PathologyPub Date : 2024-05-06DOI: 10.1016/j.pathol.2024.02.012
Jieun Park , Boram Lee , Ji-Young Song , Minjung Sung , Mi Jeong Kwon , Chae Rin Kim , Sangjin Lee , Young Kee Shin , Yoon-La Choi
{"title":"Detection of EGFR exon 20 insertion mutations in non-small cell lung cancer: implications for consistent nomenclature in precision medicine","authors":"Jieun Park , Boram Lee , Ji-Young Song , Minjung Sung , Mi Jeong Kwon , Chae Rin Kim , Sangjin Lee , Young Kee Shin , Yoon-La Choi","doi":"10.1016/j.pathol.2024.02.012","DOIUrl":"10.1016/j.pathol.2024.02.012","url":null,"abstract":"<div><p>Epidermal growth factor receptor (<em>EGFR</em>) exon 20 insertion mutations (E20ins) are the third most frequent mutations observed in non-small cell lung cancer, accounting for approximately 1–10% of all <em>EGFR</em> mutations. In the era of precision medicine and targeted therapies, consistent naming of genetic alterations is crucial to avoid confusion and errors. However, the annotation of <em>EGFR</em> E20ins mutations has been inconsistent, leading to confusion in the scientific literature and product documentation. In this study, our primary objective was to investigate the usage of different annotation related to <em>EGFR</em> E20ins in independent studies. Additionally, we assessed the distribution of <em>EGFR</em> E20ins mutations and estimated the detection coverage expected from each available <em>EGFR</em> E20ins detection assay. A total of 1,418 EGFR E20ins mutations were collected from six studies (FoundationInsights, Geneseeq Technology Inc, mobocertinib phase I/II trial, poziotinib phase II trial, sunvozertinib phase I trial, and Samsung Medical Center) and reorganised according to Human Genome Variation Society (HGVS) nomenclature. Our analysis revealed that the majority of <em>EGFR</em> E20ins mutations requiring correction were ‘insertion’ or ‘deletion-insertion’, which should be appropriately designated as ‘duplication’. Additionally, duplicated variants were reported using different annotations in each study, and furthermore, even identical variant sequences were annotated differently within the same study. In all six studies, p.A767_V769dup and p.S768_D770dup were the most frequently observed <em>EGFR</em> E20ins. The Oncomine Dx Target Test showed the highest patient coverage at 77.2%, followed by the Droplex EGFR Mutation Test v2 with a patient coverage of 70.5% for <em>EGFR</em> E20ins patients. To ensure comprehensive coverage in real-world settings, it is essential to standardise the annotations for each variant, for example using the HGVS nomenclature. The accurate classification and analysis of drug responsiveness in <em>EGFR</em> E20ins necessitate consideration of the nomenclature, particularly with respect to the locations where the actual mutations occur.</p></div>","PeriodicalId":19915,"journal":{"name":"Pathology","volume":"56 5","pages":"Pages 653-661"},"PeriodicalIF":3.6,"publicationDate":"2024-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141035352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
PathologyPub Date : 2024-05-06DOI: 10.1016/j.pathol.2024.02.013
Winkie Fong , Elena Martinez , Verlaine Timms , Andrew Ginn , Trang Nguyen , Hossinur Rahman , Vitali Sintchenko
{"title":"Increase in invasive Haemophilus influenzae serotype A infections during the COVID-19 pandemic in New South Wales, Australia","authors":"Winkie Fong , Elena Martinez , Verlaine Timms , Andrew Ginn , Trang Nguyen , Hossinur Rahman , Vitali Sintchenko","doi":"10.1016/j.pathol.2024.02.013","DOIUrl":"10.1016/j.pathol.2024.02.013","url":null,"abstract":"<div><p><em>Haemophilus influenzae,</em> a causative agent of severe invasive infections such as meningitis, sepsis and pneumonia, is classified into encapsulated or typeable (represented by serotypes A to F) and non-typeable varieties (NTHi) by the presence or absence of the polysaccharide capsule. Invasive disease caused by <em>H. influenzae</em> type B (HIB) can be prevented through vaccination which remains the main disease control intervention in many countries. This study examined the genomic diversity of circulating <em>H. influenzae</em> strains associated with invasive disease in New South Wales, Australia, before and during the COVID-19 pandemic. Ninety-six isolates representing 95 cases of invasive <em>H. influenzae</em> infections (iHi) diagnosed between January 2017 and September 2022 were typed and characterised using whole genome sequencing. These cases were caused by serotypes A (<em>n</em>=24), B (<em>n</em>=35), E (<em>n</em>=3), F (<em>n</em>=2) and NTHi (<em>n</em>=32). There was an apparent decline in the number of iHi infections during the COVID-19 pandemic, with a corresponding increase in the proportion of iHi cases caused by serotype A (HIA), which returned to pre-pandemic levels in 2022. Fifteen isolates associated with HIB or non-typeable iHi were resistant to β-lactams due to a PBP3 mutation or carriage of <em>bla</em><sub>TEM-1</sub>. Further, capsular gene duplication was observed in HIB isolates but was not found in HIA. These findings provide important baseline genomic data for ongoing iHi surveillance and control.</p></div>","PeriodicalId":19915,"journal":{"name":"Pathology","volume":"56 5","pages":"Pages 696-701"},"PeriodicalIF":3.6,"publicationDate":"2024-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141046167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
PathologyPub Date : 2024-05-06DOI: 10.1016/j.pathol.2024.02.011
{"title":"Metastatic atypical fibroxanthoma: the importance of structured reporting for cutaneous sarcoma-like tumour","authors":"","doi":"10.1016/j.pathol.2024.02.011","DOIUrl":"10.1016/j.pathol.2024.02.011","url":null,"abstract":"","PeriodicalId":19915,"journal":{"name":"Pathology","volume":"56 6","pages":"Pages 913-915"},"PeriodicalIF":3.6,"publicationDate":"2024-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141026853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
PathologyPub Date : 2024-04-24DOI: 10.1016/j.pathol.2024.02.010
Katherine A. Lau , Charles S.P. Foster , Torsten Theis , Jenny Draper , Mitchell J. Sullivan , Susan Ballard , William D. Rawlinson
{"title":"Continued improvement in the development of the SARS-CoV-2 whole genome sequencing proficiency testing program","authors":"Katherine A. Lau , Charles S.P. Foster , Torsten Theis , Jenny Draper , Mitchell J. Sullivan , Susan Ballard , William D. Rawlinson","doi":"10.1016/j.pathol.2024.02.010","DOIUrl":"10.1016/j.pathol.2024.02.010","url":null,"abstract":"<div><p>Application of whole genome sequencing (WGS) has allowed monitoring of the emergence of variants of concern (VOC) of severe acute respiratory syndrome-related coronavirus 2 (SARS-CoV-2) globally. Genomic investigation of emerging variants and surveillance of clinical progress has reduced the public health impact of infection during the COVID-19 pandemic. These steps required developing and implementing a proficiency testing program (PTP), as WGS has been incorporated into routine reference laboratory practice. In this study, we describe how the PTP evaluated the capacity and capability of one New Zealand and 14 Australian public health laboratories to perform WGS of SARS-CoV-2 in 2022. The participants' performances in characterising a specimen panel of known SARS-CoV-2 isolates in the PTP were assessed based on: (1) genome coverage, (2) Pango lineage, and (3) sequence quality, with the choice of assessment metrics refined based on a previously reported assessment conducted in 2021. The participants' performances in 2021 and 2022 were also compared after reassessing the 2021 results using the more stringent metrics adopted in 2022. We found that more participants would have failed the 2021 assessment for all survey samples and a significantly higher fail rate per sample in 2021 compared to 2022. This study highlights the importance of choosing appropriate performance metrics to reflect better the laboratories' capacity to perform SARS-CoV-2 WGS, as was done in the 2022 PTP. It also displays the need for a PTP for WGS of SARS-CoV-2 to be available to public health laboratories ongoing, with continuous refinements in the design and provision of the PTP to account for the dynamic nature of the COVID-19 pandemic as SARS-CoV-2 continues to evolve.</p></div>","PeriodicalId":19915,"journal":{"name":"Pathology","volume":"56 5","pages":"Pages 717-725"},"PeriodicalIF":3.6,"publicationDate":"2024-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140786808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Validation of prostate and breast cancer detection artificial intelligence algorithms for accurate histopathological diagnosis and grading: a retrospective study with a Japanese cohort","authors":"Kris Lami , Han-Seung Yoon , Anil V. Parwani , Hoa Hoang Ngoc Pham , Yuri Tachibana , Chaim Linhart , Maya Grinwald , Manuela Vecsler , Junya Fukuoka","doi":"10.1016/j.pathol.2024.02.009","DOIUrl":"10.1016/j.pathol.2024.02.009","url":null,"abstract":"<div><p>Prostate and breast cancer incidence rates have been on the rise in Japan, emphasising the need for precise histopathological diagnosis to determine patient prognosis and guide treatment decisions. However, existing diagnostic methods face numerous challenges and are susceptible to inconsistencies between observers. To tackle these issues, artificial intelligence (AI) algorithms have been developed to aid in the diagnosis of prostate and breast cancer. This study focuses on validating the performance of two such algorithms, Galen Prostate and Galen Breast, in a Japanese cohort, with a particular focus on the grading accuracy and the ability to differentiate between invasive and non-invasive tumours. The research entailed a retrospective examination of 100 consecutive prostate and 100 consecutive breast biopsy cases obtained from a Japanese institution. Our findings demonstrated that the AI algorithms showed accurate cancer detection, with AUCs of 0.969 and 0.997 for the Galen Prostate and Galen Breast, respectively. The Galen Prostate was able to detect a higher Gleason score in four adenocarcinoma cases and detect a previously unreported cancer. The two algorithms successfully identified relevant pathological features, such as perineural invasions and lymphovascular invasions. Although further improvements are required to accurately differentiate rare cancer subtypes, these findings highlight the potential of these algorithms to enhance the precision and efficiency of prostate and breast cancer diagnosis in Japan. Furthermore, this validation paves the way for broader adoption of these algorithms as decision support tools within the Asian population.</p></div>","PeriodicalId":19915,"journal":{"name":"Pathology","volume":"56 5","pages":"Pages 633-642"},"PeriodicalIF":3.6,"publicationDate":"2024-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0031302524001016/pdfft?md5=7213822b35e46628cf81cbec0335a121&pid=1-s2.0-S0031302524001016-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140783375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
PathologyPub Date : 2024-04-18DOI: 10.1016/j.pathol.2024.02.008
Ying-Jung Huang , Shih-Hsiang Chen , Hsi-Che Liu , Tang-Her Jaing , Ting-Chi Yeh , Ming-Chung Kuo , Tung-Liang Lin , Chiu-Chen Chen , Shih-Chung Wang , Te-Kau Chang , Chih-Cheng Hsiao , Der-Cherng Liang , Lee-Yung Shih
{"title":"Evaluation of next-generation sequencing for measurable residual disease monitoring in three major fusion transcript subtypes of B-precursor acute lymphoblastic leukaemia","authors":"Ying-Jung Huang , Shih-Hsiang Chen , Hsi-Che Liu , Tang-Her Jaing , Ting-Chi Yeh , Ming-Chung Kuo , Tung-Liang Lin , Chiu-Chen Chen , Shih-Chung Wang , Te-Kau Chang , Chih-Cheng Hsiao , Der-Cherng Liang , Lee-Yung Shih","doi":"10.1016/j.pathol.2024.02.008","DOIUrl":"10.1016/j.pathol.2024.02.008","url":null,"abstract":"<div><p>The use of next-generation sequencing (NGS) for monitoring measurable residual disease (MRD) in acute lymphoblastic leukaemia (ALL) has been gaining traction. This study aimed to investigate the utility of NGS in MRD monitoring for the three major fusion transcript (FT) subtypes of B-precursor ALL (B-ALL). The MRD results for 104 bone marrow samples from 56 patients were analysed through NGS and real time quantitative reverse transcription PCR (RT-qPCR) for the three major FTs: <em>BCR::ABL1</em>, <em>TCF3::PBX1</em>, and <em>ETV6::RUNX1</em>. To validate the NGS approach, NGS-MRD was initially compared with allele-specific oligonucleotide-qPCR-MRD, and the coefficient of determination was good (R<sup>2</sup>=0.8158). A subsequent comparison of NGS-MRD with FT-MRD yielded a good coefficient of determination (R<sup>2</sup>=0.7690), but the coefficient varied by subtype. Specifically, the R<sup>2</sup> was excellent for <em>TCF3::PBX1</em> ALL (R<sup>2</sup>=0.9157), good for <em>ETV6::RUNX1</em> ALL (R<sup>2</sup>=0.8606), and subpar for <em>BCR::ABL1</em> ALL (R<sup>2</sup>=0.5763). The overall concordance between the two methods was 83.7%, and an excellent concordance rate of 95.8% was achieved for <em>TCF3::PBX1</em> ALL. Major discordance, which was defined as a >1 log difference between discordant NGS-MRD and FT-MRD, occurred in 6.7% of the samples, with all but one sample being <em>BCR::ABL1</em> ALL. Among the four non-transplanted patients with <em>BCR::ABL1</em>-MRD (+)/NGS-MRD (−), three did not relapse after long-term follow-up. Our finding indicates that NGS-MRD has a better prognostic impact than RT-qPCR-MRD in <em>ETV6::RUNX1</em> and <em>BCR::ABL1</em> ALL, whereas in <em>TCF3::PBX1</em> ALL, both methods exhibit comparable efficacy.</p></div>","PeriodicalId":19915,"journal":{"name":"Pathology","volume":"56 5","pages":"Pages 681-687"},"PeriodicalIF":3.6,"publicationDate":"2024-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140760382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
PathologyPub Date : 2024-04-15DOI: 10.1016/j.pathol.2024.02.007
Laura Ling Ying Tan , Victor Tswen Wen Lee , Tony Kiat Hon Lim
{"title":"A case of liver angiomyolipoma accompanied with multiple focal nodular hyperplasia","authors":"Laura Ling Ying Tan , Victor Tswen Wen Lee , Tony Kiat Hon Lim","doi":"10.1016/j.pathol.2024.02.007","DOIUrl":"10.1016/j.pathol.2024.02.007","url":null,"abstract":"","PeriodicalId":19915,"journal":{"name":"Pathology","volume":"56 5","pages":"Pages 755-758"},"PeriodicalIF":3.6,"publicationDate":"2024-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140780250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A tale of two studies: is peripheral eosinophilia associated with Dientamoeba fragilis detection in adult stool samples?","authors":"Priya Garg , John Chetwood , Thuy Phan , Timothy Gray , Genevieve McKew","doi":"10.1016/j.pathol.2024.01.011","DOIUrl":"10.1016/j.pathol.2024.01.011","url":null,"abstract":"<div><p>The protozoan parasite <em>Dientamoeba fragilis</em> is a frequently isolated stool organism and postulated cause of gastrointestinal symptoms. Peripheral blood eosinophilia has been described. This is the first study amongst the Australasian adult population to assess the relationship between organism detection and eosinophilia.</p><p>A case-control study took place over 7 years at a single Sydney laboratory site, evaluating patients with <em>D. fragilis</em> identified on stool using real-time PCR with a recent full blood count, to control groups with <em>Giardia</em> spp. and sequential negatives with neither organism. A nested study compared those with microscopic evidence of <em>D. fragilis</em> as a marker of disease burden, to molecular diagnosis alone.</p><p>Sixty-four <em>D. fragilis</em>, 30 <em>Giardia</em> spp., and 94 sequential controls were enrolled. Only 60.1% of samples were preserved in sodium acetate-acetic acid formalin (SAF) fixative, indication mostly not documented. The major co-organism detected amongst all participants was <em>Blastocystis</em> sp., particularly in the <em>D. fragilis</em> cohort (37.2%). The most common pathogen amongst sequential controls was <em>Campylobacter</em> spp. (7.4%). Patients with <em>D. fragilis</em> were more likely (12.5%) to have a clinically significant eosinophilia (>0.5×10<sup>9</sup>/L) compared to those with <em>Giardia</em> spp. (3.3%) or sequential controls (4.3%) (<em>p</em>=0.03). A significant difference was also noted in the overall median eosinophil count of those with <em>D. fragilis</em> versus all controls (0.2 vs 0.1×10<sup>9</sup>/L, <em>p</em>=0.01); however, this was within the reference interval (where up to >0.5×10<sup>9</sup>/L is accepted in healthy individuals within a typical population). No eosinophil difference was found between those with molecular versus additional microscopic detection of <em>D. fragilis</em> (0.1 vs 0.1×10<sup>9</sup>/L).</p><p>These results support an association between the identification of clinically significant peripheral blood eosinophilia and <em>D. fragilis</em> presence, which may impact the diagnostic approach to the patient with unexplained eosinophilia. Further prospective trials may help assess any significance further and the implication of co-carriage with other enteric organisms. The importance of clinical indication and need for appropriate fixative media in diagnostic parasitology are also highlighted.</p></div>","PeriodicalId":19915,"journal":{"name":"Pathology","volume":"56 5","pages":"Pages 688-695"},"PeriodicalIF":3.6,"publicationDate":"2024-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0031302524000977/pdfft?md5=fade9799ae330adfbbe74b798282dad0&pid=1-s2.0-S0031302524000977-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140610288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
PathologyPub Date : 2024-04-09DOI: 10.1016/j.pathol.2024.02.006
Bobby Li , Richard King , Becca Chan , Catherine Rollo , Simon Thompson , Chris Florkowski
{"title":"An updated diagnostic range for serum free light chain kappa/lambda ratio using Freelite reagents on BN II or Optilite","authors":"Bobby Li , Richard King , Becca Chan , Catherine Rollo , Simon Thompson , Chris Florkowski","doi":"10.1016/j.pathol.2024.02.006","DOIUrl":"10.1016/j.pathol.2024.02.006","url":null,"abstract":"","PeriodicalId":19915,"journal":{"name":"Pathology","volume":"56 5","pages":"Pages 732-734"},"PeriodicalIF":3.6,"publicationDate":"2024-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140609943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}