Day 1 :
Keynote Forum
E. Blair Holladay
Chief Executive Officer, American Society for Clinical Pathology, USA
Keynote: Cancer Diagnostics in Africa: Leapfrog Technologies to Transform Care
Time : 09:30-10:10
Biography:
E Blair Holladay serves as the American Society for Clinical Pathology (ASCP) Chief Executive Officer. He has focused on globalization initiatives for the medical laboratory community that include significant contributions to the President’s Emergency Plan for AIDS Relief (PEPFAR) funded through the Centers for Disease Control and Prevention; strategic partnerships in laboratory medicine; corporate reorganization/management activities; mergers and acquisitions; international outreach; external partnerships; and health services research and delivery. ASCP has been funded for over $40 million to support patient-centered care.
His scientific research work focuses in the areas of cytopathology and molecular research. He’s been funded as a Principal Investigator for 50 scientific research grants and 100 scientific corporate contracts. He has published a number of significant research articles within the profession and is the primary author of several textbooks that are international best sellers. He is an active scientific lecturer and has given over 170 national and international speeches.
Abstract:
Cancer is a bigger problem in developing countries than human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS). It is emerging as a leading cause of death in Sub Saharan Africa with a population close to one billion people. Moving cancer treatment to global health settings has been seen as costly, challenging or close to impossible. However, early detection may lead to more affordable and effective cancer treatment so new diagnostics technologies have the potential to help overcome global healthcare disparities for cancer. The solution lies in local physicians having access to a system that ensures rapid, accurate, and reliable pathology for primary diagnosis of cancer. Sub Saharan Africa faces immense challenges in providing adequate coverage and each region, country, and district with unique obstacles to overcome when meeting the health needs of the population.
The American Society of Clinical Pathology (ASCP), in partnership with the Obama White House Office of Science Technology Policy and the Clinton Global Initiative, recently launched a 150 million dollar multi-year initiative which begins with assessment of potential countries with the greatest need--including collaboration and capacity program building with local officials and staff--to deploy full service pathology infrastructure for eligible countries to strategically to meet their population needs. Working in parallel and together, Steering Committees for Diagnostics and Technology, Care and Treatment, In-Country Medical Education, Bioethics, and Monitoring & Evaluation have focused on each potential country to optimize success.
The optimal solution includes the deployment of automated histopathology systems and integrated whole slide imaging systems linked through a customized laboratory information system to a dedicated team of pathologists from the United States. This long-term project will roll out to 20 or more countries in Africa as well as Haiti.
Keynote Forum
Maria Teresa Mascellino
Sapienza University of Rome, Italy
Keynote: Helicobacter Pylori Infection : Pathogenesis And Therapeutic Strategies
Time : 11:05-11:45
Biography:
Maria Teresa Mascellino has completed her MD at the age of 25 years in Rome during the period of 1980 and specialization studies in Microbiology and Infectious Diseases from Sapienza University of Rome (Italy). She works as aggregate professor in the Department of Public Health and Infectious Diseases at Sapienza University of Rome. She is responsible of the Simple Operative Unit “Microbiological analyses in the immunocompromised hosts” and tutor of students and residents at the Department of Infectious Diseases. The main research field is actually the study of some microorganisms involved in human pathology focusing on MDR microorganisms such as KPC Klebsiella, Acinetobacter baumannii and Helicobacter pylori as well as Candida and on antibiotics activity. She has published other than 100 papers in reputed journals and has been serving as an editorial board member of repute. She is editor of the book “Bacterial and Mycotic infections in immunocompromised hosts: microbiological and clinical aspects” ISBN:978-1-63278-005-8. She is a reviewer for many important scientific international Journals and Research Projects from Ministry of University and Scientific Research. She has attended many national and international Conferences as speaker presenting relevant research topics. She is member of scientific societies as ESCMID, ASM, New York Academy of Science, SIMIT.
Abstract:
Introduction: Helicobacter pylori (Hp) is a Gram-negative mobile bacillus, difficult to be cultured, and able to cause different diseases. In fact Hp is involved in chronic active gastritis, peptic ulcer disease, gastric carcinoma and mucosa-associated lymphoid tissue lymphoma (MALT) other than in endothelial dysfunction leading to vascular diseases. Hp is increasingly difficult to treat. The treatment regimens are declining in efficacy and the therapy of this infection is bedevilled by drug-resistant strains. Aim of our research is to study a population of 50 pangastritis already undergone multiple therapies and to evaluate the eradication rates.
Methods: All patients were positive to UBT (Urease Breath Test) then surely infected by Hp. Three biopsies were taken for each patient and submitted to rapid urease test, culture and antibiotics susceptibility by E-test
Results:. Out of 50 patients, culture and susceptibility testing were obtained in 31 patients (62%) whereas in 19 (38%) no H. pylori growth was detected. The first group was treated following the scheme shown in the image whereas the second one was empirically treated with antibiotics never taken before or with rescue therapies. The eradication rates were 52% and 63% respectively.
Conclusions: No significant difference has been seen between the two groups. Probably the higher eradication rate in patients empirically treated, where no microorganisms have been isolated, can be due to the presence of bacteria not able to grow in culture then in a less virulent or dormant phase or in a very low number to be detected. Anyway, in our study the eradication rates of these pangastritis patients undergone multiple treatments are very low. The Toronto Consensus Group (2016) has proposed new treatment strategies recommending to prolong the cure from 10 to 14 days, to use bismuth quadruple therapy containing metronidazole and tetracycline as well as various rescue therapies.
Keynote Forum
Giuseppe Scalabrino, MD
University of Milan, Italy
Keynote: Involvement of normal prions (PrPCs) in some human myelin diseases
Time : 10:10-10:50
Biography:
Giuseppe Scalabrino Born in Milan,on July 4, 1944. He Studied in Institute of General Pathology, University of Milan from 1965 to 1968 and at 1968 he became M.D., magna cum laude, discussing an experimental thesis on the radiosensitizing properties of aliphatic aldehydes.
He worked in several positions as faculty of Institute of General Pathology at University of Milan from from 1969 to present. He was the Associate Professor of General Pathology at University of Milan from 1971 to 1985. He was honored as Assistant to the Chairman of General Pathology, Faculty of Medicine and Surgery at University of Milan from 1973 to 1985. He has more than 100 Publications in high impact journals.
Abstract:
We have experimentally demonstrated that cobalamin (Cbl) deficiency increases normal cellular prion (PrPC) levels in rat spinal cord (SC) and cerebrospinal fluid (CSF), and decreases PrPC-mRNA levels in rat SC. Repeated intracerebroventricular administrations of anti-octapeptide repeat-PrPC-region antibodies to Cbl-deficient (Cbl-D) rats prevent SC myelin lesions, and the administrations of PrPCs to otherwise normal rats cause SC white matter lesions similar to those induced by Cbl deficiency. Cbl positively regulates SC PrPC synthesis in rat by stimulating the local synthesis of epidermal growth factor (EGF), which also induces the local synthesis of PrPC-mRNAs, and downregulating the local synthesis of tumor necrosis factor(TNF)-ï¡, thus preventing local PrPC overproduction. We have clinically demonstrated that PrPC levels are increased in the CSF of patients with subacute combined degeneration (SCD), unchanged in the CSF of patients with Alzheimer's disease and amyotrophic lateral sclerosis, and decreased in the CSF and SC of patients with multiple sclerosis (MS), regardless of its clinical course. We conclude that SCD (human and experimental) is a neurological disease due to excess PrPC without conformational change and aggregation, that the increase in PrPC levels in SCD and Cbl-D polyneuropathy and their decrease in MS CNS make them antipodian myelin diseases in terms of quantitative PrPC abnormalities, and that these abnormalities are related to myelin damage in the former, and impede myelin repair in the latter.
Keynote Forum
Carol Apt
South Carolina State University, USA
Keynote: Nurses as Bullies and as victims of Bullies
Time : 11:45-12:25
Biography:
Carol Apt received her Ph.D. in Sociology from Northeastern University in Boston, Massachusetts (USA), her Masters in Sociology from Boston University in Boston, Massachusetts (USA), and her Bachelors in Sociology from Indiana University in Indianapolis, Indiana (USA). She also has a Certificate of French Studies from Ecole Lemania in Lausanne, Switzerland. As she was finishing her coursework at Northeastern University, she learned that she was the recipient of an internship in Applied Medical Sociology from the American Sociological Association. She chose to assume this honor at the University of Texas Medical School, Department of Psychiatry, in San Antonio, Texas, where she worked for 2 years. During this time she did HIV/AIDS research and wrote HIVAIDS education materials which she and her staff used with high-risk individuals incarcerated in the county jail in San Antonio. During this time she also taught at the University of Texas at San Antonio, and team taught a course in psychiatric interviewing for medical students during their second-year psychiatry rotation. Dr. Apt has taught courses in Medical Sociology, Human Sexuality, and the Sociology of Genocide. She is also the host of a live, call-in radio program called “Talk to Me,” which is broadcast on 90.3 FM-WSSB in South Carolina. The subject of her radio show is sexuality and relationships
Abstract:
Gone are the days when the public perception of bullying was that it occurred mainly in residential neighborhoods and on school playgrounds, and that bullies were children whose parents had not taught them 'proper' values and behaviors. This presentation will consider the serious problem of the bullying of nurses, sometimes by other nurses, who are employed in health care settings. Regardless of the job titles of the perpetrators, the bullying of nurses can have deleterious effects on a number of areas such as: job performance, morale, productivity, turnover, and patient care, to name a few. This presentation will examine possible antecedents to such bullying behaviors as well as some of the interventions that have been undertaken to ameliorate those situations.
- Cancer Cytopathology | Comparative Pathology | Head & Neck Pathology | Renal Pathology | Hematopathology | Surgical Pathology | Clinical Pathology | Diagnostic Pathology | Oncopathology | Reproductive Pathology | Neuropathology
Session Introduction
Rebecca N Baergen
New York Presbyterian Hospital-Weill Cornell Surgical Pathology, New York, U.S.A.
Title: Preeclampsia, systemic lupus erythematosus and antiphospholipid antibody syndrome share a common pathogenic mechanism
Biography:
Rebecca Baergen has expertise in perinatal and placental pathology with a concentration on how placental pathology can explain adverse outcome, mechanisms of injury and diagnose underlying maternal and fetal disease. She has built her practice and consultation service after years of experience in clinical evaluation of placental specimens, research, and teaching of medical students, resident physicians and pathologists. She has also experience in many extramural courses of perinatal pathology hosted by many education organizations throughout the world.
Abstract:
Background: Preeclampsia (PEC), systemic lupus erythematosus (SLE), and antiphospholipid antibody syndrome (aPLA) are associated with adverse maternal and fetal outcomes but the pathogenic mechanisms have not been well studied. Methodology: We investigated the expression of complement activation products and inflammatory biomarkers in these patient groups. We compared each group with control patients who had an unremarkable clinical history and no pathologic placental findings. Immunohistochemistry for C3b, C4d, Annexin A5 (A5), and C5b-9 was performed; staining was graded on intensity (0, 1+, 2+, 3+) and distribution (absent, patchy, diffuse). 70% of PEC patients, 50% of SLE patients and 20% of aPLA patients showed at least weak, focal staining for C4d, while controls were negative. A5 staining showed focal loss in all disease groups, while controls did not. C3b staining showed more frequent strong staining in disease groups than controls. C5b-9 staining was localized to areas of fibrin deposition or infarction in all groups. Conclusion and Significance: Previously, aPLA-associated pregnancy complications have been thought to be a consequence of a unique aPLA pathogenic mechanism. However, the similarity of the IHC findings in aPLA placentas to those from SLE and PE patients - i.e. increased complement deposition and loss of A5 expression - suggests that aPLA-associated pregnancy complications may reflect a more general autoimmune mechanism, such as localized deposition of immune complexes and that this mechanism may be operating in other disease conditions associated with poor maternal and fetal outcome.
Mitrasadat Rezaei
Head of cental lab in school of medicine,Shahid beheshti University of Medical Science,Tehran,Iran
Title: Necrotizing Sarcoid Granulomatosis :case report
Biography:
Dr. Mitrasadat Rezaei worked as Assistant professor of pathology at Flowcytometry department, High Institute for research and education in blood transfusion medicine, Tehran, Islamic Republic of Iran from 2011-2014. Currently she is working as Assistant professor of pathology at pathology department, National Research Institute of Tuberculosis and lung disease, Shahid Beheshti University of Medical Science,Tehran,Iran, from 2014 and she is the Director of Molecular pathology Laboratory , Masih Daneshvari Hospital from 2014 and she is the Head of cental lab in school of medicine, Shahid beheshti University of Medical Science, Tehran, Iran from 2016.
Abstract:
Necrotizing SarcoidGranulomatosis(NSG) is a rare granulomatous pneumonitis which is composed of background of sarcoidosis-like granulomas with granulomatous vasculitis and variable amount of necrosis .We reported a case of 38-year-old non-smoking woman presented by left-sided chest pain and dyspnea for three days.Chest CT scan exhibitedcollapse consolidation of left lower lobe with presence of two septated small sized cystic lesions within collapsed segment.Video-Assisted Thoracic surgery (VATS) was performed and histologicalexamination confirmed the diagnosis by excluding other causes of granulomatousdisease.The prognosis of NSG is favorable and medical treatment is usually not necessary,as well as our case.
NSG is a rare disease with nonspecific symptoms and good prognosis which frequently confused with Wegener’s granulomatosis,sarcoidosis and churgstrauss.this entity should also be considered as differential diagnosis of necrotizing granulomatous diseases.
Hira Kareem
Services institute of medical sciences, Lahore, Pakistan
Title: Deranged levels of renal parameters after using heavy metal Kushta of copper in diet of albino rats
Biography:
Dr. Hira Kareem has completed her post graduation from University of Health Sciences Lahore at the age of 28 years.currently serving as a demonstrator in Services Institute of Medical Sciences Lahore.She has published two medical papers on reputed journels.
Abstract:
To evaluate the effects of copper preparations of Kushta on renal parameters. This study was conducted from 14th of may 2013 to 30th of November 2013 in Pathology Department of University of Health Sciences Lahore and it was an experimental study.
Method:Thirty albino rats were selected and divided into three groups. The control group A was fed on standard pellet rodent diet and tap water. The experimental group B was fed single dose of copper preparation of Kushta(0.15mg/kg of body weight) for 18 weeks while experimental group C was fed double dose of copper preparation of Kushta(0.30mg/kg of body weight) for 18 weeks.Renal parameters were calculated once at the start of experiment and then after every 6 weeks upto 18 weeks.
Results: Results showed that renal parameters in terms of serum creatinine level and proteinuria were deranged evident on biochemical analysis. When the control group A on normal diet was compared with the experimental group B and Statistically significant difference (p<0.05) was noticed in terms of renal parameters.
Conclusion: It is therefore concluded that copper preparations of Kushta deranged renal parameters in terms of serum creatinine levels and proteinuria
Jonathan J. Wisco
BYU, Department of Physiology and Developmental Biology, Neuroscience Center, USA
Title: Peering into the Iron Window of Alzheimer’s Disease MR Imaging and Pathophysiology
Biography:
Dr. Jonathan J. Wisco is Associate Professor and Director of the Laboratory for Translational Anatomy of Degenerative Disease and Developmental Disorders, College of Life Sciences,
Department of Physiology and Developmental Biology, and Neuroscience Center at Brigham Young University, Provo, UT. He is also Associate Director of the BYU MRI Research Facility. Dr. Wisco holds an Adjunct Associate Professor position in the Department of Neurobiology and Anatomy at the University of Utah School of Medicine, Salt Lake City, UT
Abstract:
The severity of pathological protein deposition, and concomitant iron presence distinguishes neurological disorders. Tissues with high amounts of protein or iron deposits have a characteristically rapid T2* MRI signal decay. Therefore, these tissue components do not appear on traditional MRI, as the NMR signal has already gone through multiple time constants of decay before any signal can be acquired. Ultra-short Echo Time (UTE) imaging, however, significantly reduces the time between the appearance of an NMR signal and its sampling, allowing for the measurement of iron-related pathology. We used a novel UTE sequence with a 3D cones k-space trajectory in a 3T Siemens scanner to image short T2* tissues in the amygdala and hippocampus in ex vivo, 20 mm thick coronal human brain slabs, each with known Alzheimer’s disease (AD) Braak VI taopathy or with cerebrovascular disease (CVD). We quantified the MR signal from tissues with T2* values of less than 1 ms at TEs of 0.25, 0.5, 0.8,
1.0, 2.0, 3.0, and 5.0 ms and TR of 12.1 ms (1 mm iso, FA=15 deg, FOV=15 cm2). Difference
images were then formed by subtracting the TE=5 ms images from the images acquired at the other TEs, effectively suppressing longer T2* tissues. T2* value in the AD amygdala and hippocampus as 4.8+/-1.9 ms (mean+/-SD), and T2* values in anatomically matching regions of the CVD brain was 2.2+/-1.1 ms. We analyzed tissue sections in these regions for the presence Abeta-42, tau, and CD-68 immunohistochemical reactivity, and enhanced Perl’s staining. We noted that the T2* signal decreased with the additive presence of amyloid plaques, tau tangles, non-heme iron, and activated microglia. UTE imaging may be a feasible method to visualize iron-related protein pathology. Future work will further examine the individual contributions of pathological proteins, non-heme iron, and inflammation to the T2* decay.
Sunita Ahlawat
Fortis Memorial Research Institute, Gurgaon, India.
Title: Clinicopatholgical spectrum of primary central nervous system lymphomas and association with Epstein-barr virus
Biography:
Dr Sunita Ahlawat has completed her MD in Pathology from the All India Institute of Medical Sciences, New Delhi, 30 years ago, since then has published 50 papers in reputed national and international journal with three chapters in books. Her interest is oncopathology and specially neuropathology She is at present the principal consultant in histopathology at the SRL- Fortis Memorial Research Institute.
Abstract:
SRL -FMRI in last 4 yrs and 4 months a total of 1953 central nervous system tumours were reported out of which 44 cases were suspected for primary central nervous system lymphoma (PCNSL) , 39/44 could be confirmed on histopathology, 5 cases could not be confirmed due to steroid therapy given before the biopsy.
We are presenting data on 39 cases which make approximately 2 % of 1953 cases of CNS tumours. The clinical presentation, radiological features, immune status and status of international extra nodal lymphoma study group (IELSG) prognostic variables is assessed.
Subtyping of lymphomas with the immunoprofile, BCL6 and BCL2 expressio At n along with Epstein-Barr virus (EBV) status by immunohistochemistry and by FISH (EBER-1) will be presented along with clinical follow up and outcome.
John Zhong
University of Southern California, CA 90089, USA
Title: Single-cell Molecular Analysis Reveal A Novel Molecular Pathway in Glioblastoma
Biography:
John Zhong obtained his B.S. degree of Molecular Biology from California State University, San Jose and purse his Ph.D. at University of Soputhern California. His study is focus on cancer biology, specifcally molecular fundation of carcinogenesis.
Abstract:
Molecular analysis has tranformed pathology from the morphological age into the molecular era. This transission is similar to the transisson from analog to digital TV. With molecular profiling, pathology is more precise and quantitative. However, tumor heterogeneity remains a major hurdle for obtaining the molecular profile of cancer. In this study, we apply single-cell technology to overcome this hurdle and obtain a molecular profile of a tumor stem cell from a glioblastoma multiforme (GBM) patient. We obtain the initial diagnostic biopsy from a male patient and a relapse biopsy from the same patient. We first enriched tumor stem cells by organ slide culture with the diagnosis biopsy, then perform single-cell RNA-seq on the cultured cells (enriched for tumor stem cells). Because the relapse tumor is generated from the tumor stem cells which is rare in the initial (diagnosis) tumor, but becomes majority in relapse. Therefore, single-cells carrying mutations detected in the relapse biopsy but not in the diagnosis biopsy (too rare to be detected) are the tumor initiation cells (tumor stem cells). With this approch we reveal a novel molecule patyway in the GBM involveing multiple memeber of the P53 pathway.
Jeannelyn Estrella
The University of Texas, MD Anderson Cancer Center, Houston, TX 77030, USA
Title: Pancreatic neuroendocrine neoplasms: review of clinically relevant information
Biography:
Dr. Estrella has completed her MD in 2005 from the University of California, San Diego School of Medicine. She completed her Anatomic pathology residency at New York Presbyterian – Weill Cornell Medical College in New York, NY, and Oncologic pathology fellowship and Gastrointestinal tract and Liver pathology fellowship at MD Anderson in Houston, TX. She is an associate professor at MD Anderson in the GI and Liver section. She is the primary investigator, co-primary investigator or collaborator in 6 institutional or national research grants. She has published 43 papers in peer-reviewed journals.
Abstract:
Pancreatic neuroendocrine neoplasms (PanNETs) are rare, representing approximately 3% of primary pancreatic neoplasms, although their incidence has risen sharply in the United States, increasing more than 100% over the past three decades. In the past, classification of PanNETs has been fraught with different nomenclature and multiple grading and staging systems. The 2010 WHO Classification of Tumours of the Digestive System and the 7th edition of AJCC Cancer Staging Manual have tried to address these issues, however, controversies still exist. This lecture will address the current grading and staging systems, issues encountered in everyday practice, clinical significance and future direction.
Tomasz S. Tkaczyk
Rice University, USA
Title: Multimodal in-vivo imaging strategies for early cancer diagnostics
Biography:
Tomasz S. Tkaczyk received his MS and PhD degrees from the Institute of Micromechanics and Photonics, Warsaw University of Technology. Currently, he is an Associate Professor of Bioengineering and Electrical and Computer Engineering at Rice University. He joined Rice University in 2007 after his research at the University of Arizona. His research is in microscopy, endoscopy/in-vivo pathology, point of care systems, and spectroscopy. He has published 60+ per-reviewed communications. Dr. Tkaczyk is a fellow of OSA and SPIE, and recepient of number of professional awards including Paul F. Forman Engineering Excellence Award (OSA), Becton Dickinson Professional Achievement Award (AAMI).
Abstract:
Monitoring and diagnostics of many cancers like oral, cervical or esophageal adenocarcinoma often require multimodal approach to perform successful diagnostics. Both morphological imaging and spectral assessment are important tools used in these applications. When, used separately, either method cannot easily achieve both high sensitivity and specificity in vivo. On the other hand if combined and working in tandem they can significantly improve the diagnostic performance. Therefore this presentation focuses on analysis of multimodal approaches/instrumentation for early in vivo cancer detection. Two groups of devices will be discussed: (1) miniature-integrated imaging microscopes (endomicroscopes) to provide morphological content and (2) multi and hyperspectral high speed systems to obtain bio-chemical signatures of the tissue. Practical aspects of multi-modal system integration, performance and parameters (field of view and resolution of individual sub-systems) will be discussed together with the design considerations to optimize its effectiveness. Number of imaging methods will be presented including (for morphological assessment): contact imaging, confocal, structure illumination, and multi-photon imaging and (in area of spectral detection) narrow band imaging (NBI), image mapping spectrometry IMS, array snapshot systems in number of cancer applications (including for example oral, cervical, and esophageal adenocarcinoma).
Dalia M. Abouelfadl
National Research Institute, Cairo, Egypt
Title: Mesenchymal Epithelial Transition Marker and Androgen Receptor in Estrogen Receptor Negative Breast Cancer
Biography:
Dalia Abouelfadl has completed her MD at the age of 32 years from Cairo University and postdoctoral studies from Westminster University School of biomedical sciences, London, UK. She is a member of Pathology Department of the Medical Division of National Research Center, a premier Research organization. she has published more than 10 papers in reputed journals.
Abstract:
Breast cancers are heterogeneous in their morphology, clinical course and response to therapy. New therapeutic targets are needed in breast cancer. The Met tyrosine kinase receptor activates cell proliferation, survival, invasion and angiogenesis and has found a strong relationship between high HGF/Met signaling and tumor progression. The biologic roles of Androgen receptors (AR) in the breast are incompletely understood since it is unclear whether the effects of androgens on breast cells are predominantly proliferative or anti-proliferative.
The purpose of this study is to determine the prognostic value of MET and AR expression in breast cancer patients with ER negative receptor.
Histologic sections from 60 cases of ER negative breast cancer including different subtypes and grades of breast cancer were evaluated using immunohistochemistry with Androgen and Met then evaluated compared to ER, PR, HER-2, using a standard avidin–biotin–peroxidase system.
Results: Out of the 60 breast cancers, 54 (90%) are positive for AR and 52 (86%) are positive for Met. There was a significant positive correlation between AR with tumor type, multicentricity and Her 2 (P<0.005). Met scores were significantly increased in patients nodal stage, DCIS and HER2 (P<0.005).
Conclusions: There is a significant correlation between the Met and AR scores and the clinicopathological prognostic parameters. The levels of AR and Met expression were relatively high as most studies stated. The activation of Met signaling pathway plays an important role in tumour-genesis of breast cancers and the patients might benefit from drug therapy targeting Met in cases showing expression of such receptor.
Claudio Luchini
University and Hospital Trust of Verona, Italy
Title: Extranodal extension of nodal metastasis and prognosis in cancer: the surgical pathologist’s point of view
Biography:
Claudio Luchini, MD, is a surgical pathologist with expertise in the field of next-generation sequencing and of systematic review with meta-analysis. He has studied in Italy (Verona University) and also in USA at Indiana University and at Johns Hopkins University School of Medicine. With next-generation sequencing, he has published some important works, for example in Journal of Clinical Oncology. With the tool of meta-analysis he has highlighted the prognostic role of the presence of extra-nodal extension of nodal metastasis in several cancer types, like colorectal and breast cancer. The main goals of his research is to find morphological and molecular markers for early diagnosis of tumors or to better stratify cancer prognosis.
Abstract:
Extranodal extension of nodal metastasis (ENE) is defined as the spread of a lymph node metastasis into surrounding soft tissue. Through this mechanism, neoplastic cells increase their capacity of local invasiveness as well as of intravascular invasion for distant metastasization. Although the TNM staging system acknowledges the importance of ENE in few cancer types (e.g. squamous cell carcinoma of vulva and of head and neck), no comprehensive studies have analyzed the prognostic impact of this parameter in these and in other solid malignancies. With the tool of meta-analysis, we demonstrated that ENE+ carried a significantly higher risk of all-cause mortality, cance- specific mortality and of recurrence in many cancer types, including gastrointestinal and breast tumors. ENE is a parameter very simple to be addressed by a pathologist and also very significant. Since it has been demonstrated as important in influencing the prognosis of patients with different cancer types, pathologists should document its eventual presence in their final pathology report, and future staging systems should taken ENE into account for a better stratification of patients’ prognosis.