149 results on '"Erminia Manfrin"'
Search Results
2. Endoscopic Ultrasound-Guided Through-the-Needle Biopsy: A Narrative Review of the Technique and Its Emerging Role in Pancreatic Cyst Diagnosis
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Filipe Vilas-Boas, Tiago Ribeiro, Guilherme Macedo, Jahnvi Dhar, Jayanta Samanta, Sokol Sina, Erminia Manfrin, Antonio Facciorusso, Maria Cristina Conti Bellocchi, Nicolò De Pretis, Luca Frulloni, and Stefano Francesco Crinò
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mucinous cystic neoplasm ,EUS-FNA ,pancreatic cancer ,cystic fluid analysis ,intraductal papillary mucinous neoplasm (IPMN) ,neuroendocrine tumor ,Medicine (General) ,R5-920 - Abstract
Pancreatic cystic lesions (PCLs) pose a diagnostic challenge due to their increasing incidence and the limitations of cross-sectional imaging and endoscopic-ultrasound-guided fine-needle aspiration (EUS-FNA). EUS-guided through the needle biopsy (EUS-TTNB) has emerged as a promising tool for improving the accuracy of cyst type determination and neoplastic risk stratification. EUS-TTNB demonstrates superior diagnostic performance over EUS-FNA, providing critical preoperative information that can significantly influence patient management and reduce unnecessary surgeries. However, the procedure has risks, with an overall adverse event rate of approximately 9%. Preventive measures and further prospective studies are essential to optimize its safety and efficacy. This review highlights the potential of EUS-TTNB to enhance the diagnostic and management approaches for patients with PCLs. It examines the current state of EUS-TTNB, including available devices, indications, procedural techniques, specimen handling, diagnostic yield, clinical impact, and associated adverse events.
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- 2024
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3. Rare Pancreatic/Peripancreatic Cystic Lesions Can Be Accurately Characterized by EUS with Through-the-Needle Biopsy—A Unique Pictorial Essay with Clinical and Histopathological Correlations
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Maria Cristina Conti Bellocchi, Erminia Manfrin, Alessandro Brillo, Laura Bernardoni, Andrea Lisotti, Pietro Fusaroli, Alice Parisi, Sokol Sina, Antonio Facciorusso, Armando Gabbrielli, and Stefano Francesco Crinò
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pancreatic cyst ,endoscopic ultrasound ,through-the-needle biopsy ,pancreatic surgery ,pancreatic cancer ,fine-needle aspiration ,Medicine (General) ,R5-920 - Abstract
Due to their aspecific macroscopic appearance, uncommon pancreatic cystic lesions (PCLs) are often misdiagnosed as mucinous lesions and improperly resected. We aimed to evaluate the endoscopic ultrasound (EUS)-guided through-the-needle biopsy (TTNB) capacity of the preoperative diagnosis of uncommon PCLs. Overall, 136 patients with PCLs who underwent EUS-TTNB between 2016 and 2022 were retrospectively identified. Common histotypes (e.g., IPMN, serous cystadenoma, and mucinous cystadenoma) were excluded and 26 (19.1%) patients (15 female, mean age 52.9 ± 10.4) were analyzed. The EUS findings, adverse events (AEs), and TTNB outcomes in uncommon PCLs were evaluated. The cysts histotype was accurately diagnosed by TTNB in 24/26 (92.3%) cases (seven cystic neuroendocrine tumors, four squamoid cysts, three acinar cells cystadenomas, two lymphoepithelial cysts, two mucinous non-neoplastic cysts, two bronchogenic cysts, two cystic lymphangiomas, one solid-pseudopapillary neoplasm, and one schwannoma). In the remaining two cases, lymphangioma was eventually diagnosed after resection. Surgery was performed in 15/26 (57.7%) patients. The mean follow-up of non-surgical patients was 32.5 months. One severe acute case of pancreatitis (3.8%) that required surgery occurred after EUS-TTNB. Uncommon pancreatic/peripancreatic lesions represent the 19.1% of PCLs in our series, with mainly benign histotypes. TTNB demonstrated a high diagnostic performance with a low rate of AEs in this setting, representing a reliable tool with which to avoid useless surgery.
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- 2023
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4. Endoscopic Ultrasound Through-the-Needle Biopsy for the Diagnosis of an Abdominal Bronchogenic Cyst
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Jessica Cassiani, Stefano Francesco Crinò, Erminia Manfrin, Matteo Rivelli, Armando Gabbrielli, Alfredo Guglielmi, and Corrado Pedrazzani
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bronchogenic cyst ,endoscopic ultrasound-guided fine-needle aspiration ,endoscopic ultrasound-guided through-the-needle biopsy ,laparoscopy ,pancreatic cyst ,Internal medicine ,RC31-1245 ,Diseases of the digestive system. Gastroenterology ,RC799-869 - Abstract
A 57-year-old woman with epigastric pain was diagnosed with a 6-cm abdominal cystic lesion of unclear origin on cross-sectional imaging. Endoscopic ultrasound (EUS) demonstrated a unilocular cyst located between the pancreas, gastric wall, and left adrenal gland, with a regular wall filled with dense fluid with multiple hyperechoic floating spots. A 19-G needle was used to puncture the cyst, but no fluid could be aspirated. Therefore, EUS-guided through-the-needle biopsy (EUS-TTNB) was performed. Histological analysis of the retrieved fragments revealed a fibrous wall lined by “respiratory-type” epithelium with ciliated columnar cells, consistent with the diagnosis of a bronchogenic cyst. Laparoscopic excision was performed, and the diagnosis was confirmed based on the findings of the surgical specimen. Abdominal bronchogenic cysts are extremely uncommon, and a definitive diagnosis is commonly obtained after the examination of surgical specimens due to the lack of pathognomonic findings on cross-sectional imaging and poor cellularity on EUS-guided fine-needle aspiration cytology. EUS-TTNB is useful for establishing a preoperative histological diagnosis, thus supporting the decision-making process.
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- 2021
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5. Secondary Tumors of the Pancreas: A Multicenter Analysis of Clinicopathological and Endosonographic Features
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Marco Spadaccini, Maria Cristina Conti Bellocchi, Benedetto Mangiavillano, Alberto Fantin, Daoud Rahal, Erminia Manfrin, Francesca Gavazzi, Silvia Bozzarelli, Stefano Francesco Crinò, Maria Terrin, Milena Di Leo, Cristiana Bonifacio, Antonio Facciorusso, Stefano Realdon, Chiara Cristofori, Francesco Auriemma, Alessandro Fugazza, Luca Frulloni, Cesare Hassan, Alessandro Repici, and Silvia Carrara
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pancreas ,cancer ,oncology ,surgery ,metastasis ,Medicine - Abstract
Many tumors may secondarily involve the pancreas; however, only retrospective autopic and surgical series are available. We retrospectively collected data from all consecutive patients with histologically confirmed secondary tumors of the pancreas referred to five Italian centers between 2010 and 2021. We described clinical and pathological features, therapeutic approach and treatment outcomes. EUS characteristics of the lesions and the tissue acquisition procedures (needle, passages, histology) were recorded. A total of 116 patients (males/females 69/47; mean age 66.7) with 236 histologically confirmed pancreatic metastases were included; kidney was the most common primary site. EUS was performed to confirm the diagnosis in 205 lesions which presented as predominantly solitary (59), hypoechoic (95) and hypervascular (60), with a heterogeneous (n = 54) pattern and well-defined borders (n = 52). EUS-guided tissue acquisition was performed in 94 patients with an overall accuracy of 97.9%. Histological evaluation was possible in 88.3% of patients, obtaining final diagnosis in all cases. When cytology alone was performed, the final diagnosis was obtained in 83.3% of cases. A total of 67 patients underwent chemo/radiation therapy, and surgery was attempted in 45 (38.8%) patients. Pancreatic metastases are a possible event in the natural history of solid tumors, even long after the diagnosis of the primary site. EUS-guided fine needle biopsy may be suggested to implement the differential diagnosis.
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- 2023
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6. Targeted next-generation sequencing identifies genomic abnormalities potentially driving the prognosis of early-stage invasive lobular breast carcinoma patients stratified according to a validated clinico-pathological model
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Luisa Carbognin, Michele Simbolo, Anna Caliò, Caterina Vicentini, Pietro Delfino, Isabella Sperduti, Matteo Fassan, Francesco Schettini, Maria Vittoria Dieci, Gaia Griguolo, Sara Pilotto, Elena Fiorio, Grazia Arpino, Valentina Guarneri, Sabino De Placido, Pierfranco Conte, Erminia Manfrin, Matteo Brunelli, Giovanni Scambia, Aldo Scarpa, Giampaolo Tortora, and Emilio Bria
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Breast cancer ,Lobular ,Prognosis ,Next-generation sequencing ,Transcriptome analysis ,CDK4 ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Introduction: The clinico-pathological and molecular factors that drive the prognosis of invasive lobular breast carcinoma (ILC) are not entirely explored. In this regard, the development and validation of a prognostic model for ILC and the investigation of the distribution of molecular abnormalities (focusing on CDK4/6 alterations) according to prognosis were the aims of this study. Patients and methods: Two clinico-pathological multi-center data-sets of early-stage ILC patients (Training/Validation Set, TS/VS) were gathered. A 3-class model was developed according to the multivariate analysis for disease-free-survival (DFS) and externally validated. Mutational, copy number variation and transcriptomic analyses by targeted next generation sequencing (NGS) were performed (and validated with quantitative PCR) in an explorative cohort of patients with poor and good prognosis. Results: Data from overall 773 patients (TS/VS: 491/282) were gathered. The developed model significantly discriminated low/intermediate/high risk in the TS (10-years DFS: 76.3%/67.6%/39.8%, respectively, p
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- 2020
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7. Molecular and Clinical Insights in Malignant Brenner Tumor of the Testis With Liver Metastases:A Case Report
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Pietro Parcesepe, Luigi Coppola, Andrea Remo, Mario Rosario D’Andrea, Giulia Coppola, Michele Simbolo, Erminia Manfrin, Aldo Scarpa, Elena De Santis, and Guido Giordano
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Brenner tumor ,testis ,epididymis ,FGFR ,malignant ,mutations ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Malignant Brenner Tumor (mBT) is extremely rare. Although BT are almost exclusive ovarian neoplasms, they may constitute a highly unusual tumor of the testis; in fact, only seven fully documented cases have been reported to date. Because of their rarity, the pathogenesis of these tumors has not been clarified and there is no standard therapeutic approach. We report the first case of epididymal mBT with synchronous, multiple, liver metastases and a very dramatic clinical course. Both primary tumor and metastasis were subjected to mutational analysis of 20 cancer associated genes. Primary tumor showed FGFR3 Tyr375Cys and PIK3CA His1047Arg missense mutations. Both mutations are reported as pathogenic in ClinVar database. The same FGFR3 mutation was present in liver metastasis. Based on these results we believe that the FGFR pathway could be an ideal candidate for personalized treatment, offering hope to a subset of patients with mBT. Personalized approach, including mutational analysis and molecular testing should be required in patients with rare tumors in order to clarify diagnosis and improve therapeutic strategies.
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- 2021
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8. JAK/Stat5-mediated subtype-specific lymphocyte antigen 6 complex, locus G6D (LY6G6D) expression drives mismatch repair proficient colorectal cancer
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Guido Giordano, Pietro Parcesepe, Mario Rosario D’Andrea, Luigi Coppola, Tania Di Raimo, Andrea Remo, Erminia Manfrin, Claudia Fiorini, Aldo Scarpa, Carla Azzurra Amoreo, Fabiana Conciatori, Michele Milella, Francesca Pia Caruso, Luigi Cerulo, Almudena Porras, and Massimo Pancione
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LY6G6D ,Colorectal cancer ,Microsatellite-stable ,Immune resistance ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Abstract Background Human microsatellite-stable (MSS) colorectal cancers (CRCs) are immunologically “cold” tumour subtypes characterized by reduced immune cytotoxicity. The molecular linkages between immune-resistance and human MSS CRC is not clear. Methods We used transcriptome profiling, in silico analysis, immunohistochemistry, western blot, RT-qPCR and immunofluorescence staining to characterize novel CRC immune biomarkers. The effects of selective antagonists were tested by in vitro assays of long term viability and analysis of kinase active forms using anti-phospho antibodies. Results We identified the lymphocyte antigen 6 complex, locus G6D (LY6G6D) as significantly overexpressed (around 15-fold) in CRC when compared with its relatively low expression in other human solid tumours. LY6G6D up-regulation was predominant in MSS CRCs characterized by an enrichment of immune suppressive regulatory T-cells and a limited repertoire of PD-1/PD-L1 immune checkpoint receptors. Coexpression of LY6G6D and CD15 increases the risk of metastatic relapse in response to therapy. Both JAK-STAT5 and RAS-MEK-ERK cascades act in concert as key regulators of LY6G6D and Fucosyltransferase 4 (FUT4), which direct CD15-mediated immune-resistance. Momelotinib, an inhibitor of JAK1/JAK2, consistently abrogated the STAT5/LY6G6D axis in vitro, sensitizing MSS cancer cells with an intact JAK-STAT signaling, to efficiently respond to trametinib, a MEK inhibitor used in clinical setting. Notably, colon cancer cells can evade JAK2/JAK1-targeted therapy by a reversible shift of the RAS-MEK-ERK pathway activity, which explains the treatment failure of JAK1/2 inhibitors in refractory CRC. Conclusions Combined targeting of STAT5 and MAPK pathways has superior therapeutic effects on immune resistance. In addition, the new identified LY6G6D antigen is a promising molecular target for human MSS CRC.
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- 2019
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9. Diagnostic Yield of Endoscopic Ultrasound-Guided Liver Biopsy in Comparison to Percutaneous Liver Biopsy: A Two-Center Experience
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Antonio Facciorusso, Daryl Ramai, Maria Cristina Conti Bellocchi, Laura Bernardoni, Erminia Manfrin, Nicola Muscatiello, and Stefano Francesco Crinò
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endoscopic ultrasound ,liver biopsy ,percutaneous liver biopsy ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
There is scarce and conflicting evidence on the comparison between endoscopic ultrasound (EUS) and percutaneous (PC)-guided liver biopsy (LB). The aim of this study was to compare the two approaches in a series of patients with parenchymal and focal liver lesions. Fifty-four patients undergoing EUS-LB in two high-volume centers between 2017 and 2021 were compared to 62 patients who underwent PC-LB. The primary outcome was diagnostic adequacy rate. The secondary outcomes were diagnostic accuracy, total sample length (TSL), number of complete portal tracts (CPTs), procedural duration, and adverse events. Variables were compared using the Chi-square and Mann–Whitney test. Median age was 56 years (interquartile range 48–69) in the EUS-LB group and 54 years (45–67) in the PC-LB group with most patients being male. Indication for LB was due to parenchymal disease in 50% of patients, whereas the other patients underwent LB due to focal liver lesions. Diagnostic adequacy was 100% in PC-LB and 94.4% in the EUS-LB group (p = 0.74), whereas diagnostic accuracy was 88.8% in the EUS-LB group and 100% in the PC-LB group (p = 0.82). Median TSL was significantly greater in the PC-LB group (27.4 mm, IQR 21–29) when compared to the EUS-LB group (18.5 mm, 10.1–22.4; p = 0.02). The number of complete portal tracts was 21 (11–24) in the PC-LB group and 18.5 (10–23.2) in EUS-LB group (p = 0.09). EUS-LB was a significantly longer procedure (7 min, 5–11 versus 1 min, 1–3 of PC-LB; p < 0.001) and no evidence of adverse events was observed in any of the study groups. These results were confirmed in the subgroup analysis performed according to an indication for LB (parenchymal disease versus focal lesion). Although PC-LB yielded specimens with greater TSL, diagnostic adequacy and accuracy were similar between the two procedures.
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- 2021
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10. CT Simplified Radiomic Approach to Assess the Metastatic Ductal Adenocarcinoma of the Pancreas
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Mirko D’Onofrio, Riccardo De Robertis, Gregorio Aluffi, Camilla Cadore, Alessandro Beleù, Nicolò Cardobi, Giuseppe Malleo, Erminia Manfrin, and Claudio Bassi
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radiomics ,pancreatic adenocarcinoma ,pancreatic cancer ,CT ,metastasis ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
The aim of this study was to perform a simplified radiomic analysis of pancreatic ductal adenocarcinoma based on qualitative and quantitative tumor features and to compare the results between metastatic and non-metastatic patients. A search of our radiological, surgical, and pathological databases identified 1218 patients with a newly diagnosed pancreatic ductal adenocarcinoma who were referred to our Institution between January 2014 and December 2018. Computed Tomography (CT) examinations were reviewed analyzing qualitative and quantitative features. Two hundred eighty-eight patients fulfilled the inclusion criteria and were included in this study. Overall, metastases were present at diagnosis in 86/288 patients, while no metastases were identified in 202/288 patients. Ill-defined margins and a hypodense appearance on portal-phase images were significantly more common among patients with metastases compared to non-metastatic patients (p < 0.05). Metastatic tumors showed a significantly larger size and significantly lower arterial index, perfusion index, and permeability index compared to non-metastatic tumors (p < 0.05). In the management of pancreatic ductal adenocarcinoma, early detection and correct staging are key elements. The study of computerized tomography characteristics of pancreatic ductal adenocarcinoma showed substantial differences, both qualitative and quantitative, between metastatic and non-metastatic disease.
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- 2021
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11. Immune Escape Mechanisms in Colorectal Cancer Pathogenesis and Liver Metastasis
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Massimo Pancione, Guido Giordano, Andrea Remo, Antonio Febbraro, Lina Sabatino, Erminia Manfrin, Michele Ceccarelli, and Vittorio Colantuoni
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Immunologic diseases. Allergy ,RC581-607 - Abstract
Over the past decade, growing evidence indicates that the tumor microenvironment (TME) contributes with genomic/epigenomic aberrations of malignant cells to enhance cancer cells survival, invasion, and dissemination. Many factors, produced or de novo synthesized by immune, stromal, or malignant cells, acting in a paracrine and autocrine fashion, remodel TME and the adaptive immune response culminating in metastasis. Taking into account the recent accomplishments in the field of immune oncology and using metastatic colorectal cancer (mCRC) as a model, we propose that the evasion of the immune surveillance and metastatic spread can be achieved through a number of mechanisms that include (a) intrinsic plasticity and adaptability of immune and malignant cells to paracrine and autocrine stimuli or genotoxic stresses; (b) alteration of positional schemes of myeloid-lineage cells, produced by factors controlling the balance between tumour-suppressing and tumour-promoting activities; (c) acquisition by cancer cells of aberrant immune-phenotypic traits (NT5E/CD73, CD68, and CD163) that enhance the interactions among TME components through the production of immune-suppressive mediators. These properties may represent the driving force of metastatic progression and thus clinically exploitable for cancer prevention and therapy. In this review we summarize results and suggest new hypotheses that favour the growing impact of tumor-infiltrating immune cells on tumour progression, metastasis, and therapy resistance.
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- 2014
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12. Ensemble of gene signatures identifies novel biomarkers in colorectal cancer activated through PPARγ and TNFα signaling.
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Stefano Maria Pagnotta, Carmelo Laudanna, Massimo Pancione, Lina Sabatino, Carolina Votino, Andrea Remo, Luigi Cerulo, Pietro Zoppoli, Erminia Manfrin, Vittorio Colantuoni, and Michele Ceccarelli
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Medicine ,Science - Abstract
We describe a novel bioinformatic and translational pathology approach, gene Signature Finder Algorithm (gSFA) to identify biomarkers associated with Colorectal Cancer (CRC) survival. Here a robust set of CRC markers is selected by an ensemble method. By using a dataset of 232 gene expression profiles, gSFA discovers 16 highly significant small gene signatures. Analysis of dichotomies generated by the signatures results in a set of 133 samples stably classified in good prognosis group and 56 samples in poor prognosis group, whereas 43 remain unreliably classified. AKAP12, DCBLD2, NT5E and SPON1 are particularly represented in the signatures and selected for validation in vivo on two independent patients cohorts comprising 140 tumor tissues and 60 matched normal tissues. Their expression and regulatory programs are investigated in vitro. We show that the coupled expression of NT5E and DCBLD2 robustly stratifies our patients in two groups (one of which with 100% survival at five years). We show that NT5E is a target of the TNF-α signaling in vitro; the tumor suppressor PPARγ acts as a novel NT5E antagonist that positively and concomitantly regulates DCBLD2 in a cancer cell context-dependent manner.
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- 2013
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13. Endoscopic ultrasound fine-needle biopsy to assess DAXX/ATRX expression and alternative lengthening of telomeres status in non-functional pancreatic neuroendocrine tumors
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Maria Gaia Mastrosimini, Erminia Manfrin, Andrea Remo, Mario De Bellis, Alice Parisi, Serena Pedron, Claudio Luchini, Matteo Brunelli, Serena Ammendola, Laura Bernardoni, Maria Cristina Conti Bellocchi, Armando Gabbrielli, Antonio Facciorusso, Antonio Pea, Luca Landoni, Aldo Scarpa, and Stefano Francesco Crinò
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Pancreatic tumor ,FISH ,Hepatology ,ALT ,Endocrinology, Diabetes and Metabolism ,Gastroenterology ,Pancreatic cancer ,Immunohistochemistry - Published
- 2023
14. EUS-guided fine needle biopsy is able to provide diagnosis in rare osteoclast-like giant cells undifferentiated carcinoma of the pancreas: report of two cases
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Ruxandra Mihaela Pop, Claudia Irina Diaconu, Mihai Rimbaş, Radu Bogdan Mateescu, Farid Rouhani, Cristiana Popp, Erminia Manfrin, Stefano Francesco Crinò, and Victor Cauni
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Endoscopic ultrasound-guided fine needle aspiration ,Osteoclast-like giant cell ,Tumor markers ,Pancreatic cancer ,Endoscopic ultrasound-guided fine needle biopsy ,Immunohistochemistry - Abstract
Undifferentiated carcinoma of the pancreas with osteoclast-like giant cells (UC-OGC) is a rare subtype of pancreatic cancer, accounting for less than 1% of all pancreatic tumors. Preoperative diagnosis is cumbersome as cross-sectional imaging is often not capable to distinguish between UC-OGC and other pancreatic tumors such as pancreatic adenocarcinoma, mucinous carcinoma or neuroendocrine tumors and specific tumor markers seem to be lacking. Endoscopic ultrasound r `m(EUS) with tissue acquisition via fine-needle aspiration (FNA) or biopsy (FNB) with microscopic HE staining and immunohistochemistry allows for an accurate diagnosis, thus influencing further treatment. We present herein the cases of two patients with osteoclast-like giant cells tumors of the pancreas diagnosed by EUS-guided fine needle biopsy and perform a literature review on the role of EUS-guided biopsy for diagnosis.
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- 2023
15. A secretory carcinoma with NTRK3 break-apart molecular rearrangement: A case report on a tumor initially diagnosed as a mucoepidermoid carcinoma
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Giangiacomo Sanna, Riccardo Nocini, Alessandro Trotolo, Andrea Fior, Matteo Brunelli, Erminia Manfrin, and Vittorio Favero
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- 2023
16. Data from Centrosome Linker–induced Tetraploid Segregation Errors Link Rhabdoid Phenotypes and Lethal Colorectal Cancers
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Massimo Pancione, Aldo Scarpa, Vittorio Colantuoni, Michele Ceccarelli, Giuseppe Viglietto, Luca Mastracci, Federica Grillo, Fulvio D'angelo, Fortunato Lonardo, Claudio Ghimenton, Guido Giordano, Massimo Delledonne, Luciano Xumerle, Marianna Garonzi, Enrico Molinari, Jacopo Giuliani, Lina Sabatino, Tommaso Colangelo, Elisabetta Baritono, Duarte Mendes Oliveira, Donatella Malanga, Michele Simbolo, Carmelo Laudanna, Ugnius Mickys, Hye Seung Han, Alberto Ferrarini, Pietro Parcesepe, Erminia Manfrin, and Andrea Remo
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Centrosome anomalies contribute to tumorigenesis, but it remains unclear how they are generated in lethal cancer phenotypes. Here, it is demonstrated that human microsatellite instable (MSI) and BRAFV600E-mutant colorectal cancers with a lethal rhabdoid phenotype are characterized by inactivation of centrosomal functions. A splice site mutation that causes an unbalanced dosage of rootletin (CROCC), a centrosome linker component required for centrosome cohesion and separation at the chromosome 1p36.13 locus, resulted in abnormally shaped centrosomes in rhabdoid cells from human colon tissues. Notably, deleterious deletions at 1p36.13 were recurrent in a subgroup of BRAFV600E-mutant and microsatellite stable (MSS) rhabdoid colorectal cancers, but not in classical colorectal cancer or pediatric rhabdoid tumors. Interfering with CROCC expression in near-diploid BRAFV600E-mutant/MSI colon cancer cells disrupts bipolar mitotic spindle architecture, promotes tetraploid segregation errors, resulting in a highly aggressive rhabdoid-like phenotype in vitro. Restoring near-wild-type levels of CROCC in a metastatic model harboring 1p36.13 deletion results in correction of centrosome segregation errors and cell death, revealing a mechanism of tolerance to mitotic errors and tetraploidization promoted by deleterious 1p36.13 loss. Accordingly, cancer cells lacking 1p36.13 display far greater sensitivity to centrosome spindle pole stabilizing agents in vitro. These data shed light on a previously unknown link between centrosome cohesion defects and lethal cancer phenotypes providing new insight into pathways underlying genome instability.Implications: Mis-segregation of chromosomes is a prominent feature of chromosome instability and intratumoral heterogeneity recurrent in metastatic tumors for which the molecular basis is unknown. This study provides insight into the mechanism by which defects in rootletin, a centrosome linker component causes tetraploid segregation errors and phenotypic transition to a clinically devastating form of malignant rhabdoid tumor. Mol Cancer Res; 16(9); 1385–95. ©2018 AACR.
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- 2023
17. Supplementary Tables 1-9 from Centrosome Linker–induced Tetraploid Segregation Errors Link Rhabdoid Phenotypes and Lethal Colorectal Cancers
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Massimo Pancione, Aldo Scarpa, Vittorio Colantuoni, Michele Ceccarelli, Giuseppe Viglietto, Luca Mastracci, Federica Grillo, Fulvio D'angelo, Fortunato Lonardo, Claudio Ghimenton, Guido Giordano, Massimo Delledonne, Luciano Xumerle, Marianna Garonzi, Enrico Molinari, Jacopo Giuliani, Lina Sabatino, Tommaso Colangelo, Elisabetta Baritono, Duarte Mendes Oliveira, Donatella Malanga, Michele Simbolo, Carmelo Laudanna, Ugnius Mickys, Hye Seung Han, Alberto Ferrarini, Pietro Parcesepe, Erminia Manfrin, and Andrea Remo
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Supplementary Table 1. Clinicopathological, immunohistochemical and molecular features of the 12 rhabdoid colorectal cancers7 Supplementary Table 2. Somatic mutations of candidate genes (15 out of 20 are reported) shared by the two rhabdoid cancers at exome sequencing Supplementary Table 3. Rhabdoid colorectal cancers (RC): molecular alterations, centrosome aberrations and ploidy Supplementary Table 4. Rhabdoid tumours of infants (RI): molecular alterations, centrosome aberrations, and ploidy Supplementary Table 5: Clinicopathologic and molecular features of classical colorectal cancers analyzed Supplementary Table 6. Sequencing and Reverse transcription PCR primers Supplementary Table 6B. SMARCB1 regions covered by the custom panel used for next-generation target sequencing Supplementary Table 7. CROCC regions covered by the custom panel used for next-generation targeted sequencing Supplementary Table 8. Antibodies employed and working conditions for immunohistochemistry, immunofluorescence or western blot analysis of tissues and cell lines Supplementary Table 9. Rhabdoid colorectal cancer reported in literature between 1993-2015
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- 2023
18. Supplementary Materials and Methods from Centrosome Linker–induced Tetraploid Segregation Errors Link Rhabdoid Phenotypes and Lethal Colorectal Cancers
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Massimo Pancione, Aldo Scarpa, Vittorio Colantuoni, Michele Ceccarelli, Giuseppe Viglietto, Luca Mastracci, Federica Grillo, Fulvio D'angelo, Fortunato Lonardo, Claudio Ghimenton, Guido Giordano, Massimo Delledonne, Luciano Xumerle, Marianna Garonzi, Enrico Molinari, Jacopo Giuliani, Lina Sabatino, Tommaso Colangelo, Elisabetta Baritono, Duarte Mendes Oliveira, Donatella Malanga, Michele Simbolo, Carmelo Laudanna, Ugnius Mickys, Hye Seung Han, Alberto Ferrarini, Pietro Parcesepe, Erminia Manfrin, and Andrea Remo
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The file contains supplementary Materials and Methods
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- 2023
19. Supplementary Figures 1-9 from Centrosome Linker–induced Tetraploid Segregation Errors Link Rhabdoid Phenotypes and Lethal Colorectal Cancers
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Massimo Pancione, Aldo Scarpa, Vittorio Colantuoni, Michele Ceccarelli, Giuseppe Viglietto, Luca Mastracci, Federica Grillo, Fulvio D'angelo, Fortunato Lonardo, Claudio Ghimenton, Guido Giordano, Massimo Delledonne, Luciano Xumerle, Marianna Garonzi, Enrico Molinari, Jacopo Giuliani, Lina Sabatino, Tommaso Colangelo, Elisabetta Baritono, Duarte Mendes Oliveira, Donatella Malanga, Michele Simbolo, Carmelo Laudanna, Ugnius Mickys, Hye Seung Han, Alberto Ferrarini, Pietro Parcesepe, Erminia Manfrin, and Andrea Remo
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S1. Whole exome sequencing analysis of two rhabdoid colorectal cancers (RC). S2. Non-silent somatic mutations in rhabdoid tumours are enriched in centrosome-microtubule components. S3. Effect of CROCC mutations on centrosome phenotype. S4. CROCC expression profiling in classical colorectal cancers (CRCs). S5. Allelic loss at the 1p36.13 locus correlates with chromosomal instability in colorectal cancer cells. S6. Centrosome and chromosome instability in colorectal cancer cells. S7. Mitotic errors and impaired cell cycle caused by stable CROCC depletion in RKO cells. S8. Invasive behavior of colorectal cancer cells triggered by CROCC depletion. S9. Mitotic aberrations suppressed by CROCC or microtubule stabilizing agents in metastatic T84 and HT29 colorectal cancer cells.
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- 2023
20. WET-SUCTION VERSUS SLOW-PULL TECHNIQUE FOR ENDOSCOPIC ULTRASOUND-GUIDED FINE-NEEDLE BIOPSY: A MULTICENTER, RANDOMIZED, CROSS-OVER TRIAL
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Stefano Francesco Crinò, Maria Cristina Conti Bellocchi, Roberto Di Mitri, Frediano Inzani, Mihai Rimbaș, Andrea Lisotti, Guido Manfredi, Anthony Y. B. Teoh, Benedetto Mangiavillano, Oriol Sendino, Laura Bernardoni, Erminia Manfrin, Daniela Scimeca, Elettra Unti, Angela Carlino, Theodor Voiosu, R. Bogdan Mateescu, Pietro Fusaroli, Stefania Lega, Elisabetta Buscarini, Lorena Pergola, Shannon M. Chan, Laura Lamonaca, Àngels Ginès, Gloria Fernández-Esparrach, Antonio Facciorusso, and Alberto Larghi
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pancreatic cancer ,gastrointestinal stromal tumor ,submucosal tumors ,diagnostic accuracy ,fine-needle aspiration ,Gastroenterology - Abstract
Background It is unknown whether there is an advantage to using the wet-suction or slow-pull technique during endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB) with new-generation needles. We aimed to compare the performance of each technique in EUS-FNB. Methods This was a multicenter, randomized, single-blind, crossover trial including patients with solid lesions of ≥ 1 cm. Four needle passes with 22 G fork-tip or Franseen-type needles were performed, alternating the wet-suction and slow-pull techniques in a randomized order. The primary outcome was the histological yield (samples containing an intact piece of tissue of at least 550 μm). Secondary end points were sample quality (tissue integrity and blood contamination), diagnostic accuracy, and adequate tumor fraction. Results Overall, 210 patients with 146 pancreatic and 64 nonpancreatic lesions were analyzed. A tissue core was retrieved in 150 (71.4 %) and 129 (61.4 %) cases using the wet-suction and the slow-pull techniques, respectively (P = 0.03). The mean tissue integrity score was higher using wet suction (P = 0.02), as was the blood contamination of samples (P Conclusion Overall, the wet-suction technique in EUS-FNB resulted in a higher tissue core procurement rate compared with the slow-pull method. Diagnostic accuracy and the rate of samples with adequate tumor fraction were similar between the two techniques.
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- 2023
21. Comparison between EUS-guided fine-needle aspiration cytology and EUS-guided fine-needle biopsy histology for the evaluation of pancreatic neuroendocrine tumors
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Erminia Manfrin, Luca Frulloni, Anna Meneghetti, Federico Pin, Stefano Francesco Crinò, Maria Cristina Conti Bellocchi, Alberto Larghi, Antonio Amodio, Antonio Facciorusso, Laura Bernardoni, Serena Ammendola, Alice Parisi, Luca Landoni, Armando Gabbrielli, Maria Gaia Mastrosimini, and Salvatore Paiella
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Adult ,Male ,medicine.medical_specialty ,Proliferative index ,Endocrinology, Diabetes and Metabolism ,Biopsy, Fine-Needle ,Pancreatic surgery ,Subgroup analysis ,Neuroendocrine tumors ,Small pNET ,Fine needle biopsy ,03 medical and health sciences ,0302 clinical medicine ,Cytology ,Biopsy ,medicine ,Humans ,Endoscopic Ultrasound-Guided Fine Needle Aspiration ,Grading (tumors) ,Endoscopic ultrasound tissue acquisition ,Ki-67 proliferative index ,Aged ,Retrospective Studies ,Hepatology ,medicine.diagnostic_test ,business.industry ,Gastroenterology ,Histology ,Middle Aged ,medicine.disease ,digestive system diseases ,Pancreatic Neoplasms ,Neuroendocrine Tumors ,030220 oncology & carcinogenesis ,Female ,030211 gastroenterology & hepatology ,Radiology ,business - Abstract
Studies comparing EUS-guided fine-needle aspiration (EUS-FNA) with EUS-guided fine-needle biopsy (EUS-FNB) for the evaluation of pancreatic neuroendocrine tumors (pNETs) are lacking. We aimed at comparing EUS-FNA with EUS-FNB in terms of Ki-67 proliferative index (PI) estimation capability, cellularity of the samples, and reliability of Ki-67 PI/tumor grading compared with surgical specimens.Patients diagnosed with pNETs on EUS and/or surgical specimens were retrospectively identified. Specimens were re-evaluated to assess Ki-67 PI feasibility, sample cellularity by manual counting, and determination of Ki-67 PI value. Outcomes in the EUS-FNA and EUS-FNB groups were compared. Kendall rank test was used for Ki-67 PI correlation between EUS and surgical specimens. Subgroup analysis including small (≤20 mm), non-functioning pNETs was performed.Three-hundred samples from 292 lesions were evaluated: 69 EUS-FNA cytology and 231 EUS-FNB histology. Ki-67 PI feasibility was similar for EUS-FNA and EUS-FNB (91.3% vs. 95.7%, p = 0.15), while EUS-FNB performed significantly better in the subgroup of 179 small pNETs (88.2% vs. 96.1%, p = 0.04). Rate of poor cellulated (500 cells) specimens was equal between EUS-FNA and EUS-FNB. A significant correlation for Ki-67 PI values between EUS and 92 correspondent surgical specimens was found in both groups, but it was stronger with EUS-FNB (tau = 0.626, p 0.0001 vs. tau = 0.452, p = 0.031). Correct grading estimation was comparable between the two groups (p = 0.482).Our study showed stronger correlation for Ki-67 values between EUS-FNB and surgical specimens, and that EUS-FNB outperformed EUS-FNA in the evaluation of small pNETs. EUS-FNB should become standard of care for grading assessment of suspected pNETs.
- Published
- 2021
22. Dual-Tracer (68Ga-DOTATOC and 18F-FDG-)-PET/CT Scan and G1-G2 Nonfunctioning Pancreatic Neuroendocrine Tumors: A Single-Center Retrospective Evaluation of 124 Nonmetastatic Resected Cases
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Matteo Salgarello, Stefano Francesco Crinò, Mirko D'Onofrio, Sara Cingarlini, G. Montagnini, Alice Parisi, Claudio Bassi, Sarah Tebaldi, Luca Landoni, Erminia Manfrin, Roberto Salvia, G. Deiro, Salvatore Paiella, Beatrice Bianchi, and Michele Zuffante
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medicine.medical_specialty ,Endocrine and Autonomic Systems ,business.industry ,Endocrinology, Diabetes and Metabolism ,Neuroendocrine tumors ,medicine.disease ,Single Center ,68ga dotatoc ,Cellular and Molecular Neuroscience ,Endocrinology ,Internal medicine ,Cohort ,Dual tracer ,Medicine ,Non metastatic ,Fdg pet ct ,business ,Nuclear medicine ,Pathological - Abstract
Introduction: The combined use of 68gallium (68Ga)-DOTA-peptides and 18fluorine-fluoro-2-deoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) scans in the workup of pancreatic neuroendocrine tumors (PanNETs) is controversial. This study aimed at assessing both tracers’ capability to identify tumors and to assess its association with pathological predictors of recurrence. Methods: Prospectively collected, preoperative, dual-tracer PET/CT scan data of G1-G2, nonmetastatic, PanNETs that underwent surgery between January 2013 and October 2019 were retrospectively analyzed. Results: The final cohort consisted of 124 cases. There was an approximately equal distribution of males and females (50.8%/49.2%) and G1 and G2 tumors (49.2%/50.8%). The disease was detected in 122 (98.4%) and 64 (51.6%) cases by 68Ga-DOTATOC and by 18F-FDG PET/CT scans, respectively, with a combined sensitivity of 99.2%. 18F-FDG-positive examinations found G2 tumors more often than G1 (59.4 vs. 40.6%; p = 0.036), and 18F-FDG-positive PanNETs were larger than negative ones (median tumor size 32 mm, interquartile range [IQR] 21 vs. 26 mm, IQR 20; p = 0.019). The median Ki67 for 18F-FDG-positive and -negative examinations was 3 (IQR 4) and 2 (IQR 4), respectively (p = 0.029). At least 1 pathological predictor of recurrence was present in 74.6% of 18F-FDG-positive cases (vs. 56.7%; p = 0.039), whereas this was not found when dichotomizing the PanNETs by their dimensions (≤/>20 mm). None of the 2 tracers predicted nodal metastasis. The receiver operating characteristic curve analysis showed that 18F-FDG uptake higher than 4.2 had a sensitivity of 49.2% and specificity of 73.3% for differentiating G1 from G2 (AUC = 0.624, p = 0.009). Conclusion: The complementary adoption of 68Ga-DOTATOC and 18F-FDG tracers may be valuable in the diagnostic workup of PanNETs despite not being a game-changer for the management of PanNETs ≤20 mm.
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- 2021
23. Percutaneous Interventional Procedures in Pancreatic Cancer
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Mirko D’Onofrio, Antonia Maria Olivieri, Francesco Verrengia, Filippo Moro, Luca Geraci, Luisa Tomaiuolo, Chiara Longo, Francesco Cicalò, Cesare Cacciatore, Alice Parisi, Erminia Manfrin, and Riccardo De Robertis
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Pancreatic biopsy ,Ultrasound-guided interventional procedures ,Pancreatic biopsy, Ultrasound-guided interventional procedures - Published
- 2022
24. Targeted next-generation sequencing identifies genomic abnormalities potentially driving the prognosis of early-stage invasive lobular breast carcinoma patients stratified according to a validated clinico-pathological model
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Caterina Vicentini, Grazia Arpino, Luisa Carbognin, Giovanni Scambia, Matteo Brunelli, Giampaolo Tortora, Valentina Guarneri, Anna Caliò, Sara Pilotto, Michele Simbolo, Pierfranco Conte, Francesco Schettini, Matteo Fassan, Sabino De Placido, Maria Vittoria Dieci, Pietro Delfino, Aldo Scarpa, Gaia Griguolo, Elena Fiorio, Emilio Bria, Erminia Manfrin, Isabella Sperduti, Carbognin, Luisa, Simbolo, Michele, Caliò, Anna, Vicentini, Caterina, Delfino, Pietro, Sperduti, Isabella, Fassan, Matteo, Schettini, Francesco, Dieci, Maria Vittoria, Griguolo, Gaia, Pilotto, Sara, Fiorio, Elena, Arpino, Grazia, Guarneri, Valentina, De Placido, Sabino, Conte, Pierfranco, Manfrin, Erminia, Brunelli, Matteo, Scambia, Giovanni, Scarpa, Aldo, Tortora, Giampaolo, and Bria, Emilio
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Oncology ,Multivariate analysis ,0302 clinical medicine ,Breast cancer ,Retrospective Studie ,Medicine ,030212 general & internal medicine ,Copy-number variation ,Stage (cooking) ,skin and connective tissue diseases ,Multivariate Analysi ,DNA Copy Number Variation ,High-Throughput Nucleotide Sequencing ,General Medicine ,Middle Aged ,lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,Prognosis ,030220 oncology & carcinogenesis ,Cohort ,Clinico pathological ,Original Article ,Female ,Survival Analysi ,Transcriptome analysis ,Invasive Lobular Breast Carcinoma ,Breast Neoplasm ,Human ,Risk ,medicine.medical_specialty ,CDK4 ,DNA Copy Number Variations ,Prognosi ,Lobular ,Next-generation sequencing ,Breast Neoplasms ,lcsh:RC254-282 ,DNA sequencing ,03 medical and health sciences ,Internal medicine ,Biomarkers, Tumor ,Humans ,Retrospective Studies ,Settore MED/06 - ONCOLOGIA MEDICA ,business.industry ,Gene Expression Profiling ,Cyclin-Dependent Kinase 4 ,Cyclin-Dependent Kinase 6 ,Sequence Analysis, DNA ,medicine.disease ,Survival Analysis ,Carcinoma, Lobular ,Transcriptome analysi ,Multivariate Analysis ,Surgery ,business - Abstract
Introduction The clinico-pathological and molecular factors that drive the prognosis of invasive lobular breast carcinoma (ILC) are not entirely explored. In this regard, the development and validation of a prognostic model for ILC and the investigation of the distribution of molecular abnormalities (focusing on CDK4/6 alterations) according to prognosis were the aims of this study. Patients and methods Two clinico-pathological multi-center data-sets of early-stage ILC patients (Training/Validation Set, TS/VS) were gathered. A 3-class model was developed according to the multivariate analysis for disease-free-survival (DFS) and externally validated. Mutational, copy number variation and transcriptomic analyses by targeted next generation sequencing (NGS) were performed (and validated with quantitative PCR) in an explorative cohort of patients with poor and good prognosis. Results Data from overall 773 patients (TS/VS: 491/282) were gathered. The developed model significantly discriminated low/intermediate/high risk in the TS (10-years DFS: 76.3%/67.6%/39.8%, respectively, p, Highlights • The current multicenter analysis developed and validated a prognostic nomogram for early stage ILC. • A next-generation sequencing analysis was performed in prognostic ‘outlier’ patients. • CDK4 gain emerges as a potential negative prognostic factor in ILC patients. .
- Published
- 2020
25. Impact of biliary stents on the diagnostic accuracy of EUS-guided fine-needle biopsy of solid pancreatic head lesions: A multicenter study
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StefanoFrancesco Crinò, MariaCristina Conti Bellocchi, Filippo Antonini, Giampiero Macarri, Silvia Carrara, Laura Lamonaca, Roberto Di Mitri, Elisabetta Conte, Carlo Fabbri, Cecilia Binda, Andrew Ofosu, Enrico Gasparini, Chiara Turri, Caterina Stornello, Ciro Celsa, Alberto Larghi, Erminia Manfrin, Armando Gabbrielli, Antonio Facciorusso, Matteo Tacelli, Crino S., Conti Bellocchi M., Antonini F., MacArri G., Carrara S., Lamonaca L., Di Mitri R., Conte E., Fabbri C., Binda C., Ofosu A., Gasparini E., Turri C., Stornello C., Celsa C., Larghi A., Manfrin E., Gabbrielli A., Facciorusso A., and Tacelli M.
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endoscopic retrograde cholangiopancreatography ,pancreatic cancer ,Hepatology ,fine-needle biopsy ,Gastroenterology ,Radiology, Nuclear Medicine and imaging ,Original Article ,fine-needle aspiration ,biliary drainage - Abstract
Background and Objectives: There is no clear evidence of a negative impact of biliary stents on the diagnostic yield of EUS-guided fine-needle biopsy (EUS-FNB) for diagnosing pancreatic head lesions. We aimed to evaluate the association between the presence of biliary stents and the diagnostic accuracy of EUS-FNB. Materials and Methods: A multicenter retrospective study including all jaundiced patients secondary to pancreatic head masses was performed. Patients were divided into two groups according to the presence of a biliary stent placed before EUS-FNB. Pathological results were classified according to the Papanicolaou classification and compared against the final diagnosis. Diagnostic measures in the two groups were compared. Multivariate logistic regression analyses including potential factors affecting EUS-FNB accuracy were performed. Results: Overall, 842 patients were included, 495 (58.8%) without and 347 (41.2%) with biliary stent. A plastic or a metal stent was placed in 217 (62.5%) and 130 (37.5%) cases, respectively. Diagnostic sensitivity and accuracy were significantly higher in patients without biliary stent than in those with stent (91.9% and 92.1% vs. 85.9% and 86.4%, P = 0.010 At multivariate analyses, lesion size (odds ratio [OR]: 1.05, 95% confidence interval [CI]: 1.02–1.09, P = 0.01) and presence of biliary stent (OR: 0.51, 95% CI: 0.32–0.89, P = 0.01) were independently associated with diagnostic accuracy. In the subgroup of patients with biliary stent, the type of stent (plastic vs. metal) did not impact EUS-FNB yield, whereas the use of larger bore needles enhanced diagnostic accuracy (OR: 2.29, 95% CI: 1.28–4.12, P = 0.005). Conclusions: In this large retrospective study, an indwelling biliary stent negatively impacted the diagnostic accuracy of EUS-FNB. Preferably, EUS-FNB should precede endoscopic retrograde cholangiopancreatography, especially in the case of small tumors.
- Published
- 2021
26. EUS-FNB WITH WET-SUCTION VERSUS SLOW-PULL FOR DIAGNOSIS OF SOLID LESIONS: INTERIM ANALYSIS OF AN INTERNATIONAL RANDOMIZED, CROSS-OVER TRIAL
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Stefano Francesco Crinò, Maria Cristina Conti Bellocchi, Roberto Di Mitri, Frediano Inzani, Mihai Rimbas, Andrea Lisotti, Guido Manfredi, Anthony Y. Teoh, Benedetto Mangiavillano, Oriol Sendino, Laura Bernardoni, Erminia Manfrin, Daniela Scimeca, Elettra Unti, Angela Carlino, Theodor Voiosu, Cristiana Popp, Pietro Fusaroli, Stefania Lega, Elisabetta Buscarini, Lorena Pergola, Shannon M. Chan, Laura Lamonaca, Angel Ginès, Gloria Fernández-Esparrach, Antonio Facciorusso, and Alberto Larghi
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Gastroenterology ,Radiology, Nuclear Medicine and imaging - Published
- 2022
27. Through-The-Needle Biopsy: Shifting From Cytology to Histology for Preoperative Assessment of Pancreatic Cystic Lesions
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Stefano Francesco Crinò and Erminia Manfrin
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Pathology ,medicine.medical_specialty ,Coronavirus disease 2019 (COVID-19) ,Cytodiagnosis ,Pathology and Forensic Medicine ,Cystic lesion ,Cytology ,medicine ,Humans ,Serous Cystadenoma ,Pancreas ,business.industry ,Biopsy, Needle ,Histology ,General Medicine ,Medical Laboratory Technology ,medicine.anatomical_structure ,Needle biopsy ,Pancreatic cyst ,Intraductal Papillary Mucinous Tumor ,Pancreas Cyst ,Pancreatic Cyst ,business - Published
- 2021
28. Bcl-10, trypsin and synaptophysin helps recognize acinar cell and mixed acinar neuroendocrine cell carcinoma of the pancreas on both preoperative cytological samples and needle biopsy specimens
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Erminia Manfrin, Alice Parisi, Sokol Sina, Andrea Remo, Lavinia Stefanizzi, Guido Giordano, Stefano Francesco Crinò, Massimo Pancione, Laura Bernardoni, Mirko D'Onofrio, and Giuseppe Pelosi
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Adult ,Male ,Pathology ,medicine.medical_specialty ,Adenosquamous carcinoma ,Synaptophysin ,Sensitivity and Specificity ,Pathology and Forensic Medicine ,Diagnosis, Differential ,Biopsy ,Bcl-10 ,Acinar cell ,medicine ,Carcinoma ,Biomarkers, Tumor ,Humans ,Trypsin ,Acinar carcinoma ,Neuroendocrine cell ,Pancreatic carcinoma ,Aged ,Retrospective Studies ,medicine.diagnostic_test ,biology ,business.industry ,Carcinoma, Acinar Cell ,Biopsy, Needle ,Cell Biology ,Middle Aged ,medicine.disease ,B-Cell CLL-Lymphoma 10 Protein ,Carcinoma, Neuroendocrine ,Pancreatic Neoplasms ,medicine.anatomical_structure ,biology.protein ,Female ,Differential diagnosis ,Pancreas ,business - Abstract
Objective Acinar cell carcinoma (ACC) of the pancreas are known to be rare and difficult to be recognize because they mimic other unrelated tumors (neuroendocrine, solid pseudopapillary) with different clinical behavior. Especially in the setting of inoperable patients, fine needle aspiration cytology (FNAC), core needle biopsy (FNAB) and immunocyto/histochemistry (ICC/IHC) play a crucial role in the differential diagnosis. The biological material available for ICC tests obtained by minimal invasive procedures is usually limited. Aim of the current study was to evaluate diagnostic panel based on a limited number of ICC markers for typing preoperatively ACC of the pancreas. Methods Of 1820 needle sampling procedures performed and related to pancreatic lesions, 21 cases were extracted with a confirmed diagnosis of ACC on histology. Of them,12 were pure ACC and 9 mixed acinar-neuroendocrine carcinoma (MANEC). Smears of ACC, MANEC and a control group composed of 34neuroendocrine, 7solid pseudopapillary, 50ductal and 4 adenosquamous carcinoma were assessed with an ICC panel made up of BCL10, trypsin, synaptophysin, chromograninA, β-catenin. Results On cytology, BCL10 sensitivity and specificity for ACC was 100%. Trypsin correctly recognized 90% of the cases. Synaptophysin was helpful to correctly identify all the cases with a mixed neuroendocrine component. No significant cross-reaction was observed between BCL10 and trypsin in any of the control group case. Conclusions BCL10 is a determinant marker for the diagnosis of acinar cell carcinoma and mixed acinar neuroendocrine cell carcinoma of the pancreas in a pre-operative citologic/histologic setting.
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- 2021
29. CROCC-mutated rhabdoid colorectal carcinoma showing in intercellular spaces lamellipodia and cellular projections revealed by electron microscopy
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R Colombari, Pietro Parcesepe, Massimo Pancione, Paolo Bernardi, Donatella Benati, Guido Giordano, Maria Paola Cecchini, F Bonomi, Andrea Remo, Matteo Fassan, Andrea Sbarbati, and Erminia Manfrin
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0301 basic medicine ,Ciliary Rootlet Coiled Coil ,Pathology ,medicine.medical_specialty ,TAX1BP2 ,Cell ,SMARCB1 ,Adenocarcinoma ,Chromatin remodeling ,Pathology and Forensic Medicine ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,law ,CROCC ,Intermediate filaments ,Lamellipodia ,Nucleolar margination ,ROLT ,Rhabdoid colorectal carcinoma ,SWI/SNF ,Scanning electron microscopy ,Transmission electron microscopy ,medicine ,Humans ,Neoplasm ,Pseudopodia ,Intermediate filament ,Molecular Biology ,Rhabdoid Tumor ,Aged ,Chemistry ,Cell Biology ,General Medicine ,medicine.disease ,Cytoskeletal Proteins ,Microscopy, Electron ,030104 developmental biology ,medicine.anatomical_structure ,Centrosome ,030220 oncology & carcinogenesis ,Female ,Electron microscope ,Lamellipodium ,Colorectal Neoplasms - Abstract
Rhabdoid colorectal carcinoma (RC) is a rare lesion localized to the proximal colon of patients with a mean age at diagnosis of around 70 years. This tumor shows an aggressive behavior with an overall survival period shorter than 12 months. The diagnostic hallmark is the presence of rhabdoid cells. Alterations in chromatin remodeling (SMARCB1) and in the centrosome structure (CROCC) are reported in RC usually BRAFmut and MSI-H. RKO intestinal neoplastic cells culture (BRAFmut, SMARCB1wt, MSI-H) with CROCC knockdown exhibit rhabdoid features and develop prominent projections from the edge of the cell. Here, we investigated two cases of CROCCmutSMARCB1wt RC by scanning and transmission electron microscopy (SEM, TEM). TEM confirmed the diagnostic presence of intermediate cytoplasmic filaments and nucleolar margination. SEM showed cellular protrusions (lamellipodia) in the intercellular spaces not evident at light microscopy. These protrusions CROCC-related might represent the pathogenetic mechanism underlying the rhabdoid aggressive behavior, independently of tumor staging. To our knowledge, the SEM technique was applied in the study of this neoplasm for the first time.
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- 2019
30. Histologic retrieval rate of a newly designed side‐bevelled 20G needle for EUS‐guided tissue acquisition of solid pancreatic lesions
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Armando Gabbrielli, Alberto Larghi, E. Armellini, Pietro Occhipinti, Luca Frulloni, Silvano Andorno, Marco Ballarè, Stefano Francesco Crinò, Elena Trisolini, Renzo Boldorini, Aldo Scarpa, Laura Bernardoni, and Erminia Manfrin
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Male ,20G ProCore® ,Endosonography ,endoscopic ultrasound-guided tissue acquisition ,fine-needle biopsy (FNB) ,pancreatic cancer ,solid pancreatic neoplasm ,medicine.medical_specialty ,Sensitivity and Specificity ,03 medical and health sciences ,0302 clinical medicine ,Pancreatic cancer ,Biopsy ,medicine ,Humans ,Endoscopic Ultrasound-Guided Fine Needle Aspiration ,Pancreas ,Aged ,medicine.diagnostic_test ,business.industry ,Gastroenterology ,Pancreatic Diseases ,Original Articles ,Middle Aged ,medicine.disease ,Immunohistochemistry ,digestive system diseases ,Bevel ,Pancreatic Neoplasms ,Tissue acquisition ,Oncology ,030220 oncology & carcinogenesis ,Female ,030211 gastroenterology & hepatology ,Radiology ,business - Abstract
BACKGROUND: Innovative approaches to improve diagnostic yield of endoscopic ultrasound-guided tissue acquisition (EUS-TA) have focused on needle design with development of fine-needle biopsy (FNB) needles with microcore-acquisition technology. Recently, a 20-gauge (20G) antegrade-cutting-side-bevelled biopsy needle (ProCore®) was developed for EUS-TA, but data about its diagnostic performance and histological capability are scant. OBJECTIVES: We assessed the diagnostic performance and histologic retrieval rate of a new 20G antegrade-cutting-side-bevelled biopsy needle compared with a 22G reverse-side-bevelled needle for EUS sampling of solid pancreatic lesions. PATIENTS AND METHODS: A retrospective analysis of 238 consecutively collected patients who underwent EUS-TA using a 20G or a 22G ProCore® needle, without rapid on-site evaluation (ROSE), was conducted at two centres. Sensitivity, specificity, positive predictive value and negative predictive value were calculated. Histologic tissue retrieval was evaluated applying a scoring system for each case. RESULTS: Sensitivity and specificity were estimated as 98.4–100% in the 20G-, and 94.9–100% in the 22G-needle groups, respectively (p > 0.99). The 20G procured more histologic-grade tissues (92.6% vs 49.5%, p
- Published
- 2019
31. S1126 Diagnostic Yield of Endoscopic Ultrasound-Guided Liver Biopsy in Comparison to Percutaneous Liver Biopsy: A Two Center Experience
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Maria Cristina Conti Bellocchi, Erminia Manfrin, Nicola Muscatiello, Daryl Ramai, Laura Bernardoni, Antonio Facciorusso, and Stefano Francesco Crinò
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Endoscopic ultrasound ,medicine.medical_specialty ,Yield (engineering) ,Hepatology ,medicine.diagnostic_test ,business.industry ,Liver biopsy ,Gastroenterology ,medicine ,Percutaneous liver biopsy ,Radiology ,business - Published
- 2021
32. Endoscopic Ultrasound Features Associated with Malignancy and Aggressiveness of Nonhypovascular Solid Pancreatic Lesions: Results from a Prospective Observational Study
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Erminia Manfrin, Filippo Vieceli, Salvatore Paiella, Maria Cristina Conti Bellocchi, Stefano Francesco Crinò, Giovanni Marchegiani, Mirko D'Onofrio, Sokol Sina, Luca Landoni, Alberto Larghi, Armando Gabbrielli, Alessandro Brandolese, Luca Frulloni, and Laura Bernardoni
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Endoscopic ultrasound ,medicine.medical_specialty ,Lymphovascular invasion ,pancreatic cancer ,Perineural invasion ,Malignancy ,Endosonography ,Surgical pathology ,03 medical and health sciences ,0302 clinical medicine ,EUS ,solid pancreatic tumors ,pancreas ,neuroendocrine tumor ,Pancreatic cancer ,medicine ,Carcinoma ,Humans ,Radiology, Nuclear Medicine and imaging ,Prospective Studies ,Endoscopic Ultrasound-Guided Fine Needle Aspiration ,Pancreatic duct ,medicine.diagnostic_test ,business.industry ,medicine.disease ,Pancreatic Neoplasms ,Neuroendocrine Tumors ,medicine.anatomical_structure ,EUS, solid pancreatic tumors, pancreas, neuroendocrine tumor, pancreatic cancer ,030220 oncology & carcinogenesis ,030211 gastroenterology & hepatology ,Radiology ,business - Abstract
On contrast-enhanced imaging studies, nonhypovascular (i. e., isovascular and hypervascular) patterns can be observed in solid pancreatic lesions (SPLs) of different nature, prognosis, and management. We aimed to identify endoscopic ultrasound (EUS) features of nonhypovascular SPLs associated with malignancy/aggressiveness. The secondary aims were EUS tissue acquisition (EUS-TA) outcome and safety in this setting of patients. This prospective observational study included patients with nonhypovascular SPLs detected on cross-sectional imaging and referred for EUS-TA. Lesion features (size, site, margins, echotexture, vascular pattern, and upstream dilation of the main pancreatic duct) were recorded. Malignancy/aggressiveness was determined by evidence of carcinoma at biopsy/surgical pathology, signs of aggressiveness (perineural invasion, lymphovascular invasion, and/or microscopic tumor extension/infiltration or evidence of metastatic lymph nodes) in the surgical specimen, radiologic detection of lymph nodes or distant metastases, and/or tumor growth 5 mm/6 months. Uni- and multivariate analyses were performed to assess the primary aim. A total of 154 patients with 161 SPLs were enrolled. 40 (24.8 %) lesions were defined as malignant/aggressive. Irregular margins and size 20 mm were independent factors associated with malignancy/aggressiveness (p 0.001, OR = 5.2 and p = 0.003, OR = 2.1, respectively). However, size20 mm was not significant in the subgroup of other-than-neuroendocrine tumor (NET) lesions. The EUS-TA accuracy was 92 %, and the rate of adverse events was 4 %. Irregular margins on EUS are associated with malignancy/aggressiveness of nonhypovascular SPLs. Size20 mm should be considered a malignancy-related feature only in NET patients. EUS-TA is safe and highly accurate for differential diagnosis in this group of patients.ZIEL: In kontrastverstärkten Bildgebungsstudien werden in soliden Pankreasläsionen (SPLs) nicht hypovaskuläre (d. h. isovaskuläre und hypervaskuläre) Muster unterschiedlichsten Ursprungs, Prognose und Behandlung beobachtet. Unser Ziel war die Bestimmung der Merkmale des endoskopischen Ultraschalls (EUS) bei nicht hypovaskulären SPLs, die mit Malignität/Aggressivität assoziiert sind. Die sekundären Ziele waren das Outcome der EUS-Gewebeaufnahme (EUS-TA) und die Patientensicherheit. Diese prospektive Beobachtungsstudie umfasste Patienten mit nicht hypovaskulären SPLs, die in einem Schnittbildverfahren entdeckt wurden und zur EUS-TA einbestellt wurden. Läsionsmerkmale (Größe, Lage, Ränder, Echotextur, Gefäßmuster und stromaufwärts gerichtete Dilatation des Hauptpankreasgangs) wurden erfasst. Die Malignität/Aggressivität wurde durch Nachweis eines Karzinoms in der Biopsie/Pathologie, durch Zeichen von Aggressivität (perineurale Invasion, lymphovaskuläre Invasion und/oder mikroskopische Tumorausdehnung/-infiltration oder Nachweis metastasierter Lymphknoten) in der chirurgischen Probe, durch den radiologischer Nachweis von Lymphknoten oder entfernten Metastasen und/oder durch Tumorwachstum 5 mm in 6 Monaten definiert. Zur Beurteilung des Primärziels wurden uni- und multivariate Analysen durchgeführt. Insgesamt wurden 154 Patienten mit 161 SPLs aufgenommen. 40 (24,8 %) Läsionen wurden als maligne/aggressiv definiert. Unabhängige, mit Malignität/Aggressivität assoziierte Faktoren waren unregelmäßige Ränder (p 0,001; OR = 5,2) und eine Größe 20 mm (p = 0,003; OR = 2,1). Allerdings war der Faktor Größe 20 mm in der Untergruppe der nicht neuroendokrinen Tumor (NET) -Läsionen nicht signifikant. Die Genauigkeit der EUS-TA betrug 92 % und die Rate der unerwünschten Ereignisse 4 %. Unregelmäßige Ränder in EUS sind mit Malignität/Aggressivität von nicht hypovaskulären SPLs assoziiert. Eine Größe 20 mm sollte nur bei NET-Patienten als Marker für Malignität angesehen werden. Die EUS-TA ist sicher und von hoher Genauigkeit für die Differenzialdiagnose in dieser Patientengruppe.
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- 2021
33. Oral Lichen Planus : risk factors of malignant transformation and follow up. Ten years retrospective study
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Erminia Manfrin, Dario Bertossi, Riccardo Nocini, Francesca Zotti, Massimo Albanese, Martina Peretti, Giorgia Capocasale, and Andrea Fior
- Subjects
medicine.medical_specialty ,Cancer prevention ,Oral Medicine and Pathology ,business.industry ,Research ,Cancer ,Retrospective cohort study ,Odds ratio ,medicine.disease ,Dermatology ,Oral Lichen Planus, Oral Cancer, Malignant transformation, risk factors ,World health ,Malignant transformation ,stomatognathic diseases ,stomatognathic system ,Cohort ,medicine ,Oral Cancer ,risk factors ,Oral lichen planus ,Oral Lichen Planus ,business ,General Dentistry ,UNESCO:CIENCIAS MÉDICAS - Abstract
Background Oral Lichen Planus (OLP) is an inflammatory chronic disease. Modified World Health Organization (WHO) diagnostic criteria (2003) suggest diagnosing OLP both clinically and histologically. Furthermore, it is known the potential of malignant transformation of OLP, especially those affecting mucosa. Aims of this retrospective study on 100 patients were i) to estimate the timing of transformation of OLP lesions in OSCC in a cohort of patients observed between 2008 and 2018; ii) to assess risk factors of OLP patients diagnosed with OSCC; iii) to analyse forms of OLP evolved in cancer. Material and methods A database of 100 patients diagnosed with OLP was evaluated and clinical, histological features of lesions, habits of patients and systemic diseases were analysed in a follow up ranged between 5 and 10 years. Results Mean time of malignant transformation was 31,62± 18,26 months; however, 4 malignant transformations out of 8 occurred about after 4 years of observation. Furthermore, Odds ratios for risk factors showed an association between malignant transformation and location. Conclusions More focused attention on follow-up scheduling and designing could be a valuable resource in early diagnosis and cancer prevention in OLP patients. Key words:Oral Lichen Planus, Oral Cancer, Malignant transformation, risk factors.
- Published
- 2021
34. Endoscopic Ultrasound Through-the-Needle Biopsy for the Diagnosis of an Abdominal Bronchogenic Cyst
- Author
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Corrado Pedrazzani, Jessica Cassiani, Armando Gabbrielli, Matteo Rivelli, Alfredo Guglielmi, Erminia Manfrin, and Stefano Francesco Crinò
- Subjects
Endoscopic ultrasound ,medicine.medical_specialty ,Bronchogenic cyst ,Medicine (miscellaneous) ,Case Report ,RC799-869 ,Epigastric pain ,Endoscopic ultrasound-guided fine needle aspiration ,Endoscopic ultrasound-guided through-the-needle biopsy ,Laparoscopy ,Pancreatic cyst ,03 medical and health sciences ,0302 clinical medicine ,Pathognomonic ,Biopsy ,medicine ,Radiology, Nuclear Medicine and imaging ,Cyst ,endoscopic ultrasound-guided fine-needle aspiration ,Internal medicine ,medicine.diagnostic_test ,business.industry ,Gastroenterology ,Diseases of the digestive system. Gastroenterology ,medicine.disease ,RC31-1245 ,digestive system diseases ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,030211 gastroenterology & hepatology ,Radiology ,Pancreas ,business - Abstract
A 57-year-old woman with epigastric pain was diagnosed with a 6-cm abdominal cystic lesion of unclear origin on cross-sectional imaging. Endoscopic ultrasound (EUS) demonstrated a unilocular cyst located between the pancreas, gastric wall, and left adrenal gland, with a regular wall filled with dense fluid with multiple hyperechoic floating spots. A 19-G needle was used to puncture the cyst, but no fluid could be aspirated. Therefore, EUS-guided through-the-needle biopsy (EUS-TTNB) was performed. Histological analysis of the retrieved fragments revealed a fibrous wall lined by “respiratory-type” epithelium with ciliated columnar cells, consistent with the diagnosis of a bronchogenic cyst. Laparoscopic excision was performed, and the diagnosis was confirmed based on the findings of the surgical specimen. Abdominal bronchogenic cysts are extremely uncommon, and a definitive diagnosis is commonly obtained after the examination of surgical specimens due to the lack of pathognomonic findings on cross-sectional imaging and poor cellularity on EUS-guided fine-needle aspiration cytology. EUS-TTNB is useful for establishing a preoperative histological diagnosis, thus supporting the decision-making process.
- Published
- 2021
35. SIDE-FENESTRATED VS. FORK-TIP NEEDLES FOR EUS-GUIDED FINE-NEEDLE BIOPSY OF SOLID PANCREATIC LESIONS: A PROSPECTIVE SINGLE CENTER RANDOMIZED STUDY
- Author
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Mcc Bellocchi, Francesca Locatelli, Armando Gabbrielli, Erminia Manfrin, Laura Bernardoni, M LeGrazie, Anna Granato, and Stefano Francesco Crinò
- Subjects
business.industry ,Fork (system call) ,Medicine ,business ,Nuclear medicine ,Single Center ,Fine needle biopsy - Published
- 2020
36. Response
- Author
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Stefano Francesco Crinò, Armando Gabbrielli, and Erminia Manfrin
- Subjects
Biopsy ,Gastroenterology ,Humans ,Radiology, Nuclear Medicine and imaging ,Pancreatic Cyst - Published
- 2020
37. Un raro aspetto istologico di fibromixoma odontogeno mandibolare
- Author
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Dario Bertossi, Luigi Fabrizio Rodella, Luca Parenti, Francesca Zotti, Massimo Albanese, and Erminia Manfrin
- Subjects
medicine.medical_specialty ,business.industry ,Oral surgery ,Odontogenic myxoma ,Histological analysis ,Fibromyxoma ,Surgical excision ,Orthodontics ,medicine.disease ,Surgery ,medicine ,business - Published
- 2020
38. Primary Pancreatic Lymphoma: Clinical Presentation, Diagnosis, Treatment and Outcome
- Author
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Cristina Tecchio, Alice Parisi, Piero Maria Stefani, Marco Ruggeri, Carlo Visco, Federica Mellone, Enrico Boninsegna, Davide Facchinelli, Francesco Piazza, Maria Chiara Tisi, Elena Maiolo, Alberto Zamò, Erminia Manfrin, Stefan Hohaus, Sokol Sina, Roberto Sartori, Michele Merli, Alex Borin, Greta Scapinello, Chiara Rusconi, Marco Basso, and Mauro Krampera
- Subjects
Male ,Abdominal pain ,medicine.medical_specialty ,Biopsy ,medicine.medical_treatment ,lymphoma ,chemotherapy ,Gastroenterology ,surgery ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Humans ,Medicine ,pancreas ,Neoplasm Staging ,Chemotherapy ,medicine.diagnostic_test ,business.industry ,Disease Management ,Hematology ,General Medicine ,Jaundice ,medicine.disease ,Debulking ,Lymphoma ,Pancreatic Neoplasms ,Patient Outcome Assessment ,Pancreatic Lymphoma ,Italy ,030220 oncology & carcinogenesis ,Female ,Disease Susceptibility ,Neoplasm Grading ,Symptom Assessment ,medicine.symptom ,business ,030215 immunology ,Rare disease - Abstract
Primary pancreatic lymphoma (PPL) is a rare disease representing 0.1% of malignant lymphomas, which lacks well-defined diagnostic and therapeutic protocols. Objectives To describe PPL clinical, diagnostic and histological characteristics, together with therapy and outcome, in a relatively large series of patients. Methods The study includes 39 PPL patients, aged ≥15 years, observed from January 2005 to December 2018, in 8 Italian Institutions. Results The main symptoms were abdominal pain (58%) and jaundice (47%). Lactate dehydrogenase serum levels were elevated in 43% of patients. Histological specimens were mostly obtained by percutaneous (41%) or endoscopic (36%) biopsy, with diffuse large B-cell lymphoma being the most frequent (69%) histological diagnosis. Chemotherapy was administered alone in 65% of patients, with radiotherapy in 17%, or after surgery in 9%. The 2-year overall survival (OS) was 62%, the 2-year progression-free survival (PFS) 44%. Debulking surgery (with or without chemotherapy) was associated with a significant worse OS. Three (9.4%) of 32 high-grade patients experienced a central nervous system (CNS) relapse. Conclusions PPL is rare, often high-grade, with symptoms and localization similar to other pancreatic malignancies. Biopsy should be the preferred diagnostic method. High-grade PPL should undergo CNS prophylaxis.
- Published
- 2020
39. Endoscopic ultrasound-guided fine-needle aspiration for the diagnosis and grading of pancreatic neuroendocrine tumors: a retrospective analysis of 110 cases
- Author
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Luca Landoni, Alice Parisi, Claudio Bassi, Sara Cingarlini, Rita T. Lawlor, Mirko D'Onofrio, Laura Bernardoni, Erminia Manfrin, Chiara Nessi, Giovanni Elio, Marco Miotto, Aldo Scarpa, Armando Gabbrielli, Stefano Francesco Crinò, Roberto Salvia, Salvatore Paiella, Roberta Rota, Matteo Valenti, and Paola Capelli
- Subjects
Endoscopic ultrasound ,medicine.medical_specialty ,Gastroenteropancreatic Neuroendocrine Tumor, Neuroendocrine Carcinoma, Carcinoid Tumor ,Carcinoid Tumor ,Neuroendocrine tumors ,Surgical pathology ,03 medical and health sciences ,0302 clinical medicine ,Gastroenteropancreatic Neuroendocrine Tumor ,Cytology ,medicine ,Humans ,Grading (tumors) ,Endoscopic Ultrasound-Guided Fine Needle Aspiration ,Retrospective Studies ,medicine.diagnostic_test ,business.industry ,Neuroendocrine Carcinoma ,Gastroenterology ,Reproducibility of Results ,Histology ,medicine.disease ,Confidence interval ,Pancreatic Neoplasms ,Neuroendocrine Tumors ,Fine-needle aspiration ,Ki-67 Antigen ,030220 oncology & carcinogenesis ,030211 gastroenterology & hepatology ,Radiology ,Neoplasm Grading ,business - Abstract
Background Data on the reliability of the Ki-67 index and grading calculations from endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) of pancreatic neuroendocrine tumors (PanNETs) are controversial. We aimed to assess the accuracy of these data compared with histology. Methods Cytological analysis from EUS-FNA in patients with suspected PanNETs (n = 110) were compared with resection samples at a single institution. A minimum of 2000 cells were considered to be adequate for grading. Correlation and agreement between cytology and histology in grading and Ki-67 values, respectively, were investigated. Secondary outcomes included the diagnostic performance of EUS-FNA. Results EUS-FNA samples were adequate for PanNET diagnosis and PanNET grading in 98/110 (89.1 %) and 77/110 (70.0 %) patients, respectively; thus, 77 samples were adequate for comparing cytology vs. histology. There were 67 (62.0 %), 40 (36.4 %), and 1 (0.9 %) patients with a final diagnosis of G1, G2, and G3 tumors, respectively. EUS-FNA grading was concordant with surgical pathology in 81.8 % of patients; under- and overgrading occurred in 15.6 % and 2.6 %, respectively. The overall level of agreement for grading was moderate (Cohen’s κ = 0.59, 95 % confidence interval [CI] 0.34 – 0.78). Spearman’s rho for Ki-67 in tumors ≤ 20 mm and > 20 mm was strong and moderate, respectively (rho = 0.68, 95 %CI 0.47 – 0.83; rho = 0.59, 95 %CI 0.35 – 0.75). The Bland – Altman plot showed that the Ki-67 values were comparable and reproducible between the two measurements. Conclusions Although they were not available for a significant number of patients, grading and Ki-67 values from cytology correlated with histology moderately to strongly.
- Published
- 2020
40. Diagnostic yield of endoscopic ultrasound-guided tissue acquisition of solid pancreatic lesions after inconclusive percutaneous ultrasound-guided tissue acquisition
- Author
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Stefano Francesco Crinò, Socrate Pallio, Armando Gabbrielli, Marco Le Grazie, Erminia Manfrin, Pietro Fusaroli, Laura Bernardoni, Maria Cristina Conti Bellocchi, Le Grazie M., Conti Bellocchi M.C., Bernardoni L., Fusaroli P., Manfrin E., Pallio S., Gabbrielli A., and Crino S.F.
- Subjects
Male ,Endoscopic ultrasound ,medicine.medical_specialty ,Delayed Diagnosis ,Percutaneous ,precision medicine ,Pancreatic cancer ,endoscopic ultrasound fine-needle biopsy ,fine-needle aspiration ,interventional ultrasound ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Humans ,Sampling (medicine) ,Endoscopic Ultrasound-Guided Fine Needle Aspiration ,Pancreas ,Retrospective Studies ,medicine.diagnostic_test ,business.industry ,Ultrasound ,Gastroenterology ,medicine.disease ,digestive system diseases ,Ultrasound guided ,Pancreatic Neoplasms ,Tissue acquisition ,Fine-needle aspiration ,030220 oncology & carcinogenesis ,030211 gastroenterology & hepatology ,Radiology ,business - Abstract
Introduction: After a failed percutaneous ultrasound (US)-guided sampling, it is recommended that endoscopic ultrasound (EUS)-guided tissue acquisition (TA) be performed for non-resectable solid pancreatic lesions according to the European Federation of Societies for Ultrasound in Medicine and Biology. However, the diagnostic performance of EUS-guided TA in this setting is unknown. Methods: We retrospectively analyzed the performance and safety of EUS-guided TA in patients with a previous failed percutaneous biopsy. We also evaluated the diagnostic delays between the percutaneous approach and EUS diagnosis. Results: Over a period of 2 years, 49 patients were identified (29 males, mean age 65 years). The reasons for failure of percutaneous sampling were inadequate samples in 25 (52.1%) cases and lesions that were not visible or targetable in 24 (47.9%) cases. In one case, EUS-guided TA was not performed because of the interposition of a metallic biliary stent. No adverse events were recorded for both the percutaneous and EUS approaches. The median diagnostic delay was 12 days. Overall, the sensitivity and accuracy of EUS-guided TA were 92.7 and 93.7%, respectively. A subgroup analysis examined cases with inadequate samples obtained with the percutaneous approach, and the sensitivity and accuracy of EUS-guided TA were 85.7 and 88%, respectively. Conclusion: EUS-guided TA is safe and accurate for the diagnosis of pancreatic lesions after a previous inconclusive percutaneous approach.
- Published
- 2020
41. Medication-related osteonecrosis of the posterior maxilla: surgical treatment using a combined transnasal endoscopic and intraoral approach, our experience with seven consecutive patients
- Author
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Dario Bertossi, Lorenzo Trevisiol, Pasquale Procacci, Fabio Lonardi, Vittorio Favero, Massimo Albanese, Antonio D'Agostino, Erminia Manfrin, and Pier Francesco Nocini
- Subjects
Male ,Natural Orifice Endoscopic Surgery ,medicine.medical_specialty ,maxillary sinusitis ,Dentistry ,03 medical and health sciences ,Upper jaw MRONJ ,0302 clinical medicine ,Maxilla ,medicine ,Humans ,030223 otorhinolaryngology ,Surgical treatment ,Upper jaw MRONJ, maxillary sinusitis ,Aged ,Retrospective Studies ,Bone Density Conservation Agents ,business.industry ,Intraoral approach ,030206 dentistry ,Middle Aged ,Surgery ,Treatment Outcome ,Otorhinolaryngology ,Bisphosphonate-Associated Osteonecrosis of the Jaw ,Female ,Denosumab ,business ,Posterior maxilla - Published
- 2017
42. Endoscopic Ultrasound–guided Fine-needle Biopsy With or Without Rapid On-site Evaluation for Diagnosis of Solid Pancreatic Lesions
- Author
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Gianpiero Manes, Francesca Locatelli, Takao Itoi, Mariangela Curatolo, Jeevinesh Naidu, Elisabetta Conte, Gianenrico Rizzatti, Hannah van Malenstein, Gloria Fernández-Esparrach, Rosa Liotta, Michele Amata, Frediano Inzani, Ilaria Tarantino, Armando Gabbrielli, Silvia Carrara, Yukitoshi Matsunami, Angels Ginès, Franca Di Nuovo, Germana de Nucci, Laura Bernardoni, Erminia Manfrin, Elettra Unti, Stefano Francesco Crinò, Vanessa M. Shami, Ivan Borbath, Masayuki Kitano, Lydi M.J.W. van Driel, Roberto Di Mitri, Oriol Sendino, Alberto Larghi, Jan-Werner Poley, Daniel S. Strand, Aldo Scarpa, Mina Komuta, Laura Lamonaca, Karoly Dolapcsiev, Daoud Rahal, Pierre Henri Deprez, Andrew Y. Wang, Francisco Baldaque-Silva, Loredana Correale, Guido Costamagna, Andrew Ruszkiewicz, Keiichi Hatamaru, Schalk Van der Merwe, Nam Q. Nguyen, Masahiro Itonaga, Marianna Signoretti, UCL - SSS/IREC/GAEN - Pôle d'Hépato-gastro-entérologie, UCL - (SLuc) Centre du cancer, UCL - (SLuc) Service de gastro-entérologie, UCL - (SLuc) Unité d'oncologie médicale, and Gastroenterology & Hepatology
- Subjects
0301 basic medicine ,Endoscopic ultrasound ,Male ,medicine.medical_specialty ,Preoperative Sampling ,law.invention ,03 medical and health sciences ,Pancreatic Cancer ,0302 clinical medicine ,Randomized controlled trial ,law ,Predictive Value of Tests ,Endoscopic Ultrasound Tissue Acquisition ,Biopsy ,Clinical endpoint ,medicine ,Humans ,Sampling (medicine) ,Prospective Studies ,Endoscopic Ultrasound-Guided Fine Needle Aspiration ,Rapid On-site Evaluation ,Aged ,Rose (mathematics) ,Hepatology ,medicine.diagnostic_test ,business.industry ,Gastroenterology ,Absolute risk reduction ,Reproducibility of Results ,Middle Aged ,Confidence interval ,Pancreatic Neoplasms ,030104 developmental biology ,Diagnostic Accuracy ,030211 gastroenterology & hepatology ,Female ,Radiology ,business - Abstract
Background and Aims: The benefit of rapid on-site evaluation (ROSE) on the diagnostic accuracy of endoscopic ultrasound–guided fine-needle biopsy (EUS-FNB) has never been evaluated in a randomized study. This trial aimed to test the hypothesis that in solid pancreatic lesions (SPLs), diagnostic accuracy of EUS-FNB without ROSE was not inferior to that of EUS-FNB with ROSE. Methods: A noninferiority study (noninferiority margin, 5%) was conducted at 14 centers in 8 countries. Patients with SPLs requiring tissue sampling were randomly assigned (1:1) to undergo EUS-FNB with or without ROSE using new-generation FNB needles. The touch-imprint cytology technique was used to perform ROSE. The primary endpoint was diagnostic accuracy, and secondary endpoints were safety, tissue core procurement, specimen quality, and sampling procedural time. Results: Eight hundred patients were randomized over an 18-month period, and 771 were analyzed (385 with ROSE and 386 without). Comparable diagnostic accuracies were obtained in both arms (96.4% with ROSE and 97.4% without ROSE, P = .396). Noninferiority of EUS-FNB without ROSE was confirmed with an absolute risk difference of 1.0% (1-sided 90% confidence interval, –1.1% to 3.1%; noninferiority P < .001). Safety and sample quality of histologic specimens were similar in both groups. A significantly higher tissue core rate was obtained by EUS-FNB without ROSE (70.7% vs. 78.0%, P = .021), with a significantly shorter mean sampling procedural time (17.9 ± 8.8 vs 11.7 ± 6.0 minutes, P < .0001). Conclusions: EUS-FNB demonstrated high diagnostic accuracy in evaluating SPLs independently on execution of ROSE. When new-generation FNB needles are used, ROSE should not be routinely recommended. (ClinicalTrial.gov number NCT03322592.)
- Published
- 2021
43. Diagnostic Yield of Endoscopic Ultrasound-Guided Liver Biopsy in Comparison to Percutaneous Liver Biopsy: A Two-Center Experience
- Author
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Daryl Ramai, Laura Bernardoni, Erminia Manfrin, Stefano Francesco Crinò, Antonio Facciorusso, Maria Cristina Conti Bellocchi, and Nicola Muscatiello
- Subjects
Endoscopic ultrasound ,Cancer Research ,Percutaneous ,Subgroup analysis ,Article ,percutaneous liver biopsy ,03 medical and health sciences ,0302 clinical medicine ,Interquartile range ,Medicine ,Adverse effect ,liver biopsy ,RC254-282 ,endoscopic ultrasound ,medicine.diagnostic_test ,business.industry ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,Portal tracts ,Oncology ,030220 oncology & carcinogenesis ,Liver biopsy ,Percutaneous liver biopsy ,030211 gastroenterology & hepatology ,business ,Nuclear medicine - Abstract
There is scarce and conflicting evidence on the comparison between endoscopic ultrasound (EUS) and percutaneous (PC)-guided liver biopsy (LB). The aim of this study was to compare the two approaches in a series of patients with parenchymal and focal liver lesions. Fifty-four patients undergoing EUS-LB in two high-volume centers between 2017 and 2021 were compared to 62 patients who underwent PC-LB. The primary outcome was diagnostic adequacy rate. The secondary outcomes were diagnostic accuracy, total sample length (TSL), number of complete portal tracts (CPTs), procedural duration, and adverse events. Variables were compared using the Chi-square and Mann–Whitney test. Median age was 56 years (interquartile range 48–69) in the EUS-LB group and 54 years (45–67) in the PC-LB group with most patients being male. Indication for LB was due to parenchymal disease in 50% of patients, whereas the other patients underwent LB due to focal liver lesions. Diagnostic adequacy was 100% in PC-LB and 94.4% in the EUS-LB group (p = 0.74), whereas diagnostic accuracy was 88.8% in the EUS-LB group and 100% in the PC-LB group (p = 0.82). Median TSL was significantly greater in the PC-LB group (27.4 mm, IQR 21–29) when compared to the EUS-LB group (18.5 mm, 10.1–22.4, p = 0.02). The number of complete portal tracts was 21 (11–24) in the PC-LB group and 18.5 (10–23.2) in EUS-LB group (p = 0.09). EUS-LB was a significantly longer procedure (7 min, 5–11 versus 1 min, 1–3 of PC-LB, p <, 0.001) and no evidence of adverse events was observed in any of the study groups. These results were confirmed in the subgroup analysis performed according to an indication for LB (parenchymal disease versus focal lesion). Although PC-LB yielded specimens with greater TSL, diagnostic adequacy and accuracy were similar between the two procedures.
- Published
- 2021
44. Sa1406 SIDE-FENESTRATED VS. FORK-TIP NEEDLES FOR EUS-GUIDED FINE-NEEDLE BIOPSY OF SOLID PANCREATIC LESIONS: A SINGLE-CENTER PROSPECTIVE RANDOMIZED STUDY
- Author
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Armando Gabbrielli, Erminia Manfrin, Stefano Francesco Crinò, Laura Bernardoni, Anna Granato, Francesca Locatelli, Marco Le Grazie, and Maria Cristina Conti Bellocchi
- Subjects
medicine.medical_specialty ,business.industry ,Fork (system call) ,Gastroenterology ,medicine ,Radiology, Nuclear Medicine and imaging ,Prospective randomized study ,Radiology ,Single Center ,business ,Fine needle biopsy - Published
- 2020
45. 663 EUS-FNB WITH VERSUS WITHOUT ROSE: INTERIM ANALYSIS OF AN INTERNATIONAL RANDOMIZED NON-INFERIORITY STUDY
- Author
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Pierre Henri Deprez, Takao Itoi, Silvia Carrara, Julio Iglesias-Garcia, Erminia Manfrin, Ilaria Tarantino, Alberto Larghi, Jan-Werner Poley, Aldo Scarpa, Gloria Fernández-Esparrach, Stefano Francesco Crinò, Angel Ginès, Roberto Di Mitri, Germana de Nucci, Armando Gabbrielli, Francisco Baldaque-Silva, Nam Q. Nguyen, Masayuki Kitano, and Vanessa M. Shami
- Subjects
Rose (mathematics) ,medicine.medical_specialty ,Non inferiority ,business.industry ,General surgery ,Gastroenterology ,Medicine ,Radiology, Nuclear Medicine and imaging ,business ,Interim analysis - Published
- 2020
46. Pseudo solid-appearing pancreatic serous microcystic adenomas: Histologic diagnosis with the EUS core biopsy fork-tip needle
- Author
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Armando Gabbrielli, Claudia Perini, Luca Frulloni, Serena Di Stefano, Alice Parisi, Sokol Sina, Stefano Francesco Crinò, Erminia Manfrin, Laura Bernardoni, and Andrea Remo
- Subjects
medicine.medical_specialty ,Adenoma ,serous cystadenoma ,03 medical and health sciences ,pancreatic cysts ,0302 clinical medicine ,Biopsy ,medicine ,Radiology, Nuclear Medicine and imaging ,EUS ,serous cystic neoplasia ,Hepatology ,medicine.diagnostic_test ,business.industry ,EUS fine-needle biopsy ,Gastroenterology ,Magnetic resonance imaging ,medicine.disease ,Serous Cystadenoma ,digestive system diseases ,Microcystic Adenoma ,Serous fluid ,Positron emission tomography ,030220 oncology & carcinogenesis ,EUS-FNA ,pancreatic neuroendocrine ,pancreatic solid neoplasm ,030211 gastroenterology & hepatology ,Original Article ,Radiology ,Pancreatic cysts ,business - Abstract
Background and Objectives: Despite rarely, serous cystic adenoma (SCA) can assume a pseudo-solid aspect mimicking other pancreatic neoplasm as neuroendocrine tumor. EUS-FNA cytology has low diagnostic accuracy due to the scant cellularity of the collected samples. Histological diagnosis is usually made after resection. Recently, end-cutting needles for EUS-fine-needle biopsy (EUS-FNB), which obtain tissue cores by penetrating the lesions, have been developed. We aimed to assess the capability of EUS-FNB with SharkCore™ needles in the preoperative diagnosis of serous cystic adenoma pseudo-solid-appearing on imaging (Sa-SCA). Materials and Methods: Between January 2016 and January 2018, data from consecutive adult patients, who were referred for EUS-FNB of a solid pancreatic lesion and were diagnosed with having SCA, were retrieved from a single-center institutional database. Results: Two patients were excluded because of microcystic aspect at EUS. Histological diagnosis of SCA was made by EUS-FNB in the remaining 7 patients (5 females; mean age of 62.5 years). Lesions (mean size of 19.8 mm) were hypervascular on cross-sectional imaging, slightly hyperdense magnetic resonance imaging with T2-weighted images can, and negative at 68Ga-somatostatin receptor positron emission tomography and 18fluoro-deoxyglucose positron emission tomography. EUS-FNB samples were judged adequate for a definitive diagnosis in all cases, achieving specimens suitable for histological evaluation and several ancillary stains. Histochemical positivity for periodic acid-Schiff (PAS) and PAS with diastase digestion was observed in 7/7 cases. Immunohistochemical positivity for α-inhibin (7/7), GLUT1 (6/6), MUC6 (5/5), and negativity for synaptophysin (7/7) and chromogranin A (2/2) favored SCA diagnosis. Conclusions: In the case of preoperative workup suspected for Sa-SCA, a “forward acquiring” needle could improve the rate of preoperative histological diagnosis.
- Published
- 2019
47. Association between macroscopically visible tissue samples and diagnostic accuracy of EUS-guided through-the-needle microforceps biopsy sampling of pancreatic cystic lesions
- Author
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Andrea Remo, Giuseppe Malleo, Lorenzo Brozzi, Alberto Larghi, Roberto Salvia, Erminia Manfrin, Luca Frulloni, Sokol Sina, Armando Gabbrielli, Luca Barresi, Alice Parisi, Stefano Francesco Crinò, and Laura Bernardoni
- Subjects
EUS-guided through-the-needle biopsy (TTNB) ,Adult ,Male ,medicine.medical_specialty ,pancreatic cystic lesions (PCLs), EUS-guided through-the-needle biopsy (TTNB) ,03 medical and health sciences ,Cystic lesion ,Young Adult ,0302 clinical medicine ,Carcinoembryonic antigen ,Cytology ,Biopsy ,medicine ,pancreatic cystic lesions (PCLs) ,Humans ,Radiology, Nuclear Medicine and imaging ,Cyst ,Sampling (medicine) ,Endoscopic Ultrasound-Guided Fine Needle Aspiration ,Aged ,Retrospective Studies ,Aged, 80 and over ,medicine.diagnostic_test ,biology ,business.industry ,Gastroenterology ,Reproducibility of Results ,Retrospective cohort study ,Equipment Design ,Middle Aged ,medicine.disease ,Surgical Instruments ,Dysplasia ,030220 oncology & carcinogenesis ,biology.protein ,030211 gastroenterology & hepatology ,Female ,Radiology ,Pancreatic Cyst ,business - Abstract
EUS-guided through-the-needle biopsy (TTNB) sampling has been reported to improve diagnostic yield compared with cytology for the evaluation of pancreatic cystic lesions (PCLs). The number of macroscopically visible tissue samples needed to reach an adequate diagnosis is still unknown.This is a retrospective, single-center study on consecutive patients with PCLs with risk features (cyst3 cm, thickened wall, cyst growth during follow-up, and mural nodules) who underwent TTNB sampling. The capability of differentiating mucinous versus nonmucinous cysts, ability to obtain a cyst-lining epithelium, definition of the grade of dysplasia, and specific diagnosis of cyst histotype were evaluated for 1, 2, or 3 TTNB macroscopically visible specimens.Sixty-one patients were evaluated. A 100% histologic adequacy was reached by 2 samples (P = .05 versus 1). Compared with cytology, 1 TTNB specimen improved the possibility of defining cyst histotype (P .0001), whereas 2 specimens increased all 4 diagnostic categories (P .003). Two specimens also increased diagnostic yield compared with 1 sample (P .085). The collection of a third sample did not improve the value of any diagnostic categories. A specific diagnosis was reached in 74% of patients with 2 histologic samples. The diagnostic reliability of TTNB sampling compared with surgical histology was 90%, with a 22.9% rate of adverse events.Two TTNB macroscopically visible specimens reached 100% histologic adequacy and a specific diagnosis in 74% of patients. The collection of a third specimen did not add any additional information and should be avoided to possibly decrease the risk of adverse events.
- Published
- 2019
48. JAK/Stat5-mediated subtype-specific lymphocyte antigen 6 complex, locus G6D (LY6G6D) expression drives mismatch repair proficient colorectal cancer
- Author
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Francesca Pia Caruso, Almudena Porras, Claudia Fiorini, Mario D'Andrea, Luigi Michele Coppola, Carla Azzurra Amoreo, Guido Giordano, Andrea Remo, Luigi Cerulo, Pietro Parcesepe, Fabiana Conciatori, Erminia Manfrin, Aldo Scarpa, Massimo Pancione, Tania Di Raimo, and Michele Milella
- Subjects
Male ,0301 basic medicine ,Cancer Research ,MAP Kinase Signaling System ,Colorectal cancer ,Immune resistance ,LY6G6D ,Microsatellite-stable ,T-Lymphocytes ,Programmed Cell Death 1 Receptor ,Immunoglobulins ,Lewis X Antigen ,Biology ,DNA Mismatch Repair ,lcsh:RC254-282 ,B7-H1 Antigen ,03 medical and health sciences ,0302 clinical medicine ,Immune system ,Antigen ,Cell Line, Tumor ,STAT5 Transcription Factor ,Humans ,Mitogen-Activated Protein Kinase Kinases ,Trametinib ,Research ,MEK inhibitor ,Janus Kinase 1 ,Janus Kinase 2 ,Fucosyltransferases ,lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,digestive system diseases ,Immune checkpoint ,Gene Expression Regulation, Neoplastic ,Pyrimidines ,030104 developmental biology ,Oncology ,030220 oncology & carcinogenesis ,Benzamides ,Cancer cell ,biology.protein ,Cancer research ,Female ,Microsatellite Instability ,Antibody ,Colorectal Neoplasms - Abstract
Background Human microsatellite-stable (MSS) colorectal cancers (CRCs) are immunologically “cold” tumour subtypes characterized by reduced immune cytotoxicity. The molecular linkages between immune-resistance and human MSS CRC is not clear. Methods We used transcriptome profiling, in silico analysis, immunohistochemistry, western blot, RT-qPCR and immunofluorescence staining to characterize novel CRC immune biomarkers. The effects of selective antagonists were tested by in vitro assays of long term viability and analysis of kinase active forms using anti-phospho antibodies. Results We identified the lymphocyte antigen 6 complex, locus G6D (LY6G6D) as significantly overexpressed (around 15-fold) in CRC when compared with its relatively low expression in other human solid tumours. LY6G6D up-regulation was predominant in MSS CRCs characterized by an enrichment of immune suppressive regulatory T-cells and a limited repertoire of PD-1/PD-L1 immune checkpoint receptors. Coexpression of LY6G6D and CD15 increases the risk of metastatic relapse in response to therapy. Both JAK-STAT5 and RAS-MEK-ERK cascades act in concert as key regulators of LY6G6D and Fucosyltransferase 4 (FUT4), which direct CD15-mediated immune-resistance. Momelotinib, an inhibitor of JAK1/JAK2, consistently abrogated the STAT5/LY6G6D axis in vitro, sensitizing MSS cancer cells with an intact JAK-STAT signaling, to efficiently respond to trametinib, a MEK inhibitor used in clinical setting. Notably, colon cancer cells can evade JAK2/JAK1-targeted therapy by a reversible shift of the RAS-MEK-ERK pathway activity, which explains the treatment failure of JAK1/2 inhibitors in refractory CRC. Conclusions Combined targeting of STAT5 and MAPK pathways has superior therapeutic effects on immune resistance. In addition, the new identified LY6G6D antigen is a promising molecular target for human MSS CRC. Electronic supplementary material The online version of this article (10.1186/s13046-018-1019-5) contains supplementary material, which is available to authorized users.
- Published
- 2019
49. Patterns of recurrence after resection for pancreatic neuroendocrine tumors: who, when, and where?
- Author
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Salvatore Paiella, Gaia Masini, Paola Capelli, Giovanni Marchegiani, Chiara Nessi, Aldo Scarpa, Mariavittoria Davì, Claudio Bassi, Sara Cingarlini, Erminia Manfrin, Riccardo De Robertis, Isacco Damoli, Luca Landoni, Beatrice Bianchi, Roberto Salvia, Elena Vivani, Mirko D'Onofrio, Giuseppe Malleo, Stefano Andrianello, Marco Miotto, and Antonio Amodio
- Subjects
Adult ,Male ,medicine.medical_specialty ,Time Factors ,Endocrinology, Diabetes and Metabolism ,030209 endocrinology & metabolism ,Neuroendocrine tumors ,030218 nuclear medicine & medical imaging ,Resection ,03 medical and health sciences ,Cellular and Molecular Neuroscience ,Liver metastases ,0302 clinical medicine ,Endocrinology ,Risk Factors ,Recurrence ,Internal medicine ,medicine ,Humans ,Gastroenteropancreatic neuroendocrine tumors ,Grading (tumors) ,Pancreas ,Survival analysis ,Aged ,Retrospective Studies ,Follow-up ,Tumor size ,Endocrine and Autonomic Systems ,business.industry ,Nodal metastasis ,Middle Aged ,medicine.disease ,Survival Analysis ,Pancreatic Neoplasms ,medicine.anatomical_structure ,Italy ,Cohort ,Female ,Radiology ,Neoplasm Recurrence, Local ,business - Abstract
Background/Aims: Pancreatic neuroendocrine tumors (pan-NENs) represent an increasingly common indication for pancreatic resection, but there are few data regarding possible recurrence after surgery. The aim of the study was to describe the frequency, timing, and patterns of recurrence after resection for pan-NENs with consequent implications for postoperative follow-up. Methods: We performed a retrospective analysis of pan-NENs resected between 1990 and 2015 at The Pancreas Institute, University of Verona Hospital Trust. Predictors of recurrence were assessed. Survival analysis was conducted using the Kaplan-Meier and conditional survival (CS) methods. Results: The cohort consisted of 487 patients with a median follow-up of 71 months. Recurrence developed in 12.3%: 54 (11.1%) liver metastases, 11 (2.3%) local recurrence, 10 (2.1%) nodal recurrence, and 8 (1.6%) metastases in other organs. Thirty-one (6.4%) died due to disease recurrence. Size > 21 mm, G3 grade, nodal metastasis, and vascular infiltration were independent predictors of overall recurrence. Recurrence occurred either during the first year of follow-up (n = 9), or after 10 years (n = 4). CS analysis revealed that nonfunctioning G1 pan-NEN ≤20 mm without nodal metastasis or vascular invasion had a negligible risk of developing recurrence. In the present series, after 5 years of follow-up without developing recurrence, tumor recurrence occurred only in the form of liver metastases. Conclusions: Recurrence of pan-NENs is rare and is predicted by tumor size, nodal metastasis, grading, and vascular invasion. Patients with G1 pan-NEN without nodal metastasis and vascular invasion may be considered cured by surgery. After 5 years without recurrence, follow-up should focus on excluding the development of liver metastases.
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- 2019
50. EUS-guided core biopsies of pancreatic solid masses using a new fork-tip needle: A multicenter prospective study
- Author
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Erminia Manfrin, Rossella Semeraro, Marco Massidda, Milena Di Leo, Loredana Correale, Daoud Rahal, G. Donato, Stefano Francesco Crinò, Silvia Carrara, Andrea Anderloni, L. Poliani, Francesco Auriemma, Pietro Occhipinti, Alessandro Fugazza, Laura Bernardoni, E. Armellini, and Alessandro Repici
- Subjects
Core needle ,Adult ,Male ,medicine.medical_specialty ,FNA ,FNB ,Pancreatic adenocarcinoma ,SharkCore needle ,Tissue acquisition ,Adenocarcinoma ,03 medical and health sciences ,Pancreatic metastasis ,0302 clinical medicine ,Primary outcome ,medicine ,Humans ,Sampling (medicine) ,Major complication ,Prospective Studies ,Prospective cohort study ,Endoscopic Ultrasound-Guided Fine Needle Aspiration ,Aged ,Aged, 80 and over ,Hepatology ,business.industry ,Gastroenterology ,Middle Aged ,medicine.disease ,Carcinoma, Neuroendocrine ,Pancreatic Neoplasms ,030220 oncology & carcinogenesis ,030211 gastroenterology & hepatology ,Female ,Radiology ,Biopsy, Large-Core Needle ,business ,Core biopsy - Abstract
Background and aim Endoscopic ultrasound-guided sampling (EUS sampling) is a safe and effective technique. The study aim was to evaluate the presence of a histological core from pancreatic lesions using a new 25G fork-tip needle. Methods Observational multicenter prospective and analytical study, including consecutive patients with solid pancreatic masses referred for EUS-guided sampling. At each needle pass, the endoscopist performed macroscopic on-site evaluation (MOSE). The primary outcome was the histological core procurement rates. Secondary outcomes were the evaluation of interobserver agreement between endoscopists and pathologists, adequacy of EUS samples for the diagnosis and post-procedure adverse events. Results 100 patients were enrolled in 3 centers. The mean size of the lesions was 28.5 mm (SD 11.7). Final diagnoses were adenocarcinoma (68%), neuroendocrine tumor (21%), inflammatory mass/benign lesions (8.0%), and pancreatic metastasis (3.0%). The pathologists described the presence of a core in 67 samples (67.0% of patients), with poor agreement with MOSE (kappa, 0. 12; 95% CI: 0.03–0.28). The diagnostic accuracy was 93%. We observed 6% of mild adverse events. Conclusion The new 25-gauge core needle showed good overall adequacy and a good rate of histological specimens during EUS sampling of solid pancreatic masses, with a minimum number of passes and no major complications. Clinicaltrial.gov number, NCT02946840.
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- 2019
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