36 results on '"Swan Thung"'
Search Results
2. ASS1 Overexpression: A Hallmark of Sonic Hedgehog Hepatocellular Adenomas; Recommendations for Clinical Practice
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Margaux Sala, Delphine Gonzales, Thierry Leste‐Lasserre, Nathalie Dugot‐Senant, Valérie Paradis, Sylvaine Di Tommaso, Jean‐William Dupuy, Vincent Pitard, Cyril Dourthe, Amedeo Sciarra, Christine Sempoux, Linda D. Ferrell, Andrew D. Clouston, Gregory Miller, Mathew M. Yeh, Swan Thung, Annette S.H. Gouw, Alberto Quaglia, Jing Han, Ji Huan, Cathy Fan, James Crawford, Yasuni Nakanuma, Kenichi Harada, Brigitte leBail, Claire Castain, Nora Frulio, Hervé Trillaud, Laurent Possenti, Jean‐Frédéric Blanc, Laurence Chiche, Christophe Laurent, Charles Balabaud, Paulette Bioulac‐Sage, Anne Aurélie Raymond, and Frédéric Saltel
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Diseases of the digestive system. Gastroenterology ,RC799-869 - Abstract
Until recently, 10% of hepatocellular adenomas (HCAs) remained unclassified (UHCA). Among the UHCAs, the sonic hedgehog HCA (shHCA) was defined by focal deletions that fuse the promoter of Inhibin beta E chain with GLI1. Prostaglandin D2 synthase was proposed as immunomarker. In parallel, our previous work using proteomic analysis showed that most UHCAs constitute a homogeneous subtype associated with overexpression of argininosuccinate synthase (ASS1). To clarify the use of ASS1 in the HCA classification and avoid misinterpretations of the immunohistochemical staining, the aims of this work were to study (1) the link between shHCA and ASS1 overexpression and (2) the clinical relevance of ASS1 overexpression for diagnosis. Molecular, proteomic, and immunohistochemical analyses were performed in UHCA cases of the Bordeaux series. The clinico‐pathological features, including ASS1 immunohistochemical labeling, were analyzed on a large international series of 67 cases. ASS1 overexpression and the shHCA subgroup were superimposed in 15 cases studied by molecular analysis, establishing ASS1 overexpression as a hallmark of shHCA. Moreover, the ASS1 immunomarker was better than prostaglandin D2 synthase and only found positive in 7 of 22 shHCAs. Of the 67 UHCA cases, 58 (85.3%) overexpressed ASS1, four cases were ASS1 negative, and in five cases ASS1 was noncontributory. Proteomic analysis performed in the case of doubtful interpretation of ASS1 overexpression, especially on biopsies, can be a support to interpret such cases. ASS1 overexpression is a specific hallmark of shHCA known to be at high risk of bleeding. Therefore, ASS1 is an additional tool for HCA classification and clinical diagnosis.
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- 2020
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3. Intratumoral heterogeneity and clonal evolution in liver cancer
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Bojan Losic, Amanda J. Craig, Carlos Villacorta-Martin, Sebastiao N. Martins-Filho, Nicholas Akers, Xintong Chen, Mehmet E. Ahsen, Johann von Felden, Ismail Labgaa, Delia DʹAvola, Kimaada Allette, Sergio A. Lira, Glaucia C. Furtado, Teresa Garcia-Lezana, Paula Restrepo, Ashley Stueck, Stephen C. Ward, Maria I. Fiel, Spiros P. Hiotis, Ganesh Gunasekaran, Daniela Sia, Eric E. Schadt, Robert Sebra, Myron Schwartz, Josep M. Llovet, Swan Thung, Gustavo Stolovitzky, and Augusto Villanueva
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Science - Abstract
Immune-mediated selection pressures impact the clonal evolution of tumours. Here, in hepatocellular carcinoma the authors map spatio-temporal interactions between tumor and immune cells, highlighting the regulatory substrate of intra-tumoural heterogeneity that correlates with regional adaptive immune responses.
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- 2020
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4. Transcriptomic characterization of cancer-testis antigens identifies MAGEA3 as a driver of tumor progression in hepatocellular carcinoma.
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Amanda J Craig, Teresa Garcia-Lezana, Marina Ruiz de Galarreta, Carlos Villacorta-Martin, Edgar G Kozlova, Sebastiao N Martins-Filho, Johann von Felden, Mehmet Eren Ahsen, Erin Bresnahan, Gabriela Hernandez-Meza, Ismail Labgaa, Delia D'Avola, Myron Schwartz, Josep M Llovet, Daniela Sia, Swan Thung, Bojan Losic, Amaia Lujambio, and Augusto Villanueva
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Genetics ,QH426-470 - Abstract
Cancer testis antigens (CTAs) are an extensive gene family with a unique expression pattern restricted to germ cells, but aberrantly reactivated in cancer tissues. Studies indicate that the expression (or re-expression) of CTAs within the MAGE-A family is common in hepatocellular carcinoma (HCC). However, no systematic characterization has yet been reported. The aim of this study is to perform a comprehensive profile of CTA de-regulation in HCC and experimentally evaluate the role of MAGEA3 as a driver of HCC progression. The transcriptomic analysis of 44 multi-regionally sampled HCCs from 12 patients identified high intra-tumor heterogeneity of CTAs. In addition, a subset of CTAs was significantly overexpressed in histologically poorly differentiated regions. Further analysis of CTAs in larger patient cohorts revealed high CTA expression related to worse overall survival and several other markers of poor prognosis. Functional analysis of MAGEA3 was performed in human HCC cell lines by gene silencing and in a genetic mouse model by overexpression of MAGEA3 in the liver. Knockdown of MAGEA3 decreased cell proliferation, colony formation and increased apoptosis. MAGEA3 overexpression was associated with more aggressive tumors in vivo. In conclusion MAGEA3 enhances tumor progression and should be considered as a novel therapeutic target in HCC.
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- 2021
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5. Feasibility and reproducibility of liver surface nodularity quantification for the assessment of liver cirrhosis using CT and MRI
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Grace C. Lo, Cecilia Besa, Michael J. King, Martin Kang, Ashley Stueck, Swan Thung, Mathilde Wagner, Andrew D. Smith, and Bachir Taouli
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Medical physics. Medical radiology. Nuclear medicine ,R895-920 - Abstract
Purpose: To assess intra-observer, inter-observer and inter-modality (CT vs. MRI) reproducibility of liver surface nodularity (LSN) scores measured with software used for detection of liver fibrosis. Methods: This IRB-approved retrospective study included patients with both abdominal CT and MRI within 6 months of histopathologic sampling. Two independent observers used post-processing software to quantify LSN scores on axial non-contrast CT (NCT), axial contrast-enhanced CT (CECT), axial T2-weighted (T2W) HASTE, and axial and coronal post-gadoxetic acid T1-weighted (T1W) images obtained during the hepatobiliary phase (HBP). Ten slices were used to acquire the LSN scores. Intra-observer, inter-observer, and inter-modality (CT vs. MRI) reproducibility were assessed with intraclass correlation coefficient (ICC) and coefficients of variability (CV). Accuracy for detection of cirrhosis was evaluated for each technique. Results: 26 patients (M/F 19/7, mean age 57 years), including 7 with cirrhosis (26.9%), were assessed. Technical failure occurred with NCT (1/23, 4.3%) and T2 HASTE (8/28, 28.6%). Intra-observer reproducibility was excellent for NCT, CECT, axial and coronal T1W HBP [ICC â¥Â 0.92, CV â¤Â 8%]. Inter-observer reproducibility was also excellent for NCT and CECT (ICC â¥Â 0.95, CV â¤Â 7.3%) and for coronal T1W HBP (ICC = 0.84, CV = 5.6%). There was fair to moderate agreement between CT and MRI (ICC 0.20â0.44). There were significant differences in mean LSN scores between non-cirrhotic and cirrhotic patients with NCT (2.6 vs. 4.2, p = 0.04) and T1W HBP (3.7 vs. 4.6; p = 0.01) images, with AUCs of 0.81 and 0.82, respectively. Conclusions: LSN measurement is highly reproducible with NCT and post-contrast T1W HBP on MRI, with different results obtained between CT and MRI. Keywords: Liver surface nodularity, Fibrosis, Cirrhosis, CT, MRI
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- 2017
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6. Performance of native and gadoxetate-enhanced liver and spleen T1 mapping for noninvasive diagnosis of clinically significant portal hypertension: preliminary results
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Emre Altinmakas, Octavia Bane, Stefanie J. Hectors, Rayane Issa, Guillermo Carbonell, Ghadi Abboud, Thomas D. Schiano, Swan Thung, Aaron Fischman, Matthew D. Kelly, Scott L. Friedman, Paul Kennedy, and Bachir Taouli
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Radiological and Ultrasound Technology ,Urology ,Gastroenterology ,Radiology, Nuclear Medicine and imaging - Published
- 2022
7. Supplementary Data from Hepatocellular Carcinoma in Mongolia Delineates Unique Molecular Traits and a Mutational Signature Associated with Environmental Agents
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Josep M. Llovet, Daniela Sia, Sasan Roayaie, Xavier Forns, Jaclyn Neely, Andrew Uzilov, Jessica Zucman-Rossi, Eric Letouzé, Jigjidsuren Chinburen, Swan Thung, Sofía Pérez-del-Pulgar, Augusto Villanueva, Amankyeldi Yerbolat, Erdenebileg Taivanbaatar, Chinbold Enkhbold, Genís Campreciós, Patricia Taik, Ajay Ramakrishnan Varadarajan, Sara Torrecilla, Carla Montironi, Wei Qiang Leow, Roger Esteban-Fabró, Mireia García-López, Thais Leonel, Philipp K. Haber, Miho Maeda, Huan Wang, Miguel Torres-Martín, Marc Puigvehí, and Laura Torrens
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Supplementary Data from Hepatocellular Carcinoma in Mongolia Delineates Unique Molecular Traits and a Mutational Signature Associated with Environmental Agents
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- 2023
8. Data from Hepatocellular Carcinoma in Mongolia Delineates Unique Molecular Traits and a Mutational Signature Associated with Environmental Agents
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Josep M. Llovet, Daniela Sia, Sasan Roayaie, Xavier Forns, Jaclyn Neely, Andrew Uzilov, Jessica Zucman-Rossi, Eric Letouzé, Jigjidsuren Chinburen, Swan Thung, Sofía Pérez-del-Pulgar, Augusto Villanueva, Amankyeldi Yerbolat, Erdenebileg Taivanbaatar, Chinbold Enkhbold, Genís Campreciós, Patricia Taik, Ajay Ramakrishnan Varadarajan, Sara Torrecilla, Carla Montironi, Wei Qiang Leow, Roger Esteban-Fabró, Mireia García-López, Thais Leonel, Philipp K. Haber, Miho Maeda, Huan Wang, Miguel Torres-Martín, Marc Puigvehí, and Laura Torrens
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Purpose:Mongolia has the world's highest incidence of hepatocellular carcinoma (HCC), with ∼100 cases/100,000 inhabitants, although the reasons for this have not been thoroughly delineated.Experimental Design:We performed a molecular characterization of Mongolian (n = 192) compared with Western (n = 187) HCCs by RNA sequencing and whole-exome sequencing to unveil distinct genomic and transcriptomic features associated with environmental factors in this population.Results:Mongolian patients were younger, with higher female prevalence, and with predominantly HBV–HDV coinfection etiology. Mongolian HCCs presented significantly higher rates of protein-coding mutations (121 vs. 70 mutations per tumor in Western), and in specific driver HCC genes (i.e., APOB and TSC2). Four mutational signatures characterized Mongolian samples, one of which was novel (SBS Mongolia) and present in 25% of Mongolian HCC cases. This signature showed a distinct substitution profile with a high proportion of T>G substitutions and was significantly associated with a signature of exposure to the environmental agent dimethyl sulfate (71%), a 2A carcinogenic associated with coal combustion. Transcriptomic-based analysis delineated three molecular clusters, two not present in Western HCC; one with a highly inflamed profile and the other significantly associated with younger female patients.Conclusions:Mongolian HCC has unique molecular traits with a high mutational burden and a novel mutational signature associated with genotoxic environmental factors present in this country.
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- 2023
9. Supplementary Figure from Hepatocellular Carcinoma in Mongolia Delineates Unique Molecular Traits and a Mutational Signature Associated with Environmental Agents
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Josep M. Llovet, Daniela Sia, Sasan Roayaie, Xavier Forns, Jaclyn Neely, Andrew Uzilov, Jessica Zucman-Rossi, Eric Letouzé, Jigjidsuren Chinburen, Swan Thung, Sofía Pérez-del-Pulgar, Augusto Villanueva, Amankyeldi Yerbolat, Erdenebileg Taivanbaatar, Chinbold Enkhbold, Genís Campreciós, Patricia Taik, Ajay Ramakrishnan Varadarajan, Sara Torrecilla, Carla Montironi, Wei Qiang Leow, Roger Esteban-Fabró, Mireia García-López, Thais Leonel, Philipp K. Haber, Miho Maeda, Huan Wang, Miguel Torres-Martín, Marc Puigvehí, and Laura Torrens
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Supplementary Figure from Hepatocellular Carcinoma in Mongolia Delineates Unique Molecular Traits and a Mutational Signature Associated with Environmental Agents
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- 2023
10. Supplementary Tables 1 - 12, Figures 1 - 7 from Wnt-Pathway Activation in Two Molecular Classes of Hepatocellular Carcinoma and Experimental Modulation by Sorafenib
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Josep M. Llovet, Scott L. Friedman, Myron Schwartz, Vincenzo Mazzaferro, Jordi Bruix, Stephen C. Ward, Swan Thung, Jordi Barretina, Hung-Wen Tsai, Philippa Newell, Beatriz Minguez, Augusto Villanueva, Yujin Hoshida, Sara Toffanin, Laia Cabellos, Radoslav Savic, Clara Alsinet, and Anja Lachenmayer
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PDF file, 10.8MB, Supplementary Table 1: Clinical characteristics of human hepatocellular carcinoma samples. Supplementary Table 2: Clinical Characteristics of 5 public HCC datasets. Supplementary Table 3: Wnt-pathway mRNA list: 210 Wnt-related genes from the literature. Supplementary Table 4: Wnt-pathway miRNA list: 49 Wnt-related miRNAs from the literature. Supplementary Table 5: Significantly differentially expressed Wnt-related genes in CTNNB1- and Wnt-TGF_-class samples of the training set. Supplementary Table 6: Summary of dysregulated CTNNB1- and Wnt-TGF_-Wnt-genes according to their cellular localization and their known or suspected function. Supplementary Table 7: Expression of known liver-related Wnt-target-genes. Supplementary Table 8: Correlation of Wnt-related transcription factors to Wnt-target-genes in the training set. Supplementary Table 9: Frequency _catenin IHC positive samples and CTNNB1 mutations Wnt-related and non-Wnt-related subclasses of HCC in the in training (T) and validation (V) sets. Supplementary Table 10: Differentially expressed Wnt-related-miRNAs in 89 HCC samples of the training set. Supplementary Table 11: Enrichment of samples identified by CTNNB1-, Wnt-TGF__ WntGenes- and CTNNB1-mutation-signature in CTNNB1 and Wnt-TGF_ subclasses in 5 independent datasets (Fisher's Exact Test). Supplementary Table 12: 21 Liver Cancer cell lines analyzed by GSEA for gene expression profiles similar to either CTNNB1 or Wnt-TGF_ class. Supplementary Figure 1: Differential Expression of Wnt-pathway mRNAs in the CTNNB1- and Wnt-TGF Beta-classes in the training set. Supplementary Figure 2: Differential Expression of Wnt-pathway-miRNAs in the CTNNB1- and Wnt-TGF Beta-classes in the training set. Supplementary Figure 3: Validation of CTNNB1- and Wnt-TGF Beta-specific Wnt-related mRNA profiles and mutation-status in 5 public HCC datasets. Supplementary Figure 4: Validation of the mutation signature in an independent cohort of HCC. Supplementary Figure 5: Correlation of gene expression data from 21 different liver cancer cell lines with CTNNB1 and Wnt-TGF Beta class signatures by GSEA. Supplementary Figure 6: Baseline luciferase levels in Wnt reporter liver cancer cells stably transduced with TCF/LEF luciferase reporter. Supplementary Figure 7: Sorafenib decreases beta-catenin protein levels in 4 liver cancer cell lines.
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- 2023
11. Data from Wnt-Pathway Activation in Two Molecular Classes of Hepatocellular Carcinoma and Experimental Modulation by Sorafenib
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Josep M. Llovet, Scott L. Friedman, Myron Schwartz, Vincenzo Mazzaferro, Jordi Bruix, Stephen C. Ward, Swan Thung, Jordi Barretina, Hung-Wen Tsai, Philippa Newell, Beatriz Minguez, Augusto Villanueva, Yujin Hoshida, Sara Toffanin, Laia Cabellos, Radoslav Savic, Clara Alsinet, and Anja Lachenmayer
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Purpose: Hepatocellular carcinoma (HCC) is a heterogeneous cancer with active Wnt signaling. Underlying biologic mechanisms remain unclear and no drug targeting this pathway has been approved to date. We aimed to characterize Wnt-pathway aberrations in HCC patients, and to investigate sorafenib as a potential Wnt modulator in experimental models of liver cancer.Experimental Design: The Wnt-pathway was assessed using mRNA (642 HCCs and 21 liver cancer cell lines) and miRNA expression data (89 HCCs), immunohistochemistry (108 HCCs), and CTNNB1-mutation data (91 HCCs). Effects of sorafenib on Wnt signaling were evaluated in four liver cancer cell lines with active Wnt signaling and a tumor xenograft model.Results: Evidence for Wnt activation was observed for 315 (49.1%) cases, and was further classified as CTNNB1 class (138 cases [21.5%]) or Wnt-TGFβ class (177 cases [27.6%]). CTNNB1 class was characterized by upregulation of liver-specific Wnt-targets, nuclear β-catenin and glutamine-synthetase immunostaining, and enrichment of CTNNB1-mutation-signature, whereas Wnt-TGFβ class was characterized by dysregulation of classical Wnt-targets and the absence of nuclear β-catenin. Sorafenib decreased Wnt signaling and β-catenin protein in HepG2 (CTNNB1 class), SNU387 (Wnt-TGFβ class), SNU398 (CTNNB1-mutation), and Huh7 (lithium-chloride-pathway activation) cell lines. In addition, sorafenib attenuated expression of liver-related Wnt-targets GLUL, LGR5, and TBX3. The suppressive effect on CTNNB1 class–specific Wnt-pathway activation was validated in vivo using HepG2 xenografts in nude mice, accompanied by decreased tumor volume and increased survival of treated animals.Conclusions: Distinct dysregulation of Wnt-pathway constituents characterize two different Wnt-related molecular classes (CTNNB1 and Wnt-TGFβ), accounting for half of all HCC patients. Sorafenib modulates β-catenin/Wnt signaling in experimental models that harbor the CTNNB1 class signature. Clin Cancer Res; 18(18); 4997–5007. ©2012 AACR.
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- 2023
12. Banff 2022 Liver Group Meeting Report: Monitoring Long Term Allograft Health
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Chris Bellamy, Jacqueline G. O'Leary, Oyedele Adeyi, Nahed Baddour, Ibrahim Batal, John Bucuvalas, Arnaud del Bello, Mohamed El Hag, Magda El-Monayeri, Alton Farris, Sandy Feng, Maria Isabel Fiel, Sandra E. Fischer, John F. Fung, Krzysztof Grzyb, Maha Guimei, Hironori Haga, John Hart, Annette Jackson, Elmar Jaeckel, Nigar Khurram, Stuart Knechtle, Drew Lesniak, Josh Levitsky, Geoff McCaughan, Catriona McKenzie, Claudia Mescoli, Rosa Miquel, Marta Minervini, Imad Nasser, Desley Neil, Maura O'Neil, Thomas Schiano, Orit Pappo, Parmjeet Randhawa, Phillip Ruiz, Alberto Sanchez Fueyo, Deborah Schady, Mylene Sebagh, Maxwell L. Smith, Heather Stevenson, Timucin Taner, Richard Taubert, Swan Thung, Pavel Trunecka, Hanlin Wang, Michelle Wood-Trageser, Funda Yilmaz, Yoh Zen, Adriana Zeevi, and Anthony J. Demetris
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History ,Polymers and Plastics ,Business and International Management ,Industrial and Manufacturing Engineering - Published
- 2023
13. Inflamed and non-inflamed classes of HCC: a revised immunogenomic classification
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Carla Montironi, Florian Castet, Philipp K Haber, Roser Pinyol, Miguel Torres-Martin, Laura Torrens, Agavni Mesropian, Huan Wang, Marc Puigvehi, Miho Maeda, Wei Qiang Leow, Elizabeth Harrod, Patricia Taik, Jigjidsuren Chinburen, Erdenebileg Taivanbaatar, Enkhbold Chinbold, Manel Solé Arqués, Michael Donovan, Swan Thung, Jaclyn Neely, Vincenzo Mazzaferro, Jeffrey Anderson, Sasan Roayaie, Myron Schwartz, Augusto Villanueva, Scott L Friedman, Andrew Uzilov, Daniela Sia, and Josep M Llovet
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Carcinoma, Hepatocellular ,Liver Neoplasms ,Mutation ,Gastroenterology ,Humans ,Interferons ,DNA Methylation ,Wnt Signaling Pathway ,Article - Abstract
ObjectiveWe previously reported a characterisation of the hepatocellular carcinoma (HCC) immune contexture and described an immune-specific class. We now aim to further delineate the immunogenomic classification of HCC to incorporate features that explain responses/resistance to immunotherapy.DesignWe performed RNA and whole-exome sequencing, T-cell receptor (TCR)-sequencing, multiplex immunofluorescence and immunohistochemistry in a novel cohort of 240 HCC patients and validated our results in other cohorts comprising 660 patients.ResultsOur integrative analysis led to define: (1) the inflamed class of HCC (37%), which includes the previously reported immune subclass (22%) and a new immune-like subclass (15%) with high interferon signalling, cytolytic activity, expression of immune-effector cytokines and a more diverse T-cell repertoire. A 20-gene signature was able to capture ~90% of these tumours and is associated with response to immunotherapy. Proteins identified in liquid biopsies recapitulated the inflamed class with an area under the ROC curve (AUC) of 0.91; (2) The intermediate class, enriched inTP53mutations (49% vs 29%, p=0.035), and chromosomal losses involving immune-related genes and; (3) the excluded class, enriched inCTNNB1mutations (93% vs 27%, pPTK2overexpression due to gene amplification and promoter hypomethylation.CTNNB1mutations outside the excluded class led to weak activation of the Wnt-βcatenin pathway or occurred in HCCs dominated by high interferon signalling and type I antigen presenting genes.ConclusionWe have characterised the immunogenomic contexture of HCC and defined inflamed and non-inflamed tumours. Two distinctCTNNB1patterns associated with a differential role in immune evasion are described. These features may help predict immune response in HCC.
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- 2022
14. Tumor Size, Not Small Vessel Invasion, Predicts Survival in Patients With Hepatocellular Carcinoma
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Dongwei Zhang, Tanzy Love, Yansheng Hao, Bella Lingjia Liu, Swan Thung, Maria Isabel Fiel, Christa L Whitney-Miller, and Xiaoyan Liao
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Cohort Studies ,Carcinoma, Hepatocellular ,Liver Neoplasms ,Humans ,Kaplan-Meier Estimate ,General Medicine ,Prognosis ,Neoplasm Staging - Abstract
Objectives The 8th edition American Joint Committee on Cancer (AJCC) staging system for hepatocellular carcinoma (HCC) has been criticized for failing to stratify patients. We aimed to reassess and modify the tumor staging criteria for HCC. Methods Three independent study cohorts were collected and analyzed. Results The initial cohort consists of 103 patients with HCC. By Kaplan-Meier survival analysis, the 8th edition failed to distinguish between T1b and T2. Only tumor size and large vessel invasion, but not small vessel invasion or other histopathologic parameters, predicted HCC survival. We modified the T staging criteria by eliminating small vessel invasion while emphasizing tumor size in the middle categories (T2 and T3), which achieved more even distribution of cases and significantly improved risk stratifications (P Conclusions Our study showed that tumor size, but not small vessel invasion, predicts survival in patients with HCC. We suggest incorporating our modified T staging criteria in future AJCC revisions.
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- 2022
15. MR elastography outperforms shear wave elastography for the diagnosis of clinically significant portal hypertension
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Paul Kennedy, Daniel Stocker, Guillermo Carbonell, Daniela Said, Octavia Bane, Stefanie Hectors, Ghadi Abboud, Jordan Cuevas, Bradley D. Bolster, Scott L. Friedman, Sara Lewis, Thomas Schiano, Dipankar Bhattacharya, Aaron Fischman, Swan Thung, Bachir Taouli, University of Zurich, and Taouli, Bachir
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Adult ,Liver Cirrhosis ,10042 Clinic for Diagnostic and Interventional Radiology ,610 Medicine & health ,General Medicine ,Middle Aged ,Portal Pressure ,Article ,Liver ,Hypertension, Portal ,2741 Radiology, Nuclear Medicine and Imaging ,Humans ,Elasticity Imaging Techniques ,Radiology, Nuclear Medicine and imaging ,Prospective Studies ,Aged - Abstract
Portal hypertension (PH) is associated with complications such as ascites and esophageal varices and is typically diagnosed through invasive hepatic venous pressure gradient (HVPG) measurement, which is not widely available. In this study, we aim to assess the diagnostic performance of 2D/3D MR elastography (MRE) and shear wave elastography (SWE) measures of liver and spleen stiffness (LS and SS) and spleen volume, to noninvasively diagnose clinically significant portal hypertension (CSPH) using HVPG measurement as the reference.In this prospective study, patients with liver disease underwent 2D/3D MRE and SWE of the liver and spleen, as well as HVPG measurement. The correlation between MRE/SWE measures of LS/SS and spleen volume with HVPG was assessed. ROC analysis was used to determine the utility of MRE, SWE, and spleen volume for diagnosing CSPH.Thirty-six patients (M/F 22/14, mean age 55 ± 14 years) were included. Of the evaluated parameters, 3D MRE SS had the strongest correlation with HVPG (r = 0.686, p0.001), followed by 2D MRE SS (r = 0.476, p = 0.004). 3D MRE SS displayed the best performance for diagnosis of CSPH (AUC = 0.911) followed by 2D MRE SS (AUC = 0.845) and 3D MRE LS (AUC = 0.804). SWE SS showed poor performance for diagnosis of CSPH (AUC = 0.583) while spleen volume was a fair predictor (AUC = 0.738). 3D MRE SS was significantly superior to SWE LS/SS (p ≤ 0.021) for the diagnosis of CSPH.SS measured with 3D MRE outperforms SWE for the diagnosis of CSPH. SS appears to be a useful biomarker for assessing PH severity. These results need further validation.• Spleen stiffness measured with 2D and 3D MR elastography correlates significantly with hepatic venous pressure gradient measurement. • Spleen stiffness measured with 3D MR elastography demonstrates excellent performance for the diagnosis of clinically significant portal hypertension (AUC 0.911). • Spleen stiffness measured with 3D MR elastography outperforms liver and spleen stiffness measured with shear wave elastography for diagnosis of clinically significant portal hypertension.
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- 2022
16. Molecular markers of response to anti-PD1 therapy in advanced hepatocellular carcinoma
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Philipp K. Haber, Florian Castet, Miguel Torres-Martin, Carmen Andreu-Oller, Marc Puigvehí, Maeda Miho, Pompilia Radu, Jean-Francois Dufour, Chris Verslype, Carolin Zimpel, Jens U. Marquardt, Peter R. Galle, Arndt Vogel, Melanie Bathon, Tim Meyer, Ismail Labgaa, Antonia Digklia, Lewis R. Roberts, Mohamed A. Mohamed Ali, Beatriz Mínguez, Davide Citterio, Vincenzo Mazzaferro, Fabian Finkelmeier, Jörg Trojan, Burcin Özdirik, Tobias Müller, Moritz Schmelzle, Anthony Bejjani, Max W. Sung, Myron E. Schwartz, Richard S. Finn, Swan Thung, Augusto Villanueva, Daniela Sia, and Josep M. Llovet
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Hepatology ,Settore MED/06 - Oncologia Medica ,Gastroenterology ,Biomarkers ,Hepatocellular Carcinoma ,Immunotherapy ,Predictors of Response ,610 Medicine & health - Abstract
Background & aims: single-agent anti-PD1 checkpoint inhibitors convey outstanding clinical benefits in a small fraction (∼20%) of patients with advanced hepatocellular carcinoma (aHCC) but the molecular mechanisms determining response are unknown. To fill this gap, we herein analyze the molecular and immune traits of aHCC in patients treated with anti-PD1. Methods: overall, 111 tumor samples from patients with aHCC were obtained from 13 centers before systemic therapies. We performed molecular analysis and immune deconvolution using whole-genome expression data (n = 83), mutational analysis (n = 72), and histologic evaluation with an endpoint of objective response. Results: among 83 patients with transcriptomic data, 28 were treated in frontline, whereas 55 patients were treated after tyrosine kinase inhibitors (TKI) either in second or third line. Responders treated in frontline showed upregulated interferon-γ signaling and major histocompatibility complex II-related antigen presentation. We generated an 11-gene signature (IFNAP), capturing these molecular features, which predicts response and survival in patients treated with anti-PD1 in frontline. The signature was validated in a separate cohort of aHCC and >240 patients with other solid cancer types where it also predicted response and survival. Of note, the same signature was unable to predict response in archival tissue of patients treated with frontline TKIs, highlighting the need for fresh biopsies before immunotherapy. Conclusion: interferon signaling and major histocompatibility complex-related genes are key molecular features of HCCs responding to anti-PD1. A novel 11-gene signature predicts response in frontline aHCC, but not in patients pretreated with TKIs. These results must be confirmed in prospective studies and highlights the need for biopsies before immunotherapy to identify biomarkers of response.
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- 2022
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17. Inflamed and non-inflamed classes of HCC: a revised immunogenomic classification.
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Montironi, Carla, Castet, Florian, Haber, Philipp K., Pinyol, Roser, Torres-Martin, Miguel, Torrens, Laura, Mesropian, Agavni, Huan Wang, Puigvehi, Marc, Maeda, Miho, Wei Qiang Leow, Harrod, Elizabeth, Taik, Patricia, Chinburen, Jigjidsuren, Taivanbaatar, Erdenebileg, Chinbold, Enkhbold, Arqués, Manel Solé, Donovan, Michael, Swan Thung, and Neely, Jaclyn
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GENE expression ,TYPE I interferons ,MOLECULAR biology ,TUMOR-infiltrating immune cells ,CIRCULATING tumor DNA - Published
- 2023
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18. Porto-Sinusoidal Vascular Disease with Obliterative Portal Venopathy Associated with Long-Term Azathioprine for Crohn’s Disease
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Jack Husney, Richard A. Manfready, Ilan Weisberg, and Swan Thung
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medicine.medical_specialty ,Crohn's disease ,Vascular disease ,business.industry ,Azathioprine ,Disease ,medicine.disease ,Gastroenterology ,Inflammatory bowel disease ,Endothelial stem cell ,Internal medicine ,medicine ,Portal hypertension ,business ,Nodular regenerative hyperplasia ,medicine.drug - Abstract
Patients receiving immunosuppressive therapy for inflammatory bowel disease may be susceptible to non-cirrhotic portal hypertension, now referred to as porto-sinusoidal vascular disease. Here we describe a patient treated with long-term azathioprine for Crohn’s disease who developed porto-sinusoidal vascular disease with obliterative portal venopathy without nodular regenerative hyperplasia on histology. Specific signs of portal hypertension were present, including porto-systemic collaterals on imaging. Histopathologic findings of porto-sinusoidal vascular disease support the hypothesis of endothelial cell injury induced by 6-thioguanine secondary to azathioprine use.
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- 2020
19. Lymphoepithelioma-like neoplasm of the biliary tract with 'probable low malignant potential'
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Binny Khandakar, Young Nyun Park, Jun-Ru Liu, Swan Thung, Irene Oi-Lin Ng, Neil D. Theise, Alexander C Kagen, Hyungjin Rhee, Ying Li, and Tommy Richard Sun-Wing Tong
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Adult ,Male ,Pathology ,medicine.medical_specialty ,Epstein-Barr Virus Infections ,Histology ,Carcinoma, Hepatocellular ,Context (language use) ,Gene mutation ,medicine.disease_cause ,Pathology and Forensic Medicine ,Cholangiocarcinoma ,medicine ,Neoplasm ,Humans ,Lymphoepithelioma ,Aged ,business.industry ,Carcinoma ,Liver Neoplasms ,General Medicine ,medicine.disease ,Epstein–Barr virus ,Bile Duct Neoplasms ,Biliary tract ,Hepatocellular carcinoma ,Female ,KRAS ,business - Abstract
AIMS Lymphoepithelioma-like carcinomas (LELCs) are uncommon epithelial cancers characteristically showing two distinct components consisting of malignant epithelial cells and prominent dense lymphoid infiltrate. Hepatic LELCs consist of two types, the lymphoepithelioma-like hepatocellular carcinoma and lymphoepithelioma-like cholangiocarcinoma (LEL-CCA), with the latter being strongly associated with Epstein-Barr virus (EBV). METHODS AND RESULTS We present a series of three cases of intrahepatic biliary EBV-associated LEL tumours in which the biliary epithelial component showed a distinctly benign appearance, instead of the usual malignant epithelial features of a typical CCA or EBV-associated LEL-CCA. In the lesions, the biliary epithelium showed interconnecting glands or cords of cells. All had a very low proliferation (Ki-67) index. Immunohistochemistry for IDH1 and TP53 performed on two cases was negative and molecular tests for EGFR and KRAS gene mutations performed on one were negative. Prognosis was very good in all three cases, with patients alive with no evidence of disease 24-62 months after surgery. Intriguingly, all three cases had co-infection of HBV and EBV. These cases are also discussed in the context of the 63 cases of LEL-CCA available in the literature, with a focus on epidemiology, clinicopathological features and potential research interests. CONCLUSIONS Based on the distinct clinicopathological features and unique survival benefits, we believe these tumours represent the benign end of the spectrum of EBV-associated lymphoepithelial biliary carcinomas. Whether these tumours require a revision of the current nomenclature to 'lymphoepithelioma-like neoplasm of the biliary tract with probable low malignant potential' will require more detailed analysis with larger case-series.
- Published
- 2021
20. Noninvasive diagnosis of portal hypertension using gadoxetate DCE-MRI of the liver and spleen
- Author
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Stefanie J, Hectors, Octavia, Bane, Paul, Kennedy, Jordan, Cuevas, Swan, Thung, Aaron, Fischman, Scott L, Friedman, Thomas D, Schiano, and Bachir, Taouli
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Liver Cirrhosis ,Liver ,Hypertension, Portal ,Elasticity Imaging Techniques ,Humans ,Middle Aged ,Magnetic Resonance Imaging ,Portal Pressure ,Spleen - Abstract
To assess the performance of gadoxetate dynamic contrast-enhanced (DCE) MRI of the liver and spleen for noninvasive diagnosis of portal hypertension (PH).Thirty-five patients (M/F 22/13, mean age 55 years) with chronic liver disease who underwent hepatic venous pressure gradient (HVPG) measurements were prospectively enrolled in this IRB-approved study. All patients underwent multiparametric MRI including gadoxetate DCE-MRI acquisition. Model-based and model-free DCE-MRI analyses were performed. The correlation between DCE-MRI parameters and HVPG was assessed. ROC analysis was employed to determine the diagnostic performance of DCE-MRI parameters alone and in combination for prediction of PH and clinically significant (CS)PH (HVPG5 and ≥ 10 mmHg, respectively).Mean HVPG was 7.0 ± 5.0 mmHg (range 0-18 mmHg). Twenty-one (60%) patients had PH, of whom 9 had CSPH. Modeled liver uptake fraction fOur results demonstrate the potential utility of hepatocyte uptake parameters and spleen interstitial fraction obtained with gadoxetate DCE-MRI for the diagnosis of PH and CSPH.• Liver uptake and spleen interstitial fraction estimates from gadoxetate DCE-MRI are significantly correlated with portal pressure measurements. • Liver uptake rate shows good diagnostic performance for the diagnosis of portal hypertension. • The combination of liver uptake rate with spleen interstitial fraction exhibits excellent diagnostic performance for the diagnosis of clinically significant portal hypertension.
- Published
- 2020
21. Hepatocellular adenoma(s) arising in nodular regenerative hyperplasia in a patient with systemic lupus erythematosus
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Mark Levstik, Xiaoyan Liao, Stan L. Weiss, Swan Thung, Xiuli Liu, Phoenix D Bell, and Dongwei Zhang
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0301 basic medicine ,Adult ,Pathology ,medicine.medical_specialty ,medicine.medical_treatment ,Biopsy ,Context (language use) ,Malignancy ,Pathology and Forensic Medicine ,Malignant transformation ,Benign tumor ,Adenoma, Liver Cell ,03 medical and health sciences ,0302 clinical medicine ,Female patient ,medicine ,Humans ,Lupus Erythematosus, Systemic ,Hyperplasia ,business.industry ,Liver Neoplasms ,Cell Biology ,Hepatocellular adenoma ,medicine.disease ,030104 developmental biology ,Liver ,Focal Nodular Hyperplasia ,030220 oncology & carcinogenesis ,Female ,business ,Anabolic steroid ,Nodular regenerative hyperplasia - Abstract
Hepatocellular adenoma (HCA) is a rare benign tumor of the liver with low risk of malignant transformation. It is associated with oral contraceptives/anabolic steroid use, metabolic disease, and rarely, vascular abnormalities. We report an interesting case of HCA arising in a background of diffuse hepatic nodular regenerative hyperplasia (NRH) in a 40-year-old female patient with systemic lupus erythematosus (SLE). She presented with sudden-onset refractory ascites, elevated liver enzymes, diffuse hepatic nodularity and mass lesions on imaging concerning for malignancy. Targeted biopsies of the mass lesion were performed with inconclusive diagnoses. The patient ultimately underwent resection of the mass, which was confirmed as HCA, inflammatory type, arising in a background of NRH. It is not uncommon for SLE patients to have liver manifestations such as NRH, but HCA arising in NRH has not been previously reported. Our case reveals an unusual relationship between HCA and hepatic vasculopathy in the clinical context of a systemic inflammatory condition, the mechanism by which is not fully understood.
- Published
- 2019
22. Detection of liver fibrosis using qualitative and quantitative MR elastography compared to liver surface nodularity measurement, gadoxetic acid uptake, and serum markers
- Author
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Cecilia, Besa, Mathilde, Wagner, Grace, Lo, Sonja, Gordic, Manjil, Chatterji, Paul, Kennedy, Ashley, Stueck, Swan, Thung, James, Babb, Andrew, Smith, and Bachir, Taouli
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Adult ,Aged, 80 and over ,Gadolinium DTPA ,Liver Cirrhosis ,Male ,Observer Variation ,Adolescent ,Reproducibility of Results ,Middle Aged ,Magnetic Resonance Imaging ,Young Adult ,ROC Curve ,Multivariate Analysis ,Elasticity Imaging Techniques ,Humans ,Female ,Biomarkers ,Aged ,Retrospective Studies - Abstract
Multiparametric magnetic resonance imaging (mpMRI) combining different techniques such as MR elastography (MRE) has emerged as a noninvasive approach to diagnose and stage liver fibrosis with high accuracy allowing for anatomical and functional information.To assess the diagnostic performance of mpMRI including qualitative and quantitative assessment of MRE, liver surface nodularity (LSN) measurement, hepatic enhancement ratios postgadoxetic acid, and serum markers (APRI, FIB-4) for the detection of liver fibrosis.IRB-approved retrospective.Eighty-three adult patients.1.5T and 3.0T MR systems. MRE and TTwo independent observers analyzed qualitative color-coded MRE maps on a scale of 0-3. Regions of interest were drawn to measure liver stiffness on MRE stiffness maps and on pre- and postcontrast TA multivariable logistic analysis was performed to identify independent predictors of liver fibrosis. Receiver operating characteristic (ROC) analysis evaluated the performance of each imaging technique for detection of fibrosis, in comparison with serum markers.Liver stiffness measured with MRE provided the strongest correlation with histopathologic fibrosis stage (r = 0.74, P0.001), and the highest diagnostic performance for detection of stages F2-F4, F3-F4, and F4 (areas under the curve [AUCs] of 0.87, 0.91, and 0.89, respectively, P0.001) compared to other methods. Qualitative assessment of MRE maps showed fair to good accuracy for detection of fibrosis (AUC range 0.76-0.84). Multivariable logistic analysis identified liver stiffness and FIB-4 as independent predictors of fibrosis with AUCs of 0.90 (F2-F4), 0.93 (F3-F4) and 0.92 (F4) when combined.Liver stiffness measured with MRE showed the best performance for detection of liver fibrosis compared to LSN and gadoxetic acid uptake, with slight improvement when combined with FIB-4.3 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2018;47:1552-1561.
- Published
- 2017
23. Long-Term Azathioprine Use and the Development of Non-Cirrhotic Portal Hypertension
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Ilan Weisberg, Swan Thung, Shmuel Golfeyz, Richard A. Manfready, and Jack Husney
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medicine.medical_specialty ,Hepatology ,business.industry ,Gastroenterology ,medicine ,Portal hypertension ,Intensive care medicine ,business ,medicine.disease ,AZATHIOPRINE USE ,Term (time) - Published
- 2018
24. Abstract 4618: Integrative molecular classification of extrahepatic cholangiocarcinoma
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Laia Cabellos, Daniela Sia, Swan Thung, Christine Sempoux, Carla Montironi, M. Schwartz, Judit Peix, Wei Qiang Leow, Parissa Tabrizian, Miho Maeda, Beatriz Minguez, Agrin Moeini, Tim Pawlik, L. Roberts, Roser Pinyol, Ismail Labgaa, Sasan Roayaie, Josep M. Llovet, Robert Montal, Laia Bassaganyas, Augusto Villanueva, Manel Solé, Maria Isabel Fiel, and Carlos Villacorta
- Subjects
Extrahepatic Cholangiocarcinoma ,Cancer Research ,Pathology ,medicine.medical_specialty ,Molecular classification ,Oncology ,business.industry ,medicine ,business - Abstract
Background and Aims: Cholangiocarcinoma (CCA) is the second most common primary hepatic malignancy. Based on its anatomical location, CCA can be divided into intrahepatic (iCCA) or extrahepatic (eCCA), with differences in etiology, pathogenesis and clinical management. Few studies have focused on the molecular profiling of eCCA as a single entity, even though it accounts for the most prevalent subtype. Thus, integrative genomic analysis of eCCA would provide critical understanding for the biological traits of this tumor. Methods: 189 FFPE primary eCCA treated by resection were collected at seven international centers from 1995 to 2015. Median survival of the cohort was of 48.5mo. Whole gene-expression profiles were submitted to unsupervised clustering by NMF consensus. Clusters were characterized by Gene Set Enrichment Analysis and Ingenuity Pathway Analysis. Activation of signaling pathways (mTOR/pRPS6 and HER2) was assessed by immunohistochemistry (IHC). Molecular features were correlated with clinico-pathological data. Screening of most prevalent somatic mutations and copy number aberrations is ongoing. Results: We have identified four distinct molecular subtypes of eCCA (cophenetic coefficient=0.995). Tumors classified within the metabolic class (18.7%) were enriched by gene signatures defining bile and fatty acid metabolism (p Conclusions: Transcriptome-based subtyping of eCCA identifies four distinct molecular classes (metabolic, proliferation, mesenchymal and immune) that correlate with clinical-pathological characteristics. These findings enhance the opportunities for therapeutic development in this tumor with dismal prognosis and without approved molecular treatments. Citation Format: Robert Montal, Wei Qiang Leow, Carla Montironi, Laia Bassaganyas, Agrin Moeini, Daniela Sia, Roser Pinyol, Laia Cabellos, Judit Peix, Miho Maeda, Carlos Villacorta, Parissa Tabrizian, Christine Sempoux, Beatriz Minguez, Tim Pawlik, Ismail Labgaa, Lewis Roberts, Manel Sole, Maria Isabel Fiel, Swan Thung, Sasan Roayaie, Augusto Villanueva, Myron Schwartz, Josep Maria Llovet. Integrative molecular classification of extrahepatic cholangiocarcinoma [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 4618.
- Published
- 2018
25. Pathologic diagnosis of early hepatocellular carcinoma: A report of the international consensus group for hepatocellular neoplasia
- Author
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Maha Guindi, Masayuki Nakano, Michiie Sakamoto, Stephen A. Geller, Gregory Y. Lauwers, Ian R. Wanless, Young Nyun Park, Fukuo Kondo, Sunil Badve, Swan Thung, Neil D. Theise, Amar P. Dhillon, Linda D. Ferrell, Venancio Avancini Ferreira Alves, Alastair D. Burt, Romil Saxena, Maria Guido, John R. Craig, Prithi S. Bhathal, Masutoshi Kudo, Charles Balabaud, Pierre Bedosa, Dina Taniakos, Tania Roskams, P. Bioulac-Sage, Massimo Roncalli, Boris Ruebner, Elizabeth M. Brunt, Masayoshi Kage, Alberto Quaglia, Masamichi Kojiro, Zackary D. Goodman, Prodromos Hytiroglou, Annette S.H. Gouw, and Valérie Paradis
- Subjects
Dysplastic nodule ,Pathology ,medicine.medical_specialty ,Carcinoma, Hepatocellular ,Hepatology ,business.industry ,Consensus Development Conferences as Topic ,Liver Neoplasms ,Cell Count ,Hepatitis B ,Hepatitis C ,Early hcc ,Disease Progression ,medicine ,Humans ,Early Hepatocellular Carcinoma ,Neoplasm Invasiveness ,Stromal Cells ,business ,Cell Division - Published
- 2008
26. An Extremely Rare Primary Osteosarcoma of the Liver: Case Report and Review
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Kevin Tin, Robert Kalter, Jack Husney, Swan Thung, and Rabin Rahmani
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Oncology ,Primary osteosarcoma ,medicine.medical_specialty ,Hepatology ,business.industry ,Internal medicine ,Gastroenterology ,medicine ,business - Published
- 2015
27. Contents, Vol. 98, 1992
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Bruno L. Diaz, Jiajia Liu, Marco A. Martins, Akihide Koda, Terry F. Davies, N. Ishikawa, Cheryl R. Robertson, Tokugoro Tsunematsu, Noriko Yamagata, C.H.L. Rieger, S. Romagnani, Masao Negishi, Hironori Kimura, W. König, Marcia C.R. Lima, Leonard D. Shultz, Hiroo Yokozeki, D.W. Fountain, Patrícia M.R. e Silva, U. Stephan, Shyam S. Mohapatra, Nishioka K, Hidekazu Fujimaki, Takashi Katsura, Y. Horii, R.A. Hilger, B. Berggren, J.H. Skerritt, Jacek Rożniecki, Hideaki Iwabuchi, F. Riedel, Kazuo Kobayashi, Shinji Souma, Jun-ichi Tsuji, Ivan Correia, Masayoshi Abe, Efyse Bissonnette, Akihiko Watanabe, Yasutake Yanagiham, K. Neuber, Swan Thung, William Boucher, Terumi Takahashi, Theoharis C. Theoharides, David S. Pisetsky, J. Rüschoff, Y. Yanagihara, Kai R. Dietz, S. Petzoldt, S. Nilsson, Renato S.B. Cordeiro, Tsuyoshi Sakane, Alessandra C. Alves, J.D. Mitchell, J. Gonczi, Po Fong, Helmut H. Wolff, S. Raam, Dean Befus, Tom Imai, Wolfgang Holter, A. Martin, Yoshihisa Iwamoto, Takanari Tominaga, Akiko Kawagoe, Sachiko Sugihara, V. Dimitriadou, Kiyoko Tanaka, S. Naujukat, Toshiyuki Masuzawa, Harissios Vliagoftis, Egil Olsen, Y. Nawa, R. Einarsson, Hirotsugu Ide, Franz W. Bauer, Esther von Stebut, Nobuaki Shigematsu, Ulrich Amon, Yoshiaki Mori, Ichiro Katayama, Tadayori Shimizu, Naoki Nagakura, and Kazue Yoshida
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business.industry ,Immunology ,Immunology and Allergy ,Medicine ,General Medicine ,business - Published
- 1992
28. Predicting recurrence after liver transplantation in patients with hepatocellular carcinoma exceeding the up-to-seven criteria
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Francesco, D'Amico, Myron, Schwartz, Alessandro, Vitale, Parissa, Tabrizian, Sasan, Roayaie, Swan, Thung, Maria, Guido, Juan, del Rio Martin, Thomas, Schiano, and Umberto, Cillo
- Subjects
Adult ,Male ,Risk ,Carcinoma, Hepatocellular ,Liver Neoplasms ,Middle Aged ,Prognosis ,Liver Transplantation ,Treatment Outcome ,Recurrence ,Humans ,Female ,Prospective Studies ,Aged ,Proportional Hazards Models - Abstract
The up-to-seven (Up-to-7) criteria [with 7 being the sum of the size and number of tumors for any given hepatocellular carcinoma (HCC)] have been recently proposed to identify potential candidates for liver transplantation (LT) among patients exceeding the Milan criteria. The aim of this study was to compare the ability of the available pathologic staging systems (the Milan, University of California San Francisco, and Up-to-7 criteria) to predict recurrence. A study population of 479 HCC transplanted patients was identified from prospectively collected databases at Mount Sinai Medical Center (New York, NY) and the University of Padua (Padua, Italy). The best pathologic staging system was identified with log rank, proportion separation index (PSEP), and Cox analyses. Pathologic tumor characteristics (tumor number, tumor size, sum of diameters, macroscopic and microscopic vascular invasion, and grading) were then tested by univariate and multivariate Cox analyses in the prognostic subgroups within and beyond the calculated criteria. The Up-to-7 criteria performed as the best pathologic staging system, the calculated 1-, 3-, and 5-year recurrence probabilities being 4%, 8%, and 14% within the criteria (n = 355) and 22%, 45%, 51% beyond the criteria (n = 124; P0.0001) and the calculated PSEP being 0.27 (95% confidence interval = 0.23-0.31). In multivariate analysis, only biological variables (vascular invasion and tumor grade) significantly predicted recurrence beyond the Up-to-7 criteria. A 3-stage pathologic staging system with a potential to be applied in the preoperative setting was thus created: within the Up-to-7 criteria (recurrence rate = 8%), beyond the Up-to-7 criteria without macrovascular invasion and poorly differentiated grade (recurrence rate = 24%), and beyond the Up-to-7 criteria with macrovascular invasion and/or poorly differentiated grade (recurrence rate = 45%). In conclusion, HCC patients within the pathologic Up-to-7 criteria were associated with a low risk of recurrence after LT. Beyond these criteria, however, a significant proportion of patients with a good HCC biological profile had an acceptable risk of recurrence.
- Published
- 2009
29. Pathologic diagnosis of early hepatocellular carcinoma: a report of the international consensus group for hepatocellular neoplasia
- Author
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Masamichi, Kojiro, Wanless, IAN R., Venancio, Alves, Sunil, Badve, Charles, Balabaud, Pierre, Bedosa, Prithi, Bhathal, PAULETTE BIOULAC SAGE, Brunt, ELIZABETH M., Burt, ALASTAIR D., Craig, JOHN R., Amar, Dhillon, Linda, Ferrell, Geller, STEPHEN A., Goodman, ZACKARY D., Gouw, ANNETTE S. H., Guido, Maria, Maha, Guindi, Prodromos, Hytiroglou, Masayoshi, Kage, Fukuo, Kondo, Masutoshi, Kudo, Gregory, Y, Lauwers, Masayuki, Nakano, Valerie, Paradis, YOUNG NYUN PARK, Alberto, Quaglia, Massimo, Roncalli, Tania, Roskams, Boris, Ruebner, Michiie, Sakamoto, Romil, Saxena, Theise, NEIL D., Swan, Thung, and AND DINA TANIAKOS
- Published
- 2009
30. 774 Interferon-based treatment for recurrent HCV infection does not influence the progression of hepatic fibrosis in liver transplant recipients
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Prodromos Hytiroglou, P Canchis, Maria Isabel Fiel, A Suriawinata, V Dubrovskaya, Swan Thung, D Gan, and Thomas D. Schiano
- Subjects
medicine.medical_specialty ,Hepatology ,business.industry ,Interferon ,Internal medicine ,Medicine ,business ,Hepatic fibrosis ,Gastroenterology ,medicine.drug - Published
- 2003
31. IgG4-Sclerosing Cholangitis in a Pediatric Patient.
- Author
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Rosen, Danya, Swan Thung, Sheflin-Findling, Shari, Lai, Joanne, Rosen, Ally, Arnon, Ronen, and Chu, Jaime
- Subjects
- *
PEDIATRIC research , *IMMUNOGLOBULIN G , *CHOLANGITIS , *STEROIDS , *PANCREATITIS - Abstract
IgG4 sclerosing cholangitis (IgG4-SC) is an immune-mediated process that results in inflammation and fibrosis of the pancreatobiliary tract. Although IgG4-SC is predominantly associated with autoimmune pancreatitis, IgG4-SC as its own entity can be difficult to diagnose. Patients with IgG4-SC are typically men over the age of 60, and present clinically with obstructive jaundice, abdominal pain, and weight loss. The diagnosis of IgG4-SC may be difficult to differentiate from primary sclerosing cholangitis (PSC) or cholangiocarcinoma. IgG4-SC is morphologically characterized by dense lymphoplasmacellular infiltration, particularly IgG4+ plasma cells and CD4+ T cells, extensive fibrosis in bile duct walls, and obliterative phlebitis. In contrast to PSC, those with IgG4-SC often have elevated serum IgG4 and can be successfully treated with immunosuppression. Here, we present the first reported case of IgG4-SC in a pediatric patient with asymptomatic elevation in liver enzymes, bile duct strictures on imaging, characteristic pathology findings, elevated serum IgG4, and excellent response to corticosteroids. Pediatric gastroenterologists and hepatologists, as well as pediatric hepatopathologists, need to be aware of IgG4-SC as a disease entity. Although certain clinical and imaging findings mimic PSC, diagnosis of IgG4-SC and its appropriate treatment with corticosteroids often lead to remission and reversal of disease. [ABSTRACT FROM AUTHOR]
- Published
- 2015
- Full Text
- View/download PDF
32. β-Catenin Activated Hepatocellular Adenoma: A Report of Three Cases in Korea.
- Author
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Gi Jeong Kim, Jae Yeon Seok, Hyungjin Rhee, Jin-Young Choi, Jin-Sub Choi, Kyung Sik Kim, Swan Thung, and Young Nyun Park
- Subjects
ADENOMA ,TUMORS ,LIVER cancer ,GLUTAMINE synthetase ,METASTASIS ,CATENINS - Abstract
Hepatocellular adenoma (HCA) is an uncommon benign hepatic tumor, and the use of oral contraceptives is known to contribute to the development of HCA. Recently, a genotype and phenotype classification system for HCA was suggested, and malignant transformation to hepatocellular carcinoma (HCC) was shown to be strongly associated with activating mutations in β -catenin. Here, we report three cases of HCA in Korean patients: 7-cm, inflammatory and β -catenin- activated HCA with HCC transformation in a 46-year-old man; 13-cm, β -catenin-activated HCA with cytological atypia in a 23-year-old woman; and 10-cm, pigmented, inflammatory and β -catenin-activated HCA in a 36-year-old man. All cases exhibited the nuclear expression of β -catenin and diffuse cytoplasmic expression of glutamine synthetase upon immunohistochemical staining. All tumors were completely resected, and the patients were followed for 3 to 6 years with no evidence of local recurrence or metastasis. [ABSTRACT FROM AUTHOR]
- Published
- 2014
- Full Text
- View/download PDF
33. Foreword
- Author
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Swan Thung
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Hepatology - Published
- 1995
34. In situ recruitment of antigen-presenting cells by intratumoral GM-CSF gene delivery.
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Ping-Ying Pan, Yu Li, Qingsheng Li, Pedi Gu, Martinet, Olivier, Swan Thung, and Shu-Hsia Chen
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ANTIGENS ,CANCER treatment ,LYMPHOID tissue ,T cells ,HERPES simplex virus ,PYRIMIDINE nucleotides - Abstract
Proper antigen presentation is paramount to the induction of effective and persistent antitumor immune responses. In a murine model of hepatic metastasis of colon cancer, we found that the numbers of in situ mature dendritic cells (DCs) and macrophages in tumor-infiltrating leukocytes (TILs) were significantly increased in mice treated with the combination therapy of herpes simplex virus thymidine kinase, interleukin 2, and GM-CSF genes when compared with control groups without GM-CSF treatment. Significantly higher levels of IFN-γ, MIP-1α, mIL-12, and GM-CSF were detected in the tumor after the combination therapy. T cells isolated from the combination therapy–treated mice exhibited higher ex vivo direct CTL activity than those from other treatment groups. Antigen-presenting cells (APCs) enriched from the TILs and liver of the combination therapy–treated mice induced higher levels of proliferation by the splenocytes from long-term surviving mice that had been cured of tumors at early time points (days 4 and 7) whereas significant APC activity was only observed in the spleen at the latter time point (day 7, 14) after the combination therapy. In contrast, APCs isolated from tk or tk + IL-2–treated mice did not induce any significant proliferation. Subcutaneous injection of fluorescence-labeled latex microspheres followed by the combination therapy showed a similar sequential trafficking of microspheres, day 4 after the combination therapy to tumor and day 14 to spleen. The results suggest that APCs recruited by intratumoral gene delivery of GM-CSF can capture antigens, mature to a stage suitable for antigen presentation, and subsequently migrate to the spleen where they can efficiently stimulate antigen-specific T cells. [ABSTRACT FROM AUTHOR]
- Published
- 2004
- Full Text
- View/download PDF
35. Well-differentiated hepatocellular neoplasm of uncertain malignant potential.
- Author
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Balabaud, Charles, Bioulac-Sage, Paulette, Ferrell, Linda, Kakar, Sanjay, Paradis, Valérie, Quaglia, Alberto, Sempoux, Christine, Swan Thung, and Zucman-Rossi, Jessica
- Published
- 2015
- Full Text
- View/download PDF
36. Letter to the Editor.
- Author
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Peter Holt and Swan Thung
- Published
- 2007
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