Endocrine Pathology最新文献

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Three Synchronous Pituitary Neuroendocrine Tumors-Epigenomics Confirm an Exceptional Triple PitNET. 三个同步垂体神经内分泌肿瘤-表观基因组学证实了一个特殊的三重PitNET。
IF 11.3 2区 医学
Endocrine Pathology Pub Date : 2025-05-16 DOI: 10.1007/s12022-025-09864-1
Temor Rafiq, Jakob Matschke, Jörg Flitsch, Matthias Dottermusch
{"title":"Three Synchronous Pituitary Neuroendocrine Tumors-Epigenomics Confirm an Exceptional Triple PitNET.","authors":"Temor Rafiq, Jakob Matschke, Jörg Flitsch, Matthias Dottermusch","doi":"10.1007/s12022-025-09864-1","DOIUrl":"https://doi.org/10.1007/s12022-025-09864-1","url":null,"abstract":"","PeriodicalId":55167,"journal":{"name":"Endocrine Pathology","volume":"36 1","pages":"19"},"PeriodicalIF":11.3,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Clinicopathological Correlates of Hormone Expression-Based Subtypes of Non-Functioning Duodenal/Ampullary Neuroendocrine Tumors: A Multicenter Study of 151 Cases. 151例无功能十二指肠/壶腹神经内分泌肿瘤激素表达亚型的临床病理相关性:一项多中心研究
IF 11.3 2区 医学
Endocrine Pathology Pub Date : 2025-05-10 DOI: 10.1007/s12022-025-09861-4
Alessandro Vanoli, Nestor Piva, Frediano Socrate Inzani, Federica Grillo, Catherine Klersy, Silvia Uccella, Paola Spaggiari, Luca Albarello, Marco Schiavo Lena, Massimo Milione, Caterina Antoniacomi, Anna Caterina Milanetto, Alessandro Zerbi, Antonio Di Sabatino, Massimo Falconi, Andrea Anderloni, Paola Mattiolo, Claudio Luchini, Aldo Scarpa, Matteo Fassan, Paola Parente, Ombretta Luinetti, Guido Rindi, Marco Paulli, Stefano La Rosa
{"title":"Clinicopathological Correlates of Hormone Expression-Based Subtypes of Non-Functioning Duodenal/Ampullary Neuroendocrine Tumors: A Multicenter Study of 151 Cases.","authors":"Alessandro Vanoli, Nestor Piva, Frediano Socrate Inzani, Federica Grillo, Catherine Klersy, Silvia Uccella, Paola Spaggiari, Luca Albarello, Marco Schiavo Lena, Massimo Milione, Caterina Antoniacomi, Anna Caterina Milanetto, Alessandro Zerbi, Antonio Di Sabatino, Massimo Falconi, Andrea Anderloni, Paola Mattiolo, Claudio Luchini, Aldo Scarpa, Matteo Fassan, Paola Parente, Ombretta Luinetti, Guido Rindi, Marco Paulli, Stefano La Rosa","doi":"10.1007/s12022-025-09861-4","DOIUrl":"https://doi.org/10.1007/s12022-025-09861-4","url":null,"abstract":"<p><p>Duodenal neuroendocrine tumors (Duo-NETs) may arise in the ampullary and non-ampullary duodenum. Non-functioning Duo-NETs (NF-Duo-NETs), which account for most cases, may express various hormones. Previous studies have suggested that hormone production might be associated with biological aggressiveness. Current treatment protocols are based on functionality, tumor size, and location, but small NF-Duo-NETs may also have metastatic potential. We aimed to investigate whether tumor cell subtyping, based on hormone expression, could provide further insights into NF-Duo-NET biological behavior. We analyzed the clinico-pathological correlates of hormone expression in a multicenter series of 151 NF-Duo-NETs, subdividing tumors into five subtypes: gastrin-producing G-cell NETs (Gas-NETs), somatostatin-producing D-cell NETs (Som-NETs), serotonin-producing enterochromaffin-cell NETs (Ser-NETs), plurihormonal NETs, and gastrin-, somatostatin-, and serotonin-negative NETs (GSSN-NETs). Som-NETs were the most frequent (31%), followed by plurihormonal NETs (26%), Gas-NETs (24%), GSSN-NETs (13%), and Ser-NETs (4%). Som-NETs and GSSN-NETs were more commonly located in the ampullary region and showed significantly larger size, more frequent lymphatic and/or vascular invasion, and higher pT, pN, and American Joint Committee on Cancer (AJCC-9th edition) stages compared to Gas-NETs, which were often (77%) diagnosed at AJCC stage I. Ampullary Som-NETs showed a more invasive and metastatic potential compared to non-ampullary Som-NETs, while, among plurihormonal NETs, the predominantly expressed hormone influenced tumor biological features, with gastrin-predominant NETs showing less invasive potential. At logistic regression, both tumor cell subtype and tumor size were independently associated with aggressiveness (pT3, pN1, or pM1 stage at diagnosis). Hormonal expression profiling may be clinically relevant in NF-Duo-NETs, independently of tumor size.</p>","PeriodicalId":55167,"journal":{"name":"Endocrine Pathology","volume":"36 1","pages":"18"},"PeriodicalIF":11.3,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12065733/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144060574","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
ABCC3 Is a Differential Marker of CYP11B2-Negative Zona Glomerulosa Cells in Human Adrenal Cortex. ABCC3是人肾上腺皮质cyp11b2阴性肾小球带细胞的差异标志物。
IF 11.3 2区 医学
Endocrine Pathology Pub Date : 2025-05-07 DOI: 10.1007/s12022-025-09862-3
Yingxian Pang, Sanas Mir-Bashiri, Zhuolun Sun, Yuhong Yang, Isabella Castellano, Thomas Knösel, Martin Reincke, Tracy Ann Williams
{"title":"ABCC3 Is a Differential Marker of CYP11B2-Negative Zona Glomerulosa Cells in Human Adrenal Cortex.","authors":"Yingxian Pang, Sanas Mir-Bashiri, Zhuolun Sun, Yuhong Yang, Isabella Castellano, Thomas Knösel, Martin Reincke, Tracy Ann Williams","doi":"10.1007/s12022-025-09862-3","DOIUrl":"https://doi.org/10.1007/s12022-025-09862-3","url":null,"abstract":"<p><p>ATP Binding Cassette Subfamily C Member 3 (ABCC3) is a membrane transporter that exports diverse compounds, influencing drug resistance in cancers and impacting metabolic and malignant diseases. We previously reported ABCC3 upregulation in human adrenal cells under lipid peroxidation-induced oxidative stress. We investigated ABCC3 expression and function in the human adrenal cortex in the context of primary aldosteronism, focusing on its relationship to CYP11B2 (aldosterone synthase) in zona glomerulosa (ZG) cells and aldosterone-producing lesions. ABCC3 expression in aldosterone-producing adenomas (APAs) was markedly reduced compared to the adjacent adrenal cortex, cortisol-producing adenomas, and non-functioning adenomas. The reduction in APAs showed genotypic variability: in APAs harboring KCNJ5 mutations-known drivers of autonomous aldosterone production via altered potassium channel function-ABCC3 mRNA/protein levels were significantly higher than in wild-type KCNJ5 APAs. Spatial transcriptomics and immunofluorescence colocalization revealed an inverse expression pattern between ABCC3 and CYP11B2 (aldosterone synthase) in APAs and aldosterone-producing micronodules (APMs). Notably, high ABCC3 expression was exclusively observed in adrenal ZG cells that lacked CYP11B2 expression. This expression pattern distinguishes ABCC3 from common ZG markers such as KCNJ5 and DAB2, which are expressed across adrenal ZG cells, APMs, and APA tumor cells. In cultured human adrenocortical cells, both angiotensin II stimulation and induced expression of the KCNJ5-L168R mutation resulted in upregulation of CYP11B2 transcription while concomitantly suppressing ABCC3 expression. In conclusion, ABCC3 serves as a novel marker of CYP11B2-negative ZG cells, providing a histopathological tool to differentiate normal adrenal zonation from aldosterone-producing lesions in primary aldosteronism, as well as from cortisol-producing and nonfunctional adenomas.</p>","PeriodicalId":55167,"journal":{"name":"Endocrine Pathology","volume":"36 1","pages":"17"},"PeriodicalIF":11.3,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144043009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Is Ectopic Cushing Syndrome Commonly Associated with Small Cell Lung Cancer (SCLC)? Critical Review of the Literature and ACTH Expression in Resected SCLC. 异位库欣综合征通常与小细胞肺癌(SCLC)有关吗?文献综述及ACTH在切除的SCLC中的表达。
IF 11.3 2区 医学
Endocrine Pathology Pub Date : 2025-05-02 DOI: 10.1007/s12022-025-09860-5
Ayako Ura, Elisa Moser, Matthias Evert, Katja Evert, Bruno Märkl, Eva Sipos, Marcus Kremer, Hironobu Sasano, Yoshinori Okada, Katja Steiger, Carolin Mogler, Hans Hoffmann, Alexander von Werder, Daniel Kaemmerer, Silvia Uccella, Stefano La Rosa, Günter Klöppel, Atsuko Kasajima
{"title":"Is Ectopic Cushing Syndrome Commonly Associated with Small Cell Lung Cancer (SCLC)? Critical Review of the Literature and ACTH Expression in Resected SCLC.","authors":"Ayako Ura, Elisa Moser, Matthias Evert, Katja Evert, Bruno Märkl, Eva Sipos, Marcus Kremer, Hironobu Sasano, Yoshinori Okada, Katja Steiger, Carolin Mogler, Hans Hoffmann, Alexander von Werder, Daniel Kaemmerer, Silvia Uccella, Stefano La Rosa, Günter Klöppel, Atsuko Kasajima","doi":"10.1007/s12022-025-09860-5","DOIUrl":"https://doi.org/10.1007/s12022-025-09860-5","url":null,"abstract":"<p><p>The literature emphasizes that pulmonary ectopic Cushing syndrome (ECS) is associated not only with neuroendocrine tumors (NETs), but also with small cell lung carcinomas (SCLCs). This statement is debatable, because extrapulmonary ECS is associated with NETs in the vast majority of cases and very rarely with neuroendocrine carcinomas (NECs). Therefore, we critically reviewed the literature on SCLCs associated with ECS (ECS-SCLC) and performed immunohistochemical analysis of ACTH expression in 155 resected SCLCs and 158 pulmonary NETs. The literature search revealed that 90% of the 205 ECS-SCLC patients identified between 1952 and 2023 had no or poor-quality histologic images, so the diagnosis of SCLC could not be confirmed. Review of the 20 reports (10%) with histologic images revealed that 18/20 (90%) had to be reclassified as \"probable NET\", of which 5/18 (28%) showed spindle cell morphology, while only 2 cases were qualified as \"SCLC compatible\" due to their pleomorphic cell features. Immunohistochemically, 5/155 (3%) resected SCLCs, all without ECS, showed weak single cell ACTH expression, whereas in the NET cohort, 61/158 (39%) tumors expressed ACTH, of which 4 (3%) were associated with ECS. Both observations, the literature review, which casts doubt on previously reported data regarding the frequency of SCLC in ECS, and the immunohistochemical study, suggest that there is limited evidence that SCLC is the cause of ECS.</p>","PeriodicalId":55167,"journal":{"name":"Endocrine Pathology","volume":"36 1","pages":"16"},"PeriodicalIF":11.3,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12048459/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144057584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
TERT Amplification a Risk Stratification Marker in Papillary Thyroid Carcinoma, Significantly Correlated with Tumor Recurrence and Survival. TERT扩增是甲状腺乳头状癌的危险分层标志,与肿瘤复发和生存显著相关。
IF 11.3 2区 医学
Endocrine Pathology Pub Date : 2025-04-24 DOI: 10.1007/s12022-025-09853-4
Gil-Bernabé Sara, Feás-Rodríguez Noa, Pérez-Riesgo Enrique, Corraliza-Gómez Miriam, Fra Rodríguez Joaquín, García-Rostán Ginesa
{"title":"TERT Amplification a Risk Stratification Marker in Papillary Thyroid Carcinoma, Significantly Correlated with Tumor Recurrence and Survival.","authors":"Gil-Bernabé Sara, Feás-Rodríguez Noa, Pérez-Riesgo Enrique, Corraliza-Gómez Miriam, Fra Rodríguez Joaquín, García-Rostán Ginesa","doi":"10.1007/s12022-025-09853-4","DOIUrl":"https://doi.org/10.1007/s12022-025-09853-4","url":null,"abstract":"<p><p>Few studies have analyzed the prevalence of TERT amplification in thyroid cancer, showing discrepancies in various topics. The impact on tumor recurrence and patient survival in papillary thyroid carcinoma (PTC) remains unknown. Thirteen cancer cell lines and 215 tumor samples from 91 patients, who underwent surgery for PTC (41), poorly differentiated thyroid carcinoma (PDC = 15), or anaplastic thyroid carcinoma (ATC = 35), were analyzed. Clonality, spread with tumor dedifferentiation or metastatic PTC cells, and coexistence with TERTp, BRAF, RAS, and PIK3CA mutations were also investigated. TERT amplification was found in 17%, 20%, and 17% of the PTC, PDC, and ATC, respectively. It was more frequent in follicular variant PTC and PTC with distant metastases (86%, P = 0.0448). The cell lines HTh74, SW1736, and T242 had amplification. In PTC, TERT amplification was a subclonal event. The increase in TERT copy number spread in all cases with metastatic PTC cells. In 67% of the PDC and 100% of the ATC, TERT activation segregated with tumor dedifferentiation. TERT amplification correlated with TERTp mutations in PTC (P = 0.0313) and PIK3CA mutations in ATC (P = 0.0272). TERT amplification significantly correlated with vascular invasion (P = 0.03637), distant metastases at diagnosis and/or follow-up (P = 0.04482), metachronous distant metastases (P = 0.03131), death patient status (P = 0.000829), stage at diagnosis (P = 0.01995), and stage III/IV at last follow-up (P = 0.01552). TERT amplification associated independently with tumor-related recurrence and death. Our study shows that PTC can be stratified into clinically prognostic relevant categories based on the presence or not of TERT amplification in the cells.</p>","PeriodicalId":55167,"journal":{"name":"Endocrine Pathology","volume":"36 1","pages":"15"},"PeriodicalIF":11.3,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12021720/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Identification of Specific Biomarkers for Anaplastic Thyroid Carcinoma Through Spatial Transcriptomic and Immunohistochemical Profiling. 通过空间转录组学和免疫组织化学分析鉴定间变性甲状腺癌的特异性生物标志物。
IF 11.3 2区 医学
Endocrine Pathology Pub Date : 2025-04-17 DOI: 10.1007/s12022-025-09858-z
Faridul Haq, Andrey Bychkov, Ozgur Mete, Sora Jeon, Chan Kwon Jung
{"title":"Identification of Specific Biomarkers for Anaplastic Thyroid Carcinoma Through Spatial Transcriptomic and Immunohistochemical Profiling.","authors":"Faridul Haq, Andrey Bychkov, Ozgur Mete, Sora Jeon, Chan Kwon Jung","doi":"10.1007/s12022-025-09858-z","DOIUrl":"https://doi.org/10.1007/s12022-025-09858-z","url":null,"abstract":"<p><p>Anaplastic thyroid carcinoma (ATC) is an aggressive malignancy with a poor prognosis. Despite its rarity, identifying predictive molecular markers that distinguish ATC from follicular cell-derived non-anaplastic thyroid carcinomas is critical for improving diagnosis and treatment strategies. This study aimed to identify and validate key mRNA and protein markers associated with ATC progression and dedifferentiation. We performed spatial transcriptomic analysis on an index case of ATC coexisting with papillary thyroid carcinoma (PTC) and identified eight differentially expressed mRNA markers. These findings were validated in a large cohort using immunohistochemistry on tissue microarrays across various thyroid tumor types, including follicular adenoma, PTC, poorly differentiated thyroid carcinoma, medullary thyroid carcinoma, and ATC. Additionally, the impact of BRAF p.V600E mutation status on these markers was evaluated. COL7A1, LAMC2, SPHK1, and SRPX2 mRNA and protein levels were significantly overexpressed in ATCs. Conversely, CD24, EPHX1, GPX3, and RBM47 mRNA and protein levels were markedly downregulated in ATCs. Functional enrichment analysis, based on mRNA expression data, identified the role of these proteins in tumor invasion, epithelial-mesenchymal transition, extracellular matrix remodeling, and immune evasion. The expression levels of these markers were independent of BRAF p.V600E mutation status, highlighting their potential as diagnostic markers. In summary, this study identified eight molecular markers that can distinguish ATC from other thyroid tumors. The validation of these markers at both the mRNA and protein levels underscores their clinical relevance in ATC diagnosis and tumor characterization. These findings provide a foundation for future biomarker-driven diagnostic and therapeutic strategies for ATC.</p>","PeriodicalId":55167,"journal":{"name":"Endocrine Pathology","volume":"36 1","pages":"14"},"PeriodicalIF":11.3,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144041288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Prevalence and Clinical Impact of BRAF p.V600E Mutation in Papillary Thyroid Carcinoma. BRAF p.V600E突变在甲状腺乳头状癌中的患病率及临床影响
IF 11.3 2区 医学
Endocrine Pathology Pub Date : 2025-04-16 DOI: 10.1007/s12022-025-09859-y
Alexandria Brumfield, Sara Abou Azar, Rachel Nordgren, Ronald N Cohen, David Sarne, Xavier M Keutgen, Megan Applewhite, Peter Angelos, Nicole A Cipriani
{"title":"Prevalence and Clinical Impact of BRAF p.V600E Mutation in Papillary Thyroid Carcinoma.","authors":"Alexandria Brumfield, Sara Abou Azar, Rachel Nordgren, Ronald N Cohen, David Sarne, Xavier M Keutgen, Megan Applewhite, Peter Angelos, Nicole A Cipriani","doi":"10.1007/s12022-025-09859-y","DOIUrl":"https://doi.org/10.1007/s12022-025-09859-y","url":null,"abstract":"<p><p>Identifying risk factors in papillary thyroid carcinoma (PTC) that warrant more aggressive treatment is paramount. Importantly, the prevalence and clinical significance of BRAF p.V600E mutation in PTC remain debatable. This study aims to determine the association of BRAF p.V600E with demographic and clinicopathologic characteristics, including recurrence. Single institution data from consecutive PTC patients with BRAF p.V600E immunohistochemistry and/or molecular testing was collected between 2018 and 2022, including BRAF status, morphologic subtype, TN category, tumor size, nodal disease burden, tumor multifocality, extrathyroidal extension, treatment, follow-up time, loco-regional and distant recurrence, and mortality. This study included 301 patients, 30% male. The majority had BRAF p.V600E mutation (78.7%), and BRAF p.V600E was associated with morphologic subtype (p < 0.001), with 88% of classic subtype PTCs, 38% of PTCs with extensive follicular growth, and 100% of tall cell subtype expressing BRAF p.V600E. BRAF p.V600E was not associated with tumor size (p = 0.696) or nodal disease burden (p = 0.962). On multivariate analysis using Cox proportional hazard model, large volume nodal disease burden (HR 3.37, 95%CI 1.49-7.64, p = 0.004) and male gender (HR 2.29, 95%CI 1.23-4.26, p = 0.009) were significantly associated with recurrence. BRAF p.V600E (HR 0.71, 95% CI 0.31-1.65, p = 0.4) was not significantly associated with recurrence. In conclusion, presence of BRAF p.V600E in the absence of high risk histologic features does not have an impact on PTC recurrence, and thus, its utility in risk stratification is questionable in the setting of other clinicopathologic risk factors.</p>","PeriodicalId":55167,"journal":{"name":"Endocrine Pathology","volume":"36 1","pages":"13"},"PeriodicalIF":11.3,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12003545/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144019416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Subclassifying "Atypia of Undetermined Significance (AUS)" Category in the 2023 Bethesda System for Thyroid Cytopathology: Analyzing K-TIRADS, BRAF V600E Mutation, and Risk of Malignancy. 亚分类“不确定意义异型性(AUS)”2023 Bethesda系统甲状腺细胞病理学分类:分析K-TIRADS、BRAF V600E突变和恶性肿瘤风险
IF 11.3 2区 医学
Endocrine Pathology Pub Date : 2025-04-15 DOI: 10.1007/s12022-025-09856-1
Heejin Bang, Chulshin Cho, Mi Young Kim, Jiyeon Hyeon, Seung Eun Lee
{"title":"Subclassifying \"Atypia of Undetermined Significance (AUS)\" Category in the 2023 Bethesda System for Thyroid Cytopathology: Analyzing K-TIRADS, BRAF V600E Mutation, and Risk of Malignancy.","authors":"Heejin Bang, Chulshin Cho, Mi Young Kim, Jiyeon Hyeon, Seung Eun Lee","doi":"10.1007/s12022-025-09856-1","DOIUrl":"https://doi.org/10.1007/s12022-025-09856-1","url":null,"abstract":"<p><p>The 2023 Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) update refines the atypia of undetermined significance (AUS) category by subclassifying it into AUS-nuclear atypia (AUS-N) and AUS-other atypia (AUS-O) based on risk of malignancy, to enhance clarity of diagnosis and patient management. This study evaluates the impact of AUS subclassification on malignancy risk prediction in thyroid nodules. A total of 118 AUS cases were analyzed for subclassification using the nuclear scoring (NS) system to evaluate nuclear features, along with the ultrasonography-based Korean Thyroid Imaging Reporting and Data System (K-TIRADS) for risk stratification, and BRAF V600E mutation testing. Logistic regression and ROC curve analyses were used to identify predictors of malignancy and to assess model performance. The AUS category was divided into AUS-N and AUS-O, with AUS-N having a significantly higher risk of malignancy (ROM) (78.1%) compared to AUS-O (27.3%). The subcategories AUS-N1, N2, and N5 showed significantly high ROM (96.9%, 71.7%, and 90.0%), whereas AUS-N3 and N4 showed lower ROM (20.0% and 33.3%). The NS system standardized the assessment of nuclear atypia, reducing interobserver variability and improving diagnostic reproducibility. BRAF V600E mutation, present in 28.1% of AUS-N cases but absent in AUS-O cases, was a strong predictor of malignancy. Models integrating imaging, detailed cytologic subclassification, and molecular findings achieved high specificity (81.0-86.5%) but moderate sensitivity (58.0-61.3%). These findings support the use of AUS subclassification and molecular testing for BRAF V600E mutation to improve ROM prediction and are consistent with the 2023 TBSRTC emphasis on tailored risk stratification.</p>","PeriodicalId":55167,"journal":{"name":"Endocrine Pathology","volume":"36 1","pages":"12"},"PeriodicalIF":11.3,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144052802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Multicentric Retrospective Analysis of Oncocytic Adrenocortical Carcinoma: Insights into Clinical and Management Strategies. 嗜瘤性肾上腺皮质癌的多中心回顾性分析:临床和治疗策略的见解。
IF 11.3 2区 医学
Endocrine Pathology Pub Date : 2025-04-11 DOI: 10.1007/s12022-025-09857-0
Antonio Prinzi, Valentina Guarnotta, Guido Di Dalmazi, Letizia Canu, Filippo Ceccato, Francesco Ferraù, Giuseppe Badalamenti, Manuela Albertelli, Maria Cristina De Martino, Giuseppe Fanciulli, Roberta Modica, Angelo Pani, Francesco Arcidiacono, Ignazio Barca, Francesca Donnarumma, Lorenzo Zanatta, Marianna Torchio, Ylenia Alessi, Chiara Vitiello, Francesco Frasca, Pasqualino Malandrino
{"title":"Multicentric Retrospective Analysis of Oncocytic Adrenocortical Carcinoma: Insights into Clinical and Management Strategies.","authors":"Antonio Prinzi, Valentina Guarnotta, Guido Di Dalmazi, Letizia Canu, Filippo Ceccato, Francesco Ferraù, Giuseppe Badalamenti, Manuela Albertelli, Maria Cristina De Martino, Giuseppe Fanciulli, Roberta Modica, Angelo Pani, Francesco Arcidiacono, Ignazio Barca, Francesca Donnarumma, Lorenzo Zanatta, Marianna Torchio, Ylenia Alessi, Chiara Vitiello, Francesco Frasca, Pasqualino Malandrino","doi":"10.1007/s12022-025-09857-0","DOIUrl":"https://doi.org/10.1007/s12022-025-09857-0","url":null,"abstract":"<p><p>Oncocytic adrenocortical carcinoma (OAC) is a rare variant of conventional adrenocortical carcinoma (ACC), characterized by oncocytic tumor cells comprising more than 90% of the tumor. Due to its rarity, there is a lack of reliable data on the clinicopathological features and outcomes of OAC. The aim of this study was to assess the clinical presentation, treatment modalities, and outcomes of patients with OAC, comparing these results with a cohort of patients with conventional ACC. Data from 9 referral centers in Italy on 44 patients with OAC were retrospectively analyzed and compared with data from 145 patients with conventional ACC. Patients with OAC had a smaller median tumor size, more favorable resection margin status, and lower incidences of venous invasion and persistent/recurrent disease during follow-up. Additionally, patients with OAC exhibited longer times to progression (TTP) and overall survival (OS) compared to patients with conventional ACC. Multivariable analyses identified Ki67 and tumor size as features independently associated with disease progression during post-surgical follow-up, while Ki67 and distant metastases at diagnosis were independently associated with OS in OAC patients. After complete tumor removal, the risk of recurrent disease was higher in patients with either Ki67 ≥ 20% or ENSAT stage III/IV. OAC appears to have a more indolent clinical course and better prognosis than conventional ACC. Similar to conventional ACC, Ki67 remains a significant prognostic marker for OAC and, along with ENSAT stage, serves as a reliable biomarker for identifying patients who may benefit from adjuvant mitotane therapy.</p>","PeriodicalId":55167,"journal":{"name":"Endocrine Pathology","volume":"36 1","pages":"11"},"PeriodicalIF":11.3,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11991974/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058310","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Impact of Tissue Thickness on Computational Quantification of Features in Whole Slide Images for Diagnostic Pathology. 组织厚度对病理诊断全切片图像特征计算量化的影响。
IF 11.3 2区 医学
Endocrine Pathology Pub Date : 2025-04-08 DOI: 10.1007/s12022-025-09855-2
Manav Shah, António Polónia, Mónica Curado, João Vale, Andrew Janowczyk, Catarina Eloy
{"title":"Impact of Tissue Thickness on Computational Quantification of Features in Whole Slide Images for Diagnostic Pathology.","authors":"Manav Shah, António Polónia, Mónica Curado, João Vale, Andrew Janowczyk, Catarina Eloy","doi":"10.1007/s12022-025-09855-2","DOIUrl":"10.1007/s12022-025-09855-2","url":null,"abstract":"<p><p>Tissue section thickness (TST) is an understudied variable in digital pathology that significantly impacts both visual assessments and computational analyses. This study systematically examines the effects of TST on whole slide images (WSIs) and nuclear-level features using thyroid tissue samples (n = 144) prepared at thicknesses ranging from 0.5 to 10 µm. By minimizing preanalytical variables and batch effects, we aimed to isolate TST as the primary factor in our experiment. Visual assessments indicated that thinner Sects. (0.5-3 µm) were more transparent with distinct cellular features, while thicker Sects. (5-10 µm) appeared darker with increased staining intensity and artifacts. Quantitative analyses were performed using open-source tools such as HistoQC for WSI quality control, HoverNet for nuclear segmentation, and feature extraction with Scikit-learn and Mahotas. Both WSI and nuclear-level metrics were significantly influenced by TST. The Haralick texture feature of difference entropy, which measures texture complexity, showed a 13.7% decrease in nuclei as TST increased, indicating fewer complex textures in thicker sections. Additionally, intensity decreased substantially with thicker tissue, dropping by 26.1% at the WSI level and 30.4% at the nuclear level. WSI contrast exhibited an increase of 92.6% when transitioning from 0.5 to 10 µm. These findings demonstrate that variations in TST can obscure or alter the appearance of biological signals, complicating both visual diagnostics and computationally extracted features. The study highlights the need for standardized tissue section thickness protocols, alongside consistent reporting of these standards, to ensure accuracy and reliability in both visual evaluations and computational analyses within digital pathology workflows.</p>","PeriodicalId":55167,"journal":{"name":"Endocrine Pathology","volume":"36 1","pages":"10"},"PeriodicalIF":11.3,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11978545/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143813045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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