Influence of DNA Mismatch Repair (MMR) System in Survival and Response to Immune Checkpoint Inhibitors (ICIs) in Non-Small Cell Lung Cancer (NSCLC): Retrospective Analysis.

Mutations in the mismatch repair (MMR) system predict the response to immune checkpoint inhibitors (ICIs) like colon or gastric cancer. However, the MMR system's involvement in non-small cell lung cancer (NSCLC) remains unknown. Addressing this issue will improve clinical guidelines in the case of mutations in the main genes of the MMR system (MLH1, MSH2, MSH6, and PMS2). This work retrospectively assessed the role that these gene mutations play in the response to and survival of ICIs in NSCLC. Patients with NSCLC treated with nivolumab as the second-line treatment in the University Hospital of Salamanca were enrolled in this study. Survival and response analyses were performed according to groups of MMR system gene expression (MMR expression present or deficiency) and other subgroups, such as toxicity. There was a statistically significant relationship between the best response obtained and the expression of the MMR system (p = 0.045). The presence of toxicity grade ≥ 3 was associated with the deficiency expression of MMR (dMMR/MSI-H) group (p = 0.022; odds ratio = 10.167, 95% confidence interval (CI) 1.669-61.919). A trend towards greater survival and response to ICIs was observed in NSCLC and dMMR. Assessing the genes in the MMR system involved in NSCLC is key to obtaining personalized immunotherapy treatments.

Clinicopathological and prognostic characterization of oral lichenoid disease and its main subtypes: A series of 384 cases

BACKGROUND: To clinicopathologically characterize the diagnosis of oral lichenoid disease (OLD) and its main subtypes: oral lichen planus (OLP) and oral lichenoid lesion (OLL), in order to correctly asses their prognosis. MATERIAL AND METHODS: Ambispective cohort study of 384 patients with diagnosis of OLD, based on pre-established clinical and histopathological criteria. We have analysed 272 (70.8%) women and 112 (29.2%), whose mean age was 57.1+/-11.8 years (range 21-90); minimum follow-up time was 36 months. A specific protocol was designed for this study, where we gathered the data of each patient, including malignant transformation. RESULTS: OLP was diagnosed in 229 cases (77.9%) and OLL in 85 (22.1%). Tobacco consumption was found in 20.3% of the patients and alcohol intake in 41.1%. Liver pathology was present in 10.7% of the cases, thyroid pathology in 11.5%, arterial hypertension in 15.6%, diabetes mellitus in 7.6%, psycho-emotional disorders in 33.3%, skin involvement in 12% and genital involvement in 4.9%. Ten patients (2.6%) developed an oral squamous cell carcinoma, 5 (1.7%) with OLP and 5 (5.9%) with OLL. CONCLUSIONS: OLD is a potentially malignant disorder of the oral mucosa which has to be correctly diagnosed as either OLP or OLL, since the risk of malignancy of these subtypes is significantly different

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Histopathological analysis of biopsies of "peri-implant inflammatory lesions." Everything is not what it seems.

BACKGROUND: Peri-implantitis is the inflammatory process, which most commonly affects the therapy with dental implants. However, there are other reactive and neoplastic entities, mainly benign but also malignant, which also take place in the peri-implant mucosa. There is little information about the histopathological analysis of these peri-implant inflammatory diseases. PURPOSE: To analyze the histopathological diagnosis of biopsies located in the peri-implant mucosa that showed an inflammatory clinical appearance. MATERIALS AND METHODS: We have made a retrospective study of 111 peri-implant biopsies analyzed in the Oral and Maxillofacial Pathology Unit of the Dental Clinic Service at the University of the Basque Country, from January 2001 to December 2018. These samples corresponded to 84 women and 27 men, whose mean age was 59 years. We performed a standard histological processing with paraffin embedding, and sections were stained with H&E and PAS. All cases were analyzed following a specific diagnostic histopathological protocol. A descriptive statistical analysis was carried out with the obtained data. RESULTS: Lesions located in the mandible (64.8%) were more frequent and 34.2% of the biopsies arrived without a presumptive clinical diagnosis. "Inflammatory peri-implant lesion" or peri-implantitis was the most common clinical diagnosis. Histopathologically, the majority of the lesions were peri-implant nonspecific inflammatory hyperplasia (60.3%), followed by peripheral giant cell granuloma (18.1%), pyogenic granuloma (lobular capillary hemangioma) (14.4%), actinomicotic infection (3.6%), and squamous cell carcinoma (3.6%). Individually, peri-implant lesions were more common among women and in the mandible, except for actinomicotic infection and squamous cell carcinoma. CONCLUSIONS: An important percentage of cases whose initial presumptive clinical diagnosis was "peri-implant inflammatory lesion" truly corresponded to other reactive and neoplastic processes. Thus, it is key to always submit all the tissue removed during the implant surgery, in order to perform a good histopathological study and achieve the correct final diagnosis.

[Follicular cystitis. Case report and bibliographic review]. / Cistitis folicular. Aportación de un caso y revisión de la uteratura.

OBJECTIVE: To report one case of chronic follicular cystitis and to perform a bibliographic review on this pathology. CASE REPORT: We report a case of a 70-year-old woman with an irritative voiding syndrome over an eight-month period, with several previous episodes of urinary tract infection treated by her family doctor. Bullous lesions were found in the bladder mucosa on cystoscopy. Histological tests showed lymphoid follicles at the level of the bladder mucosa, leading to the diagnosis of follicular cystitis. RESULTS: Medical treatment was carried out with ciprofloxacin, vitamin A, and prednisone, which led to symptom remission. CONCLUSIONS: Follicular cystitis is an entity that belongs to the group of chronic cystopathies; it is a non-specific chronic inflammatory disease characterized by the presence of large number of plasmatic cells and lymphocytes in lymphoid follicles within the bladder mucosa and submucosa; pathologic study is necessary for the final diagnosis of this entity.

Cistitis folicular. Aportación de un caso y revisión de la literatura / Follicular cystitis. Case report and bibliographic review

OBJETIVOS: Aportar un caso clínico con diagnóstico de cistitis crónica folicular y revisión de la literatura existente sobre esta patología. METODOS: Describimos el caso de una mujer de 70 años con síndrome miccional irritativo de 8 meses de evolución, con varios episodios previos de infección urinaria tratados por su médico de cabecera y en cuyo estudio se descubrió lesiones bullosas vesicales durante la cistoscopia; el estudio histológico demostró folículos linfoides a nivel de la mucosa vesical, permitiendo el diagnóstico de cistitis folicular. RESULTADOS: Se inicio tratamiento médico con ciprofloxacino, vitamina A y prednisona remitiendo la sintomatología. CONCLUSIONES: La cistitis folicular es una entidad que pertenece al grupo de las cistopatías crónicas, al tratarse de un proceso inflamatorio inespecífico crónico que se caracteriza por presentar a nivel de mucosa y submucosa células plasmáticas y linfocitos constituyendo folículos linfoides, siendo imprescindible el estudio histológico para diagnosticar esta patología (AU)

OBJECTIVE: To report one case of chronic follicular cystitis and to perform a bibliographic review on this pathology. CASE REPORT: We report a case of a 70-year-old woman with an irritative voiding syndrome over an eight-month period, with several previous episodes of urinary tract infection treated by her family doctor. Bullous lesions were found in the bladder mucosa on cystoscopy. Histological tests showed lymphoid follicles at the level of the bladder mucosa, leading to the diagnosis of follicular cystitis. RESULTS: Medical treatment was carried out with ciprofloxacin, vitamin A, and prednisone, which led to symptom remission. CONCLUSIONS: Follicular cystitis is an entity that belongs to the group of chronic cystopathies; it is a non-specific chronic inflammatory disease characterized by the presence of large number of plasmatic cells and lymphocytes in lymphoid follicles within the bladder mucosa and submucosa; pathologic study is necessary for the final diagnosis of this entity