Concordance of microsatellite instability and mismatch repair status in paired biopsies and surgical specimens of resectable gastroesophageal adenocarcinoma: time for a call to action.

BACKGROUND: Reliability of mismatch repair proteins and microsatellite instability assessment is essential in order to define treatment strategy and identify candidates to immune checkpoint inhibitors in locally advanced gastroesophageal carcinoma. We evaluated the concordance of deficient mismatch repair (dMMR) and microsatellite instability-high (MSI-H) status between endoscopic biopsies and surgical specimens. METHODS: Consecutive patients with resectable gastric or gastroesophageal junction adenocarcinoma classified as MSI-H/dMMR by polymerase chain reaction (PCR) or immunohistochemistry (IHC) and operated at three referral Institutions were included. The primary endpoint was the rate of concordance between biopsy and surgical samples. If needed, central revision by IHC/PCR was performed by specialized pathologists from coordinating Institutions. RESULTS: Thirteen (19.7%) out of 66 patients showed discordant MSI-H/dMMR results in the original pathology reports. In most cases (11, 16.7%) this was due to the diagnosis of proficient mismatch repair status on biopsies. Among the ten cases available for central review, four were due to sample issues, four were reclassified as dMMR, one case showed dMMR status but was classified as microsatellite stable by PCR, one was linked to misdiagnosis of endoscopic biopsy by the local pathologist. Heterogeneity of mismatch repair proteins staining was observed in two cases. CONCLUSIONS: Available methods can lead to conflicting results in MSI-H/dMMR evaluation between endoscopic biopsies and surgical samples of gastroesophageal adenocarcinoma. Strategies aiming to improve the reliability of assessment should be primarily focused on the optimization of tissue collection and management during endoscopy and adequate training of dedicated gastrointestinal pathologists within the multidisciplinary team.

Drying Techniques and Storage: Do They Affect the Nutritional Value of Bee-Collected Pollen?

In this study, the effect of different drying processes (freeze-drying (FD), microwave-assisted drying (MWD) and classic hot air drying (HAD)) on the polyphenols, flavonoids, and amino acids content was investigated on bee-collected chestnut, willow and ivy pollen for human consumption. Furthermore, the pollen chemical properties were monitored after three and six months of storage, and then analyzed using a multivariate approach. Chestnut pollen was the richest source of polyphenols, flavonoids, and rutin, while ivy pollen contained the highest amount of total and free amino acids, and total and free proline. Drying and storage affected pollen chemical composition with species-dependent effects. MWD allowed the best retention of flavonoids in chestnut pollen for up to six months of storage. All drying techniques led to a depletion of flavonoids in willow pollen; however, MWD ensured the highest flavonoids content after six months. FD and MWD did not lead to flavonoids depletion in ivy pollen during storage. Additionally, storage did not affect the rutin content, which was highest in FD willow samples after six months. Notably, both FD and MWD techniques are efficient in preserving amino acids-related quality of bee pollen up to six months of storage.

Outcomes of the Tall-Cell Variant of Papillary Thyroid Carcinoma in Patients with Different Ages: A 17-Year Mono-Institutional Experience.

The tall-cell variant of papillary thyroid carcinoma (TCPTC) is the most common aggressive variant of papillary thyroid carcinoma (PTC) and typically occurs in older patients. In this study, we analyzed retrospectively the largest mono-institutional series of PTCs with tall-cell features (989 patients) over a 17-year period, re-evaluating tumors based on age at presentation and outcomes in different age groups. We divided patients into three age groups following different criteria (the criterion from the American Joint Committee on Cancer Tumor Node Metastasis (AJCC TNM) guidelines, criterion for the statistical division into tertiles and adolescent/post-adolescent criterion) to analyze the clinicopathological characteristics in different age groups, especially in terms of recurrence-free survival (RFS) and distant recurrence-free survival (DRFS). We obtained three main results: 1. the population is distributed among the different age groups, and therefore, this type of cancer is not exclusively found among those of an older age; 2. in the RFS analysis, we can see a higher probability of local recurrence in the younger and older groups and, unexpectedly, a lower probability of local recurrence in the "median age" group; and 3. in the DRFS analysis, we can observe a higher probability of distant recurrence in older patients. From a molecular perspective, no significant differences in the mutational status of BRAF were detected according to different age groups, while mutations in the TERT promoter were exclusively present in older patients of all age groups, highlighting the potential prognostic implications of TERT promoter mutations in PTCs. In conclusion, the results of this series confirm that TC morphology alone in PTCs does not have the same negative prognostic significance in the younger population as in the older population. The reason for these different outcomes remains unclear and needs further studies.

Freeze-drying duration influences the amino acid and rutin content in honeybee-collected chestnut pollen.

Honeybee-collected pollen is gaining attention as functional food for human consumption, due to antiproliferative, antiallergic, antibiotic, antidiarrheic and antioxidant activities. Among the different bioactive compounds, flavonoids from bee-collected pollen are currently recognised as powerful antioxidant and antiradical molecules. Traditional conservation methods influence pollen organoleptic properties as well as the contents of nutrients and nutraceutical compounds. Here, freeze-drying (FD) was proposed as a novel conservation method, estimating its adequacy as drying process by the evaluation of changes in free and total amino acids and proline as well as in their ratios. Honeybee-collected chestnut pollen was taken into consideration and the level of rutin, as main flavonoid, was considered as marker compound highlighting the maintenance of pollen nutraceutical properties. Results showed that FD influenced rutin level, depending on the FD duration. However, the free proline to free amino acid ratio was always below 80%, and the free amino acid to total amino acid ratio remained unaltered indicating the adequacy of the FD treatment, which did not affect the nutritional value of chestnut pollen. Overall, this study shed light on the nutraceutical profile of honeybee-collected chestnut pollen, highlighting the promising potential of FD as a novel method to treat pollen for human consumption.

Microwave-Assisted Drying for the Conservation of Honeybee Pollen.

Bee pollen is becoming an important product thanks to its nutritional properties, including a high content of bioactive compounds such as essential amino acids, antioxidants, and vitamins. Fresh bee pollen has a high water content (15%-30% wt %), thus it is a good substrate for microorganisms. Traditional conservation methods include drying in a hot air chamber and/or freezing. These techniques may significantly affect the pollen organoleptic properties and its content of bioactive compounds. Here, a new conservation method, microwave drying, is introduced and investigated. The method implies irradiating the fresh pollen with microwaves under vacuum, in order to reduce the water content without reaching temperatures capable of thermally deteriorating important bioactive compounds. The method was evaluated by taking into account the nutritional properties after the treatment. The analyzed parameters were phenols, flavonoids, with special reference to rutin content, and amino acids. Results showed that microwave drying offers important advantages for the conservation of bee pollen. Irrespective of microwave power and treatment time, phenol and flavonoid content did not vary over untreated fresh pollen. Similarly, rutin content was unaffected by the microwave drying, suggesting that the microwave-assisted drying could be a powerful technology to preserve bioprotective compounds in fresh pollen.