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1.
Proc Natl Acad Sci U S A ; 117(33): 20159-20170, 2020 08 18.
Artículo en Inglés | MEDLINE | ID: mdl-32747553

RESUMEN

Although immune checkpoint blockade (ICB) therapy has revolutionized cancer treatment, many patients do not respond or develop resistance to ICB. N6 -methylation of adenosine (m6A) in RNA regulates many pathophysiological processes. Here, we show that deletion of the m6A demethylase Alkbh5 sensitized tumors to cancer immunotherapy. Alkbh5 has effects on m6A density and splicing events in tumors during ICB. Alkbh5 modulates Mct4/Slc16a3 expression and lactate content of the tumor microenvironment and the composition of tumor-infiltrating Treg and myeloid-derived suppressor cells. Importantly, a small-molecule Alkbh5 inhibitor enhanced the efficacy of cancer immunotherapy. Notably, the ALKBH5 gene mutation and expression status of melanoma patients correlate with their response to immunotherapy. Our results suggest that m6A demethylases in tumor cells contribute to the efficacy of immunotherapy and identify ALKBH5 as a potential therapeutic target to enhance immunotherapy outcome in melanoma, colorectal, and potentially other cancers.


Asunto(s)
Desmetilasa de ARN, Homólogo 5 de AlkB/metabolismo , Vacunas contra el Cáncer/inmunología , Lactatos/metabolismo , Melanoma/metabolismo , Receptor de Muerte Celular Programada 1/inmunología , Linfocitos T Reguladores/fisiología , Desmetilasa de ARN, Homólogo 5 de AlkB/genética , Anticuerpos , Citocinas/genética , Citocinas/metabolismo , Eliminación de Gen , Regulación Neoplásica de la Expresión Génica , Humanos , Melanoma/terapia , Metiltransferasas/genética , Metiltransferasas/metabolismo , Transportadores de Ácidos Monocarboxílicos/genética , Transportadores de Ácidos Monocarboxílicos/metabolismo , Proteínas Musculares/genética , Proteínas Musculares/metabolismo , Células Supresoras de Origen Mieloide/fisiología , Sitios de Empalme de ARN , Empalme del ARN , Simportadores/genética , Simportadores/metabolismo , Transcriptoma , Microambiente Tumoral , Factor A de Crecimiento Endotelial Vascular/genética , Factor A de Crecimiento Endotelial Vascular/metabolismo
2.
Proc Natl Acad Sci U S A ; 114(31): 8241-8246, 2017 08 01.
Artículo en Inglés | MEDLINE | ID: mdl-28716944

RESUMEN

Human ribonucleotide reductase (hRR) is crucial for DNA replication and maintenance of a balanced dNTP pool, and is an established cancer target. Nucleoside analogs such as gemcitabine diphosphate and clofarabine nucleotides target the large subunit (hRRM1) of hRR. These drugs have a poor therapeutic index due to toxicity caused by additional effects, including DNA chain termination. The discovery of nonnucleoside, reversible, small-molecule inhibitors with greater specificity against hRRM1 is a key step in the development of more effective treatments for cancer. Here, we report the identification and characterization of a unique nonnucleoside small-molecule hRR inhibitor, naphthyl salicylic acyl hydrazone (NSAH), using virtual screening, binding affinity, inhibition, and cell toxicity assays. NSAH binds to hRRM1 with an apparent dissociation constant of 37 µM, and steady-state kinetics reveal a competitive mode of inhibition. A 2.66-Å resolution crystal structure of NSAH in complex with hRRM1 demonstrates that NSAH functions by binding at the catalytic site (C-site) where it makes both common and unique contacts with the enzyme compared with NDP substrates. Importantly, the IC50 for NSAH is within twofold of gemcitabine for growth inhibition of multiple cancer cell lines, while demonstrating little cytotoxicity against normal mobilized peripheral blood progenitor cells. NSAH depresses dGTP and dATP levels in the dNTP pool causing S-phase arrest, providing evidence for RR inhibition in cells. This report of a nonnucleoside reversible inhibitor binding at the catalytic site of hRRM1 provides a starting point for the design of a unique class of hRR inhibitors.


Asunto(s)
Hidrazonas/farmacología , Naftalenos/farmacología , Ribonucleótido Reductasas/antagonistas & inhibidores , Salicilatos/farmacología , Dominio Catalítico , Ciclo Celular/efectos de los fármacos , Cristalografía por Rayos X , Nucleótidos de Desoxiadenina/metabolismo , Ensayos de Selección de Medicamentos Antitumorales/métodos , Humanos , Hidrazonas/química , Naftalenos/química , Ribonucleósido Difosfato Reductasa , Ribonucleótido Reductasas/química , Ribonucleótido Reductasas/metabolismo , Salicilatos/química , Proteínas Supresoras de Tumor/antagonistas & inhibidores , Proteínas Supresoras de Tumor/química , Proteínas Supresoras de Tumor/metabolismo
3.
Cultur Divers Ethnic Minor Psychol ; 26(2): 149-162, 2020 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-31045396

RESUMEN

OBJECTIVE: Across a correlational cross-sectional and experimental study, we investigate how contextual variables, such as majority group perceptions, interact with individual variables, such as the relationship between ethnic and national identity, to ultimately influence intergroup relations between bicultural individuals and White Americans. METHOD: Across 2 studies (Study 1, n = 187; Study 2, n = 176), bicultural participants completed a battery of surveys measuring bicultural identity integration, impressions of majority group attitudes, and behavioral intentions targeted at majority group members. Additionally, majority group attitudes were experimentally manipulated in Study 2. RESULTS: Individuals with integrated bicultural identities were more likely to approach and less likely to avoid majority members. Although perceptions of negative majority group attitudes are typically associated with negative intergroup relations, individuals with greater harmony (Study 1) and blendedness (Study 2) between their ethnic and national identities were buffered from these adverse effects. CONCLUSIONS: These findings highlight the importance of both individual and contextual factors in intergroup relations. The distinct effects of blendedness and harmony across self-report and experimental studies have theoretical and practical implications for our understanding of bicultural identity integration. Finally, implications for encouraging more positive intercultural relationships between majority and minority group members will be discussed. (PsycInfo Database Record (c) 2020 APA, all rights reserved).


Asunto(s)
Grupos Minoritarios/psicología , Identificación Social , Estudiantes/psicología , Población Blanca/psicología , Adulto , Estudios Transversales , Etnicidad , Femenino , Humanos , Masculino , Grupos Minoritarios/estadística & datos numéricos , Estudiantes/estadística & datos numéricos , Encuestas y Cuestionarios , Población Blanca/estadística & datos numéricos , Adulto Joven
4.
Psychol Sci ; 25(6): 1169-77, 2014 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-24747168

RESUMEN

Prior research suggests that cultural groups vary on an overarching dimension of independent versus interdependent social orientation, with European Americans being more independent, or less interdependent, than Asians. Drawing on recent evidence suggesting that the dopamine D4 receptor gene (DRD4) plays a role in modulating cultural learning, we predicted that carriers of DRD4 polymorphisms linked to increased dopamine signaling (7- or 2-repeat alleles) would show higher levels of culturally dominant social orientations, compared with noncarriers. European Americans and Asian-born Asians (total N = 398) reported their social orientation on multiple scales. They were also genotyped for DRD4. As in earlier work, European Americans were more independent, and Asian-born Asians more interdependent. This cultural difference was significantly more pronounced for carriers of the 7- or 2-repeat alleles than for noncarriers. Indeed, no cultural difference was apparent among the noncarriers. Implications for potential coevolution of genes and culture are discussed.


Asunto(s)
Pueblo Asiatico/genética , Pueblo Asiatico/psicología , Cognición/fisiología , Receptores de Dopamina D4/genética , Conducta Social , Población Blanca/genética , Población Blanca/psicología , Alelos , Evolución Cultural , Femenino , Genotipo , Humanos , Masculino , Repeticiones de Minisatélite , Polimorfismo Genético , Encuestas y Cuestionarios , Adulto Joven
5.
Cancer Res Commun ; 3(1): 119-129, 2023 01.
Artículo en Inglés | MEDLINE | ID: mdl-36968224

RESUMEN

Although immune checkpoint inhibitors targeting T-cell immunoregulatory proteins have revolutionized cancer treatment, they are effective only in a limited number of patients, and new strategies are needed to enhance tumor responses to immunotherapies. Deletion of protein tyrosine phosphatase non-receptor type 2 (Ptpn2), a regulator of growth factor and cytokine signaling pathways, has been shown to sensitize murine B16F10 melanoma cells to IFNγ and anti-PD-1 immunotherapy. Here, we investigated the potential therapeutic utility of small-molecule PTPN2 inhibitors. Ten inhibitors were synthesized on the basis of in silico modeling and structure-based design and functionally tested in vitro and in vivo. We show that the inhibitors had little effect on B16F10 cells alone, but effectively sensitized the tumor cells to IFNγ treatment in vitro and to anti-PD-1 therapy in vivo. Under both conditions, Ptpn2 inhibitor cotreatment suppressed B16F10 cell growth and enhanced Stat1 phosphorylation and expression of IFNγ response genes. In vivo, PTPN2 inhibitor cotreatment significantly reduced melanoma and colorectal tumor growth and enhanced mouse survival compared with anti-PD-1 treatment alone, and this was accompanied by increased tumor infiltration by granzyme B+ CD8+ T cells. Similar results were obtained with representative murine and human colon cancer and lung cancer cell lines. Collectively, these results demonstrate that small-molecule inhibitors of PTPN2 may have clinical utility as sensitizing agents for immunotherapy-resistant cancers. Significance: To enhance the effectiveness of immunotherapies in resistant or nonresponsive cancers, it is important to develop inhibitors of enzymes that negatively influence the outcome of treatments. We have designed and evaluated small-molecule inhibitors of PTPN2 demonstrating that these compounds may have clinical utility as sensitizing agents for immunotherapy-resistant cancers.


Asunto(s)
Linfocitos T CD8-positivos , Melanoma , Humanos , Ratones , Animales , Linfocitos T CD8-positivos/metabolismo , Proteína Tirosina Fosfatasa no Receptora Tipo 2/genética , Melanoma/tratamiento farmacológico , Interferón gamma , Inmunoterapia/métodos
6.
Biomolecules ; 12(6)2022 06 10.
Artículo en Inglés | MEDLINE | ID: mdl-35740940

RESUMEN

Ribonucleotide reductase (RR) is an essential multi-subunit enzyme found in all living organisms; it catalyzes the rate-limiting step in dNTP synthesis, namely, the conversion of ribonucleoside diphosphates to deoxyribonucleoside diphosphates. As expression levels of human RR (hRR) are high during cell replication, hRR has long been considered an attractive drug target for a range of proliferative diseases, including cancer. While there are many excellent reviews regarding the structure, function, and clinical importance of hRR, recent years have seen an increase in novel approaches to inhibiting hRR that merit an updated discussion of the existing inhibitors and strategies to target this enzyme. In this review, we discuss the mechanisms and clinical applications of classic nucleoside analog inhibitors of hRRM1 (large catalytic subunit), including gemcitabine and clofarabine, as well as inhibitors of the hRRM2 (free radical housing small subunit), including triapine and hydroxyurea. Additionally, we discuss novel approaches to targeting RR and the discovery of new classes of hRR inhibitors.


Asunto(s)
Neoplasias , Ribonucleótido Reductasas , Dominio Catalítico , Difosfatos , Inhibidores Enzimáticos/farmacología , Inhibidores Enzimáticos/uso terapéutico , Humanos , Neoplasias/tratamiento farmacológico , Ribonucleótido Reductasas/metabolismo
7.
J Med Chem ; 65(16): 10920-10937, 2022 08 25.
Artículo en Inglés | MEDLINE | ID: mdl-35939803

RESUMEN

Aberrant regulation of N6-methyladenosine (m6A) RNA modification has been implicated in the progression of multiple diseases, including cancer. Previously, we identified a small molecule inhibitor of the m6A demethylase fat mass- and obesity-associated protein (FTO), which removes both m6A and N6,2'-O-dimethyladenosine (m6Am) RNA modifications. In this work, we describe the rational design and optimization of a new class of FTO inhibitors derived from our previous lead FTO-04 with nanomolar potency and high selectivity against the homologous m6A RNA demethylase ALKBH5. The oxetanyl class of compounds comprise competitive inhibitors of FTO with potent antiproliferative effects in glioblastoma, acute myeloid leukemia, and gastric cancer models where lead FTO-43 demonstrated potency comparable to clinical chemotherapeutic 5-fluorouracil. Furthermore, FTO-43 increased m6A and m6Am levels in a manner comparable to FTO knockdown in gastric cancer cells and regulated Wnt/PI3K-Akt signaling pathways. The oxetanyl class contains significantly improved anticancer agents with a variety of applications beyond glioblastoma.


Asunto(s)
Antineoplásicos , Glioblastoma , Neoplasias Gástricas , Adenosina/metabolismo , Adenosina/farmacología , Dioxigenasa FTO Dependiente de Alfa-Cetoglutarato/genética , Dioxigenasa FTO Dependiente de Alfa-Cetoglutarato/metabolismo , Antineoplásicos/farmacología , Glioblastoma/tratamiento farmacológico , Humanos , Fosfatidilinositol 3-Quinasas , ARN , ARN Mensajero/metabolismo , Neoplasias Gástricas/tratamiento farmacológico
8.
J Med Chem ; 65(4): 2866-2879, 2022 02 24.
Artículo en Inglés | MEDLINE | ID: mdl-34570513

RESUMEN

The emergence of a new coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), presents an urgent public health crisis. Without available targeted therapies, treatment options remain limited for COVID-19 patients. Using medicinal chemistry and rational drug design strategies, we identify a 2-phenyl-1,2-benzoselenazol-3-one class of compounds targeting the SARS-CoV-2 main protease (Mpro). FRET-based screening against recombinant SARS-CoV-2 Mpro identified six compounds that inhibit proteolysis with nanomolar IC50 values. Preincubation dilution experiments and molecular docking determined that the inhibition of SARS-CoV-2 Mpro can occur by either covalent or noncovalent mechanisms, and lead E04 was determined to inhibit Mpro competitively. Lead E24 inhibited viral replication with a nanomolar EC50 value (844 nM) in SARS-CoV-2-infected Vero E6 cells and was further confirmed to impair SARS-CoV-2 replication in human lung epithelial cells and human-induced pluripotent stem cell-derived 3D lung organoids. Altogether, these studies provide a structural framework and mechanism of Mpro inhibition that should facilitate the design of future COVID-19 treatments.


Asunto(s)
Antivirales/farmacología , Benzotiazoles/farmacología , Proteasas 3C de Coronavirus/antagonistas & inhibidores , Inhibidores de Cisteína Proteinasa/farmacología , Descubrimiento de Drogas , SARS-CoV-2/efectos de los fármacos , Animales , Antivirales/síntesis química , Antivirales/química , Benzotiazoles/química , COVID-19/metabolismo , Chlorocebus aethiops , Proteasas 3C de Coronavirus/aislamiento & purificación , Proteasas 3C de Coronavirus/metabolismo , Cristalografía por Rayos X , Inhibidores de Cisteína Proteinasa/síntesis química , Inhibidores de Cisteína Proteinasa/química , Relación Dosis-Respuesta a Droga , Transferencia Resonante de Energía de Fluorescencia , Humanos , Pruebas de Sensibilidad Microbiana , Simulación del Acoplamiento Molecular , Estructura Molecular , SARS-CoV-2/enzimología , Células Vero , Replicación Viral/efectos de los fármacos , Tratamiento Farmacológico de COVID-19
9.
ACS Chem Biol ; 16(2): 324-333, 2021 02 19.
Artículo en Inglés | MEDLINE | ID: mdl-33412003

RESUMEN

N6-methyladenosine (m6A) has emerged as the most abundant mRNA modification that regulates gene expression in many physiological processes. m6A modification in RNA controls cellular proliferation and pluripotency and has been implicated in the progression of multiple disease states, including cancer. RNA m6A methylation is controlled by a multiprotein "writer" complex including the enzymatic factor methyltransferase-like protein 3 (METTL3) that regulates methylation and two "eraser" proteins, RNA demethylase ALKBH5 (ALKBH5) and fat mass- and obesity-associated protein (FTO), that demethylate m6A in transcripts. FTO can also demethylate N6,2'-O-dimethyladenosine (m6Am), which is found adjacent to the m7G cap structure in mRNA. FTO has recently gained interest as a potential cancer target, and small molecule FTO inhibitors such as meclofenamic acid have been shown to prevent tumor progression in both acute myeloid leukemia and glioblastoma in vivo models. However, current FTO inhibitors are unsuitable for clinical applications due to either poor target selectivity or poor pharmacokinetics. In this work, we describe the structure-based design, synthesis, and biochemical evaluation of a new class of FTO inhibitors. Rational design of 20 small molecules with low micromolar IC50's and specificity toward FTO over ALKBH5 identified two competitive inhibitors FTO-02 and FTO-04. Importantly, FTO-04 prevented neurosphere formation in patient-derived glioblastoma stem cells (GSCs) without inhibiting the growth of healthy neural stem cell-derived neurospheres. Finally, FTO-04 increased m6A and m6Am levels in GSCs consistent with FTO inhibition. These results support FTO-04 as a potential new lead for treatment of glioblastoma.


Asunto(s)
Dioxigenasa FTO Dependiente de Alfa-Cetoglutarato/antagonistas & inhibidores , Antineoplásicos/farmacología , Inhibidores Enzimáticos/farmacología , Pirimidinas/farmacología , Adenosina/análogos & derivados , Adenosina/química , Dioxigenasa FTO Dependiente de Alfa-Cetoglutarato/química , Dioxigenasa FTO Dependiente de Alfa-Cetoglutarato/metabolismo , Antineoplásicos/síntesis química , Antineoplásicos/metabolismo , Sitios de Unión , Desmetilación/efectos de los fármacos , Diseño de Fármacos , Inhibidores Enzimáticos/síntesis química , Inhibidores Enzimáticos/metabolismo , Humanos , Simulación del Acoplamiento Molecular , Células Madre Neoplásicas , Unión Proteica , Pirimidinas/síntesis química , Pirimidinas/metabolismo , ARN/química , ARN/metabolismo
10.
mBio ; 10(1)2019 02 26.
Artículo en Inglés | MEDLINE | ID: mdl-30808702

RESUMEN

The HIV-1 accessory protein Vif, which counteracts the antiviral action of the DNA-editing cytidine deaminase APOBEC3G (A3G), is an attractive and yet unexploited therapeutic target. Vif reduces the virion incorporation of A3G by targeting the restriction factor for proteasomal degradation in the virus-producing cell. Compounds that inhibit Vif-mediated degradation of A3G in cells targeted by HIV-1 would represent a novel antiviral therapeutic. We previously described small molecules with activity consistent with Vif antagonism. In this study, we derived inhibitor escape HIV-1 variants to characterize the mechanism by which these novel agents inhibit virus replication. Here we show that resistance to these agents is dependent on an amino acid substitution in Vif (V142I) and on a point mutation that likely upregulates transcription by modifying the lymphocyte enhancing factor 1 (LEF-1) binding site. Molecular modeling demonstrated a docking site in the Vif-Elongin C complex that is disrupted by these inhibitors. This docking site is lost when Vif acquires the V142I mutation that leads to inhibitor resistance. Competitive fitness experiments indicated that the V142I Vif and LEF-1 binding site mutations created a virus that is better adapted to growing in the presence of A3G than the wild-type virus.IMPORTANCE Although antiretroviral therapy can suppress HIV-1 replication effectively, virus reservoirs persist in infected individuals and virus replication rapidly rebounds if therapy is interrupted. Currently, there is a need for therapeutic approaches that eliminate, reduce, or control persistent viral reservoirs if a cure is to be realized. This work focuses on the preclinical development of novel, small-molecule inhibitors of the HIV-1 Vif protein. Vif inhibitors represent a new class of antiretroviral drugs that may expand treatment options to more effectively suppress virus replication or to drive HIV-1 reservoirs to a nonfunctional state by harnessing the activity of the DNA-editing cytidine deaminase A3G, a potent, intrinsic restriction factor expressed in macrophage and CD4+ T cells. In this study, we derived inhibitor escape variants to characterize the mechanism by which these novel agents inhibit virus replication and to provide evidence for target validation.


Asunto(s)
Antivirales/farmacología , Farmacorresistencia Viral , VIH-1/efectos de los fármacos , Mutación Missense , Replicación Viral/efectos de los fármacos , Productos del Gen vif del Virus de la Inmunodeficiencia Humana/antagonistas & inhibidores , Desaminasa APOBEC-3G/metabolismo , Sustitución de Aminoácidos , Sitios de Unión , Línea Celular , VIH-1/genética , Humanos , Factor de Unión 1 al Potenciador Linfoide/metabolismo , Simulación del Acoplamiento Molecular , Mutación Puntual , Productos del Gen vif del Virus de la Inmunodeficiencia Humana/química , Productos del Gen vif del Virus de la Inmunodeficiencia Humana/genética
11.
J Med Chem ; 61(3): 666-680, 2018 02 08.
Artículo en Inglés | MEDLINE | ID: mdl-29253340

RESUMEN

Ribonucleotide reductase (RR), an established cancer target, is usually inhibited by antimetabolites, which display multiple cross-reactive effects. Recently, we discovered a naphthyl salicyl acyl hydrazone-based inhibitor (NSAH or E-3a) of human RR (hRR) binding at the catalytic site (C-site) and inhibiting hRR reversibly. We herein report the synthesis and biochemical characterization of 25 distinct analogs. We designed each analog through docking to the C-site of hRR based on our 2.7 Å X-ray crystal structure (PDB ID: 5TUS). Broad tolerance to minor structural variations preserving inhibitory potency is observed. E-3f (82% yield) displayed an in vitro IC50 of 5.3 ± 1.8 µM against hRR, making it the most potent in this series. Kinetic assays reveal that E-3a, E-3c, E-3t, and E-3w bind and inhibit hRR through a reversible and competitive mode. Target selectivity toward the R1 subunit of hRR is established, providing a novel way of inhibition of this crucial enzyme.


Asunto(s)
Inhibidores Enzimáticos/síntesis química , Inhibidores Enzimáticos/farmacología , Hidrazonas/síntesis química , Hidrazonas/farmacología , Ribonucleótido Reductasas/antagonistas & inhibidores , Técnicas de Química Sintética , Inhibidores Enzimáticos/química , Inhibidores Enzimáticos/metabolismo , Humanos , Hidrazonas/química , Simulación del Acoplamiento Molecular , Conformación Proteica , Ribonucleótido Reductasas/química , Ribonucleótido Reductasas/metabolismo , Relación Estructura-Actividad
12.
J Med Chem ; 58(24): 9498-509, 2015 Dec 24.
Artículo en Inglés | MEDLINE | ID: mdl-26488902

RESUMEN

Ribonucleotide reductase (RR) catalyzes the rate-limiting step of dNTP synthesis and is an established cancer target. Drugs targeting RR are mainly nucleoside in nature. In this study, we sought to identify non-nucleoside small-molecule inhibitors of RR. Using virtual screening, binding affinity, inhibition, and cell toxicity, we have discovered a class of small molecules that alter the equilibrium of inactive hexamers of RR, leading to its inhibition. Several unique chemical categories, including a phthalimide derivative, show micromolar IC50s and KDs while demonstrating cytotoxicity. A crystal structure of an active phthalimide binding at the targeted interface supports the noncompetitive mode of inhibition determined by kinetic studies. Furthermore, the phthalimide shifts the equilibrium from dimer to hexamer. Together, these data identify several novel non-nucleoside inhibitors of human RR which act by stabilizing the inactive form of the enzyme.


Asunto(s)
Antineoplásicos/química , Ribonucleótido Reductasas/antagonistas & inhibidores , Proteínas Supresoras de Tumor/antagonistas & inhibidores , Antineoplásicos/farmacología , Línea Celular Tumoral , Proliferación Celular/efectos de los fármacos , Simulación por Computador , Cristalografía por Rayos X , Bases de Datos de Compuestos Químicos , Ensayos de Selección de Medicamentos Antitumorales , Humanos , Simulación del Acoplamiento Molecular , Ftalimidas/química , Ftalimidas/farmacología , Unión Proteica , Conformación Proteica , Multimerización de Proteína , Ribonucleósido Difosfato Reductasa , Ribonucleótido Reductasas/química , Relación Estructura-Actividad , Proteínas Supresoras de Tumor/química
13.
Appl Immunohistochem Mol Morphol ; 21(1): 21-30, 2013 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-22820657

RESUMEN

The anatomic pathology discipline is slowly moving toward a digital workflow, where pathologists will evaluate whole-slide images on a computer monitor rather than glass slides through a microscope. One of the driving factors in this workflow is computer-assisted scoring, which depends on appropriate selection of regions of interest. With advances in tissue pattern recognition techniques, a more precise region of the tissue can be evaluated, no longer bound by the pathologist's patience in manually outlining target tissue areas. Pathologists use entire tissues from which to determine a score in a region of interest when making manual immunohistochemistry assessments. Tissue pattern recognition theoretically offers this same advantage; however, error rates exist in any tissue pattern recognition program, and these error rates contribute to errors in the overall score. To provide a real-world example of tissue pattern recognition, 11 HER2-stained upper gastrointestinal malignancies with high heterogeneity were evaluated. HER2 scoring of gastric cancer was chosen due to its increasing importance in gastrointestinal disease. A method is introduced for quantifying the error rates of tissue pattern recognition. The trade-off between fully sampling tumor with a given tissue pattern recognition error rate versus randomly sampling a limited number of fields of view with higher target accuracy was modeled with a Monte-Carlo simulation. Under most scenarios, stereological methods of sampling-limited fields of view outperformed whole-slide tissue pattern recognition approaches for accurate immunohistochemistry analysis. The importance of educating pathologists in the use of statistical sampling is discussed, along with the emerging role of hybrid whole-tissue imaging and stereological approaches.


Asunto(s)
Adenocarcinoma/patología , Inmunohistoquímica/métodos , Receptor ErbB-2/metabolismo , Neoplasias Gástricas/patología , Adenocarcinoma/metabolismo , Simulación por Computador , Diagnóstico por Computador , Errores Diagnósticos , Humanos , Imagenología Tridimensional/métodos , Microscopía , Método de Montecarlo , Receptor ErbB-2/inmunología , Neoplasias Gástricas/metabolismo , Flujo de Trabajo
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