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1.
Pathology ; 56(3): 343-356, 2024 Apr.
Article in English | MEDLINE | ID: mdl-38184384

ABSTRACT

Accurate characterisation of gastrointestinal stromal tumours (GIST) is important for prognosis and the choice of targeted therapies. Histologically the diagnosis relies on positive immunostaining of tumours for KIT (CD117) and DOG1. Here we report that GISTs also abundantly express the type 3 Sarco/Endoplasmic Reticulum Calcium ATPase (SERCA3). SERCA enzymes transport calcium ions from the cytosol into the endoplasmic reticulum and play an important role in regulating the intensity and the periodicity of calcium-induced cell activation. GISTs from various localisations, histological and molecular subtypes or risk categories were intensely immunopositive for SERCA3 with the exception of PDGFRA-mutated cases where expression was high or moderate. Strong SERCA3 expression was observed also in normal and hyperplastic interstitial cells of Cajal. Decreased SERCA3 expression in GIST was exceptionally observed in a zonal pattern, where CD117 staining was similarly decreased, reflecting clonal heterogeneity. In contrast to GIST, SERCA3 immunostaining of spindle cell tumours and other gastrointestinal tumours resembling GIST was negative or weak. In conclusion, SERCA3 immunohistochemistry may be useful for the diagnosis of GIST with high confidence, when used as a third marker in parallel with KIT and DOG1. Moreover, SERCA3 immunopositivity may be particularly helpful in cases with negative or weak KIT or DOG1 staining, a situation that may be encountered de novo, or during the spontaneous or therapy-induced clonal evolution of GIST.


Subject(s)
Gastrointestinal Stromal Tumors , Humans , Gastrointestinal Stromal Tumors/diagnosis , Gastrointestinal Stromal Tumors/genetics , Sarcoplasmic Reticulum Calcium-Transporting ATPases/genetics , Sarcoplasmic Reticulum Calcium-Transporting ATPases/metabolism , Calcium , Endoplasmic Reticulum/metabolism , Immunohistochemistry , Proto-Oncogene Proteins c-kit/metabolism
2.
Semin Musculoskelet Radiol ; 27(4): 421-431, 2023 Aug.
Article in English | MEDLINE | ID: mdl-37748465

ABSTRACT

The periosteum is a membrane that covers almost all bones in the body. It is a living structure but attracts little attention unless it reacts excessively. We highlight the important points in the anatomy, histology, and physiology of the periosteum, the stimuli and various aspects of periosteal reaction, and the main conditions underlying periosteal reaction.


Subject(s)
Diagnostic Imaging , Periosteum , Humans , Periosteum/anatomy & histology , Periosteum/physiology
3.
Dig Liver Dis ; 55(8): 1105-1113, 2023 08.
Article in English | MEDLINE | ID: mdl-37142454

ABSTRACT

BACKGROUND: Microsatellite instability (MSI) is a negative predictive factor for neoadjuvant chemotherapy in resectable oesogastric adenocarcinoma and a crucial determinant for immunotherapy. We aimed to evaluate reliability of dMMR/MSI status screening performed on preoperative endoscopic biopsies. METHODS: Paired pathological samples from biopsies and surgical specimen of oesogastric adenocarcinoma were retrospectively collected between 2009 and 2019. We compared dMMR status obtained by immunohistochemistry (IHC) and MSI status by PCR. dMMR/MSI status on surgical specimen was considered as reference. RESULTS: PCR and IHC were conclusive on biopsies respectively for 53 (96.4%) and 47 (85.5%) of the 55 patients enrolled. IHC was not contributive for 1 surgical specimen. A third reading of IHC was carried out for 3 biopsies. MSI status was observed in 7 (12.5%) surgical specimens. When analyses were contributive, sensitivity and specificity of biopsies for dMMR/MSI were respectively 85% and 98% for PCR vs. 86% and 98% for IHC. Concordance rate between biopsies and surgical specimen was 96.2% for PCR and 97.8% for IHC. CONCLUSIONS: Endoscopic biopsies are a suitable source of tissue for dMMR/MSI status determination in oesogastric adenocarcinoma which should be routinely performed at diagnosis to better adapt neoadjuvant treatment. MINIABSTRACT: By comparison of dMMR phenotype obtained by immunohistochemistry and MSI status by PCR between match-paired samples of oesogastric cancer's endoscopic biopsies and surgical specimen, we observed that biopsies are a suitable source of tissue for dMMR/MSI status determination.


Subject(s)
Adenocarcinoma , Colorectal Neoplasms , Stomach Neoplasms , Humans , Microsatellite Instability , Retrospective Studies , Reproducibility of Results , Adenocarcinoma/genetics , Adenocarcinoma/pathology , Colorectal Neoplasms/pathology , Stomach Neoplasms/genetics , Biopsy , Esophagus/pathology , DNA Mismatch Repair
4.
Laryngoscope ; 132(10): 1904-1908, 2022 10.
Article in English | MEDLINE | ID: mdl-35366007

ABSTRACT

Branchial cyst of the second pouch is the most common lesion of the nasopharyngeal lateral wall, generally localized between the pharyngeal wall and internal carotid artery. Cases consistent with such lesion, were collected. Symptomatic patients were treated with endoscopic trans-nasal marsupialisation, asymptomatic cases were followed-up. Among the 10 patients included, 4 were symptomatic and accordingly treated. In the literature, 36 cases were found, all of which were treated, most commonly with a total excision. Considering the benign nature of branchial nasopharyngeal cyst, its treatment should be tailored to each patient: endoscopic marsupialization in symptomatic lesion, follow-up in asymptomatic one. Laryngoscope, 132:1904-1908, 2022.


Subject(s)
Branchioma , Head and Neck Neoplasms , Branchial Region/surgery , Branchioma/surgery , Endoscopy , Head and Neck Neoplasms/surgery , Humans , Nasopharynx/pathology , Nasopharynx/surgery
5.
Cancers (Basel) ; 13(18)2021 Sep 15.
Article in English | MEDLINE | ID: mdl-34572851

ABSTRACT

The role of the proangiogenic factor olfactomedin-like 3 (OLFML3) in cancer is unclear. To characterize OLFML3 expression in human cancer and its role during tumor development, we undertook tissue expression studies, gene expression analyses of patient tumor samples, in vivo studies in mouse cancer models, and in vitro coculture experiments. OLFML3 was expressed at high levels, mainly in blood vessels, in multiple human cancers. We focused on colorectal cancer (CRC), as elevated expression of OLFML3 mRNA correlated with shorter relapse-free survival, higher tumor grade, and angiogenic microsatellite stable consensus molecular subtype 4 (CMS4). Treatment of multiple in vivo tumor models with OLFML3-blocking antibodies and deletion of the Olfml3 gene from mice decreased lymphangiogenesis, pericyte coverage, and tumor growth. Antibody-mediated blockade of OLFML3 and deletion of host Olfml3 decreased the recruitment of tumor-promoting tumor-associated macrophages and increased infiltration of the tumor microenvironment by NKT cells. Importantly, targeting OLFML3 increased the antitumor efficacy of anti-PD-1 checkpoint inhibitor therapy. Taken together, the results demonstrate that OLFML3 is a promising candidate therapeutic target for CRC.

6.
Clin Res Hepatol Gastroenterol ; 45(4): 101691, 2021 Jul.
Article in English | MEDLINE | ID: mdl-33852952

ABSTRACT

BACKGROUND: The prevalence and prognosis association of microsatellite instability (MSI) in oesogastric junction and gastric adenocarcinoma (OGC) have been reported with conflicting results. METHODS: Patients with OGC from 2010 to 2015 were enrolled in this retrospective multicenter study. MSI was determined by genotyping. MLH1 promoter methylation and BRAFV600E mutation were screened in the MSI tumors. RESULTS: Among 315 tumors analyzed, 39 (12.4%) were of the MSI phenotype. Compared to MSS tumors, MSI tumors were more frequent in patients >70 years (17% vs 9%, p=0.048) and in gastric antral primary (20% versus 5% in junction tumor and 12% in fundus tumor. Among 29 MSI tumors analyzed, 28 had a loss of MLH1 protein expression and 27 had MLH1 promotor hypermethylation. None had a BRAF V600E mutation. The 4-year cumulative incidence of recurrence for patients with resected tumor was significantly lower in dMMR tumors versus pMMR tumors (17% versus 47%, p=0.01). For the patients with unresectable tumor the median overall survival was 11 months in MSS group and 14 months in MSI group (p=0.24). CONCLUSION: MSI prevalence in OGC was 12.4%, associated with antral localization and advanced age. Patients with MSI tumors had a lower cumulative incidence of recurrence after surgery. MSI phenotype was mainly associated with loss of MLH1 protein expression, MLH1 promotor hypermethylation and had no BRAFV600E mutation.


Subject(s)
Adenocarcinoma , Microsatellite Instability , Stomach Neoplasms , Adenocarcinoma/genetics , Humans , MutL Protein Homolog 1/genetics , Prevalence , Prognosis , Retrospective Studies , Stomach Neoplasms/genetics
7.
Ultrasound Med Biol ; 47(3): 759-768, 2021 03.
Article in English | MEDLINE | ID: mdl-33358050

ABSTRACT

The goal of the work described here was to assess the performance of Doppler ultrasound (US) of the superior mesenteric artery (SMA) and celiac trunk (CT) in the evaluation of tumor response in female mice with ovarian peritoneal carcinomatosis treated either with bevacizumab or with carboplatin. Compared with untreated mice, carboplatin-treated mice had a lower weight (23.3 ± 2.0 vs. 27.9 ± 2.9 g, p < 0.001), peritoneal carcinomatosis index (PCI, 11 ± 3 vs. 28 ± 6, p < 0.001), Ki67-positive staining surfaces (p < 0.001), vascular density (p < 0.001), mean blood flow velocity (mBFVel) in the SMA (7.0 ± 1.4 vs. 10.9 ± 1.8 cm/s, p < 0.001) and CT (8.0 ± 1.8 vs. 14.3 ± 4.6 cm/s, p < 0.001) and no ascites. Weight and mBFVel were similar in bevacizumab-treated and untreated mice. The mBFVels in the SMA and CT correlated with the PCI used as an estimation of the tumor burden, R = 0.70 (p < 0.0001) and R = 0.65 (p < 0.0001), respectively. Doppler US allows non-invasive assessment of the effects of anticancer therapy in ovarian peritoneal carcinomatosis-induced mice.


Subject(s)
Antineoplastic Agents/therapeutic use , Bevacizumab/therapeutic use , Carboplatin/therapeutic use , Celiac Artery/diagnostic imaging , Mesenteric Artery, Superior/diagnostic imaging , Ovarian Neoplasms/blood supply , Ovarian Neoplasms/drug therapy , Peritoneal Neoplasms/blood supply , Peritoneal Neoplasms/drug therapy , Ultrasonography, Doppler , Animals , Female , Mice , Mice, Inbred C57BL , Treatment Outcome , Tumor Cells, Cultured
8.
Eur Arch Otorhinolaryngol ; 278(4): 1271-1276, 2021 Apr.
Article in English | MEDLINE | ID: mdl-32661717

ABSTRACT

PURPOSE: To describe and analyse functional treatment of temporal bone chondroblastoma (TBCh). METHODS: From January 2000 to June 2019, at the Department of Otorhinolaryngology, Hôpital Lariboisière, Paris, France, patients with TBCh were enrolled in this study. All cases routinely performed pre-operatory work-up including evaluation of performance status, audio-vestibular function test, ear endoscopy, contrasted CT scan and MRI of head and neck region; in one case we also performed an angio-CT scan. All patients underwent resection of the tumour with a "functional" approach RESULTS: Three male patients (mean age 46,6 years)-two primary tumours and one recurrence-were treated. In all three cases the tumour invaded the middle ear with a variable degree of hearing loss and infiltration of temporal bone structures. All surgeries were performed with a microscopic approach associated with open/endoscopic approach when necessary. Inner ear and facial nerve were speared in all cases and the TMJ was partially resected in 2 cases due to its moderate involvement. At present, after a mean follow-up of 103 months (range 40-225 months), only one case presented recurrence which has been successfully treated with radiotherapy. CONCLUSIONS: Our results of treatment suggest that functional surgery can be relevant in the management of TBCh since it is focused on both treatment of this pathology and maintenance of a good quality of life.


Subject(s)
Bone Neoplasms , Chondroblastoma , Chondroblastoma/diagnostic imaging , Chondroblastoma/surgery , France , Humans , Male , Middle Aged , Neoplasm Recurrence, Local , Paris , Quality of Life , Retrospective Studies , Temporal Bone/diagnostic imaging , Temporal Bone/surgery
9.
Surg Oncol ; 33: 158-163, 2020 Jun.
Article in English | MEDLINE | ID: mdl-32561082

ABSTRACT

BACKGROUND: This study evaluated the histologic response after preoperative systemic therapy (pST) using the Peritoneal Regression Grading Score (PRGS) and tumor regression grade (TRG) classifications for patients with peritoneal metastases (PM) from colorectal cancer (CRC). METHODS: Twenty-three patients were selected from a prospective database of 196 patients who underwent CRS followed by HIPEC for synchronous PM from CRC. In all study patients, biopsies of the PM obtained before pST (during the first laparoscopy) and after pST (during cytoreductive surgery) were compared. RESULTS: Complete (PRGS 1), Major (PRGS 2), Minor (PRGS 3) and no histological responses (PRGS 4) were obtained in 17,5%, 52% and 13% and 17,5% of patients, respectively. Major (TRG 1-2), partial (TRG3), and no (TRG4-5) histological tumor regression were observed in 61%, 9% and 30% of patients, respectively. Regardless of the classification applied, median OS was significantly higher in patients with a "complete or major" response than in those with a "minor/partial or no" response (54 vs. 26 months, p < 0.05). CONCLUSIONS: The PRGS and TRG can be used in clinical practice to evaluate the histological response after pST. This study demonstrated that a complete histologic response of PM from CRC can be obtained after pST.


Subject(s)
Adenocarcinoma, Mucinous/drug therapy , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Colorectal Neoplasms/drug therapy , Cytoreduction Surgical Procedures , Hyperthermic Intraperitoneal Chemotherapy , Neoadjuvant Therapy , Peritoneal Neoplasms/drug therapy , Adenocarcinoma/drug therapy , Adenocarcinoma/secondary , Adenocarcinoma, Mucinous/secondary , Antineoplastic Agents, Immunological/administration & dosage , Bevacizumab/administration & dosage , Camptothecin/analogs & derivatives , Camptothecin/therapeutic use , Cetuximab/administration & dosage , Colorectal Neoplasms/pathology , Disease-Free Survival , Female , Fluorouracil/therapeutic use , Humans , Leucovorin/therapeutic use , Male , Organoplatinum Compounds/therapeutic use , Peritoneal Neoplasms/secondary , Proportional Hazards Models
10.
BMC Cancer ; 20(1): 565, 2020 Jun 17.
Article in English | MEDLINE | ID: mdl-32552705

ABSTRACT

BACKGROUND: It may be impossible to perform cancer surgery with free margins in the presence of an unresectable structure. Local drug treatment after surgery has been proposed to increase the rate of tumor control. METHODS: Multi-nanolayers (10-330 nm) were generated by a low-pressure (375mTorr) inductively coupled plasma (13.56 MHz) reactor for anticancer drug delivery by the deposition of polycaprolactone-polyethylene glycol multistack barrier on the collagen membrane (100 µm thickness). Carboplatin (300 µg/cm2) was used for the in vitro and in vivo investigations. Energy-dispersive X-ray spectroscopy (15 keV), scanning electron microscopy and inductively coupled plasma mass spectrometry were used to detect the presence of carboplatin in the nanolayer, the tumor sample and the culture medium. Preclinical studies were performed on ovarian (OVCAR-3NIH) and colon (CT26) cancer cell lines as xenografts (45 days) and allografts (23 days) in Swiss-nude (n = 6) and immunocompetent BALB/cByJ mice (n = 24), respectively. RESULTS: The loading of carboplatin or other drugs between the nanofilm on the collagen membrane did not modify the mesh complex architecture or the drug properties. Drugs were detectable on the membrane for more than 2 weeks in the in vitro analysis and more than 10 days in the in vivo analysis. Cytotoxic mesh decreased cell adherence (down 5.42-fold) and induced cancer cell destruction (up to 7.87-fold). Implantation of the mesh on the mouse tumor nodule modified the cell architecture and decreased the tumor size (50.26%) compared to the control by inducing cell apoptosis. CONCLUSION: Plasma technology allows a mesh to be built with multi-nanolayer anticancer drug delivery on collagen membranes.


Subject(s)
Antineoplastic Agents/administration & dosage , Drug Compounding/methods , Drug Delivery Systems/methods , Neoplasms/drug therapy , Plasma Gases , Animals , Apoptosis/drug effects , Carboplatin/administration & dosage , Cell Line, Tumor , Female , Humans , Mice , Nanomedicine/methods , Nanostructures , Neoplasms/pathology , Xenograft Model Antitumor Assays
11.
Oncol Rep ; 43(6): 1797-1804, 2020 06.
Article in English | MEDLINE | ID: mdl-32236615

ABSTRACT

A tumor contains special types of cells that have characteristics similar to stem cells that aid in tumor initiation, evasion and proliferation and are often resistant to chemotherapy. These cancer stem cells can be differentiated to eradicate their stemness and proliferative capacity by differentiating agents. This study investigated the effect of differentiation on the expression of two immune checkpoint inhibitors, human leukocyte antigen­G (HLA­G) and programmed death ligand­1 (PD­L1). Two cancer cell lines (OVCAR­3­NIH and KATO­III) were treated with adipocyte and neurocyte differentiation media for 14 days. Bone­marrow derived mesenchymal stem cells (BM­MSCs) were used as control healthy stem cells. We found that the cancer cell lines (OVCAR­3­NIH and KATO­III) when subjected to differentiation lost their proliferation ability. BM­MSC proliferation was not halted but was decreased in the adipocyte differentiation media. There was no decrease in the CD90 stem cell marker in the BM­MSCs; however, both cancer cell lines showed decreased CD90 stem cell marker. A significant increase in HLA­G was noted for both the cancer cell lines following adipocyte differentiation. No effect was found for BM­MSCs. Moreover, an increase in PD­L1 in cancer cell lines was found following neurocyte differentiation. Moreover, we found that differentiation resulted in decreased PD­L1 expression in BM­MSCs. Differentiation therapy of cancer stem cells may result in increased immunosuppression ability, hence causing hindrance in the removal of cancer cells. Moreover, the differentiation of healthy stem cells can result in increased immunogenic reactivity owing to a decrease in PD­L1 expression.


Subject(s)
B7-H1 Antigen/genetics , HLA-G Antigens/genetics , Mesenchymal Stem Cells/cytology , Neoplasms/genetics , B7-H1 Antigen/metabolism , Cell Culture Techniques/methods , Cell Differentiation , Cell Line, Tumor , Cell Proliferation , Culture Media/chemistry , Gene Expression Regulation, Neoplastic , HLA-G Antigens/metabolism , Humans , Mesenchymal Stem Cells/drug effects , Neoplasms/metabolism , Thy-1 Antigens/metabolism
12.
Eur J Surg Oncol ; 46(1): 160-165, 2020 01.
Article in English | MEDLINE | ID: mdl-31540756

ABSTRACT

This experimental study evaluated the histological response of peritoneal metastases (PM) from colorectal cancer (CRC) after preoperative systemic chemotherapy (pCT). The results demonstrated that the Peritoneal Regression Grade Score could be used in medical practice. AIM: The aim was to evaluate the histological criteria used by the tumour regression grade (TRG) and Peritoneal Regression Grade Score (PRGS) for determining the response to chemotherapy (CT), in a mouse model of peritoneal metastases (PM) from colorectal cancer (CRC). METHODS: Twenty immunocompetent BALB/c mice were randomized into four groups at day (D) 10 after intraperitoneal (ip) injection with bioluminescent CRC tumour cells (CT26-luc). A histology before treatment group was obtained by sacrifice on D10; the other groups all received one of the following ip treatments over 15 days: 5% glucose (control, G5); 5-fluorouracil (5FU, 0.03 mg/g); or 5FU with oxaliplatin (Ox, 0.006 mg/g). The histological response (HR) was analysed by comparing the histology of PM before and after treatment, using both scores: TRG and PRGS. RESULTS: All mice showed limited PM as visualised by bioluminescence and confirmed at the time of sacrifice in the histology before treatment group. The mean peritoneal carcinomatosis index (PCI) was = 8 [6-10], The rate of complete HR was significantly higher in the Ox-5FU group (83.3%) than 5FU group (0%) and G5 group (0%) (p = 0.016). Fibrosis was present only in CT-treated groups (p = 0.05). PCI, ascites volume and haemorrhagic ascites were significantly higher in the G5 group than CT groups (p < 0.05). CONCLUSIONS: The TRG score can be used in practice when we want to compare the HR between the primary tumour and the PMs. The PRGS is a good measure of HR and is correlated with the efficacy of CT.


Subject(s)
Antineoplastic Combined Chemotherapy Protocols/pharmacology , Colorectal Neoplasms/pathology , Neoplasm Grading/methods , Peritoneal Neoplasms/drug therapy , Peritoneal Neoplasms/secondary , Animals , Disease Models, Animal , Fluorouracil/pharmacology , Luminescent Measurements , Mice , Mice, Inbred BALB C , Oxaliplatin/pharmacology
13.
Neoplasia ; 21(3): 331-342, 2019 03.
Article in English | MEDLINE | ID: mdl-30802770

ABSTRACT

The present study focuses on the influence of the tumor microenvironment on the expression of HLA-G in ovarian cancer and its impact on immune cells. We used carcinomatosis fluids (n = 16) collected from patients diagnosed with epithelial ovarian cancer, detected by an increase in CA125 levels. Our results indicate that HLA-G is expressed by 1) ascitic cell clusters, 2) stromal cells (hospicells) extracted from cancer cell clusters, and 3) cancer cell lines and tumor cells. The origin of HLA-G was linked to inflammatory cytokines present in the cancer microenvironment. In parallel, the ascitic fluid of patients with ovarian cancer contains soluble HLA-G (sHLA-G). The mesothelial cell layer and submesothelial tissues, as well as the immune cell infiltrate, do not secrete HLA-G. In contrast, sHLA-G is absorbed by peritoneal tissues along with mesothelial layers as well as immune cell infiltrates. We demonstrated that interleukin-1ß along with TGF-ß can be a major HLA-G-inducing factor that upregulates HLA-G expression through the NF-κB pathway. The level of HLA-G in ascites correlated positively with the expression of T regulatory (T-regs) cells, while it negatively correlated with the expression of natural killer and memory cells in tumor-infiltrating immune cells. In conclusion, the production of HLA-G is associated with the presence of inflammatory cytokines and is strongly correlated with microenvironment tolerant cells such as T-regs and diminution of NK and memory T cells.


Subject(s)
Carcinoma/genetics , Gene Expression Regulation, Neoplastic , HLA-G Antigens/genetics , Ovarian Neoplasms/genetics , Biomarkers , Carcinoma/immunology , Carcinoma/metabolism , Cell Adhesion , Cell Line, Tumor , Cell Membrane/metabolism , Cytokines/metabolism , Enzyme-Linked Immunosorbent Assay , Female , HLA-G Antigens/immunology , HLA-G Antigens/metabolism , Humans , Immunohistochemistry , Interleukin-1beta/metabolism , Lymphocytes, Tumor-Infiltrating/immunology , Lymphocytes, Tumor-Infiltrating/metabolism , Ovarian Neoplasms/immunology , Ovarian Neoplasms/metabolism , Protein Binding
14.
Open Forum Infect Dis ; 6(12): ofz511, 2019 Dec.
Article in English | MEDLINE | ID: mdl-31909081

ABSTRACT

BACKGROUND: The microbiological diagnosis of bone and joint infections (BJI) currently relies on cultures, and the relevance of molecular methods is still debated. The aim of this study was to determine whether polymerase chain reaction (PCR) could improve the etiological diagnosis of BJI. METHODS: A prospective study was conducted during a 4-year period at Lariboisiere University Hospital (Paris, France), including patients with suspicion of infectious spondylodiscitis, septic arthritis, prosthetic joint infections, and respective noninfected groups. Clinical and radiological data were collected at inclusion and during follow-up. All samples were analyzed by conventional cultures and 16S ribosomal deoxyribonucleic acid (rDNA) gene (16S-PCR). Specific cultures and PCR targeting Mycobacterium tuberculosis were also performed for spondylodiscitis samples. Case records were subsequently analyzed by an independent expert committee to confirm or invalidate the suspicion of infection and definitively classify the patients in a case or control group. The sensitivity of the combination of culture and PCR was compared with culture alone. RESULTS: After expert committee analysis, 105 cases of BJI cases and 111 control patients were analyzed. The most common pathogens of BJI were staphylococci (30%), M tuberculosis (19%), and streptococci (14%). Adding PCR enhanced the sensitivity compared with culture alone (1) for the diagnosis of M tuberculosis spondylodiscitis (64.4% vs 42.2%; P < .01) and (2) for nonstaphylococci BJI (81.6% vs 71.3%; P < .01). It is interesting to note that 16S-PCR could detect BJI due to uncommon bacteria such as Mycoplasma and fastidious bacteria. CONCLUSIONS: Our study showed the benefit of 16S-PCR and PCR targeting M tuberculosis as add-on tests in cases of suspected BJI.

16.
JAMA Oncol ; 5(4): 551-555, 2019 Apr 01.
Article in English | MEDLINE | ID: mdl-30452494

ABSTRACT

IMPORTANCE: Primary resistance to immune checkpoint inhibitors is observed in 10% to 40% of patients with metastatic colorectal cancer (mCRC) displaying microsatellite instability (MSI) or defective mismatch repair (dMMR). OBJECTIVE: To investigate possible mechanisms underlying primary resistance to immune checkpoint inhibitors of mCRC displaying MSI or dMMR. DESIGN, SETTING, AND PARTICIPANTS: This post hoc analysis of a single-center, prospective cohort included 38 patients with mCRC diagnosed as MSI or dMMR by local laboratories and entered into trials of immune checkpoint inhibitors between January 1, 2015, and December 31, 2016. The accuracy of MSI or dMMR status was also assessed in a retrospective cohort comprising 93 cases of mCRC that were diagnosed as MSI or dMMR between January 1, 1998, and December 31, 2016, in 6 French hospitals. Primary resistance of mCRC was defined as progressive disease according to Response Evaluation Criteria in Solid Tumors criteria, 6 to 8 weeks after initiation of immune checkpoint inhibitors, without pseudo-progression. All tumor samples were reassessed for dMMR status using immunohistochemistry with antibodies directed against MLH1, MSH2, MSH6, and PMS2, and for MSI using polymerase chain reaction with pentaplex markers and with the HSP110 T17 (HT17) repeat. MAIN OUTCOMES AND MEASURES: The primary outcome was positive predictive value. RESULTS: Among the 38 patients (15 women and 23 men; mean [SD] age, 55.6 [13.7] years) in the study with mCRC displaying MSI or dMMR, primary resistance to immune checkpoint inhibitors was observed in 5 individuals (13%). Reassessment of the status of MSI or dMMR revealed that 3 (60%) of these 5 resistant tumors were microsatellite stable or displayed proficient mismatch repair. The positive predictive value of MSI or dMMR status assessed by local laboratories was therefore 92.1% (95% CI, 78.5%-98.0%). In the retrospective cohort of 93 patients (44 women and 49 men; mean [SD] age, 56.8 [18.3] years) without immune checkpoint inhibitor treatment, misdiagnosis of the MSI or dMMR status by local assessment was 10% (n = 9), with a positive predictive value of 90.3% (95% CI, 82.4%-95.0%). Testing for MSI with the HT17 assay confirmed the MSI or dMMR status in 2 of 4 cases showing discrepant results between immunohistochemistry and pentaplex polymerase chain reaction (ie, dMMR but microsatellite stable). CONCLUSIONS AND RELEVANCE: Primary resistance of mCRC displaying MSI or dMMR to immune checkpoint inhibitors is due mainly to misdiagnosis of their MSI or dMMR status. Larger studies are required to confirm these findings. Microsatellite instability or dMMR status should be tested routinely using both immunohistochemistry and polymerase chain reaction methods prior to treatment with immune checkpoint inhibitors.


Subject(s)
Antineoplastic Agents, Immunological/therapeutic use , Colorectal Neoplasms , DNA Mismatch Repair , Diagnostic Errors , Drug Resistance, Neoplasm , Microsatellite Instability , Adult , Colorectal Neoplasms/diagnosis , Colorectal Neoplasms/drug therapy , Colorectal Neoplasms/genetics , Colorectal Neoplasms/pathology , Female , Humans , Male , Middle Aged , Predictive Value of Tests , Prospective Studies , Retrospective Studies
17.
Arthritis Rheumatol ; 70(9): 1481-1488, 2018 09.
Article in English | MEDLINE | ID: mdl-29669392

ABSTRACT

OBJECTIVE: To determine risk factors for primary Sjögren's syndrome (SS)-associated lymphoma in a multicenter cohort of patients, with analysis of the predictive power of previously reported risk factors, including the presence of ectopic germinal center (GC)-like structures in minor salivary gland (MSG) biopsy tissue. METHODS: One hundred fifteen patients with primary SS were included, and MSG biopsy tissue from these patients was retrospectively examined, focusing on the presence of ectopic GC-like structures. Epidemiologic, clinical, biologic, immunologic, and histologic data were collected at the time of diagnosis of primary SS. Patients with non-Hodgkin's lymphoma (NHL) were compared with those without NHL during the follow-up period, using a Cox proportional hazards multiple regression model. RESULTS: NHL was diagnosed in 8 patients (6.96%), and ectopic GC-like structures in 19 patients (16.5%). The presence of ectopic GC-like structures was associated with a 7.8-fold increased risk of lymphoma occurrence (95% confidence interval [95% CI] 1.73-34.86 [P = 0.0075]). Other independent predictors included a positive cryoglobulin test result (hazard ratio [HR] 7.10, 95% CI 1.74-28.92 [P = 0.006]), male sex (HR 28.73, 95% CI 4.46-144.87 [P = 0.0004]), sensorimotor neuropathy (HR 35.48, 95% CI 5.79-217.39 [P = 0.0001]), and splenomegaly (HR 19.9, 95% CI 4.4-90 [P = 0.0001]). CONCLUSION: The presence of ectopic GC-like structures in MSG biopsy tissue is associated with the risk of lymphoma in patients with primary SS. These data reinforce the major role of MSG biopsy tissue in primary SS, for the identification a priori of a subgroup of patients with the highest risk of lymphoma.


Subject(s)
Choristoma/complications , Germinal Center , Lymphoma, Non-Hodgkin/etiology , Salivary Gland Diseases/complications , Sjogren's Syndrome/pathology , Biopsy , Choristoma/pathology , Female , Humans , Male , Middle Aged , Proportional Hazards Models , Retrospective Studies , Salivary Gland Diseases/pathology , Salivary Glands, Minor/pathology , Sjogren's Syndrome/complications
18.
Eur J Surg Oncol ; 44(6): 784-791, 2018 06.
Article in English | MEDLINE | ID: mdl-29525466

ABSTRACT

BACKGROUND: Curative surgery of synchronous peritoneal metastases (PM) and colorectal liver metastases (LM) has been recently investigated as feasible option. When synchronous peritoneal and liver resection is not achievable, the sequence of the surgery remains unknown. Our hypothesis was that liver resection (LR) promotes peritoneal growth resulting in a non-resectable PM. We sought to analyse the effects of major LR and liver regeneration after hepatectomy in a murine model of PM and the associated angiogenesis. METHODS: Murine model of colorectal PM in Balb/C mice was developed by intraperitoneal injection of different CT-26 tumour cell concentrations. Five days after the injection, mice were randomized into three groups: 68% hepatectomy group, sham laparotomy and control group without surgery. On post-operative days 1, 5 and 20, PM was evaluated macroscopically, tumour growth and liver regeneration by immunohistochemistry, and angiogenesis by immunofluorescence. Circulating progenitor cells, plasmatic cytokines and digestive arterial blood flow velocity measurements were also analysed. RESULTS: Reproducible murine model of limited colorectal PM was obtained. Surgery induced PM increases and promoted neo-angiogenesis. Major hepatectomy influence the tumour growth in the late phase after surgery, the extent of extra-peritoneal metastasis and the increase of Ki-67 expression in the remnant liver. CONCLUSIONS: This animal model confirms the pro-tumoural and pro-angiogenic role of surgery, laparotomy and major LR, which promotes the increase of angiogenic factors and their participation in PM growth. These results suggest that peritoneal resection should be first step in the case of two-step liver and peritoneal surgery for patients with colorectal PM and LM.


Subject(s)
Colorectal Neoplasms/pathology , Hepatectomy/adverse effects , Immunocompromised Host , Liver Neoplasms/surgery , Neoplasm Transplantation/pathology , Neoplasms, Experimental , Peritoneal Neoplasms/secondary , Animals , Disease Progression , Female , Liver/pathology , Liver Neoplasms/diagnosis , Liver Neoplasms/secondary , Liver Regeneration , Mice , Mice, Inbred BALB C , Peritoneal Neoplasms/diagnosis , Prognosis , Tumor Cells, Cultured
19.
Dig Liver Dis ; 49(8): 924-928, 2017 Aug.
Article in English | MEDLINE | ID: mdl-28668271

ABSTRACT

BACKGROUND: The interval between surgery and adjuvant chemotherapy (AC) is a predictive factor of survival in high-risk colon cancer (CC). This study aimed to evaluate the impact of intraoperative sentinel lymph node (SLN) analysis using the one-step nucleic acid amplification (OSNA) technique on the time interval between surgery and AC. METHODS: We performed a prospective study analyzing 56 consecutive patients who had surgery for CC between July 2012 and October 2014, including 20 patients needing AC. SLN status was determined intraoperatively in 17 patients in the OSNA group; when positive, a portacath (PAC) was placed during the procedure for upcoming AC. In the remaining patients, we proceeded without SLN status determination and the PAC was installed after definitive histopathological analysis of the specimen if needed. RESULTS: There was no difference between the groups regarding cancer staging, duration of hospitalization (7.5days in the OSNA group and 10days in the control group, p=0.43) and major complications (20% vs 30% respectively, p=0.55). The time interval between surgery and adjuvant chemotherapy was significantly shorter in the OSNA group at 35 (±8) days vs 67 (±36) days (p=0.021). CONCLUSION: SLN status determination by the OSNA technique is safe, feasible and could significantly reduce time between surgery and adjuvant chemotherapy in a pilot study.


Subject(s)
Carcinoma/genetics , Colonic Neoplasms/genetics , Lymphatic Metastasis/pathology , Sentinel Lymph Node Biopsy , Sentinel Lymph Node/pathology , Aged , Aged, 80 and over , Carcinoma/pathology , Chemotherapy, Adjuvant , Colon/pathology , Colonic Neoplasms/pathology , Female , France , Humans , Intraoperative Period , Male , Middle Aged , Neoplasm Staging , Nucleic Acid Amplification Techniques , Pilot Projects , Prospective Studies , Time-to-Treatment
20.
Ann Pathol ; 35(6): 479-85, 2015 Dec.
Article in French | MEDLINE | ID: mdl-26596691

ABSTRACT

Cryptococcosis is a serious infection, possibly lethal, of worldwide distribution. It mainly affects immunosuppressed patients resulting with pulmonary and/or meningeal involvements or disseminated infections. Due to the rarity of visceral and osseous infections, and to the absence of specific clinical symptoms, this diagnosis is often deferred. Resulting of diagnostic errors, samples are often directed to the department of pathology and more rarely to the department of mycology. Histopathological examination appears crucial, highlighting encapsulated yeasts with alcian blue staining. Once the diagnosis is performed, an appropriate antifungal therapy must be quickly introduced because these infections are associated with a high mortality rate. The aim of our work was to report five extra-cerebral and extra-pulmonary cryptococcosis cases, to describe their histopathological features, to evoke diagnostic techniques and to discuss the differential diagnoses.


Subject(s)
AIDS-Related Opportunistic Infections/pathology , Cryptococcosis/pathology , Dermatomycoses/pathology , Discitis/pathology , Liver Abscess/pathology , Lymphatic Diseases/pathology , Sacrum/pathology , AIDS-Related Opportunistic Infections/microbiology , Adult , Biopsy , Cryptococcosis/complications , Cryptococcus/isolation & purification , Dermatomycoses/microbiology , Discitis/microbiology , Hepatitis B, Chronic/complications , Humans , Liver Abscess/microbiology , Lymphatic Diseases/microbiology , Male , Meningitis, Cryptococcal/complications , Organ Specificity , Retrospective Studies , Sacrum/microbiology
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