelly G, Martin CM, O'Leary JJ. Exposure to tobacco smoke measured by urinary nicotine metabolites increases risk of p16/Ki-67 co-expression and high-grade cervical neoplasia in HPV positive women: A two year prospective study. Cancer Epidemiol 2020; 68:101793. [PMID: 32841926 DOI: 10.1016/j.canep.2020.101793] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 07/15/2020] [Accepted: 07/28/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND Human papillomavirus (HPV) is considered the strongest epidemiologic risk factor for cervical cancer. However, it is not a sufficient cause given the high prevalence of transient infections. We examined the relationship between exposure to tobacco smoke, measured using urinary nicotine metabolite concentrations, and p16/Ki-67 co-expression in cervical smears and subsequent risk of developing CIN2+/CIN3+ lesions in HPV positive women. METHODS This prospective longitudinal study enrolled women presenting to colposcopy with cytological abnormalities LSIL/ASCUS at the National Maternity Hospital, Dublin. Women gave a urine sample which was used to perform the Nicotine Metabolite Assay (Siemens). HPV positive (HC2) cervical smears were stained by immunocytochemistry for p16/Ki-67 (CINtec PLUS, Roche). Two year follow-up data, including histological diagnosis, was collected for each woman. Crude and adjusted odds ratios were calculated using logistic regression to investigate associations between tobacco smoke, p16/Ki-67 positivity and CIN2+/CIN3 + . RESULTS In total, 275 HPV positive women were included. Women with nicotine metabolite concentrations above 500 ng/mL, indicative of smoking, were classified as smokers. Smokers were at an increased risk of testing positive for p16/Ki-67 (OR 1.678; 1.027-2.740) and CIN2+ and CIN3+ (OR 1.816; 1.107-2.977 and OR 2.453; 1.200-5.013) in compared to non-smokers. In p16/Ki-67 positive women, smoking further increased their risk of CIN2+/CIN3+ (OR 2.290; 1.017-5.159 and OR 3.506 (1.534-8.017). CONCLUSION HPV positive women exposed to tobacco smoke are at a higher risk of testing positive for p16/Ki-67 co-expression. Risk of high-grade disease is almost doubled in women who are exposed to tobacco smoke.
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Affiliation(s)
- Christine M White
- Dept. Histopathology and Morbid Anatomy, Trinity College Dublin, Dublin 2, Ireland; Dept. Pathology, Coombe Women & Infants University Hospital, Dublin 8, Ireland.
| | - Salih Bakhiet
- Dept. Pathology, Coombe Women & Infants University Hospital, Dublin 8, Ireland
| | - Mark Bates
- Dept. Histopathology and Morbid Anatomy, Trinity College Dublin, Dublin 2, Ireland; Dept. Pathology, Coombe Women & Infants University Hospital, Dublin 8, Ireland
| | - Carmel Ruttle
- Dept. Pathology, Coombe Women & Infants University Hospital, Dublin 8, Ireland
| | | | - Helen Keegan
- Dept. Pathology, Coombe Women & Infants University Hospital, Dublin 8, Ireland
| | - Sharon A O'Toole
- Dept. Obstetrics and Gynaecology, Trinity College Dublin, Dublin 2, Ireland
| | - Linda Sharp
- Institute of Health & Society, Newcastle University, UK
| | - Ruth O'Kelly
- Dept. Pathology, Coombe Women & Infants University Hospital, Dublin 8, Ireland
| | - Prerna Tewari
- Dept. Histopathology and Morbid Anatomy, Trinity College Dublin, Dublin 2, Ireland; Dept. Pathology, Coombe Women & Infants University Hospital, Dublin 8, Ireland
| | | | - Cara M Martin
- Dept. Histopathology and Morbid Anatomy, Trinity College Dublin, Dublin 2, Ireland; Dept. Pathology, Coombe Women & Infants University Hospital, Dublin 8, Ireland
| | - John J O'Leary
- Dept. Histopathology and Morbid Anatomy, Trinity College Dublin, Dublin 2, Ireland; Dept. Pathology, Coombe Women & Infants University Hospital, Dublin 8, Ireland
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19
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Ragoonanan D, Khazal SJ, Wang J, Payne A, Kohorst M, Harden A, Tewari P, Petropoulos D, Shoberu B, Kebriaei P, Mahadeo KM, Tambaro FP. Improved detection of sinusoidal obstructive syndrome using pediatric-AYA diagnostic criteria and severity grading. Bone Marrow Transplant 2020; 56:175-184. [PMID: 32665674 DOI: 10.1038/s41409-020-00998-w] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 06/23/2020] [Accepted: 07/02/2020] [Indexed: 01/19/2023]
Abstract
New diagnostic criteria and severity grading for sinusoidal obstructive syndrome (SOS) among pediatric and adolescent young adult (AYA) patients have been recently endorsed by international consensus. The extent to which these have been adopted in the US remains unclear. We sought to assess the potential impact via retrospective application of these criteria among patients treated at a large academic center in the United States. This is a single center retrospective study of pediatric-AYA patients who underwent hematopoietic cell transplantation (HCT) between July 2009 and 2019. The incidence of SOS was assessed using historic Baltimore and Seattle diagnostic criteria and compared with more recent guidelines (pEBMT) as proposed by the Paediatric Diseases Working Party of the European Society for Blood and Marrow Transplantation. Among 226 patients, application of the pEBMT diagnostic criteria was associated with a higher incidence (15.9%) and earlier time to diagnosis of SOS (by 2.5-3 days) compared with the modified Seattle (12.3%), and Baltimore (6.6%) criteria, respectively. The pEBMT criteria were sensitive and highly specific. Refractory thrombocytopenia was present in 75% of patients at diagnosis. Approximately 61% of patients with SOS were anicteric at diagnosis, though the majority (94.4%) developed hyperbilirubinemia as SOS progressed over a median time of 4 (1-57) days. Application of pEBMT criteria may have resulted in earlier indication for definitive treatment by 3 days. Timely diagnosis and administration of definitive treatment of SOS has been associated with improved outcomes. Prospective studies may better characterize the risk factors and natural course of SOS using pEBMT criteria.
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Affiliation(s)
- D Ragoonanan
- Department of Pediatrics, Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX, 77030, USA.
| | - S J Khazal
- Department of Pediatrics, Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX, 77030, USA
| | - J Wang
- Department of Biostatistics, Division of Basic Sciences, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX, 77030, USA
| | - A Payne
- Department of Pediatrics, Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX, 77030, USA
| | - M Kohorst
- Department of Pediatrics, Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX, 77030, USA
| | - A Harden
- Department of Pediatrics, Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX, 77030, USA
| | - P Tewari
- Department of Pediatrics, Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX, 77030, USA
| | - D Petropoulos
- Department of Pediatrics, Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX, 77030, USA
| | - B Shoberu
- Department of Pediatrics, Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX, 77030, USA
| | - P Kebriaei
- Department of Stem Cell Transplantation and Cellular Therapy, MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, Texas, 77030, USA
| | - K M Mahadeo
- Department of Pediatrics, Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX, 77030, USA
| | - F P Tambaro
- Department of Pediatrics, Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX, 77030, USA.,UOC SIT-TMO AORN Santobono-Pausilipon, Napoli, Italy
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20
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Tewari P, White C, Kelly L, Pilkington L, Keegan H, D'Arcy T, Toole SO, Sharp L, O'Leary JJ, Martin CM. Clinical performance of the Cobas 4800 HPV test and the Aptima HPV assay in the management of women referred to colposcopy with minor cytological abnormalities. Diagn Cytopathol 2018; 46:987-992. [DOI: 10.1002/dc.24066] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Revised: 07/30/2018] [Accepted: 08/08/2018] [Indexed: 11/10/2022]
Affiliation(s)
- Prerna Tewari
- Department of Histopathology; Trinity College Dublin; Dublin Ireland
- CERVIVA, Department of Molecular Pathology; Coombe Women and Infants University Hospital; Dublin Ireland
| | - Christine White
- Department of Histopathology; Trinity College Dublin; Dublin Ireland
- CERVIVA, Department of Molecular Pathology; Coombe Women and Infants University Hospital; Dublin Ireland
| | - Lynne Kelly
- Department of Histopathology; Trinity College Dublin; Dublin Ireland
| | - Loretto Pilkington
- CERVIVA, Department of Molecular Pathology; Coombe Women and Infants University Hospital; Dublin Ireland
| | - Helen Keegan
- CERVIVA, Department of Molecular Pathology; Coombe Women and Infants University Hospital; Dublin Ireland
| | - Tom D'Arcy
- Department of Obstetrics and Gynaecology; Coombe Women and Infants University Hospital; Dublin Ireland
| | - Sharon O’ Toole
- Department of Histopathology; Trinity College Dublin; Dublin Ireland
- CERVIVA, Department of Molecular Pathology; Coombe Women and Infants University Hospital; Dublin Ireland
| | - Linda Sharp
- Institute of Health and Society; Newcastle University; Newcastle UK
| | - John J O'Leary
- Department of Histopathology; Trinity College Dublin; Dublin Ireland
- CERVIVA, Department of Molecular Pathology; Coombe Women and Infants University Hospital; Dublin Ireland
| | - Cara M Martin
- Department of Histopathology; Trinity College Dublin; Dublin Ireland
- CERVIVA, Department of Molecular Pathology; Coombe Women and Infants University Hospital; Dublin Ireland
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21
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O'Leary JJ, White C, Spillane C, Naik P, O'Brien R, Reynolds S, Pham T, Pilkington L, Sharkey Ochoa I, Bolger N, Barry O'Crowley J, Tewari P, O'Toole S, Sweeney M, Keegan H, Normand C, Sharp L, Flannelly G, Martin C. Cervical screening: A new way forward (tests of risk and tests of disease). HRB Open Res 2018. [DOI: 10.12688/hrbopenres.12794.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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
Cervical screening has been a highly successful health promotion initiative. The way cervical screening is delivered is about to change dramatically, with the introduction of 'tests of risk' and 'tests of disease' based on primary HPV testing and the use of cell host response biomarkers. This article addresses the fundamental basis of this change in clinical practice and offers insights into how the future of cervical screening will look.
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22
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Woods RSR, Keegan H, White C, Tewari P, Toner M, Kennedy S, O'Regan EM, Martin CM, Timon CVI, O'Leary JJ. Cytokeratin 7 in Oropharyngeal Squamous Cell Carcinoma: A Junctional Biomarker for Human Papillomavirus-Related Tumors. Cancer Epidemiol Biomarkers Prev 2017; 26:702-710. [PMID: 28082347 DOI: 10.1158/1055-9965.epi-16-0619] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2016] [Revised: 11/29/2016] [Accepted: 12/06/2016] [Indexed: 11/16/2022] Open
Abstract
Background: Human papillomavirus (HPV)-related oropharyngeal squamous cell carcinoma (SCC) represents a distinct subgroup of head and neck tumors. We analyze the expression of cytokeratin 7, a junctional biomarker with a SEQIKA fragment, which stabilizes HPV-16 E7 transcripts, in oropharyngeal SCCs.Methods: Archived tumor specimens and epidemiologic data were collected from patients with oropharyngeal SCCs over 10 years. Briefly, DNA was extracted from tissue blocks, and HPV testing was carried out using SPF10 HPV PCR and INNO-LiPA HPV Genotyping. Immunohistochemical staining for CK7 and p16ink4a was performed on the Ventana BenchMark Ultra Immunostainer. Analysis was by light microscopy using the H-score. CK7 expression was correlated with epidemiologic data, p16ink4a positivity, and HPV status using SPSS.Results: CK7 expression was observed specifically and uniformly in the tonsillar crypt epithelium of normal tonsils and tumor specimens. There were 226 cases of oropharyngeal SCCs, with 70 demonstrating both HPV and p16 positivity. Of 216 cases evaluated for CK7, 106 demonstrated some positivity, whereas H-score > 60 was seen in 55 of these. CK7 H-score > 60 was significantly associated with tonsillar subsite and HPV and p16 positivity.Conclusions: An association between CK7 and HPV has been demonstrated. CK7-expressing tonsillar crypt cells potentially represent an oropharyngeal subsite susceptible to HPV-related SCC.Impact: Along with the cervix and anorectum, specific oropharyngeal expression of CK7 in a site predisposed to HPV-related tumors may suggest a role for CK7 in the pathogenesis of this subgroup of tumors. Further research is warranted to characterize the association between CK7 and HPV-related head and neck SCC. Cancer Epidemiol Biomarkers Prev; 26(5); 702-10. ©2017 AACR.
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Affiliation(s)
- Robbie S R Woods
- Department of Otolaryngology, St. James's Hospital, Dublin, Ireland. .,Department of Otolaryngology, Trinity College Dublin, Dublin, Ireland.,Department of Histopathology & Morbid Anatomy, Trinity College Dublin, Dublin, Ireland.,Department of Otolaryngology, Royal Victoria Eye and Ear Hospital, Dublin, Ireland.,CERVIVA Research Consortium, Ireland
| | - Helen Keegan
- Department of Histopathology & Morbid Anatomy, Trinity College Dublin, Dublin, Ireland.,CERVIVA Research Consortium, Ireland
| | - Christine White
- Department of Histopathology & Morbid Anatomy, Trinity College Dublin, Dublin, Ireland.,CERVIVA Research Consortium, Ireland
| | - Prerna Tewari
- Department of Histopathology & Morbid Anatomy, Trinity College Dublin, Dublin, Ireland.,CERVIVA Research Consortium, Ireland
| | - Mary Toner
- Department of Histopathology & Morbid Anatomy, Trinity College Dublin, Dublin, Ireland.,Department of Histopathology, St. James's Hospital, Dublin, Ireland
| | - Susan Kennedy
- Department of Histopathology, Royal Victoria Eye and Ear Hospital, Dublin, Ireland
| | - Esther M O'Regan
- Department of Histopathology & Morbid Anatomy, Trinity College Dublin, Dublin, Ireland.,Department of Histopathology, St. James's Hospital, Dublin, Ireland
| | - Cara M Martin
- Department of Histopathology & Morbid Anatomy, Trinity College Dublin, Dublin, Ireland.,CERVIVA Research Consortium, Ireland
| | - Conrad V I Timon
- Department of Otolaryngology, St. James's Hospital, Dublin, Ireland.,Department of Otolaryngology, Trinity College Dublin, Dublin, Ireland.,Department of Otolaryngology, Royal Victoria Eye and Ear Hospital, Dublin, Ireland
| | - John J O'Leary
- Department of Histopathology & Morbid Anatomy, Trinity College Dublin, Dublin, Ireland.,CERVIVA Research Consortium, Ireland.,Department of Histopathology, St. James's Hospital, Dublin, Ireland
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23
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Kumar P, Figliola M, Maiti S, Huls M, Kontoyiannis D, Tewari P, Richter A, Kaltz N, Champlin R, Cooper L. Unassisted Production of Clinical-Grade Viral-Specific T Cells: Bringing Production to the Bedside. Cytotherapy 2016. [DOI: 10.1016/j.jcyt.2016.03.061] [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: 10/21/2022]
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24
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Gately K, Forde L, Gray S, Morris D, Corvin A, Tewari P, O'Byrne K. Mutational analysis of the insulin-like growth factor 1 receptor tyrosine kinase domain in non-small cell lung cancer patients. Mol Clin Oncol 2015; 3:1073-1079. [PMID: 26623053 DOI: 10.3892/mco.2015.580] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Accepted: 04/02/2015] [Indexed: 11/06/2022] Open
Abstract
The insulin-like growth factor 1 receptor (IGF1R) pathway plays an important role in the pathogenesis of non-small cell lung cancer (NSCLC) and also provides a mechanism of resistance to targeted therapies. IGF1R is therefore an ideal therapeutic target and several inhibitors have entered clinical trials. However, thus far the response to these inhibitors has been poor, highlighting the importance of predictive biomarkers to identify patient cohorts who will benefit from these targeted agents. It is well-documented that mutations and/or deletions in the epidermal growth factor receptor (EGFR) tyrosine kinase (TK) domain predict sensitivity of NSCLC patients to EGFR TK inhibitors. Single-nucleotide polymorphisms (SNPs) in the IGF pathway have been associated with disease, including breast and prostate cancer. The aim of the present study was to elucidate whether the IGF1R TK domain harbours SNPs, somatic mutations or deletions in NSCLC patients and correlates the mutation status to patient clinicopathological data and prognosis. Initially 100 NSCLC patients were screened for mutations/deletions in the IGF1R TK domain (exons 16-21) by sequencing analysis. Following the identification of SNP rs2229765, a further 98 NSCLC patients and 866 healthy disease-free control patients were genotyped using an SNP assay. The synonymous SNP (rs2229765) was the only aberrant base change identified in the IGF1R TK domain of 100 NSCLC patients initially analysed. SNP rs2229765 was detected in exon 16 and was found to have no significant association between IGF1R expression and survival. The GA genotype was identified in 53.5 and 49.4% of NSCLC patients and control individuals, respectively. No significant difference was found in the genotype (P=0.5487) or allele (P=0.9082) frequencies between the case and control group. The present findings indicate that in contrast to the EGFR TK domain, the IGF1R TK domain is not frequently mutated in NSCLC patients. The synonymous SNP (rs2229765) had no significant association between IGF1R expression and survival in the cohort of NSCLC patients.
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Affiliation(s)
- Kathy Gately
- Thoracic Oncology Research Group, Institute of Molecular Medicine, Trinity College Dublin, St. James's Hospital, Dublin, Republic of Ireland
| | - Lydia Forde
- Thoracic Oncology Research Group, Institute of Molecular Medicine, Trinity College Dublin, St. James's Hospital, Dublin, Republic of Ireland
| | - Stephen Gray
- Thoracic Oncology Research Group, Institute of Molecular Medicine, Trinity College Dublin, St. James's Hospital, Dublin, Republic of Ireland
| | - Derek Morris
- Neuropsychiatric Genetics Research Group, Institute of Molecular Medicine, Trinity College Dublin, St. James's Hospital, Dublin, Republic of Ireland
| | - Aidan Corvin
- Discipline of Biochemistry, National University of Ireland, Galway, Republic of Ireland
| | - Prerna Tewari
- Molecular Pathology Research Group, Trinity College, Coombe Womens and Infants University Hospital, Dublin, Republic of Ireland
| | - Kenneth O'Byrne
- Thoracic Oncology Research Group, Institute of Molecular Medicine, Trinity College Dublin, St. James's Hospital, Dublin, Republic of Ireland ; Medical Oncology, Princess Alexandra Hospital, Queensland University of Technology, Translational Research Institute, Brisbane, Queensland, Australia
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25
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Perrotta C, Kleefeld S, Staines A, Tewari P, De Roos AJ, Baris D, Birmann B, Chiu B, Cozen W, Becker N, Foretova L, Maynadié M, Nieters A, de Sanjosé S, Miligi L, Seniori Costantini A, Purdue M, Spinelli J, Cocco P. Multiple myeloma and occupation: a pooled analysis by the International Multiple Myeloma Consortium. Cancer Epidemiol 2013; 37:300-5. [PMID: 23403129 DOI: 10.1016/j.canep.2013.01.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2012] [Revised: 01/16/2013] [Accepted: 01/19/2013] [Indexed: 10/27/2022]
Abstract
OBJECTIVE We investigated occupational risk of multiple myeloma (MM) in a pooled analysis of five international case-control studies. METHODS We calculated the odds ratio and its 95% confidence interval for selected occupations with unconditional regression analysis in 1959 MM cases and 6192 controls, by pooling study-specific risks using random-effects meta-analysis. Exposure to organic solvents was assessed with a job-exposure matrix (JEM). RESULTS Gardeners and nursery workers combined, most likely exposed to pesticides, showed a 50% increase in risk (OR = 1.50, 95% CI 0.9-2.3), while other farming jobs did not. Metal processors (OR = 1.55, 95% CI 0.9-2.3), female cleaners (OR = 1.32, 95% CI 1.0-1.8), and high level exposure to organic solvents (OR = 1.38, 95% CI 0.96-1.8) also showed moderately increased risks. CONCLUSIONS Additional case-control studies of MM aetiology are warranted to further investigate the nature of the repeatedly reported increase in MM risk in several occupational groups.
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Affiliation(s)
- Carla Perrotta
- Family and Community Medicine Department, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
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26
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Tewari P, Ryan AW, Hayden PJ, Catherwood M, Drain S, Staines A, Grant T, Nieters A, Becker N, de Sanjose S, Foretova L, Maynardie M, Cocco P, Boffetta P, Brennan P, Chanock S, Lawler M, Browne PV. Genetic variation at the 8q24 locus confers risk to multiple myeloma. Br J Haematol 2011; 156:133-6. [DOI: 10.1111/j.1365-2141.2011.08798.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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27
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Murphy TM, Ryan M, Foster T, Kelly C, McClelland R, O'Grady J, Corcoran E, Brady J, Reilly M, Jeffers A, Brown K, Maher A, Bannan N, Casement A, Lynch D, Bolger S, Tewari P, Buckley A, Quinlivan L, Daly L, Kelleher C, Malone KM. Risk and protective genetic variants in suicidal behaviour: association with SLC1A2, SLC1A3, 5-HTR1B &NTRK2 polymorphisms. Behav Brain Funct 2011; 7:22. [PMID: 21711518 PMCID: PMC3141406 DOI: 10.1186/1744-9081-7-22] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2011] [Accepted: 06/28/2011] [Indexed: 01/05/2023] Open
Abstract
Background Suicidal behaviour is known to aggregate in families. Patients with psychiatric disorders are at higher risk for suicide attempts (SA), however protective and risk genetic variants for suicide appear to be independent of underlying psychiatric disorders. Here we investigate genetic variants in genes important for neurobiological pathways linked to suicidal behaviour and/or associated endophenotypes, for association with SA among patients with co-existing psychiatric illness. Selected gene-gene and gene-environment interactions were also tested. Methods DNA was obtained from bloods of 159 patients (76 suicide attempters and 83 non-attempters), who were profiled for DSM-IV Axis I psychiatric diagnosis. Twenty-eight single nucleotide polymorphisms (SNPs) from 18 candidate genes (COMT, 5-HT2A, 5-HT1A, 5-HTR1B, TPH1, MAO-A, TPH2, DBH, CNR1, BDNF, ABCG1, GABRA5, GABRG2, GABRB2, SLC1A2, SLC1A3, NTRK2, CRHR1) were genotyped. Genotyping was performed by KBioscience. Tests of association between genetic variants and SA were conducted using Chi squared and Armitage Trend tests. Binary logistical regression analyses were performed to evaluate the contribution of individual genetic variants to the prediction of SA, and to examine SNPs for potential gene-gene and gene-environment interactions. Results Our analysis identified 4 SNPs (rs4755404, rs2269272, rs6296 and rs1659400), which showed evidence of association with SA compared to a non-attempter control group. We provide evidence of a 3-locus gene-gene interaction, and a putative gene-environment interaction, whereby genetic variation at the NTRK2 locus may moderate the risk associated with history of childhood abuse. Conclusion Preliminary findings suggest that allelic variability in SLC1A2/3, 5-HTR1B and NTRK2 may be relevant to the underlying diathesis for suicidal acts.
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Affiliation(s)
- Therese M Murphy
- Department of Psychiatry & Mental Health Research, St. Vincent's University Hospital, University College Dublin, Elm Park, Dublin 4, Ireland.
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28
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Desai S, Tewari P, Whelan M, Kurtzberg J, Prasad V. Vitamin D Deficiency in Children Undergoing Hematopoietic Stem Cell Transplantation. Biol Blood Marrow Transplant 2011. [DOI: 10.1016/j.bbmt.2010.12.366] [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: 10/18/2022]
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29
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Prasad V, Mendizabal A, Tewari P, Page K, Parikh S, Szabolcs P, Driscoll T, Martin P, Kurtzberg J. Differential Impact of HLA-A, -B, and -DRB1 Mismatching in Relation to Other Variables on the Outcomes of Myeloablative Unrelated Single Donor Umbilical Cord Blood Transplantation From 4/6 Matched Units in Children and Young Adults. Biol Blood Marrow Transplant 2011. [DOI: 10.1016/j.bbmt.2010.12.100] [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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30
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Maginn EN, Browne PV, Hayden P, Vandenberghe E, MacDonagh B, Evans P, Goodyer M, Tewari P, Campiani G, Butini S, Williams DC, Zisterer DM, Lawler MP, McElligott AM. PBOX-15, a novel microtubule targeting agent, induces apoptosis, upregulates death receptors, and potentiates TRAIL-mediated apoptosis in multiple myeloma cells. Br J Cancer 2010; 104:281-9. [PMID: 21179037 PMCID: PMC3031893 DOI: 10.1038/sj.bjc.6606035] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [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] [Indexed: 01/12/2023] Open
Abstract
Background: In recent years, much progress has been made in the treatment of multiple myeloma. However, a major limitation of existing chemotherapeutic drugs is the eventual emergence of resistance; hence, the development of novel agents with new mechanisms of action is pertinent. Here, we describe the activity and mechanism of action of pyrrolo-1,5-benzoxazepine-15 (PBOX-15), a novel microtubule-targeting agent, in multiple myeloma cells. Methods: The anti-myeloma activity of PBOX-15 was assessed using NCI-H929, KMS11, RPMI8226, and U266 cell lines, and primary myeloma cells. Cell cycle distribution, apoptosis, cytochrome c release, and mitochondrial inner membrane depolarisation were analysed by flow cytometry; gene expression analysis was carried out using TaqMan Low Density Arrays; and expression of caspase-8 and Bcl-2 family of proteins was assessed by western blot analysis. Results: Pyrrolo-1,5-benzoxazepine-15 induced apoptosis in ex vivo myeloma cells and in myeloma cell lines. Death receptor genes were upregulated in both NCI-H929 and U266 cell lines, which displayed the highest and lowest apoptotic responses, respectively, following treatment with PBOX-15. The largest increase was detected for the death receptor 5 (DR5) gene, and cotreatment of both cell lines with tumour necrosis factor-related apoptosis-inducing ligand (TRAIL), the DR5 ligand, potentiated the apoptotic response. In NCI-H929 cells, PBOX-15-induced apoptosis was shown to be caspase-8 dependent, with independent activation of extrinsic and intrinsic apoptotic pathways. A caspase-8-dependent decrease in expression of BimEL preceded downregulation of other Bcl-2 proteins (Bid, Bcl-2, Mcl-1) in PBOX-15-treated NCI-H929 cells. Conclusion: PBOX-15 induces apoptosis and potentiates TRAIL-induced cell death in multiple myeloma cells. Thus, PBOX-15 represents a promising agent, with a distinct mechanism of action, for the treatment of this malignancy.
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Affiliation(s)
- E N Maginn
- John Durkan Leukaemia Laboratories, Institute of Molecular Medicine, Trinity College Dublin, St James's Hospital, Dublin 8, Ireland
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31
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Singh H, Dulhani N, Kumar BN, Singh P, Tewari P, Nayak K. A pharmacovigilance study in medicine department of tertiary care hospital in chhattisgarh (jagdalpur), India. J Young Pharm 2010; 2:95-100. [PMID: 21331200 PMCID: PMC3035895 DOI: 10.4103/0975-1483.62222] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The aim of the present study was to observe adverse drug reactions (ADRs) with respect to polypharmacy at tertiary care centre at Bastar, Jagdalpur (Government Medical College, Jagdalpur). A prospective, observational evaluation of the ADRs conducted over a period of 6 months in Department of Medicine in Government Medical College, Jagdalpur. During the study period, a total of about 4850 patients visited the OPD and inpatient ward of medicine department, and 154 ADRs events were reported. Out of 154 reports that were identified, a higher percentage of ADRs in females (51.29%) was observed as compared to males (48.7%). Of the 154 ADRs, 76 (49.35%) were found to be mild, 55 moderate (35.71%), and 23 severe (14.93%). A total of 99 (64.28%) ADRs were observed in patients receiving four or more medications concurrently. Conversely 55 (35.71%) ADRs were detected in patients using three or less medicines. The largest number of reports was associated with antimicrobial therapy (28.57%), followed by antihypertensive (24.02%) and antidiabetics (14.28%). Among the affected organ systems, gastrointestinal ADRs constituted a major component (39.61%) followed by skin reactions (28.57%). On causality assessment, nearly 36.36% ADRs were considered as probable, 31.16% possible, and 9.74% could not be categorized and were placed under unassessable. Expected, limited ADR are permissible in normal clinical setting, but the present study focuses on the result showing increased and amplified ADR associated with the polypharmacy practices, which may be curtailed with rational drug prescribing habit.
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Affiliation(s)
- H Singh
- Department of Pharmacology, Government Medical College, Jagdalpur, Chhattisgarh, India
| | - N Dulhani
- Department of Medicine, Government Medical College, Jagdalpur, Chhattisgarh, India
| | - BN Kumar
- Department of Pharmacology, Government Medical College, Jagdalpur, Chhattisgarh, India
| | - P Singh
- Department of Pharmacology, Government Medical College, Rewa, MP, India
| | - P Tewari
- Department of Anatomy, Government Medical College, Jagdalpur, Chhattisgarh, India
| | - K Nayak
- Department of Pharmacology, Government Medical College, Jagdalpur, Chhattisgarh, India
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Abstract
A female infant who presented with autoimmune hemolytic anemia and thrombocytopenia subsequently developed hepatic, dermatologic, renal, pulmonary, gastrointestinal, endocrine, and nervous system involvement. Prolonged and intensive treatment with prednisone, IVIG, mycophenolate mofetil, and anti-CD20 and anti-CD52 antibodies was necessary to control the symptoms. Laboratory evaluation showed normal lymphocyte subsets and function. There was normal Foxp3 and CD25 expression, no increased CD4(-)CD8(-) T-cell population, and the AIRE and Fas genes were without mutations. These features place the patient at the most severe portion of the Evans syndrome spectrum, and suggest that this case may represent a rare, new immunodeficiency disorder.
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Affiliation(s)
- Paul T Jubinsky
- Section of Pediatric Hematology/Oncology, Yale University School of Medicine, New Haven, Connecticut 06520-8064, USA.
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33
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Foley R, Marignol L, Thomas AZ, Cullen IM, Perry AS, Tewari P, O'Grady A, Kay E, Dunne B, Loftus B, Watson WR, Fitzpatrick JM, Woodson K, Lehman T, Hollywood D, Lynch TH, Lawler M. The HIF-1alpha C1772T polymorphism may be associated with susceptibility to clinically localised prostate cancer but not with elevated expression of hypoxic biomarkers. Cancer Biol Ther 2009; 8:118-24. [PMID: 19106642 DOI: 10.4161/cbt.8.2.7086] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
We investigated the role of the C1772T polymorphisms in exon 12 of the Hypoxia-inducible factor-1 alpha (HIF-1alpha) gene C1772T genotype in prostate cancer (PCa) and amplification of the hypoxic response. We identified the heterozygous germline CT genotype as an increased risk factor for clinically localised prostate cancer (Odds ratio = 6.2; p < 0.0001). While immunostaining intensity for HIF-1alpha and VEGF was significantly enhanced in 75% of PCa specimens when compared to matched benign specimens (p < 0.0001), the CT genotype did not modulate the kinetics of HIF-1alpha protein expression in hypoxia in vitro, and was not associated with enhanced expression of hypoxic biomarkers. This study provides the first evidence of an increased risk for clinically localised prostate cancer in men carrying the C1772T HIF-1alpha gene polymorphism. Although our results did not suggest an association between expression of hypoxic biomarkers and genotype status, the correlation may merit further investigation.
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Affiliation(s)
- Ruth Foley
- Department of Haematology and Academic Unit of Clinical and Molecular Oncology, Institute of Molecular Medicine, Dublin, Ireland
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34
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Ryan J, Quinn F, Meunier A, Boublikova L, Crampe M, Tewari P, O'Marcaigh A, Stallings R, Neat M, O'Meara A, Breatnach F, McCann S, Browne P, Smith O, Lawler M. Minimal residual disease detection in childhood acute lymphoblastic leukaemia patients at multiple time-points reveals high levels of concordance between molecular and immunophenotypic approaches. Br J Haematol 2008; 144:107-15. [PMID: 19016726 DOI: 10.1111/j.1365-2141.2008.07429.x] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
In this single centre study of childhood acute lymphoblastic leukaemia (ALL) patients treated on the Medical Research Council UKALL 97/99 protocols, it was determined that minimal residual disease (MRD) detected by real time quantitative polymerase chain reaction (RQ-PCR) and 3-colour flow cytometry (FC) displayed high levels of qualitative concordance when evaluated at multiple time-points during treatment (93.38%), and a combined use of both approaches allowed a multi time-point evaluation of MRD kinetics for 90% (53/59) of the initial cohort. At diagnosis, MRD markers with sensitivity of at least 0.01% were identified by RQ-PCR detection of fusion gene transcripts, IGH/TRG rearrangements, and FC. Using a combined RQ-PCR and FC approach, the evaluation of 367 follow-up BM samples revealed that the detection of MRD >1% at Day 15 (P = 0.04), >0.01% at the end of induction (P = 0.02), >0.01% at the end of consolidation (P = 0.01), >0.01% prior to the first delayed intensification (P = 0.01), and >0.1% prior to the second delayed intensification and continued maintenance (P = 0.001) were all associated with relapse and, based on early time-points (end of induction and consolidation) a significant log-rank trend (P = 0.0091) was noted between survival curves for patients stratified into high, intermediate and low-risk MRD groups.
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Affiliation(s)
- Jacqueline Ryan
- The John Durkan Laboratory for Leukaemia Research, Institute of Molecular Medicine, St James's Hospital & Trinity College Dublin, University of Dublin, Dublin, Ireland.
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35
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Hayden PJ, Tewari P, Morris DW, Staines A, Crowley D, Nieters A, Becker N, de Sanjosé S, Foretova L, Maynadié M, Cocco PL, Boffetta P, Brennan P, Chanock SJ, Browne PV, Lawler M. Variation in DNA repair genes XRCC3, XRCC4, XRCC5 and susceptibility to myeloma. Hum Mol Genet 2007; 16:3117-27. [PMID: 17901044 DOI: 10.1093/hmg/ddm273] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.6] [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: 11/13/2022] Open
Abstract
Cytogenetic analysis in myeloma reveals marked chromosomal instability. Both widespread genomic alterations and evidence of aberrant class switch recombination, the physiological process that regulates maturation of the antibody response, implicate the DNA repair pathway in disease pathogenesis. We therefore assessed 27 SNPs in three genes (XRCC3, XRCC4 and XRCC5) central to DNA repair in patients with myeloma and controls from the EpiLymph study and from an Irish hospital registry (n = 306 cases, 263 controls). For the haplotype-tagging SNP (htSNP) rs963248 in XRCC4, Allele A was significantly more frequent in cases than in controls (86.4 versus 80.8%; odds ratio 1.51; 95% confidence interval 1.10-2.08; P = 0.0133), as was the AA genotype (74 versus 65%) (P = 0.026). Haplotype analysis was performed using Unphased for rs963248 in combination with additional SNPs in XRCC4. The strongest evidence of association came from the A-T haplotype from rs963248-rs2891980 (P = 0.008). For XRCC5, the genotype GG from rs1051685 was detected in 10 cases from different national populations but in only one control (P = 0.015). This SNP is located in the 3'-UTR of XRCC5. Overall, these data provide support for the hypothesis that common variation in the genes encoding DNA repair proteins contributes to susceptibility to myeloma.
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Affiliation(s)
- Patrick J Hayden
- Durkan Leukaemia Laboratories, Department of Haematology, Institute of Molecular Medicine, Trinity College Dublin, Ireland
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Abstract
Introduction: Some medical emergencies need compromised airway management as the first measure. Most of these cases are first seen by an ENT surgeon, whose proper evaluation and timely intervention can prove decisive. Knowledge of alternatives for airway management can prove life-saving, although these may require the active involvement of other specialities.Case reports: Two patients, a 27-year-old man and a 31-year-old woman, presented in respiratory distress with cyanosis. Each had a pedunculated mass in the lower trachea above the carina, with about 90 per cent tracheal lumen obstruction. They were managed successfully with femorofemoral cardiopulmonary bypass and restoration of airway.Conclusion: Femorofemoral cardiopulmonary bypass can be a relatively safe option which gains time for airway management in such conditions. Knowledge of this procedure among ENT surgeons can lead to timely intervention, in properly selected cases, which can save valuable time.
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Affiliation(s)
- I Tyagi
- Neuro-otology Unit, Department of Neuro-surgery, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow (UP), India
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37
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Kumar A, Pathak SR, Ahmad P, Ray S, Tewari P, Srivastava AK. Novel substituted naphthalen-1-yl-methanone derivatives as anti-hyperglycemic agents. Bioorg Med Chem Lett 2006; 16:2719-23. [PMID: 16500101 DOI: 10.1016/j.bmcl.2006.02.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [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: 11/28/2005] [Revised: 01/25/2006] [Accepted: 02/07/2006] [Indexed: 10/25/2022]
Abstract
A series of aminoalkoxy phenyl-substituted naphthalene-1-yl-methanone was synthesized and tested for its anti-hyperglycemic activity in SLM and STZ-S rat models. Some compounds (3b, 4c and 4h) of the series were showing significant anti-hyperglycemic activity in male Sprague-Dawley rats in sucrose-loaded model (SLM) as well as in streptozotocin-induced model (STZ-S). Active compounds were also evaluated for relative binding affinity against glucagon receptor.
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Affiliation(s)
- Atul Kumar
- Medicinal and Process Chemistry Division, Central Drug Research Institute, Lucknow 226001, India.
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38
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Mindicino HJ, Carlsen J, Tewari P, Aagaard O, Zhang B, Conarpe C. An evaluation of an automated homocysteine method on the Bayer ADVIA Centaur automated chemiluminescent system. Clin Lab 2003; 48:493-6. [PMID: 12389709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
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39
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Prasad N, Gulati S, Jain M, Tewari P. An unusual case of neonatal anuria. Indian Pediatr 2003; 40:258-60. [PMID: 12657763] [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: 03/01/2023]
Abstract
Neonatal anuria is not an uncommon problem in neonates. Here, we report an unusual case of neonatal anuria due to renal tubular dysgenesis, secondary to the use of angiotensin converting enzyme inhibitor (ACEI) during pregnancy. ACEI remains one of the most commonly used antihypertensive drug at present. A greater awareness needs to be created in the medical fraternity especially among pediatricians, gynecologists and internists that ACE inhibitors should not be prescribed during any trimester of pregnancy.
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Affiliation(s)
- N Prasad
- Department of Nephrology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Raebareli Road, Lucknow 226 014, India
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40
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Tewari P. I live in the intensive care unit. Crit Care Med 2001; 29:2234-5. [PMID: 11700437 DOI: 10.1097/00003246-200111000-00037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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41
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Tewari P. A new grip to help during endotracheal intubation. Anesth Analg 2001; 93:244-5. [PMID: 11429381 DOI: 10.1097/00000539-200107000-00057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Tewari P, Pandey CK, Tyagi I. Retropharyngeal neurofibroma presenting with severe kypho-scoliosis: respiratory obstruction in postoperative period. Can J Anaesth 2001; 48:422-3. [PMID: 11339791 DOI: 10.1007/bf03014981] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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44
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Tewari P, Sinha A, Kanhere V. Inadvertent cannulation of the left internal thoracic vein during central vein catheter insertion. Ann Card Anaesth 2000; 3:25-6. [PMID: 17848768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/17/2023] Open
Abstract
The left internal thoracic vein was accidentally cannulated during an attempt to establish central vein catheterization through left internal jugular vein. The surgeon found this during left internal mammary artery dissection and it needed to be repositioned.
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Affiliation(s)
- P Tewari
- Department of Anaesthesiology, Cardiothoracic Surgery, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Luckhnow, India.
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45
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46
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Abstract
BACKGROUND Ice/saline slush used along with cold cardioplegia for heart arrest in cardiac operations can cause hypothermic damage to certain structures, an important one being the left phrenic nerve, damage of which results in raised left hemidiaphragm and delayed recovery of the patient. In coronary artery bypass grafting, opening of the pleura and collection of the ice/saline slush in the pleural cavity increases the incidence of injury. METHODS Three of our nonconsecutive patients underwent coronary artery bypass grafting with cold cardioplegia and open pleura, with collection of ice/saline slush in the pleural cavity for a sufficiently long time. RESULTS Simultaneous involvement of left recurrent laryngeal nerve along with left phrenic nerve was found in all patients without any concurrent topical injury around the larynx. the recurrent laryngeal nerve took 8 to 10 months to recover. CONCLUSIONS The left recurrent nerve as it arches around aorta lies in the thorax very close to the parietal pleura and may be prone to hypothermic injury by ice/slush collecting in the pleural cavity during cardiac operations. Judicious use of ice/saline slush had helped in eliminating the problem to some extent.
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Affiliation(s)
- P Tewari
- Department of Anaesthesiology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India
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47
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48
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Abstract
The purpose of this report is to draw attention to haemodynamic changes during intraoperative adrenal gland manipulation. Severe hypertension, ventricular tachycardia and subendocardial ischaemia occurred during the manipulation of adrenal gland in a patient who underwent live related donor nephrectomy. The patient responded well to intravenous lidocaine. Plasma norepinephrine concentration was elevated at the time of event. Further investigations after surgery excluded the possibility of phaeochromocytoma. In two years follow-up patient remains well. Suspicion for the cause of the event remains the excessive release of catecholamines with manipulation of a normal adrenal gland. The presence of halothane might have contributed to the arrythmia.
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Affiliation(s)
- P Tewari
- Department of Anaesthesiology & Critical Care Medicine, SGPGIMS, Lucknow, India
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49
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50
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Abstract
As the survival rate after modified Fontan procedure is increasing, cardiopulmonary resuscitation may be needed in such patients for other causes not related to their cardiac status. The state-of-the-art cardiopulmonary resuscitation with external chest compression may not be sufficient to revive such patients, and the addition of external abdominal compressions may help in the final outcome, as is reported here.
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Affiliation(s)
- P Tewari
- Department of Anaesthesiology and Critical Care Medicine, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
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