Toward best practice in cancer mutation detection with whole-genome and whole-exome sequencing.

Clinical applications of precision oncology require accurate tests that can distinguish true cancer-specific mutations from errors introduced at each step of next-generation sequencing (NGS). To date, no bulk sequencing study has addressed the effects of cross-site reproducibility, nor the biological, technical and computational factors that influence variant identification. Here we report a systematic interrogation of somatic mutations in paired tumor-normal cell lines to identify factors affecting detection reproducibility and accuracy at six different centers. Using whole-genome sequencing (WGS) and whole-exome sequencing (WES), we evaluated the reproducibility of different sample types with varying input amount and tumor purity, and multiple library construction protocols, followed by processing with nine bioinformatics pipelines. We found that read coverage and callers affected both WGS and WES reproducibility, but WES performance was influenced by insert fragment size, genomic copy content and the global imbalance score (GIV; G > T/C > A). Finally, taking into account library preparation protocol, tumor content, read coverage and bioinformatics processes concomitantly, we recommend actionable practices to improve the reproducibility and accuracy of NGS experiments for cancer mutation detection.

Myeloperoxidase deficiency attenuates systemic and dietary iron-induced adverse effects.

Iron deficiency is routinely treated with oral or systemic iron supplements, which are highly reactive and could induce oxidative stress via augmenting the activity of proinflammatory enzyme myeloperoxidase (MPO). To investigate the extent to which MPO is involved in iron-induced toxicity, acute (24 h) iron toxicity was induced by intraperitoneal administration of FeSO4 (25 mg/kg body weight) to MPO-deficient (MpoKO) mice and their wild-type (WT) littermates. Acute iron toxicity was also assessed in WT mice pretreated with an MPO inhibitor, 4-aminobenzoic acid hydrazide. Systemic iron administration up-regulated circulating MPO and neutrophil elastase and elevated systemic inflammatory and organ damage markers in WT mice. However, genetic deletion of MPO or its inhibition significantly reduced iron-induced organ damage and systemic inflammatory responses. In contrast to the acute model, 8 weeks of 2% carbonyl iron diet feeding to WT mice did not change the levels of circulating MPO and neutrophil elastase but promoted their accumulation in the liver. Even though both MpoKO and WT mice displayed similar levels of diet-induced hyperferremia, MpoKO mice showed significantly reduced inflammatory response and oxidative stress than the WT mice. In addition, WT bone-marrow-derived neutrophils (BMDN) generated more reactive oxygen species than MPO-deficient BMDN upon iron stimulation. Altogether, genetic deficiency or pharmacologic inhibition of MPO substantially attenuated acute and chronic iron-induced toxicity. Our results suggest that targeting MPO during iron supplementation is a promising approach to reduce iron-induced toxicity/side effects in vulnerable population.

Cytomorphologic characteristics and differential diagnoses of lymphoepithelial carcinoma of the parotid.

INTRODUCTION: Lymphoepithelial carcinoma of the salivary gland is an extremely rare neoplasm and is challenging to diagnose by fine needle aspiration (FNA). There are rare reports on the cytopathologic features of lymphoepithelial carcinoma, which may be mistaken for other high-grade salivary gland neoplasm or a metastasis to the salivary gland. MATERIALS AND METHODS: A retrospective review was undertaken of 7 cases of lymphoepithelial carcinoma of the parotid diagnosed on FNA with histologic confirmation from 4 major medical centers. RESULTS: Cytomorphologic features of lymphoepithelial carcinoma include smears with moderate cellularity displaying a rich nonneoplastic population of lymphoplasmacytic cells admixed with tissue fragments of high grade, malignant undifferentiated epithelial cells with high nuclear to cytoplasm ratio, hyperchromasia, prominent nucleoli, and scant to abundant, indistinct cytoplasm. DISCUSSION: Diagnostic pitfalls of lymphoepithelial carcinoma include metastatic squamous cell carcinoma, metastatic nasopharyngeal carcinoma, and other high grade primary salivary gland neoplasms. Recognizing this lesion may help guide clinicians to perform additional imaging studies to exclude a primary from other sites.

Image microarrays derived from tissue microarrays (IMA-TMA): New resource for computer-aided diagnostic algorithm development.

BACKGROUND: Conventional tissue microarrays (TMAs) consist of cores of tissue inserted into a recipient paraffin block such that a tissue section on a single glass slide can contain numerous patient samples in a spatially structured pattern. Scanning TMAs into digital slides for subsequent analysis by computer-aided diagnostic (CAD) algorithms all offers the possibility of evaluating candidate algorithms against a near-complete repertoire of variable disease morphologies. This parallel interrogation approach simplifies the evaluation, validation, and comparison of such candidate algorithms. A recently developed digital tool, digital core (dCORE), and image microarray maker (iMAM) enables the capture of uniformly sized and resolution-matched images, with these representing key morphologic features and fields of view, aggregated into a single monolithic digital image file in an array format, which we define as an image microarray (IMA). We further define the TMA-IMA construct as IMA-based images derived from whole slide images of TMAs themselves. METHODS: Here we describe the first combined use of the previously described dCORE and iMAM tools, toward the goal of generating a higher-order image construct, with multiple TMA cores from multiple distinct conventional TMAs assembled as a single digital image montage. This image construct served as the basis of the carrying out of a massively parallel image analysis exercise, based on the use of the previously described spatially invariant vector quantization (SIVQ) algorithm. RESULTS: Multicase, multifield TMA-IMAs of follicular lymphoma and follicular hyperplasia were separately rendered, using the aforementioned tools. Each of these two IMAs contained a distinct spectrum of morphologic heterogeneity with respect to both tingible body macrophage (TBM) appearance and apoptotic body morphology. SIVQ-based pattern matching, with ring vectors selected to screen for either tingible body macrophages or apoptotic bodies, was subsequently carried out on the differing TMA-IMAs, with attainment of excellent discriminant classification between the two diagnostic classes. CONCLUSION: The TMA-IMA construct enables and accelerates high-throughput multicase, multifield based image feature discovery and classification, thus simplifying the development, validation, and comparison of CAD algorithms in settings where the heterogeneity of diagnostic feature morphologic is a significant factor.

Microarray analysis of bladder smooth muscle from patients with myelomeningocele.

OBJECTIVE: To examine whether gene profiles can provide a molecular evaluation of the quality and therapeutic potential in patients with myelomeningocele (MM), by comparing genetic profiles of smooth muscle cells (SMCs) from healthy bladders and bladders from patients, to identify genes that are over- and under-expressed in MM bladder SMCs. MATERIAL AND METHODS: Bladder SM biopsies were obtained from 'healthy' subjects undergoing bladder surgery for vesico-ureteric reflux and from patients with a neurogenic bladder secondary to MM. Bladder SMCs were expanded in vitro and total RNA was isolated and hybridized to gene chips to evaluate the differential expression levels of 22 283 genes. Differentially expressed genes were identified by two methods. In the first analysis, we directly compared raw data sets of healthy SMCs to those derived from patients with MM. In the second analysis, we indirectly compared healthy SMCs and MM SMCs to a reference file, to create a genetic signature of genes that are over- and under-expressed in MM SMCs. RESULTS: The direct analysis identified 240 genes that were over-expressed and 104 that were under-expressed in MM SMCs. Gene ontology classifications were used to identify biological themes and pathways. Genes that were over-expressed in MM SMCs were involved in development: mesenchyme homeobox 2 (-fold change, 9.3); bone morphogenic protein 6 (4.0); fibroblast growth factor 2 (4.8); inhibin A (4.2), cartilage oliogomeric matrix protein (9.97); collagen 11A (6); collagen 5A2 (3) and collagen 1A1 (2.18). The indirect analysis identified 665 genes that were over-expressed and 1343 that were under-expressed in MM SMCs. Pathway-based analysis of these genetic signatures showed an over-expression of genes involved in muscle development and focal adhesion/extracellular matrix interactions. Genes that were under-expressed in MM SMCs were mapped to muscle contraction, transmission of nerve impulses, and cell-cell adhesion pathways. CONCLUSION: Our results are consistent with previous studies showing that MM bladders have an excess of extracellular matrix deposition, improper contraction, and are developmentally immature relatively to healthy SMCs. The clinical implication of microarray analysis of MM SMCs is that it provides potential targets that could induce muscle differentiation and inhibit extracellular matrix production.

GeneChip analysis of human embryonic stem cell differentiation into hemangioblasts: an in silico dissection of mixed phenotypes.

BACKGROUND: Microarrays are being used to understand human embryonic stem cell (hESC) differentiation. Most differentiation protocols use a multi-stage approach that induces commitment along a particular lineage. Therefore, each stage represents a more mature and less heterogeneous phenotype. Thus, characterizing the heterogeneous progenitor populations upon differentiation are of increasing importance. Here we describe a novel method of data analysis using a recently developed differentiation protocol involving the formation of functional hemangioblasts from hESCs. Blast cells are multipotent and can differentiate into multiple lineages of hematopoeitic cells (erythroid, granulocyte and macrophage), endothelial and smooth muscle cells. RESULTS: Large-scale transcriptional analysis was performed at distinct time points of hESC differentiation (undifferentiated hESCs, embryoid bodies, and blast cells, the last of which generates both hematopoietic and endothelial progenies). Identifying genes enriched in blast cells relative to hESCs revealed a genetic signature indicative of erythroblasts, suggesting that erythroblasts are the predominant cell type in the blast cell population. Because of the heterogeneity of blast cells, numerous comparisons were made to publicly available data sets in silico, some of which blast cells are capable of differentiating into, to assess and characterize the blast cell population. Biologically relevant comparisons masked particular genetic signatures within the heterogeneous population and identified genetic signatures indicating the presence of endothelia, cardiomyocytes, and hematopoietic lineages in the blast cell population. CONCLUSION: The significance of this microarray study is in its ability to assess and identify cellular populations within a heterogeneous population through biologically relevant in silico comparisons of publicly available data sets. In conclusion, multiple in silico comparisons were necessary to characterize tissue-specific genetic signatures within a heterogeneous hemangioblast population.