Day 2 :
Keynote Forum
Yao-Shan Fan
University of Miami Miller School of Medicine, USA
Keynote: The 2013 ASCO/CAP recommendations on HER2 testing in breast cancer have increased equivocal HER2 FISH results and the use of anti-HER2 therapies
Time : 10:00
Biography:
Yao-Shan Fan,MD, PhD, Professor of Pathology, Director of Cytogenetics & Molecular Laboratory, University of Miami Miller School of Medicine, USA. He worked as a lab director, assistant/associate professor at the University of Western Ontario, and the Chair of the Genetics Committee, Laboratory Proficiency Testing Program in Canada as well as a CCMG Cytogenetics Committee member. He has published 100 articles in peer reviewed journals, authored a book, “Molecular Cytogenetics: Protocols and Applicationsâ€, and contributed to “Encyclopedia of Medical Genomics and Proteomics†as Editorial Advisory. His current research and services focuses on developmental disorders and molecular diagnosis of human cancers.
Abstract:
The status of HER2 must be evaluated for breast cancer patients to receive anti-HER2 therapy, by either IHC or ISH or a combination of both. Based on the recommendations of American Society of Clinical Oncologists (ASCO) and College of American Pathologists(CAP) in 2007, a positive result is IHC 3+, or dual probe FISH showing a ratio (HER2/chromosome 17 centromere signals) >2.2; a negative result is IHC 0 or 1+, or dual probe FISH showing a ratio <1.8. An equivocal IHC (2+) is referred for FISH. A patient having an equivocal FISH result with a ration ≥2 is qualified for anti-HER2 treatment. In 2013, ASCO and CAP updated the guideline for HER2 testing in breast cancer. With the new recommendations and when HER2 is evaluate by dual probe FISH, a positive result is a ratio ≥ 2.0, or ≥ 6.0 copies of the HER2 gene; a negative result is a ratio <2.0 or <4.0 copies; an equivocal result is a ratio <2.0 and 4.0~5.9 copies. Our lab has performed dual probe FISH and reported HER2 status using the updated ASCO/CAP recommendations in the past 2 years. To evaluate the significance of the new recommendations on HER2 amplification detection and the use of anti-HER2 therapies, we have compared the results determined by the 2007 and 2013 recommendations on the same cases we reported since 2013. Our comparison has shown that the new recommendations have significantly increased the frequency of equivocal results and the use of anti-HER2 therapies for breast cancer.
- Track 2: General cytopathology
Track 4: Surgical Cytopathology
Track 6: Cytopathology In Laboratory Medicine Technology
Track 8: Advanced Cytopathology
Chair
Yao-Shan Fan
University of Miami Miller School of Medicine,USA
Co-Chair
Qing Kay Li
The Johns Hopkins University School of Medicine, USA
Session Introduction
Qing Kay Li
Johns Hopkins Medical Institutions, USA
Title: Value of Cytopathology in the diagnosis of respiratory diseases
Biography:
Dr. Li is an internationally recognized expert in the field of cytopathology and co-PI in Johns Hopkins Biomarker Discovery Center. She provides diagnostic service at Johns Hopkins, and conducts research in the field of novel biomarkers in lung and prostate cancers. Her research has been presented at many national/international meetings. Dr. Li also serves as editorial board members for several journals, committee member of the American Society of Cytopathology, and study sections of government agents and private organizations. She has more than 70 publications and book chapters. Dr. Li is also the editor of “Diagnostic Cytopathology Board Review and Self-Assessmentâ€.
Abstract:
Although the cytology (cytopathology) was first used as a diagnostic tool in the lung disease in early 1900s, it is not until the 1960s that pulmonary cytology becomes a diagnostic discipline. Since then, tremendous improvements have been made due to the innovation of sample collection and preparation techniques. The commonly used respiratory specimens in clinical diagnosis include: sputum, bronchial brushing and washing, bronchoalveolar lavage (BAL), transbronchial fine needle aspiration (TBNA), endobronchial ultrasound-guided transbronchial fine needle aspiration (EBUS-TBNA), and transthoracic CT- or ultrasound-guided fine needle aspiration (FNA). The familiarity of cytomorphological features of respiratory cells, and current techniques of obtaining samples are crucial to make an accurate diagnosis. Similar to other type of non-gynecologic cytological specimens, the diagnoses of respiratory diseases are typically made based on the cytomorphological evaluation of respiratory cells. In addition, an explanation note of the diagnosis is often used in the report at our institution to report immunohistochemical and molecular results, and also provide suggestions to our clinical colleagues if necessary. In this presentation, we will discuss the cytomorphological findings of both benign and malignant respiratory diseases, and the differential diagnosis of lung cancers.
Noeme Sousa Rocha
Sao Paulo State University. Brazil
Title: Sensibility cell block (FNA) for detection of CK5, ER and PR in spontaneous mammary carcinoma in female dogs
Biography:
Noeme Sousa Rocha is graduated in Veterinary Medicine from the State University of Maranhão (1989), Masters in Pathology from the Sao Paulo State University (1994) and PhD in Pathology from the Sao Paulo State University (1998). It is currently - Journal of Animal Science Faculty, Veterinary Medicine and Agronomy (Uruguaiana) and associate professor of Sao Paulo State University. Has experience in the area of veterinary medicine, with emphasis on Animal Pathology Anatomy, acting on the following topics: veterinary, cytopathology, pathology, cancer and istopathology. Associate member of the International Academy of Pathology.
Abstract:
Breast carcinomas in a dog is a malignant disease relatively frequent in bitches of 10 years old displays important morbidity and evolve to death. The cell block for the diagnosis of injury in women is the method of choice in the investigation, because it provides subsidies to provide for response to therapy. However, for the dog is unknown the application of this technique, therefore, this study aimed to correlate the morphological patterns of canine mammary tumors between cell block technique and surgical specimen and compare the immunohistochemical marking of ER, PR and CK5 between the two methods in 23 animals. After the diagnosis of breast carcinoma made by cytological exam the animal was submitted to mastectomy, FNA for cell block was made in the surgical specimen. The cell block and surgical specimens were submitted to histological processing, preparation of slides for HE and subsequent immunohistochemistry (IQ) for estrogen receptor α (ER) and cytokeratin 5 (CK5). Were considered positive for ER and CK5 the cases where there was marking on more than 10% of neoplastic cells. The level of agreement between the cell block and the surgical specimen was 86.9% for CK5 and 82.6% for the RE. Finally, the procedure that has been established for the woman when applied in dog kept the same benefits, such as affordable method, time and limited financial resources, sensitivity and specificity expressive. Therefore it validates the technique for the diagnosis of breast cancer in dogs.
K Sujathan
Regional Cancer Centre (RCC-T), India
Title: Computer aided screening of cervical cancer using methodologies of quantitative Cytology
Biography:
Dr.K.Sujathan has completed his PhD at the age of 41 years from Annamalai University and postdoctoral studies from Regional Cancer Centre, Thiruvananthapuram, India. He is currently Associate Professor, Regional Cancer Centre, a premier Cancer treatment and research Institute. He has published 34 papers in reputed journals of Pathology and Cancer Research, some which has been cited in leading text books like Diagnostic Cytology and its histopathologic basis by LG Koss, Obstetrics and Gynecology for post graduates by Arul Kumaresan etc. His outstanding research works have received five national awards and he has been serving as reviewer and editorial board member of repute and PhD guide.
Abstract:
Cervical cancer is the fourth most common cancer among women with an estimated 528,000 new cases every year. Among the different screening methods, cytology based screening using PAP smear remains as the best method for the pre-selection of women with cervical intraepithelial lesions. However, this method pose a challenge in practical implementation as it is resource intensive requiring trained professionals skilled enough to identify a handful of abnormal cells among few hundred thousand cells. This motivates the need for automating the screening methodology. Since the 1960-ies several groups have attempted such automated screening systems leading also to a couple of commercial products. Still these have had limited impact on the screening situation in most of the world. C-DAC(T) together with RCC-T and Uppsala University has developed a semi-automated system which analyses digitized PAP slides prepared using LBC techniques and employs quantitative analysis using image processing and machine learning algorithms to screen out clearly normal smears and direct abnormal smears for human review. A low cost alternative to commercial LBC technique was also identified. The system filters out normal smears without human intervention while referring the suspicious cases for expert’s review. It was evaluated on 1006 smears with a sensitivity of 96% and specificity of 72% for high grade lesions, which is comparable to that of human experts. Since in screening programs, a big majority of cases are within normal limits, the system is able to drastically reduce the workload of Cytologists, thus able to screen a larger population even in low resource settings.
Ahmed El-Habashi
NCI, Cairo University, Egypt
Title: Thyroid lesions fine needle aspiration Cytology: Comprehensive cytomorphology and update reporting
Biography:
Prof. DR. Ahmed El-Habashi has completed his MD, PhD at the age of 40 years from Cairo University and Tulane University in a channel system scholarship program. He got post-doctoral fellowship at Groningen University Hospital, The Netherlands at 1998. He is the past- director of pathology department, National Cancer Institute, Cairo University and now he is working in the capacity of Professor of Pathology. He got the International Board of Cytopathology from International Academy of Cytopathology at 2007. He is an international cytology speaker and he conducted many Cytopathology workshops in Egypt and Arab countries aiming to improve the cytology practice and profession. He has published more than 35 papers in reputed journals and has been serving as a reviewer for more than three reputed Journals.
Abstract:
FNAC is recommended as a routine prime investigation in the work-up of the solitary cold thyroid nodule. Requirements for accurate diagnosis are adequate material, optimal smearing, proper staining and experience. The accuracy of FNAC in thyroid lesions is over 90%, with sensitivity of malignancy diagnosis almost 100%, false negative is about 10% and false positive is 1-3%. The author in this workshop will demonstrate cytomorphologic features of majority of diagnostic entities in thyroid lesions FNA together with an emphasis on potential diagnostic pitfalls. The updated Bethesda System (TBS) for thyroid lesions FNA cytology will be discussed with its clinical significance and management guidelines. The end of the talk will include case presentations to ensure that the audience will achieve the basic ILOs objectives of the workshop.
Biography:
Dr. Lazar obtained his MD (1989) with high honors at The University of Timisoara (Romania). He became a Specialist in Medical Clinical Biology and obtained his PhD in Molecular Biology (1997) with highest honors and the Prize of the University at The University René Descartes in Paris. Dr. Lazar is specialized in clinical biology, molecular biology, and molecular pathology, and has postgraduate degrees in biotechnology and project management. He is the author of six patents, and has authored / co-authored over 100 publications. Dr. Lazar initiated the WIN Consortium and serves as its Chief Operating Officer
Abstract:
Background: Combining three targeted therapies significantly improved outcomes in AIDS. A similar strategy could theoretically benefit patients with metastatic NSCLC, but a scientific method for rational selection of drug combinations is needed. Methods: We assessed genomics and the transcriptome (including miRNA), utilizing defined subsets of relevant genes/gene products, and scored information about the relationships between targeted drugs and genes, based in part on the biological hallmarks of cancer. Interventional points (genes/group of genes) that, when activated, could be blocked by a customized therapy combination, were identified. The underlying algorithm integrates and weighs the genomic (DNA sequencing) and transcriptomic data (mRNA and miRNA differential expression between tumor and normal -bronchial mucosa - tissues). Results: Key genes (N = 183) grouped in 24 interventional points forming the Simplified Interventional Mapping System (SIMS) were elucidated. Frequency and trends of coactivation derived from 121 NSCLC patients defined a list of candidate triple therapy combinations. The focus, in order to limit toxicity, was on the application of two small molecules (TKI) and an immune-modulator (anti-PD1L). Twenty-eight percent of NSCLC patients displayed the simultaneous activation of PD1L, Ras/Raf and mTor/PI3K interventional points. Overall, fifty two percent of NSCLC patients could be targeted by a triple combination that includes an anti-PD1L agent. Most individuals could benefit from two or even more triple combinations to overcome resistance. Conclusions: The SIMS’s strategy enables conversion of thousands of genomic and transcriptomic measurements into a simple and actionable result (a 1 to 10 score) that may be usable by physicians to select triple drug therapy. Comparing tumor and normal tissue biopsies has proven feasible in the ongoing WINTHER trial (NCT01856296). This novel strategy may allow deployment of personalized tri-targeted therapies that will be prospectively tested in a clinical trial with the objective to significantly impact survival in advanced NSCLC and other malignancies.
Sunita Arvind Bamanikar
Dr. D. Y. Patil Vidyapeeth, India
Title: Significance of marginal vacuoles in fine needle aspiration cytology of diffuse thyroid swelling
Biography:
Sunita Arvind Bamanikar is a Professor of Pathology at Dr. D. Y. Patil Medical College, Hospital and Research Centre, Pune, India. She has obtained her Medical Graduation from Seth G.S. Medical College and KEM Hospital, Mumbai University in 1981. After getting her Doctorate (MD) in Pathology in 1987 from B.J. Medical College & Sassoon General Hospitals, Pune University, she held Faculty Assignments in Medical Colleges in India and abroad with over 12 years at the Sultan Qaboos University, Oman and Universiti Brunei Darussalam. She has published over 30 papers in reputed journals and is currently an Associate Editor for the Journal of Medical Research.
Abstract:
Evaluation of thyroid swelling by Fine Needle Aspiration Cytology (FNAC) is an established first-line diagnostic test. Marginal Vacuoles (MVs) or fire-flare appearance in Fine Needle Aspiration (FNA) smears stained by Leishman’s stain have been described as a distinctive feature of thyrotoxic goiter but was also found in various nontoxic thyroid lesions. Although these MVs have been characterized as dilated endoplasmic reticulum and manifestation of active pinocytosis/vacuoles containing colloid, their exact nature is not so far resolved. The aim of the study was to assess the presence of MVs in diffuse thyroid swelling and evaluate the strength of association between MVs, thyroid hormonal and biochemical tests and cytological diagnosis. Seventy six cases of diffuse thyroid swelling (goiter) were studied. Cytomorphological features were examined with special reference to MVs. Grading for MVs was adopted as grade I (scant), grade II (moderate) and grade III (abundant). The strength of association was studied by applying the Chi-square test and test of proportion; a P≤0.05 was considered significant. Abundant MVs were not associated with hypothyroidism in this study; 71% of these cases were hyperthyroid. Further, abundant MVs in thyroid FNACs were seen in cases of primary hyperplasia and Hashimoto\\\'s thyroiditis and Grave’s disease. There was a significant correlation between the presence of abundant/moderate MVs and primary hyperplasia and their absence in colloid goiter. Scant MVs in diffuse goiters were not found to correlate with thyroid function. Thus, all diffuse goiters with prominent MVs warrant hormonal evaluation to rule out hyper functioning goiter.
Resende, L.S.A
HRAN – Regional Hospital, Brazil
Title: Brazilian national screening program of cervical cancer: Critical analysis
Biography:
Leandro Resende has completed his Masters’s degree at the age of 32 years from State University of Campinas – UNICAMP, Campinas, SP, Brazil. He is currently responsible for colposcopy service HRAN (Regional Hospital) in Brasilia DF. Participates in the Unicamp research group, with Prof. PhD. Sophie Derchain
Abstract:
Introduction: Cervical cancer ranks third in prevalence and fourth as cause of death in women worldwide in Brazil, 17,540 women were diagnosed in 2012. Screening of precursor lesions of cervical cancer is done through the annual collection of cytology (Pap smear test) in women aged 25-64 and sexually active. Objective: Demonstrate poor adherence of the target population for screening for precursor lesions of cervical cancer in Brazil due to the current program adopted by the national health agency. Exhibit the prevalence of precursor lesions of cervical cancer in Brazil. Methods: All information was obtained by consulting the INCA (National Institute of Cancer) database and Federal District Health Department. Non-parametric tests were performed.Chi-squares (and Fisher’s Exact test where appropriate) were used to compare the prevalence of cytological abnormalities. Results: 27% of eligible women participated in the screening program in 2013-2014 and less than 1% were referred for colposcopy. The frequencies of cytological abnormalities were ASC-H (0.41%); AGC-HSIL (0.09%); HSIL (0.56%); invasive carcinoma (0.04%); adenocarcinoma in situ (0.03%) and invasive adenocarcinoma (0.01%). Discussion: The current screeningof precursor lesions of cervical cancer adopted in Brazil is not organized and has low catch-up program adherence. Women aged 25-64 are first attended for a primary screening and referred to a trained colposcopist if abnormal cytological result detected. Women's target population in Brasilia as the capital of Brazil is nearly 900,000 individuals. However, in the current program, few women have cytology collected annually and has a minority colposcopic assessment if necessary.
MA El-Barrawy
Alexandria University, Egypt
Title: Comparative immunohistochemical analysis of beclin-1 & mdm-2 in benign & malignant ameloblastomas
Biography:
MA El-Barrawy post doctoral fellow of M.D. Anderson Cancer & Tumor Institute, Texas University (Houston, USA): October 1988-April 1989 and currently teaching and supervising postgraduate Physicians, Pharmacists, Chemists, and Veterinarians enrolled at HIPH, Alex. University, to get their postgraduate degree. Having experience in various investigations of: Microbiology (Bacteriology, Virology and Mycology), Immunology, Clinical Pathology, Histocompatibility, and field surveys .
Abstract:
Ameloblastoma is the most frequently encountered neoplasm arising from the odontogenic epithelium. Beclin 1 protein plays a critical role in autophagy as a tumor suppressor gene. Whereas, the Murine Double Minute 2 (MDM 2) is a cellular proto-oncogene capable, if amplified, of causing tumor-genesis. The expression & prognostic significance of both genes are largely unexplored, yet, in this neoplasia. Therefore, the present investigation aimed to assess their possible biological role in ameloblastomas. Methods: This study was done among 35 studied cases: 29 cases of benign ameloblastomas, and 6 cases of ameloblastic carcinomas. Labeled Streptavidin Biotin (LSAB + Dako) immunohistochemical method, utilizing monoclonal antibodies for Beclin 1 & MDM 2 genes, was used. Results: Most of the benign ameloblastomas showed intense total cell positivity for the Beclin 1, while, the ameloblastic carcinomas revealed mild to negative expression. Inversely, the MDM 2 oncoprotein demonstrated intense brown total cell reactivity in amelobastic carcinoma & loss of the reaction to mild brown stain in benign ameloblastoma. Conclusion: Based from these findings, one could conclude that, MDM 2 could be a specific marker to identify the proliferative activity, tumor aggressiveness & directly proportional with the degree of malignancy. In contrast, the high Beclin 1 expression could be a good indicator of prognosis in ameloblastomas. Hence, an overall comparison, both studied genes may be very promising molecular prognostic biomarkers.
Marino E. Leon
University of South Florida, USA
Title: Molecular assays in cytopathology for thyroid cancer
Biography:
Dr. Leon is certified by the American Board of Pathology in Anatomic and Clinical Pathology and in the subspecialty of Cytopathology. At the H. Lee Moffitt Cancer Center and Research Institute, Dr. Leon works in the Head and Neck Pathology, and Cytopathology Clinical Services. He has an extensive experience in Fine needle aspiration, especially in Head and Neck and Thoracic tumors. His research interests include translational collaborative research on the development of novel biomarkers for cancer diagnosis and personalized cancer treatment. He is also actively involved in medical education and in pathology residents, oncologic surgical pathology fellows, cytopathology fellows training.
Abstract:
The rapid translation into the clinical field of new discoveries in the molecular basis of thyroid cancer has led to the development of several molecular tests that address the deficiencies of thyroid cytopathology. Despite lack of adequate, validated, independently performed clinical studies, several molecular tests are commercially available on the market and are being used on indeterminate thyroid nodules to guide patient-care decisions. This presentation will discuss and summarize the current evidence on the role and limitations of molecular tests used in combination with thyroid cytopathology to refine the pre-surgical diagnosis of thyroid nodules. The presentation will address the fact that the clinical performance of molecular tests depends on the pretest risk of malignancy within the specific cytological group being assessed. This risk is variable and should be assessed at each institution to optimize the selection of the molecular test and the interpretation of its results. The use of Next-generation sequencing (NGS) will be discussed; NGS has increased the sensitivity of oncogene panels while maintaining high specificity. Tests assessing the gene expression pattern have shown promising results, with high sensitivity but low specificity. The impact of the molecular markers on clinical practice remains in flux and their effect on health care costs remains poorly understood. Further large, independent, confirmatory, clinical validation studies and real-world, cost-effec¬tiveness studies are necessary before the widespread adoption of these tests can be endorsed as standard of care.
Matthew T. Olson
The Johns Hopkins University School of Medicine, USA
Title: The Paris system for reporting urinary cytology: Diagnostic paradigm shift, current topics, and the potential for molecular testing
Biography:
Matthew T. Olson, M.D. completed his medical education at The George Washington University, his Anatomic and Clinical Residency and his cytopathology fellowship at Johns Hopkins University where he is now faculty. He has published more than 40 peer reviewed original research papers mainly on the subject of diagnostic cytopathology and currently serves as a member of the steering committee TPS, chair of the adequacy subcommittee, and member of the ancillary studies subcommittee in addition other committees and ad hoc reviewer roles in a number of prominent journals.
Abstract:
Urinary cytology has long been used as a first-step in the evaluation of a patient with a clinical suspicion for urothelial carcinoma (UC) as well as for surveillance of patients who have a known history of UC. Urinary cytology is most sensitive and specific in the diagnosis of high-grade carcinoma, which is also the tumor that is most likely to invade, metastasize, and cause mortality and morbidity for the patient. As such, the Paris System (TPS) for Reporting Cytopathology, which is an international consensus system developed with the backing of the International Academy of Cytology (IAC) and the American Society of Cytopathology (ASC), focuses on standardizing the reporting template worldwide and optimizing it for the detection of high grade UC. As such, TPS represents a major paradigm shift both because it is the first time urinary cytological reports are poised to have international uniformity and because it clearly outlines the appropriate place for how urinary cytology should be used and interpreted. This level of standardization should enable the deployment of molecular and other ancillary testing to targeted clinical problems in a manner that is most conducive to guiding patient care in a clinically relevant and cost-effective manner. Several strategies, including the existing technologies as well as a new gene expression classifier that is in development, will be discussed specifically in the context of TPS.
Biography:
Sahar Samaha, M.D. is board certified in AP/CP and Cytopathology. Has completed her residency and 2 fellowships in surgical pathology and cytopathology at University of Kansas Medical Center. She is in practice for over 15 years. She got her medical degree from Ain Shams University, Cairo, Egypt. Before moving to the united states, she finished her residency and obtained her master’s degree in Ophthalmology. She is the director of Aloha lab at Miraca life sciences.
Abstract:
At Miraca Life Sciences, we receive anorectal pap smears and biopsies from a colorectal clinic dealing primarily with “high risk†populations, mainly HIV positive patients. Our large database includes anorectal pap smears for screening and follw up as well as biopsies collected from the keratinized, non-keratinized portions and transformation zone. Dacron fiber swabs and liquid-based sampling are used. Questions to be answered, What is the natural history of the anorectal dysplasia? What is the difference between the cervical and anorectal pap? Follow up and treatment, is it different from cervical dysplasia? Correlation between anal pap smears and biopsies? Should anal-rectal cytology be a standared of patient care in high risk population and female patients with genital HPV infection?
Miral Patel
University of Pennsylvania, USA
Title: Protein extraction from methanol fixed paraffin embedded tissue blocks: A new possibility using cell blocks
Biography:
Miral was 23 years old when he completed his degree. He has Msc in Biotechnology from University of Pennsylvania. Currently, he is program manager for Biorepository at Children Hospital of Philadelphia. He is involved in many clinical and transitional researches. He said publish several articles mainly on the subject of Biobanking and quality of samples in Biobanks.
Abstract:
The traditional cellblock is an essential cytology preparation, which offers benefits over cytological smears by preservation of cell architecture and the performance of immunohistochemical studies. In the current era of minimally invasive techniques for obtaining tissue samples for diagnostic and prognostic markers, cellblocks containing “limited material†specimens are routinely used to provide the valuable information about pre-disease and disease processes. The methanol fixed and paraffin embedded cellblocks are prepared manually with minimal automation with their quality highly dependent upon the experience of the cytopreparation personnel. Currently, Cellient® automated cell block system is widely used for MFPE cellblock preparation to ensure consistent quality preparation by minimizing the operator dependency. Despite advances in technology, the relatively small size of the cytology scrapings MFPE cell blocks in comparison to the formalin fixed and paraffin embedded counterparts have caused them to be often overlooked in biomarker discovery. Recently, in the field of proteomics, there is an emphasis on utilizing limited tissue samples such as core biopsies and cellblocks for the evaluation of molecular biomarkers. These have the potential of being eventually converted into novel diagnostic marker assays that will aid in improving the efficacy of clinical intervention, as well as the validation of leads and targets. Proteomic platforms have developed over the past few years due to advances in scientific knowledge and technology with the next technologic leap being the application of proteomic technologies to the bedside. At present, there is a lack of established methods or resources for extracting proteins from MFPE cell blocks.
Filomena Aste Silveira
Federal University of Rio de Janeiro,Brazil
Title: Cytologic study of behavior, cytology of low grade squamous lesions associated with p16INK4a gene methylation and genotyping of human papillomavirus
Biography:
Filomena Aste Silveira graduated in Medicine, Ph.D. from the Federal University of Rio de Janeiro (UFRJ), and member of the Society of cervical pathology, with title of qualification. Member of the commission of sexually transmitted diseases (STDs), the Brazilian Federation of Gynecology and Obstetrics (FEBRASGO), Prof. Silveira responsible for Gynecology discipline of Valença Medical School (RJ-Brazil). Appraisal professor of gynecology specialist title of proof (TEGO). Medical Institute of Ginecologia- UFRJ - Brazil. Develops research in diseases precursor of cervical cancer and biomarkers, has published some articles in scientific journals.
Abstract:
The low grade cervical intraepithelial squamous lesion (LSIL) is a high prevalence and its behavior is variable. This lesion can minimize, persist or progress. The performance of viral proteins and the epigenetic abnormalities are factors involved in the carcinogenesis of uterine cervix. We studied about the identify the type of HPV-DNA in this lesion and detected the p16INK4a gene methylation too. We analyze the results found about type of HPV-DNA, and methylation then observed with development of LSIL. The time of observation was two years. There was association of oncogenic HPV 16 and 18 with persistence / progression of these lesions. The presence of p16INK4a gene methylation in LSIL was infrequent event and regardless of presence of HPV DNA. We observed that all patients who presented p16INK4a gene methylation showed persistence/progression of this lesion.
Biography:
James Joseph Navin is a MD Graduate from Creighton University, went back in the army in the senior year. He was Internship US Army Tripler Army Med Center, Honolulu in 1962-63. He was on the post of Pathology Residency TAMC between 1963-1967. He was the Chair of Anatomical Pathology TAMC 1969-1972 and Chair of Pathology Straub Clinic and Hospital & also at Kapiolani Women's and Childrens Hosptial and SmithKline Lab. Dr. James was the first Cytopathologist in Hawaii. He received multiple awards as teacher of the year from American Society of Cytopathology for outstanding advocacy efforts. President of American Pathology foundation and having recognition from ACOG for career long dedication to Women's Health .
Abstract:
Commercial labs set a pattern of low payment for Pap smears. They allowed clinicians to bill for the Paps as long as they sent the other work to the lab. This led to a marked reduction in payment to other labs which did Paps and resulted in Pap smears becoming a money losing test for the other labs. Insurance companies and Medicare lowered their payment as well. This produced financial problems for many labs. Some lived with the problem others began to reduce costs by screening faster, not using cytotechs and other ventures that greatly reduced quality. Upon recognizing the problem we began to fix it. We first went after local payors and when that was fixed we went after the Federal Govt. the following is the story of what transpired. It encompasses about 4 years of work which included going to DC every month sometime 3-4 times to meet with the players. Honolulu, by the way is not very close to DC
Hyeyoung Lee
College of Health Sciences, South Korea
Title: Use of HPV E6/E7 and hTERT mRNA RT-qPCR assays in combination for diagnosing high grade cervical lesions
Biography:
Hyeoyung Lee has completed her PhD at the age of 30 years from University of Minnesota, Dept. of Microbiology. She is the professor at the Yonsei Univesity Wonju Campus of the Department of Biomedical Laboratory Science, College of Health Sciences, South Korea. She has published more than 82 papers in reputed journals and has over 30 patents registered
Abstract:
Human papillomavirus (HPV) is a major cause of cervical cancer, which is the third most common cancer in women. HPV E6 oncoprotein initiates degradation of cellular tumor suppressor protein p53, and induces human telomerase reverse transcriptase (hTERT) activity. Activation of hTERT then leads to progressive cervical carcinogenesis. In this study, multiplex RT-qPCR assay which detects 16 HPV high-risk subtypes (HPV 16, 18, 31, 33, 35, 39, 45, 51, 52, 53, 56, 58, 59, 66, 68 and 69), and the RT-qPCR assay which detects hTERT mRNA were evaluated using 545 ThinPrepⓇ Pap (Hologic Inc., Bedford, MA, USA) samples of Korea. The rates of positivity for the HPV E6/E7 mRNA RT-qPCR assay were 94.4%, 95.2%, 82.4%, 46.5%, 25.0%, and 1.1% in SCC, HSIL, ASC-H, LSIL, ASC-US and normal cytology samples, respectively. Five CIN2+ samples were not detected by the HPV E6/E7 mRNA assay; however they exhibited positive signals in the hTERT mRNA assay. Notably, the hTERT mRNA expression level was increased in high grade cervical lesions, but was very low in all 288 normal samples. These data suggest that the combination of HPV E6/E7 and hTERT mRNA expression levels could be used in a complementary manner in diagnosing high grade cervical lesions, and might be useful as a predictive marker in monitoring low grade cervical lesions
Biography:
Zhongren (David) Zhou has completed his MD and PhD in 1993. Dr. Zhou finished his posdoctoral training in MIT in 1998 and had Instructor in Havard Medical School. He finished his resident training at Bonston University. He had his Cytopathology Fellow in Baylor Medical College and his surgical pathology fellow in MD Anderson Cancer Center. Now he is an interim Director of Cytopathology in University of Rochester. He is invovled in many clinical and translation research. He is also a committee member of Research and Current Concepts Committee in ASC and TCGA GI committee in National Cancer Institute.
Abstract:
Recent advances in imaging technology have resulted in an increase in incidental discoveries of pancreatic cystic lesions. Pancreatic cysts comprise a wide variety of lesions and include non-neoplastic cysts and neoplastic cysts. Because some pancreatic cysts have more of a malignant potential than others, it is absolutely essential that an accurate diagnosis is rendered so that effective care can be given to each patient. In many centers, EUS-guided FNA has emerged as the modality of choice that enables one to distinguish between mucinous and non-mucinous lesion. Multiple methods including pancreatic enzyme levels, genetic analysis, and other tumor biomarkers are used to study cyst fluid for further diagnostic studies.
Biography:
Amr Amin has completed his PhD at University of Illinois at Chicago, and received a post-doctoral training in the field of molecular genetics at the University Of Pennsylvania School Of Medicine. He started his academic career at UAE University where he serves now as a Full Professor of Cell and Molecular Biology. Amr’s research focuses on ways to control cancer, particularly liver cancer. He published many research and review articles and serves as reviewer and as an editorial member of many specialized peer-reviewed journals. He is also a member of many specialized societies and the sole recipient of many scientific awards.
Abstract:
Hepatocellular carcinoma (HCC) is the second most common cause of cancer-related death worldwide. The prognosis of patients with HCC is usually poor; hence, a novel approach against HCC is essential for a better therapeutic outcome. Saffron and its active constituents were reported to have antioxidant, anti-inflammatory, and anti-tumor properties. The aim of this study was to investigate chemopreventive action of crocin, one of the promising active constituents of saffron, against diethylnitrosamine (DEN)-induced liver cancer in rats, and the possible mechanisms by which crocin exerts its anti-tumor effects. Findings reported herein demonstrated the anti-proliferative and pro-apoptotic properties of crocin when administrated in DEN-treated rats. Additionally, crocin exhibited anti-inflammatory properties that inhibited NF-kB, among other inflammatory markers. According to our network analysis, NF-kB was identified as a regulatory hub, and therefore, a candidate therapeutic drug target. Taken together, our findings introduces crocin as a potent chemopreventive and therapeutic agent against HCC.
Alvaro Ibarra V
Anatomopatólogo Jefe, Servicio de AnatomÃa Patológica ClÃnica las Condes, USA
Title: Cytological intraoperative study of surgical margins and sentinel nodes in breast pathology
Biography:
Abstract:
The study of surgical margins in breast pathology is very important, because a diagnosis of negativity or positivity permits to make the best surgical procedure, obtaining in the majority of cases an excellent correlation with the results of definitive histopathological report. The intraoperative study of sentinel axillary nodes, in most of the cases, allows resolving in one surgical time, the regional treatment in breast cancer. We will show our experience with cytological study in more than eight hundreds of cases of breast tumors and sentinel axillary nodes, with simple and efficient technics.