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A preliminary study on the diagnostic performance of the uPath PD-L1 (SP263) artificial intelligence (AI) algorithm in patients with NSCLC treated with PD-1/PD-L1 checkpoint blockade. 关于uPath PD-L1 (SP263)人工智能(AI)算法在接受PD-1/PD-L1检查点阻断治疗的NSCLC患者中诊断性能的初步研究。
IF 4.4 Q1 PATHOLOGY Pub Date : 2024-08-01 DOI: 10.32074/1591-951X-998
Alessio Cortellini, Claudia Zampacorta, Michele De Tursi, Lucia R Grillo, Serena Ricciardi, Emilio Bria, Maurizio Martini, Raffaele Giusti, Marco Filetti, Antonella Dal Mas, Marco Russano, Filippo Gustavo Dall'Olio, Fiamma Buttitta, Antonio Marchetti

Objective: The uPath PD-L1 (SP263) is an AI-based platform designed to aid pathologists in identifying and quantifying PD-L1 positive tumor cells in non-small cell lung cancer (NSCLC) samples stained with the SP263 assay.

Methods: In this preliminary study, we explored the diagnostic performance of the uPath PD-L1 algorithm in defining PD-L1 tumor proportion score (TPS) and predict clinical outcomes in a series of patients with advanced stage NSCLC treated with single agent PD-1/PD-L1 checkpoint blockade previously assessed with the SP263 assay in clinical practice.

Results: 44 patients treated from August 2015 to January 2019 were included, with baseline PD-L1 TPS of ≥ 50%, 1-49% and < 1% in 38.6%, 25.0% and 36.4%, respectively. The median uPath PD-L1 score was 6 with a significant correlation with the baseline PD-L1 TPS (r: 0.83, p < 0.01). However, only 27 cases (61.4%) were scored within the same clinically relevant range of expression (≥ vs < 50%). In the study population the baseline PD-L1 TPS was not significantly associated with clinical outcomes, while the uPath PD-L1 score showed a good diagnostic ability for the risk of death at the ROC curve analysis [AUC: 0.81 (95%CI: 0.66-0.91), optimal cut-off of ≥ 3.2], resulting in 19 patients (43.2%) being u-Path low and 25 patients (56.8%) being uPath high. The objective response rate in uPath high and low was 51.6% and 25.0% (p = 0.1), respectively, although the uPath was significantly associated with overall survival (OS, HR 2.45, 95%CI: 1.19-5.05) and progression free survival (PFS, HR 3.04, 95%CI: 1.51-6.14). At the inverse probability of treatment weighting analysis used to balance baseline covariates, the uPath categories confirmed to be independently associated with OS and PFS.

Conclusions: This preliminary analysis suggests that AI-based, digital pathology tools such as uPath PD-L1 (SP263) can be used to optimize already available biomarkers for immune-oncology treatment in patients with NSCLC.

目的:uPath PD-L1 (SP263)是一个基于人工智能的平台,旨在帮助病理学家识别和量化用SP263检测法染色的非小细胞肺癌(NSCLC)样本中的PD-L1阳性肿瘤细胞:在这项初步研究中,我们探索了uPath PD-L1算法在定义PD-L1肿瘤比例评分(TPS)方面的诊断性能,并预测了一系列晚期NSCLC患者的临床结局:纳入2015年8月至2019年1月接受治疗的44例患者,基线PD-L1 TPS≥50%、1-49%和<1%的患者分别占38.6%、25.0%和36.4%。UPath PD-L1 评分中位数为 6,与基线 PD-L1 TPS 有显著相关性(r:0.83,p < 0.01)。然而,只有 27 个病例(61.4%)的得分在相同的临床相关表达范围内(≥ vs <50%)。在研究人群中,基线PD-L1 TPS与临床结果无显著相关性,而uPath PD-L1评分在ROC曲线分析中对死亡风险显示出良好的诊断能力[AUC:0.81(95%CI:0.66-0.91),最佳临界值≥3.2],结果19例患者(43.2%)为u-Path低分,25例患者(56.8%)为uPath高分。uPath高和uPath低的客观反应率分别为51.6%和25.0%(p = 0.1),但uPath与总生存期(OS,HR 2.45,95%CI:1.19-5.05)和无进展生存期(PFS,HR 3.04,95%CI:1.51-6.14)显著相关。在用于平衡基线协变量的逆概率治疗加权分析中,uPath类别证实与OS和PFS独立相关:这项初步分析表明,基于人工智能的数字病理学工具(如uPath PD-L1 (SP263))可用于优化现有的生物标记物,用于NSCLC患者的免疫肿瘤治疗。
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引用次数: 0
The 2023 WHO updates on skin tumors: advances since the 2018 edition. 2023年世卫组织皮肤肿瘤更新:2018年版以来的进展。
IF 4.4 Q1 PATHOLOGY Pub Date : 2024-08-01 DOI: 10.32074/1591-951X-1006
Francesco Fortarezza, Gerardo Cazzato, Giuseppe Ingravallo, Angelo Paolo Dei Tos

Pathology is pivotal in diagnosing skin tumors, and the precision of diagnosis is crucial to devise customized treatment plans and enhance patient care in dermatology. The latest edition of the World Health Organization's classification of skin tumors serves as a comprehensive compendium, summarizing and categorizing all recent advancements in both anatomical-pathological and molecular aspects of cutaneous neoplasms. Several relevant advances have been introduced and new entities have been described. While the fundamental structure of the classification remains unchanged, notable additions include three new sections aimed at providing a more exhaustive description of skin lesions: nail unit tumors, skin metastases, and genetic tumor syndromes associated with skin malignancies. Recent strides in molecular pathology have led to significant breakthroughs in decoding the underlying mechanisms of various skin tumors, ranging from adnexal neoplasms to hematolymphoid neoplasms, soft tissue tumors, and melanocytic lesions. Of particular importance is the evolution in our understanding of melanocytic neoplasms, with the introduction of the term "melanocytoma" reserved for lesions exhibiting "intermediate" biological behavior and characterized by specific molecular mutations. The pathologic diagnosis process integrates morphological, immunohistochemical, and molecular features, playing a crucial role in clinical decision-making. The WHO classification serves as a valuable tool in promoting multidisciplinarity in the management of cutaneous neoplasms with the aim of translating novel pathological discoveries into more effective treatments. This review aims to distill the major updates introduced by the new classification, providing a synthesis of the latest scientific insights.

病理学是诊断皮肤肿瘤的关键,而诊断的精确性对于制定个性化治疗方案和加强皮肤科患者护理至关重要。最新版的世界卫生组织皮肤肿瘤分类法是一部全面的汇编,总结了皮肤肿瘤在解剖病理和分子方面的所有最新进展并进行了分类。其中引入了一些相关进展,并描述了新的实体。虽然分类的基本结构保持不变,但新增了三个显著部分,旨在更详尽地描述皮肤病变:甲单位肿瘤、皮肤转移和与皮肤恶性肿瘤相关的遗传肿瘤综合征。分子病理学的最新进展使我们在解码各种皮肤肿瘤(从附件肿瘤到血淋巴肿瘤、软组织肿瘤和黑素细胞病变)的内在机制方面取得了重大突破。尤其重要的是,我们对黑色素细胞肿瘤的认识也在不断发展,"黑色素细胞瘤 "这一术语是专门针对表现出 "中间 "生物学行为并以特定分子突变为特征的病变而使用的。病理诊断过程综合了形态学、免疫组化和分子特征,在临床决策中起着至关重要的作用。世卫组织分类是促进皮肤肿瘤多学科管理的重要工具,其目的是将新的病理发现转化为更有效的治疗方法。本综述旨在提炼新分类所引入的主要更新内容,提供最新科学见解的综述。
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引用次数: 0
Oral sialadenoma papilliferum with kras mutation in a patient with linear nevus sebaceous syndrome. 一名患有线性皮脂腺痣综合征的患者口腔乳头状腺瘤伴有 kras 突变。
IF 4.4 Q1 PATHOLOGY Pub Date : 2024-08-01 DOI: 10.32074/1591-951X-992
Giulia Querzoli, Giovanni Badiali, Francesco Vitali, Achille Tarsitano, Dario De Biase, Liliana Gabrielli, Maria Pia Foschini

Linear nevus sebaceous syndrome (LNSS) is a rare neurocutaneous syndrome part of the epidermal nevus syndromes group, characterized by the presence of sebaceous nevi and other extracutaneous lesions genetically related to RAS family gene mutations. Sialadenoma papilliferum (SP) is a rare benign intraoral neoplasm which is usually BRAF or HRAS mutated. We report a case of a young female girl diagnosed with a LNSS who developed a SP which had a KRAS mutation. This is the first case of SP with a KRAS mutation in the context of a LNSS.

线性皮脂腺痣综合征(LNSS)是一种罕见的神经皮肤综合征,属于表皮痣综合征,其特征是出现皮脂腺痣和其他皮肤外病变,遗传上与 RAS 家族基因突变有关。乳头状唾液腺瘤(SP)是一种罕见的口腔内良性肿瘤,通常伴有BRAF或HRAS基因突变。我们报告了一例被诊断为LNSS的年轻女性患者,她患上了KRAS突变的SP。这是首例在LNSS背景下出现KRAS突变的SP病例。
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引用次数: 0
Asbestos exposure diagnosis in pulmonary tissues. 肺组织中的石棉暴露诊断。
IF 4.4 Q1 PATHOLOGY Pub Date : 2024-08-01 DOI: 10.32074/1591-951X-930
Donata Bellis, Alessandro Croce, Alex Glorioso, Marinella Bertolotti, Antonio Maconi

The diagnosis of asbestosis requires different criteria depending on whether it is in a clinical or medical/legal setting. In the latter context, only when a "diffuse interstitial fibrosis associated to asbestos bodies (ABs)" is present, it can be said to be asbestosis. Considering the medical/legal setting, the diagnosis must be certain and proven. Unfortunately, it is often difficult to identify ABs by light microscopy (LM), but this does not mean that the diagnosis should be clinically excluded. Other parameters are important, such as working history and/or diagnostic imaging. In addition to LM, normally used for diagnosis, there are other techniques, e.g.: scanning electron microscopy with attached microanalysis microprobe (SEM/EDS), but they require tissue digestion and higher cost. A new approach with micro-Raman spectroscopy and SEM/EDS techniques is able to analyse histological sections without other manipulations that could interfere with analysis of asbestos fibres. In this work, we propose an algorithm for asbestosis diagnosis, especially in the forensic medical field, demonstrating the importance of close collaboration between multiple professionals.

诊断石棉沉滞症需要不同的标准,这取决于是在临床环境还是在医疗/法律环境中。就后者而言,只有当出现 "与石棉体(ABs)相关的弥漫性间质纤维化 "时,才能说是石棉沉滞症。考虑到医疗/法律环境,诊断必须是确定的和经过证实的。遗憾的是,通常很难通过光学显微镜(LM)来识别 ABs,但这并不意味着临床上应排除这一诊断。其他参数也很重要,如工作史和/或影像诊断。除了通常用于诊断的光学显微镜外,还有其他技术,例如:扫描电子显微镜和附带的显微分析微探针(SEM/EDS),但它们需要对组织进行消化,成本较高。利用微拉曼光谱和扫描电镜/电子显微镜技术的新方法能够分析组织切片,而无需其他可能干扰石棉纤维分析的操作。在这项工作中,我们提出了一种用于石棉沉滞症诊断的算法,特别是在法医领域,证明了多个专业人员之间密切合作的重要性。
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引用次数: 0
Digital transition in pathology lab: a survey from the Lombardy region. 病理实验室的数字化转型:来自伦巴第大区的调查。
IF 4.4 Q1 PATHOLOGY Pub Date : 2024-08-01 DOI: 10.32074/1591-951X-1004
Elisa Belloni, Emanuela Bonoldi, Giorgio Bovo, Sabrina Buoro, Michele Cerati, Fulvia Milena Cribiú, Emanuele Dainese, Alessandro Del Gobbo, Mattia Facchetti, Andrea Gianatti, Umberto Gianelli, Paolo Giunta, Vincenzo L'Imperio, Massimo Milione, Manuela Nebuloni, Fabio Pagni, Marco Paulli, Antonella Piga, Fabio Pasotti

Objective: Digital pathology is an opportunity to revise the routine and old artisanal workflow, moving to standard operating procedures, quality control and reproducibility. Here the results of a survey promoted by the Coordinamento della Medicina di Laboratorio (CRC Med Lab) of the Lombardy region in Italy are reported to shed light on the current situation of digital adoption in the country.

Methods: The survey composed of 58 questions was sent to 60 pathology laboratories. The results were collected and most significant answers were reported and discussed.

Results: Answers were received from 57 (95%) laboratories, a minority organized in spoke-hub networks (16%) with a centralized processing phase (11%). Hybrid manual/computer-assisted traceability was prevalent (36%), with QR/barcode labeling starting within the pathology lab (23%). Different laboratory information systems (LIS) were employed, mostly with alert functions and/or multimedial file attachments (56% and 46%, respectively). The majority opted for a semi-automated tracking management (44, 77%) and 18 centers (32%) were partly digitizing the routine (¾ scanning < 25% of slides). Whole slide images were retained for 3.7 years in average; in-house blocks/slides archiving was still preferred (30, 53%), with 1838 (±1551) and 1798 (±1950) days (5 years) internal permanence for blocks and slides that are stored in out-source (mean turnaround time for return on-demand 3.7±2.1, range 1-10 days).

Conclusions: The advantages of digital pathology must be balanced against the challenges faced in the structural revision of the pathology workflow. This regional scouting can represent the foundation to build an efficient and connected digital pathology system in the territory.

目的:数字病理学是一个机会,可借以修改常规和旧式的手工工作流程,转向标准操作程序、质量控制和可重复性。本文报告了由意大利伦巴第大区医学实验室协调员(CRC Med Lab)发起的一项调查的结果,以揭示该国采用数字化技术的现状:方法:向 60 家病理实验室发送了包含 58 个问题的调查问卷。方法:向 60 家病理实验室发送了由 58 个问题组成的调查问卷,并收集了调查结果,报告和讨论了最重要的答案:结果:共收到 57 家(95%)实验室的答复,其中少数实验室以辐式集线器网络(16%)为组织形式,集中处理阶段(11%)。人工/计算机辅助混合型追溯系统非常普遍(36%),病理实验室内部开始使用 QR/条形码标签(23%)。采用了不同的实验室信息系统(LIS),大多具有警报功能和/或多媒介文件附件(分别占 56% 和 46%)。大多数中心选择了半自动化跟踪管理(44 个,77%),18 个中心(32%)对常规工作进行了部分数字化(¾ 扫描小于 25% 的玻片)。整张切片图像平均保存3.7年;内部切块/切片归档仍是首选(30,53%),外部存储的切块和切片的内部永久保存时间分别为1838(±1551)天和1798(±1950)天(5年)(按需返回的平均周转时间为3.7±2.1,范围为1-10天):数字病理学的优势必须与病理学工作流程结构改革所面临的挑战相平衡。这次地区考察为在该地区建立高效、互联的数字病理系统奠定了基础。
{"title":"Digital transition in pathology lab: a survey from the Lombardy region.","authors":"Elisa Belloni, Emanuela Bonoldi, Giorgio Bovo, Sabrina Buoro, Michele Cerati, Fulvia Milena Cribiú, Emanuele Dainese, Alessandro Del Gobbo, Mattia Facchetti, Andrea Gianatti, Umberto Gianelli, Paolo Giunta, Vincenzo L'Imperio, Massimo Milione, Manuela Nebuloni, Fabio Pagni, Marco Paulli, Antonella Piga, Fabio Pasotti","doi":"10.32074/1591-951X-1004","DOIUrl":"https://doi.org/10.32074/1591-951X-1004","url":null,"abstract":"<p><strong>Objective: </strong>Digital pathology is an opportunity to revise the routine and old artisanal workflow, moving to standard operating procedures, quality control and reproducibility. Here the results of a survey promoted by the Coordinamento della Medicina di Laboratorio (CRC Med Lab) of the Lombardy region in Italy are reported to shed light on the current situation of digital adoption in the country.</p><p><strong>Methods: </strong>The survey composed of 58 questions was sent to 60 pathology laboratories. The results were collected and most significant answers were reported and discussed.</p><p><strong>Results: </strong>Answers were received from 57 (95%) laboratories, a minority organized in spoke-hub networks (16%) with a centralized processing phase (11%). Hybrid manual/computer-assisted traceability was prevalent (36%), with QR/barcode labeling starting within the pathology lab (23%). Different laboratory information systems (LIS) were employed, mostly with alert functions and/or multimedial file attachments (56% and 46%, respectively). The majority opted for a semi-automated tracking management (44, 77%) and 18 centers (32%) were partly digitizing the routine (¾ scanning < 25% of slides). Whole slide images were retained for 3.7 years in average; in-house blocks/slides archiving was still preferred (30, 53%), with 1838 (±1551) and 1798 (±1950) days (5 years) internal permanence for blocks and slides that are stored in out-source (mean turnaround time for return on-demand 3.7±2.1, range 1-10 days).</p><p><strong>Conclusions: </strong>The advantages of digital pathology must be balanced against the challenges faced in the structural revision of the pathology workflow. This regional scouting can represent the foundation to build an efficient and connected digital pathology system in the territory.</p>","PeriodicalId":45893,"journal":{"name":"PATHOLOGICA","volume":"116 4","pages":"232-241"},"PeriodicalIF":4.4,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11460148/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142394147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Fibrin associated large B-cell lymphoma accidentally identified in a breast implant capsule: a molecular report of a rare entity. 乳房植入物囊中意外发现的纤维蛋白相关大 B 细胞淋巴瘤:一份罕见病例的分子报告。
IF 4.4 Q1 PATHOLOGY Pub Date : 2024-08-01 DOI: 10.32074/1591-951X-944
Cristian Scatena, Antonio Giuseppe Naccarato, Margherita Vannucchi, Maria Chiara Siciliano, Angelo Giovanni Bonadio, Livio Colizzi, Matteo Ghilli, Arianna Di Napoli, Giuseppe Nicolò Fanelli, Stefano Lazzi

Breast implant-associated (BIA) lymphoma is a rare malignancy, typically originating from T-cells; however, few cases of diffuse large B-cell lymphoma (LBCL) have been recently described. These cases share major features: Epstein-Barr virus positivity and a favorable prognosis with surgical intervention alone, hinting at a potential link to fibrin-associated LBCL (FA-LBCL). This study presents the first case of BIA-FA-LBCL in Italy and one of the few assessed from a molecular standpoint so far. We identified two pathogenic mutations in DNMT3A and a variant of uncertain significance (VUS) in JAK2. These findings suggest that dysfunctional epigenetic mechanisms and constitutive activation of the JAK-STAT pathway may underpin BIA-FA-LBCL lymphomagenesis. Finally, we summarized all the previously reported cases in alignment with the updated WHO-HAEM5 classification, shedding further light on the nature of this new entity. This report highlights the rarity of BIA-FA-LBCL and underscores the importance of comprehensive capsule sampling and reporting to national databases for accurate characterization and management of these lymphomas. The study supports the classification of BIA-FA-LBCL within the spectrum of FA-LBCL, emphasizing the need for further research to elucidate its molecular underpinnings and improve clinical outcomes.

乳房植入物相关(BIA)淋巴瘤是一种罕见的恶性肿瘤,通常起源于T细胞;不过,最近也有少数弥漫大B细胞淋巴瘤(LBCL)病例被描述出来。这些病例具有共同的主要特征:这些病例的主要特征是:Epstein-Barr 病毒阳性,仅通过手术治疗预后良好,这暗示着与纤维蛋白相关的 LBCL(FA-LBCL)可能存在联系。本研究是意大利首例BIA-FA-LBCL病例,也是迄今为止从分子角度进行评估的少数病例之一。我们在 DNMT3A 中发现了两个致病突变,在 JAK2 中发现了一个意义不明的变体(VUS)。这些发现表明,表观遗传机制失调和JAK-STAT通路的构成性激活可能是BIA-FA-LBCL淋巴瘤发生的基础。最后,我们根据最新的WHO-HAEM5分类总结了以前报道的所有病例,进一步揭示了这一新实体的性质。本报告强调了BIA-FA-LBCL的罕见性,并强调了全面的胶囊采样和向国家数据库报告对于准确鉴定和管理这些淋巴瘤的重要性。该研究支持将BIA-FA-LBCL归入FA-LBCL谱系,强调了进一步研究以阐明其分子基础和改善临床结果的必要性。
{"title":"Fibrin associated large B-cell lymphoma accidentally identified in a breast implant capsule: a molecular report of a rare entity.","authors":"Cristian Scatena, Antonio Giuseppe Naccarato, Margherita Vannucchi, Maria Chiara Siciliano, Angelo Giovanni Bonadio, Livio Colizzi, Matteo Ghilli, Arianna Di Napoli, Giuseppe Nicolò Fanelli, Stefano Lazzi","doi":"10.32074/1591-951X-944","DOIUrl":"https://doi.org/10.32074/1591-951X-944","url":null,"abstract":"<p><p>Breast implant-associated (BIA) lymphoma is a rare malignancy, typically originating from T-cells; however, few cases of diffuse large B-cell lymphoma (LBCL) have been recently described. These cases share major features: Epstein-Barr virus positivity and a favorable prognosis with surgical intervention alone, hinting at a potential link to fibrin-associated LBCL (FA-LBCL). This study presents the first case of BIA-FA-LBCL in Italy and one of the few assessed from a molecular standpoint so far. We identified two pathogenic mutations in DNMT3A and a variant of uncertain significance (VUS) in JAK2. These findings suggest that dysfunctional epigenetic mechanisms and constitutive activation of the JAK-STAT pathway may underpin BIA-FA-LBCL lymphomagenesis. Finally, we summarized all the previously reported cases in alignment with the updated WHO-HAEM5 classification, shedding further light on the nature of this new entity. This report highlights the rarity of BIA-FA-LBCL and underscores the importance of comprehensive capsule sampling and reporting to national databases for accurate characterization and management of these lymphomas. The study supports the classification of BIA-FA-LBCL within the spectrum of FA-LBCL, emphasizing the need for further research to elucidate its molecular underpinnings and improve clinical outcomes.</p>","PeriodicalId":45893,"journal":{"name":"PATHOLOGICA","volume":"116 4","pages":"242-248"},"PeriodicalIF":4.4,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11460149/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142394148","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Histopathological lesions of the gastrointestinal tract associated with the use of polystyrene sulfonate and sevelamer: a meta-analysis. 与使用聚苯乙烯磺酸盐和sevelamer有关的胃肠道组织病理学病变:一项荟萃分析。
IF 4.4 Q1 PATHOLOGY Pub Date : 2024-08-01 DOI: 10.32074/1591-951X-994
Gianluca Di Rienzo, Pellegrino Crafa, Marco Delsante, Enrico Fiaccadori, Giuseppe Pedrazzi, Nicoletta Campanini, Emilia Corradini

Background: Gastrointestinal severe adverse events such as ulceration and perforation have been reported for sodium or calcium polystyrene sulfonate and sevelamer. Howewer, their role in the pathogenesis is unclear. Chronic kidney disease is a well known risk factor, while the role of hypertension and/or diabetes is uncertain.

Methods: A meta-analysis of the published literature was conducted to review the clinical features, risk factors and histopathological findings of patients who experienced gastrointestinal adverse events after administration of polystyrene sulfonate or sevelamer.

Results: The meta-analysis indicated that patients were more likely to show necrosis and/or perforation when the resin used was polystyrene sulfonate compared to sevelamer (p < 0.001). Death was more likely in patients taking polystyrene sulfonate compared to sevelamer (p < 0.001).

Discussion: The results show that sevelamer is more likely to lead to inflammation or ulceration in the gastrointestinal tract than polystyrene sulfonate, which is more likely to be associated with severe gastrointestinal adverse events such as necrosis and/or perforation. Polystyrene sulfonate is significantly associated with death compared to sevelamer.

背景:据报道,聚苯乙烯磺酸钠或聚苯乙烯磺酸钙和司维拉姆可引起溃疡和穿孔等严重的胃肠道不良反应。但它们在发病机制中的作用尚不明确。慢性肾病是一个众所周知的风险因素,而高血压和/或糖尿病的作用尚不确定:对已发表的文献进行了荟萃分析,回顾了服用聚苯乙烯磺酸盐或司维拉姆后出现胃肠道不良反应的患者的临床特征、风险因素和组织病理学结果:荟萃分析表明,使用聚苯乙烯磺酸盐树脂的患者比使用司维拉姆的患者更容易出现坏死和/或穿孔(P 0.001)。服用聚苯乙烯磺酸盐的患者比服用司维拉姆的患者更容易死亡(P 0.001):讨论:研究结果表明,与聚苯乙烯磺酸盐相比,西维拉姆更容易导致胃肠道炎症或溃疡,而聚苯乙烯磺酸盐更容易导致严重的胃肠道不良事件,如坏死和/或穿孔。与西维拉姆相比,聚苯乙烯磺酸盐与死亡的关系更为密切。
{"title":"Histopathological lesions of the gastrointestinal tract associated with the use of polystyrene sulfonate and sevelamer: a meta-analysis.","authors":"Gianluca Di Rienzo, Pellegrino Crafa, Marco Delsante, Enrico Fiaccadori, Giuseppe Pedrazzi, Nicoletta Campanini, Emilia Corradini","doi":"10.32074/1591-951X-994","DOIUrl":"10.32074/1591-951X-994","url":null,"abstract":"<p><strong>Background: </strong>Gastrointestinal severe adverse events such as ulceration and perforation have been reported for sodium or calcium polystyrene sulfonate and sevelamer. Howewer, their role in the pathogenesis is unclear. Chronic kidney disease is a well known risk factor, while the role of hypertension and/or diabetes is uncertain.</p><p><strong>Methods: </strong>A meta-analysis of the published literature was conducted to review the clinical features, risk factors and histopathological findings of patients who experienced gastrointestinal adverse events after administration of polystyrene sulfonate or sevelamer.</p><p><strong>Results: </strong>The meta-analysis indicated that patients were more likely to show necrosis and/or perforation when the resin used was polystyrene sulfonate compared to sevelamer (p <b><</b> 0.001). Death was more likely in patients taking polystyrene sulfonate compared to sevelamer (p <b><</b> 0.001).</p><p><strong>Discussion: </strong>The results show that sevelamer is more likely to lead to inflammation or ulceration in the gastrointestinal tract than polystyrene sulfonate, which is more likely to be associated with severe gastrointestinal adverse events such as necrosis and/or perforation. Polystyrene sulfonate is significantly associated with death compared to sevelamer.</p>","PeriodicalId":45893,"journal":{"name":"PATHOLOGICA","volume":"116 4","pages":"216-221"},"PeriodicalIF":4.4,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11460155/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142394149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Colitis cystica profunda associated with diverticulosis and calcification mimicking colorectal carcinoma: a case report and a brief literature review. 伴有憩室和钙化的深部结肠炎模仿结肠直肠癌:病例报告和简要文献综述。
IF 4.4 Q1 PATHOLOGY Pub Date : 2024-08-01 DOI: 10.32074/1591-951X-969
Giovanni Nunzio Rosano, Eleonora Aiello, Samaneh Kherad Pisheh, Enrica Deiana, Lorenzo Memeo, Cristina Colarossi

Colitis cystica profunda (CCP) is a rare, uncommon and nonneoplastic condition that can occur anywhere in gastrointestinal tract, but its main occurrence is in the rectum and sigmoid colon. It is characterized by the presence of mucin filled cysts, lined by benign epithelium, beneath the muscularis mucosae, usually confined to the submucosa, and it can clinically and radiologically mimic a neoplasm. Here we report a rare case of CCP in a patient with a 2-months history of abdominal pain and severe anemia, associated with diverticulosis. The knowledge of this entity and its differential diagnosis, in particular with the intestinal mucinous adenocarcinoma, is necessary, as it can be a clinically and histological mimic of a malignant neoplasm.

深部结肠囊炎(CCP)是一种罕见的非肿瘤性疾病,可发生在胃肠道的任何部位,但主要发生在直肠和乙状结肠。它的特征是粘膜下出现由良性上皮衬里的粘液囊肿,通常局限于粘膜下层,在临床和影像学上可与肿瘤相似。我们在此报告了一例罕见的 CCP 病例,患者有两个月的腹痛和严重贫血病史,并伴有憩室炎。有必要了解这种疾病及其鉴别诊断,尤其是与肠粘液腺癌的鉴别诊断,因为它可以在临床和组织学上模拟恶性肿瘤。
{"title":"Colitis cystica profunda associated with diverticulosis and calcification mimicking colorectal carcinoma: a case report and a brief literature review.","authors":"Giovanni Nunzio Rosano, Eleonora Aiello, Samaneh Kherad Pisheh, Enrica Deiana, Lorenzo Memeo, Cristina Colarossi","doi":"10.32074/1591-951X-969","DOIUrl":"https://doi.org/10.32074/1591-951X-969","url":null,"abstract":"<p><p>Colitis cystica profunda (CCP) is a rare, uncommon and nonneoplastic condition that can occur anywhere in gastrointestinal tract, but its main occurrence is in the rectum and sigmoid colon. It is characterized by the presence of mucin filled cysts, lined by benign epithelium, beneath the muscularis mucosae, usually confined to the submucosa, and it can clinically and radiologically mimic a neoplasm. Here we report a rare case of CCP in a patient with a 2-months history of abdominal pain and severe anemia, associated with diverticulosis. The knowledge of this entity and its differential diagnosis, in particular with the intestinal mucinous adenocarcinoma, is necessary, as it can be a clinically and histological mimic of a malignant neoplasm.</p>","PeriodicalId":45893,"journal":{"name":"PATHOLOGICA","volume":"116 4","pages":"249-253"},"PeriodicalIF":4.4,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11460153/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142394146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A case series of chorioangiomas in placentas with clinical indication for histological examination. 胎盘绒毛血管瘤病例系列,临床指征为组织学检查。
IF 4.4 Q1 PATHOLOGY Pub Date : 2024-08-01 DOI: 10.32074/1591-951X-1003
Eleonora Nardi, Angela Silvano, Francesca Castiglione, Erika Olivo, Isabella Abati, Daniela Massi, Viola Seravalli, Mariarosaria Di Tommaso

Chorioangiomas are benign angiomas arising from chorionic tissue and they are the most common non-trophoblastic tumors of the placenta, as they are observed in 1% of all placentas examined. Most chorioangiomas are small and asymptomatic, often undetected during a prenatal ultrasound, and their clinical significance is still unknown. Large chorioangiomas, measuring more than 4-5 cm in diameter, can usually be detected prenatally by gray-scale or color Doppler sonography, and may be associated with maternal or fetal complications, such as preeclampsia, maternal mirror syndrome, preterm delivery, nonimmune fetal hydrops, fetal growth restriction and fetal demise. We herein describe the clinical-pathological features of a monocentric series of 30 placental chorioangiomas and discuss their clinical-pathological features and possible molecular mechanisms underlying their development.

绒毛血管瘤是由绒毛组织产生的良性血管瘤,是胎盘中最常见的非滋养细胞肿瘤,在所有受检胎盘中占 1%。大多数绒毛膜血管瘤较小且无症状,通常在产前超声检查中未被发现,其临床意义尚不清楚。大的绒毛膜血管瘤直径超过 4-5 厘米,通常可在产前通过灰阶或彩色多普勒超声检查发现,可能与母体或胎儿的并发症有关,如子痫前期、母体镜像综合征、早产、非免疫性胎儿水肿、胎儿生长受限和胎儿死亡。我们在此描述了 30 例胎盘绒毛膜血管瘤单中心系列的临床病理特征,并讨论了其临床病理特征及其可能的分子机制。
{"title":"A case series of chorioangiomas in placentas with clinical indication for histological examination.","authors":"Eleonora Nardi, Angela Silvano, Francesca Castiglione, Erika Olivo, Isabella Abati, Daniela Massi, Viola Seravalli, Mariarosaria Di Tommaso","doi":"10.32074/1591-951X-1003","DOIUrl":"https://doi.org/10.32074/1591-951X-1003","url":null,"abstract":"<p><p>Chorioangiomas are benign angiomas arising from chorionic tissue and they are the most common non-trophoblastic tumors of the placenta, as they are observed in 1% of all placentas examined. Most chorioangiomas are small and asymptomatic, often undetected during a prenatal ultrasound, and their clinical significance is still unknown. Large chorioangiomas, measuring more than 4-5 cm in diameter, can usually be detected prenatally by gray-scale or color Doppler sonography, and may be associated with maternal or fetal complications, such as preeclampsia, maternal mirror syndrome, preterm delivery, nonimmune fetal hydrops, fetal growth restriction and fetal demise. We herein describe the clinical-pathological features of a monocentric series of 30 placental chorioangiomas and discuss their clinical-pathological features and possible molecular mechanisms underlying their development.</p>","PeriodicalId":45893,"journal":{"name":"PATHOLOGICA","volume":"116 4","pages":"258-266"},"PeriodicalIF":4.4,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11460147/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142394143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Precision medicine in ovarian cancer: disparities and inequities in access to predictive biomarkers. 卵巢癌的精准医疗:获得预测性生物标记物方面的差距和不公平。
IF 4.4 Q1 PATHOLOGY Pub Date : 2024-06-01 DOI: 10.32074/1591-951X-959
Massimo Barberis, Nicoletta Colombo, Nicoletta Cerana
{"title":"Precision medicine in ovarian cancer: disparities and inequities in access to predictive biomarkers.","authors":"Massimo Barberis, Nicoletta Colombo, Nicoletta Cerana","doi":"10.32074/1591-951X-959","DOIUrl":"10.32074/1591-951X-959","url":null,"abstract":"","PeriodicalId":45893,"journal":{"name":"PATHOLOGICA","volume":"116 3","pages":"141-143"},"PeriodicalIF":4.4,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11447653/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141560034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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