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How many polyps need to be histologically assessed when multiple polyps are submitted for the Bowel Cancer Screening Program? 如果将多个息肉提交给肠癌筛查计划,需要对多少个息肉进行组织学评估?
IF 3.9 2区 医学 Q2 CELL BIOLOGY Pub Date : 2024-10-07 DOI: 10.1111/his.15337
Newton A C S Wong, Hannah E Jones, Katherine M Halloran

Aims: Since 2020 there has been an increase in the number of polyps removed from patients scoped for the Bowel Cancer Screening Programme (BCSP) of England. General cellular pathology workload also continues to increase disproportionately ahead of consultant pathologist numbers in the United Kingdom. The Optical Diagnosis initiative for BCSP patients has not yet, and may not be, implemented at every hospital in England. The following study therefore aimed to determine whether only a certain number of removed polyps need to be histologically assessed to consistently guide a BCSP patient's post-polypectomy management, and whether all remaining smaller polyps beyond that number could then be discarded.

Methods: This retrospective study considered all BCSP specimens/cases submitted to the Cellular Pathology department of a large English teaching hospital from 2016 to 2024. Only cases with six or more resected polyps, for which the endoscopic report stated individual sizes, were included in the final study cohort.

Results: Of the 8066 BCSP cases submitted to the aforementioned department, there were six or more polyps for 345 cases. Analysis of the final study cohort of 135 cases showed that assessment of the seven largest polyps measured endoscopically was sufficient to correctly guide follow-up management of the BCSP patient as per the 2020 British Society of Gastroenterology post-polypectomy guidelines.

Conclusions: When colonoscopy of a BCSP patient leads to removal of multiple polyps, only the seven largest polyps need to be assessed histologically and the remaining smaller polyps could be discarded with no impact to the patient's BCSP-related management.

目的:自 2020 年以来,从英格兰肠癌筛查计划(BCSP)范围内的患者身上切除的息肉数量有所增加。在英国,普通细胞病理学的工作量也继续不成比例地增加,超过了病理顾问的人数。针对 BCSP 患者的光学诊断计划尚未在英格兰的每家医院实施,也可能不会实施。因此,以下研究旨在确定是否只需对一定数量的切除息肉进行组织学评估,就能始终如一地指导 BCSP 患者的息肉切除术后管理,以及超出这一数量的所有剩余较小息肉是否都可以丢弃:这项回顾性研究考虑了 2016 年至 2024 年期间提交给一家大型英国教学医院细胞病理部门的所有 BCSP 标本/病例。只有切除息肉数量达到或超过六个且内镜报告中注明了单个息肉大小的病例才被纳入最终研究队列:在提交给上述部门的8066例BCSP病例中,有345例有6个或6个以上的息肉。对最终研究队列中 135 个病例的分析表明,根据 2020 年英国胃肠病学会息肉切除术后指南,评估内镜下测得的七个最大息肉足以正确指导 BCSP 患者的后续治疗:结论:当 BCSP 患者的结肠镜检查导致切除多个息肉时,只需对七个最大的息肉进行组织学评估,其余较小的息肉可以丢弃,不会影响患者的 BCSP 相关管理。
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引用次数: 0
A new algorithm for coeliac disease based on the 'long forgotten' TCRγδ+ intra-epithelial lymphocytes detected with an antibody working on FFPE sections. 根据在 FFPE 切片上使用抗体检测到的 "久已被遗忘的 "TCRγδ+ 上皮内淋巴细胞,建立一种新的乳糜泻算法。
IF 3.9 2区 医学 Q2 CELL BIOLOGY Pub Date : 2024-10-07 DOI: 10.1111/his.15330
Eda N Kozan, Bilge A Kırmızı, Ceyda T Kirsaclioglu, Derya Gokmen, Berna Savas, Aydan Kansu, Arif I Soykan, Arzu Ensari

Aims: Diagnosis of coeliac disease (CD) with mild mucosal changes is difficult for all parties involved. We aimed to determine the power of T cell receptor (TCR)γδ+ intra-epithelial lymphocytes (IELs) in discriminating CD from other causes of intra-epithelial lymphocytosis using a new monoclonal antibody.

Methods: A total of 167 cases categorised as coeliac (117 untreated CD, classified according to Marsh, updated by Ensari, including 29 type 1, 29 type 2, 39 type 3 and 20 treated CD), and non-coeliac groups (24 controls and 26 non-coeliac IELosis) based on clinical, serological and histological data were studied for IEL counts enumerated per 100 enterocytes using haematoxylin and eosin, CD3, TCR δ-stains.

Results: TCRγδ+ IELs were significantly higher in CD (24.83 ± 16.13) compared to non-CD (6.72 ± 6.32) and were correlated with the degree of mucosal damage. Both γδ+ IEL count and ratio showed higher performance in differentiating untreated coeliacs from controls, with a sensitivity of 83.76; 85.57 and specificity of 95.83; 79.17, respectively. TCRγδ+ IEL counts distinguished type 1 CD (20.41 ± 13.57) from non-coeliac IELosis (9.42 ± 7.28) (p = 0.025). Discriminant analysis revealed that villus/crypt ratio, γδ+ and CD3+ IEL counts, γδ+/CD3+IEL ratio, IEL distribution pattern were potent discriminants and correctly classified 82.3% of cases while the algorithm accurately diagnosed 93.4% of cases.

Conclusions: The new antibody detecting γδ+ IELs in FFPE sections revealed thresholds of 10.5 for γδ+ IELs and 14% for γδ+/CD3+IEL ratio which distinguished coeliacs from non-coeliacs with high sensitivity and specificity, particularly in cases with normal villus/crypt axis including type 1 CD, non-CD IELosis and controls. A 'coeliac algorithm' based on γδ+ IELs is proposed with the hope that it will be used in the histopathological diagnostic approach by the pathology community.

目的:对所有相关方而言,诊断伴有轻微粘膜变化的乳糜泻(CD)都很困难。我们旨在利用一种新型单克隆抗体确定 T 细胞受体(TCR)γδ+ 上皮内淋巴细胞(IELs)在区分 CD 和其他原因引起的上皮内淋巴细胞增多方面的作用:根据临床、血清学和组织学数据将 167 例病例归类为乳糜泻组(117 例未经治疗的 CD,根据 Marsh 分类,由 Ensari 更新,包括 29 例 1 型、29 例 2 型、39 例 3 型和 20 例经治疗的 CD)和非乳糜泻组(24 例对照组和 26 例非乳糜泻 IELosis),使用血色素和伊红、CD3、TCR δ 染料对每 100 个肠细胞中的 IEL 计数进行研究:结果:与非 CD(6.72 ± 6.32)相比,CD(24.83 ± 16.13)中的 TCRγδ+ IELs 明显较高,且与粘膜损伤程度相关。γδ+IEL计数和比值在区分未经治疗的乳糜泻患者和对照组方面均表现出较高的性能,敏感性分别为83.76;85.57,特异性分别为95.83;79.17。TCRγδ+ IEL计数可区分1型CD(20.41 ± 13.57)和非糜烂性IEL病(9.42 ± 7.28)(p = 0.025)。判别分析显示,绒毛/室管膜比值、γδ+和CD3+ IEL计数、γδ+/CD3+IEL比值、IEL分布模式是有效的判别因素,正确分类了82.3%的病例,而算法准确诊断了93.4%的病例:结论:在FFPE切片中检测γδ+ IELs的新抗体显示,γδ+ IELs的阈值为10.5,γδ+/CD3+IEL比值为14%,该抗体能以高灵敏度和特异性区分乳糜泻患者和非乳糜泻患者,特别是在绒毛/隐窝轴正常的病例中,包括1型CD、非CD IELosis和对照组。根据γδ+ IELs提出了一种 "乳糜泻算法",希望病理学界能将其用于组织病理学诊断方法。
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引用次数: 0
A deep learning approach to case prioritisation of colorectal biopsies. 结直肠活检病例优先排序的深度学习方法。
IF 3.9 2区 医学 Q2 CELL BIOLOGY Pub Date : 2024-10-03 DOI: 10.1111/his.15331
Ciara D White, Runjan Chetty, John Weldon, Maria E Morrissey, Rob Sykes, Corina Gîrleanu, Mirko Colleuori, Jenny Fitzgerald, Adam Power, Ajaz Ahmad, Seán Carmody, Pierre Moulin, Donal O'Shea, Muhammad Aslam, Mahomed A Dada, Maurice B Loughrey, Martine C McManus, Klaudia M Nowak, Kristopher McCombe, Sinead Hutton, Máirín Rafferty, Niall Mulligan

Aims: To create and validate a weakly supervised artificial intelligence (AI) model for detection of abnormal colorectal histology, including dysplasia and cancer, and prioritise biopsies according to clinical significance (severity of diagnosis).

Materials and methods: Triagnexia Colorectal, a weakly supervised deep learning model, was developed for the classification of colorectal samples from haematoxylin and eosin (H&E)-stained whole slide images. The model was trained on 24 983 digitised images and assessed by multiple pathologists in a simulated digital pathology environment. The AI application was implemented as part of a point and click graphical user interface to streamline decision-making. Pathologists assessed the accuracy of the AI tool, its value, ease of use and integration into the digital pathology workflow.

Results: Validation of the model was conducted on two cohorts: the first, on 100 single-slide cases, achieved micro-average model specificity of 0.984, micro-average model sensitivity of 0.949 and micro-average model F1 score of 0.949 across all classes. A secondary multi-institutional validation cohort, of 101 single-slide cases, achieved micro-average model specificity of 0.978, micro-average model sensitivity of 0.931 and micro-average model F1 score of 0.931 across all classes. Pathologists reflected their positive impressions on the overall accuracy of the AI in detecting colorectal pathology abnormalities.

Conclusions: We have developed a high-performing colorectal biopsy AI triage model that can be integrated into a routine digital pathology workflow to assist pathologists in prioritising cases and identifying cases with dysplasia/cancer versus non-neoplastic biopsies.

目的:创建并验证一种弱监督人工智能(AI)模型,用于检测异常结直肠组织学,包括发育不良和癌症,并根据临床意义(诊断严重程度)确定活检的优先次序:Triagnexia Colorectal是一种弱监督深度学习模型,用于从血红素和伊红(H&E)染色的整张切片图像中对结肠直肠样本进行分类。该模型在 24 983 张数字化图像上进行了训练,并由多名病理学家在模拟数字病理环境中进行了评估。人工智能应用是作为点选式图形用户界面的一部分实施的,以简化决策过程。病理学家对人工智能工具的准确性、价值、易用性以及与数字病理工作流程的整合进行了评估:在两个队列中对模型进行了验证:第一个队列对 100 个单张病例进行了验证,在所有类别中,模型特异性的微观平均值为 0.984,模型灵敏度的微观平均值为 0.949,模型 F1 的微观平均值为 0.949。由 101 个单滑动病例组成的二级多机构验证队列的微观平均模型特异性为 0.978,微观平均模型灵敏度为 0.931,所有类别的微观平均模型 F1 得分为 0.931。病理学家对人工智能检测结直肠病理异常的整体准确性给予了积极评价:我们开发了一种高效的结直肠活检人工智能分检模型,可将其整合到常规数字病理工作流程中,协助病理学家确定病例的优先次序,并识别发育不良/癌症病例与非肿瘤性活检病例。
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引用次数: 0
HMGA2-positive salivary gland neoplasms with prominent trabecular/canalicular morphology: a focus on carcinomas arising within this phenotype. HMGA2 阳性唾液腺肿瘤具有突出的小梁/针状形态:重点研究这种表型中出现的癌。
IF 3.9 2区 医学 Q2 CELL BIOLOGY Pub Date : 2024-10-03 DOI: 10.1111/his.15334
Melad N Dababneh, Elizabeth M Azzato, Joy Nakitandwe, Vincent Cracolici, Akeesha A Shah

Aims: Pleomorphic adenoma (PA) with a prominent trabecular/canalicular morphology has consistent HMGA2 protein expression, and association with HMGA2 fusions. We report our experience with this subtype, with emphasis on the carcinomas that can arise in this context.

Methods and results: A retro- and prospective review (2013-2024) of major salivary gland tumours with prominent trabecular/canalicular morphology was performed. Twenty-one parotid tumours met the criteria: 14 benign (66.7%), six carcinomas (28.6%), and one of uncertain behaviour (4.7%). HMGA2 immunohistochemistry (IHC) was performed on all cases. Next-generation sequencing was successfully performed on 18. Seven benign cases had a conventional PA component. In all cases, the tumour cells in these trabecular/canalicular areas demonstrated variable papillary thyroid carcinoma-like nuclear changes, including chromatin clearing, overcrowding, membrane irregularities, and intranuclear pseudoinclusions. Benign tumours were well-demarcated, whereas carcinomas demonstrated either a multinodular pattern of invasion or subtle infiltration. Two carcinomas showed increased cytologic atypia and architectural complexity and one had perineural invasion. By IHC, all were positive for HMGA2. In the trabecular/canalicular areas, there was consistent strong expression of CAM5.2, S-100, and SOX-10 and variable expression of p63 but negative p40. HMGA2 alterations were detected in 16 of 18 cases (89%). Follow-up was available on two carcinomas, with one being locally recurrent.

Conclusion: While most HMGA2-positive salivary gland neoplasms with a prominent trabecular/canalicular growth pattern are benign, they, like traditional PAs, may give rise to carcinomas that can locally recur. These carcinomas can be deceptively bland, subtly infiltrative, or have a multinodular pattern of invasion.

目的:具有突出小梁/针状形态的多形性腺瘤(PA)具有一致的HMGA2蛋白表达,并与HMGA2融合相关。我们报告了我们在这一亚型方面的经验,重点是在这种情况下可能出现的癌:我们对具有突出小梁/针状形态的主要唾液腺肿瘤进行了回顾性和前瞻性研究(2013-2024 年)。21例腮腺肿瘤符合标准:其中 14 例良性(66.7%),6 例癌(28.6%),1 例行为不确定(4.7%)。所有病例均进行了HMGA2免疫组化(IHC)。对 18 例病例成功进行了新一代测序。7例良性病例具有传统的PA成分。在所有病例中,这些小梁/针孔区的肿瘤细胞都表现出不同的甲状腺乳头状癌样核改变,包括染色质变清、过度拥挤、膜不规则和核内假包涵体。良性肿瘤分界清楚,而癌肿则表现为多结节性浸润或细微浸润。两个癌瘤的细胞学不典型性和结构复杂性增加,一个癌瘤有神经周围浸润。通过 IHC 检测,所有癌细胞的 HMGA2 均呈阳性。在小梁/颅骨区域,CAM5.2、S-100和SOX-10持续强表达,p63表达不一,但p40呈阴性。18 个病例中有 16 个(89%)检测到 HMGA2 改变。对两例癌症进行了随访,其中一例为局部复发:结论:虽然大多数 HMGA2 阳性唾液腺肿瘤具有突出的小梁/针状生长模式,属于良性肿瘤,但它们与传统的 PA 一样,可能会引发局部复发的癌变。这些癌肿可能是平淡无奇的,也可能是轻微浸润性的,或具有多结节浸润模式。
{"title":"HMGA2-positive salivary gland neoplasms with prominent trabecular/canalicular morphology: a focus on carcinomas arising within this phenotype.","authors":"Melad N Dababneh, Elizabeth M Azzato, Joy Nakitandwe, Vincent Cracolici, Akeesha A Shah","doi":"10.1111/his.15334","DOIUrl":"https://doi.org/10.1111/his.15334","url":null,"abstract":"<p><strong>Aims: </strong>Pleomorphic adenoma (PA) with a prominent trabecular/canalicular morphology has consistent HMGA2 protein expression, and association with HMGA2 fusions. We report our experience with this subtype, with emphasis on the carcinomas that can arise in this context.</p><p><strong>Methods and results: </strong>A retro- and prospective review (2013-2024) of major salivary gland tumours with prominent trabecular/canalicular morphology was performed. Twenty-one parotid tumours met the criteria: 14 benign (66.7%), six carcinomas (28.6%), and one of uncertain behaviour (4.7%). HMGA2 immunohistochemistry (IHC) was performed on all cases. Next-generation sequencing was successfully performed on 18. Seven benign cases had a conventional PA component. In all cases, the tumour cells in these trabecular/canalicular areas demonstrated variable papillary thyroid carcinoma-like nuclear changes, including chromatin clearing, overcrowding, membrane irregularities, and intranuclear pseudoinclusions. Benign tumours were well-demarcated, whereas carcinomas demonstrated either a multinodular pattern of invasion or subtle infiltration. Two carcinomas showed increased cytologic atypia and architectural complexity and one had perineural invasion. By IHC, all were positive for HMGA2. In the trabecular/canalicular areas, there was consistent strong expression of CAM5.2, S-100, and SOX-10 and variable expression of p63 but negative p40. HMGA2 alterations were detected in 16 of 18 cases (89%). Follow-up was available on two carcinomas, with one being locally recurrent.</p><p><strong>Conclusion: </strong>While most HMGA2-positive salivary gland neoplasms with a prominent trabecular/canalicular growth pattern are benign, they, like traditional PAs, may give rise to carcinomas that can locally recur. These carcinomas can be deceptively bland, subtly infiltrative, or have a multinodular pattern of invasion.</p>","PeriodicalId":13219,"journal":{"name":"Histopathology","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142365105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Inflammatory spindle cell PEComa of the lung with YAP1::TFE3 fusion: a report of two cases and a potential relationship with clear cell stromal tumour. 伴有 YAP1::TFE3 融合的肺部炎性纺锤形细胞 PEC 瘤:两例病例报告及与透明细胞间质瘤的潜在关系。
IF 3.9 2区 医学 Q2 CELL BIOLOGY Pub Date : 2024-09-26 DOI: 10.1111/his.15328
Naoki Kojima, Shogo Nishino, Yukiko Sasahara, Tetsuro Taki, Hiroki Imada, Tomohiro Miyoshi, Shun-Ichi Watanabe, Genichiro Ishii, Yasushi Yatabe, Taisuke Mori, Akihiko Yoshida

Aims: The PEComa family of tumours is defined by spindle/epithelioid cells with myomelanocytic differentiation. A small subset harbours TFE3 fusion; however, YAP1::TEE3 has not been reported. Clear cell stromal tumour of the lung (CCST-L) is an emerging entity characterized by spindle to epithelioid cells with focal cytoplasmic clearing, inflammatory infiltrates, no myomelanocytic differentiation, and YAP1::TFE3 fusion. Herein, we report two cases of lung tumours with myomelanocytic differentiation that showed inflammatory spindle cell histology, focal epithelioid clear cells, as well as YAP1::TFE3 fusion.

Methods and results: The patients were both men, aged 61 and 68 years. The tumours in both cases presented as well-circumscribed solid masses involving the lung hilum. After lobectomy, no recurrence was observed at 7 and 32 months. Both tumours shared storiform to short fascicular growth of long spindle cells, with a minor component of epithelioid cells showing clear cytoplasm in the background of substantial intratumoral chronic inflammation and dilated blood vessels. One tumour showed focal melanin deposition. Both tumours were immunohistochemically positive for HMB45, Melan A, and h-caldesmon. Fluorescence in situ hybridization assays indicated the presence of YAP1::TFE3 fusions, which was confirmed by RNA sequencing in one case tested, and by immunohistochemical TFE3 expression and loss of YAP1 C-terminus staining.

Conclusion: We present two cases of inflammatory spindle to epithelioid cell tumours of the lungs with myomelanocytic differentiation and YAP1::TFE3 fusion. This unique morphology and gene fusion suggest that these tumours may constitute a distinct subset of lung PEComa. Furthermore, morphological and molecular overlap with CCST-L gives rise to a hypothesis of a potential inherent relationship between PEComa and CCST-L.

目的:PEComa 肿瘤家族是由具有骨髓细胞分化的纺锤形/上皮样细胞所定义的。其中一小部分存在 TFE3 融合;但 YAP1::TEE3 尚未见报道。肺透明细胞基质瘤(CCST-L)是一种新出现的实体瘤,其特征为纺锤形至上皮样细胞,伴局灶性细胞质清亮、炎性浸润、无髓样细胞分化和YAP1::TFE3融合。在此,我们报告了两例具有骨髓细胞分化的肺肿瘤,其组织学表现为炎性纺锤形细胞、局灶上皮样透明细胞以及 YAP1::TFE3 融合:患者均为男性,年龄分别为 61 岁和 68 岁。两例患者的肿瘤均为圆形实性肿块,累及肺门。肺叶切除术后,7 个月和 32 个月未见复发。两例肿瘤均由长纺锤形细胞呈storiform至短束状生长,少量上皮样细胞胞质清晰,瘤内存在大量慢性炎症和扩张的血管。其中一个肿瘤有局灶性黑色素沉积。两个肿瘤的 HMB45、Melan A 和 h-caldesmon 免疫组化均呈阳性。荧光原位杂交检测表明存在YAP1::TFE3融合,其中一个病例的RNA测序以及免疫组化TFE3表达和YAP1 C端染色缺失证实了这一点:我们报告了两例肺部炎性纺锤形上皮样细胞瘤,这些肿瘤具有骨髓细胞分化和 YAP1::TFE3 融合。这种独特的形态和基因融合表明,这些肿瘤可能是肺上皮细胞瘤的一个独特亚群。此外,与CCST-L在形态和分子上的重叠使人们产生了PEComa与CCST-L之间可能存在内在联系的假设。
{"title":"Inflammatory spindle cell PEComa of the lung with YAP1::TFE3 fusion: a report of two cases and a potential relationship with clear cell stromal tumour.","authors":"Naoki Kojima, Shogo Nishino, Yukiko Sasahara, Tetsuro Taki, Hiroki Imada, Tomohiro Miyoshi, Shun-Ichi Watanabe, Genichiro Ishii, Yasushi Yatabe, Taisuke Mori, Akihiko Yoshida","doi":"10.1111/his.15328","DOIUrl":"https://doi.org/10.1111/his.15328","url":null,"abstract":"<p><strong>Aims: </strong>The PEComa family of tumours is defined by spindle/epithelioid cells with myomelanocytic differentiation. A small subset harbours TFE3 fusion; however, YAP1::TEE3 has not been reported. Clear cell stromal tumour of the lung (CCST-L) is an emerging entity characterized by spindle to epithelioid cells with focal cytoplasmic clearing, inflammatory infiltrates, no myomelanocytic differentiation, and YAP1::TFE3 fusion. Herein, we report two cases of lung tumours with myomelanocytic differentiation that showed inflammatory spindle cell histology, focal epithelioid clear cells, as well as YAP1::TFE3 fusion.</p><p><strong>Methods and results: </strong>The patients were both men, aged 61 and 68 years. The tumours in both cases presented as well-circumscribed solid masses involving the lung hilum. After lobectomy, no recurrence was observed at 7 and 32 months. Both tumours shared storiform to short fascicular growth of long spindle cells, with a minor component of epithelioid cells showing clear cytoplasm in the background of substantial intratumoral chronic inflammation and dilated blood vessels. One tumour showed focal melanin deposition. Both tumours were immunohistochemically positive for HMB45, Melan A, and h-caldesmon. Fluorescence in situ hybridization assays indicated the presence of YAP1::TFE3 fusions, which was confirmed by RNA sequencing in one case tested, and by immunohistochemical TFE3 expression and loss of YAP1 C-terminus staining.</p><p><strong>Conclusion: </strong>We present two cases of inflammatory spindle to epithelioid cell tumours of the lungs with myomelanocytic differentiation and YAP1::TFE3 fusion. This unique morphology and gene fusion suggest that these tumours may constitute a distinct subset of lung PEComa. Furthermore, morphological and molecular overlap with CCST-L gives rise to a hypothesis of a potential inherent relationship between PEComa and CCST-L.</p>","PeriodicalId":13219,"journal":{"name":"Histopathology","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142345813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
MTAP protein status is highly concordant with CDKN2A fluorescent in situ hybridization and allows stratification of the luminal subtype in muscle-invasive bladder cancer. MTAP 蛋白状态与 CDKN2A 荧光原位杂交高度吻合,可对肌肉浸润性膀胱癌的管腔亚型进行分层。
IF 3.9 2区 医学 Q2 CELL BIOLOGY Pub Date : 2024-09-26 DOI: 10.1111/his.15324
Ekaterina Olkhov-Mitsel, Alexander Oberc, Kenneth J Craddock, Christopher Sherman, Elzbieta Slodkowska, Michelle R Downes

Aims: Loss of heterozygosity in chromosome 9p21, common in urothelial carcinoma (UC), typically involves deletion of CDKN2A and MTAP genes. MTAP loss is emerging as a promising therapeutic target and predictive biomarker in UC. This single-centrre retrospective study examined the incidence of CDKN2A deletions and MTAP loss in muscle-invasive bladder cancer (MIBC) and metastatic urothelial carcinoma (mUC), investigating their correlations with clinical, pathological, and genomic features, as well as patient outcomes.

Methods: Fluorescence in situ hybridization (FISH) and immunohistochemistry (IHC) were performed on 302 MIBC specimens and 63 biopsy-proven metachronous urothelial metastases to assess CDKN2A deletions and MTAP protein expression.

Results: CDKN2A homozygous deletion (HD), identified in 30.3% of MIBCs, and MTAP loss, found in 28.8% of MIBCs, were both significantly associated with the luminal-URO subtype, FGFR3 mutations, and normal/wildtype p53 IHC (P < 0.05). Loss of MTAP expression was significantly correlated with CDKN2A HD, with 84.0% sensitivity, 92.3% negative predictive value (NPV), 96.3% specificity, and 91.9% positive predictive value (PPV). MTAP expression was 100% concordant between primary tumours and nodal metastases. Patients with MTAP loss had a higher incidence of visceral metastases (50%) compared to bone/soft tissue (35.7%) and nodes (14.3%). Mean progression-free survival and overall survival were shorter for patients with MTAP loss, although not statistically significant.

Conclusion: Our findings highlight CDKN2A HD and MTAP loss as prevalent genetic alterations in MIBC and mUC, particularly within the luminal-URO subtype and FGFR3-mutated, p53-normal/wildtype tumours. MTAP IHC can serve as a surrogate marker for 9p21.3 HD, highlighting its clinical relevance and potential as a therapeutic target and predictive biomarker in MIBC.

目的:9p21染色体上的杂合性缺失常见于尿路上皮癌(UC),通常涉及CDKN2A和MTAP基因的缺失。MTAP基因缺失正逐渐成为UC的治疗靶点和预测性生物标志物。这项单中心回顾性研究探讨了肌浸润性膀胱癌(MIBC)和转移性尿路上皮癌(mUC)中CDKN2A缺失和MTAP缺失的发生率,研究了它们与临床、病理和基因组特征以及患者预后的相关性:对302例MIBC标本和63例经活检证实的转移性尿路上皮癌进行荧光原位杂交(FISH)和免疫组化(IHC),以评估CDKN2A缺失和MTAP蛋白的表达:结果:在30.3%的MIBC中发现了CDKN2A同源缺失(HD),在28.8%的MIBC中发现了MTAP缺失,它们都与管腔-URO亚型、FGFR3突变和正常/野生型p53 IHC显著相关(P 结论:我们的研究结果表明,CDKN2A同源缺失和MTAP缺失与管腔-URO亚型、FGFR3突变和正常/野生型p53 IHC显著相关:我们的研究结果突出表明,CDKN2A HD和MTAP缺失是MIBC和mUC中普遍存在的基因改变,尤其是在管腔-URO亚型和FGFR3突变、p53正常/野生型肿瘤中。MTAP IHC可作为9p21.3 HD的替代标记物,突出了其作为MIBC治疗靶点和预测性生物标记物的临床相关性和潜力。
{"title":"MTAP protein status is highly concordant with CDKN2A fluorescent in situ hybridization and allows stratification of the luminal subtype in muscle-invasive bladder cancer.","authors":"Ekaterina Olkhov-Mitsel, Alexander Oberc, Kenneth J Craddock, Christopher Sherman, Elzbieta Slodkowska, Michelle R Downes","doi":"10.1111/his.15324","DOIUrl":"https://doi.org/10.1111/his.15324","url":null,"abstract":"<p><strong>Aims: </strong>Loss of heterozygosity in chromosome 9p21, common in urothelial carcinoma (UC), typically involves deletion of CDKN2A and MTAP genes. MTAP loss is emerging as a promising therapeutic target and predictive biomarker in UC. This single-centrre retrospective study examined the incidence of CDKN2A deletions and MTAP loss in muscle-invasive bladder cancer (MIBC) and metastatic urothelial carcinoma (mUC), investigating their correlations with clinical, pathological, and genomic features, as well as patient outcomes.</p><p><strong>Methods: </strong>Fluorescence in situ hybridization (FISH) and immunohistochemistry (IHC) were performed on 302 MIBC specimens and 63 biopsy-proven metachronous urothelial metastases to assess CDKN2A deletions and MTAP protein expression.</p><p><strong>Results: </strong>CDKN2A homozygous deletion (HD), identified in 30.3% of MIBCs, and MTAP loss, found in 28.8% of MIBCs, were both significantly associated with the luminal-URO subtype, FGFR3 mutations, and normal/wildtype p53 IHC (P < 0.05). Loss of MTAP expression was significantly correlated with CDKN2A HD, with 84.0% sensitivity, 92.3% negative predictive value (NPV), 96.3% specificity, and 91.9% positive predictive value (PPV). MTAP expression was 100% concordant between primary tumours and nodal metastases. Patients with MTAP loss had a higher incidence of visceral metastases (50%) compared to bone/soft tissue (35.7%) and nodes (14.3%). Mean progression-free survival and overall survival were shorter for patients with MTAP loss, although not statistically significant.</p><p><strong>Conclusion: </strong>Our findings highlight CDKN2A HD and MTAP loss as prevalent genetic alterations in MIBC and mUC, particularly within the luminal-URO subtype and FGFR3-mutated, p53-normal/wildtype tumours. MTAP IHC can serve as a surrogate marker for 9p21.3 HD, highlighting its clinical relevance and potential as a therapeutic target and predictive biomarker in MIBC.</p>","PeriodicalId":13219,"journal":{"name":"Histopathology","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142345814","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Importance of the criteria used for assessment of lymphovascular space invasion in endometrial carcinoma. 子宫内膜癌淋巴管间隙侵犯评估标准的重要性。
IF 3.9 2区 医学 Q2 CELL BIOLOGY Pub Date : 2024-09-26 DOI: 10.1111/his.15329
Jutta Huvila
{"title":"Importance of the criteria used for assessment of lymphovascular space invasion in endometrial carcinoma.","authors":"Jutta Huvila","doi":"10.1111/his.15329","DOIUrl":"https://doi.org/10.1111/his.15329","url":null,"abstract":"","PeriodicalId":13219,"journal":{"name":"Histopathology","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142345812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Characterisation of Kürsteiner canals of parathyroid: imparting relevance to a one-and-a-quarter-century-old concept. 甲状旁腺Kürsteiner管的特征:赋予一个已有四分之一世纪历史的概念以现实意义。
IF 3.9 2区 医学 Q2 CELL BIOLOGY Pub Date : 2024-09-24 DOI: 10.1111/his.15326
Haley Corbin, Linwah Yip, Sally E Carty, Miguel Reyes-Múgica, Raja R Seethala

Aims: Kürsteiner canals (KC) were described at least 125 years ago as pharyngeal pouch embryological remnants of parathyroid and thymic development. While considered precursors for a subset of parathyroid cysts and salivary heterotopias (SH), they remain enigmatic. We now define a comprehensive phenotype of KC remnants and investigate their role in a spectrum of parathyroid lesions.

Methods and results: `Sixty-two cystic and 22 non-cystic parathyroid lesions (73 patients) were retrieved from our institutional archive (2011-23) and evaluated for the presence of KC and prevalence of KC phenotype in parathyroid hormone (PTH)-positive and PTH-negative cysts. KC phenotype was defined as: cysts and tubules with surrounding sclerosis; bland, unilayered lining with frequent nuclear indentation of lumina; vesicular chromatin relative to chief cells; attenuated eosinophilic to 'hyper-cleared' cytoplasm; and staining pattern PTH-negative, SOX-10-positive, CK7-positive, GATA-3-positive and PAX-9 dim, a subset with oestrogen/progesterone receptor (ER/PR) positivity. Thirty PTH-negative cysts were identified in the neck/mediastinum; 14 of this group also showed SH. Thirty-two PTH-positive cysts included: 11 cystic parathyroid adenomas, 17 hyperplastic parathyroids, and four carcinomas. KC showed two distinct subtypes and were often found near PTH-negative cysts. PTH-negative cysts were associated with inferior parathyroids, SOX-10 positivity, fibrosclerosis, vesicular nuclei indenting cyst lumina and hyper-cleared or attenuated eosinophilic cytoplasm.

Conclusions: KC are common in parathyroids and show a distinct histological and immunohistochemical profile, with an inferior predilection favouring branchial cleft III distribution. Diagnostically, the high prevalence of this phenotype in PTH-negative cysts and salivary heterotopia supports derivation of non-functioning cysts from KC. Conversely, PTH-positive cysts are more compatible with cystic change within hyperfunctioning glands.

目的:Kürsteiner 管道(KC)至少在 125 年前被描述为甲状旁腺和胸腺发育过程中的咽囊胚胎残留物。虽然KC被认为是甲状旁腺囊肿和唾液异位症(SH)的前体,但它们仍然是谜。我们现在定义了KC残基的综合表型,并研究了它们在甲状旁腺病变中的作用:我们从本机构的档案(2011-23年)中检索了62例囊性和22例非囊性甲状旁腺病变(73例患者),并评估了甲状旁腺激素(PTH)阳性囊肿和PTH阴性囊肿中是否存在KC以及KC表型的流行率。KC表型定义为囊肿和小管周围硬化;内膜平滑、单层,管腔核经常凹陷;相对于主任细胞,染色质呈水泡状;胞质嗜酸性减弱至 "过度清亮";染色模式为PTH阴性、SOX-10阳性、CK7阳性、GATA-3阳性和PAX-9暗淡,其中一个亚群雌激素/孕激素受体(ER/PR)阳性。在颈部/纵膈发现了 30 个 PTH 阴性囊肿,其中 14 个也显示为 SH。32个PTH阳性囊肿包括11个囊性甲状旁腺腺瘤、17个增生性甲状旁腺和4个癌。KC有两种不同的亚型,通常出现在PTH阴性囊肿附近。PTH阴性囊肿与下位甲状旁腺、SOX-10阳性、纤维硬化、囊腔内凹陷的泡状核以及过度清亮或减弱的嗜酸性细胞质有关:结论:KC 常见于甲状旁腺,并表现出独特的组织学和免疫组化特征,偏向于下位,呈支裂 III 型分布。在诊断上,这种表型在PTH阴性囊肿和唾液异位症中的高发率支持从KC衍生出无功能囊肿。相反,PTH 阳性的囊肿更符合功能亢进腺体内囊变的情况。
{"title":"Characterisation of Kürsteiner canals of parathyroid: imparting relevance to a one-and-a-quarter-century-old concept.","authors":"Haley Corbin, Linwah Yip, Sally E Carty, Miguel Reyes-Múgica, Raja R Seethala","doi":"10.1111/his.15326","DOIUrl":"10.1111/his.15326","url":null,"abstract":"<p><strong>Aims: </strong>Kürsteiner canals (KC) were described at least 125 years ago as pharyngeal pouch embryological remnants of parathyroid and thymic development. While considered precursors for a subset of parathyroid cysts and salivary heterotopias (SH), they remain enigmatic. We now define a comprehensive phenotype of KC remnants and investigate their role in a spectrum of parathyroid lesions.</p><p><strong>Methods and results: </strong>`Sixty-two cystic and 22 non-cystic parathyroid lesions (73 patients) were retrieved from our institutional archive (2011-23) and evaluated for the presence of KC and prevalence of KC phenotype in parathyroid hormone (PTH)-positive and PTH-negative cysts. KC phenotype was defined as: cysts and tubules with surrounding sclerosis; bland, unilayered lining with frequent nuclear indentation of lumina; vesicular chromatin relative to chief cells; attenuated eosinophilic to 'hyper-cleared' cytoplasm; and staining pattern PTH-negative, SOX-10-positive, CK7-positive, GATA-3-positive and PAX-9 dim, a subset with oestrogen/progesterone receptor (ER/PR) positivity. Thirty PTH-negative cysts were identified in the neck/mediastinum; 14 of this group also showed SH. Thirty-two PTH-positive cysts included: 11 cystic parathyroid adenomas, 17 hyperplastic parathyroids, and four carcinomas. KC showed two distinct subtypes and were often found near PTH-negative cysts. PTH-negative cysts were associated with inferior parathyroids, SOX-10 positivity, fibrosclerosis, vesicular nuclei indenting cyst lumina and hyper-cleared or attenuated eosinophilic cytoplasm.</p><p><strong>Conclusions: </strong>KC are common in parathyroids and show a distinct histological and immunohistochemical profile, with an inferior predilection favouring branchial cleft III distribution. Diagnostically, the high prevalence of this phenotype in PTH-negative cysts and salivary heterotopia supports derivation of non-functioning cysts from KC. Conversely, PTH-positive cysts are more compatible with cystic change within hyperfunctioning glands.</p>","PeriodicalId":13219,"journal":{"name":"Histopathology","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142307660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
WHO Classification of Tumours: moving towards the sixth edition 世界卫生组织肿瘤分类:迈向第六版
IF 6.4 2区 医学 Q2 CELL BIOLOGY Pub Date : 2024-09-19 DOI: 10.1111/his.15325
Christine Giesen, Gabrielle Goldman‐Levy, Ian A Cree, Ramon Cierco Jimenez, Alberto Machado, Dilani Lokuhetty
{"title":"WHO Classification of Tumours: moving towards the sixth edition","authors":"Christine Giesen, Gabrielle Goldman‐Levy, Ian A Cree, Ramon Cierco Jimenez, Alberto Machado, Dilani Lokuhetty","doi":"10.1111/his.15325","DOIUrl":"https://doi.org/10.1111/his.15325","url":null,"abstract":"","PeriodicalId":13219,"journal":{"name":"Histopathology","volume":null,"pages":null},"PeriodicalIF":6.4,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142263501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Time requirements for diagnosing mesothelioma in situ 诊断原位间皮瘤的时间要求
IF 6.4 2区 医学 Q2 CELL BIOLOGY Pub Date : 2024-09-17 DOI: 10.1111/his.15322
Andrew Churg
{"title":"Time requirements for diagnosing mesothelioma in situ","authors":"Andrew Churg","doi":"10.1111/his.15322","DOIUrl":"https://doi.org/10.1111/his.15322","url":null,"abstract":"","PeriodicalId":13219,"journal":{"name":"Histopathology","volume":null,"pages":null},"PeriodicalIF":6.4,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142263503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Histopathology
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