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Lookup NU author(s): Dr Pasquale RescignoORCiD
This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).
© 2022 by the authors. Licensee MDPI, Basel, Switzerland.We aimed to overcome intratumoral heterogeneity in clear cell renal cell carcinoma (clear-RCC). One hundred cases of clearRCC were sampled. First, usual standard sampling was applied (1 block/cm of tumor); second, the whole tumor was sampled, and 0.6 mm cores were taken from each block to construct a tissue microarray; third, the residual tissue, mapped by taking pieces 0.5 × 0.5 cm, reconstructed the entire tumor mass. Precisely, six randomly derived pieces of tissues were placed in each cassette, with the number of cassettes being based on the diameter of the tumor (called multisite 3D fusion). Angiogenic and immune markers were tested. Routine 5231 tissue blocks were obtained. Multisite 3D fusion sections showed pattern A, homogeneous high vascular density (10%), pattern B, homogeneous low vascular density (8%) and pattern C, heterogeneous angiogenic signatures (82%). PD-L1 expression was seen as diffuse (7%), low (33%) and absent (60%). Tumor-infiltrating CD8 scored high in 25% (pattern hot), low in 65% (pattern weak) and zero in 10% of cases (pattern desert). Grading was upgraded in 26% of cases (G3–G4), necrosis and sarcomatoid/rhabdoid characters were observed in, respectively, 11 and 7% of cases after 3D fusion (p = 0.03). CD8 and PD-L1 immune expressions were higher in the undifferentiated G4/rhabdoid/sarcomatoid clearRCC subtypes (p = 0.03). Again, 22% of cases were set to intermediate to high risk of clinical recurrence due to new morphological findings of all aggressive G4, sarcomatoid/rhabdoid features by using 3D fusion compared to standard methods (p = 0.04). In conclusion, we propose an easy-to-apply multisite 3D fusion sampling that negates bias due to tumor heterogeneity.
Author(s): Brunelli M, Martignoni G, Malpeli G, Volpe A, Cima L, Raspollini MR, Barbareschi M, Tafuri A, Masi G, Barzon L, Ammendola S, Villanova M, Cerruto MA, Milella M, Buti S, Bersanelli M, Fornarini G, Rebuzzi SE, Vellone VG, Gaggero G, Procopio G, Verzoni E, Bracarda S, Fanelli M, Sabbatini R, Passalacqua R, Perrucci B, Giganti MO, Donini M, Panni S, Tucci M, Prati V, Ortega C, Calio A, Eccher A, Alongi F, Pappagallo G, Iacovelli R, Mosca A, Umari P, Montagnani I, Gobbo S, Atzori F, Munari E, Maruzzo M, Basso U, Pierconti F, Patriarca C, Colombo P, Lapini A, Conti G, Salvioni R, Bollito E, Cossarizza A, Massari F, Rizzo M, Franco R, Zito-Marino F, Plata YA, Galuppini F, Sbaraglia M, Fassan M, Dei Tos AP, Colecchia M, Moch H, Scaltriti M, Porta C, Delahunt B, Giannarini G, Bortolus R, Rescigno P, Banna GL, Signori A, Obispo MAL, Perris R, Antonelli A
Publication type: Article
Publication status: Published
Journal: Journal of Personalized Medicine
Year: 2022
Volume: 12
Issue: 5
Print publication date: 01/05/2022
Online publication date: 30/04/2022
Acceptance date: 26/04/2022
Date deposited: 08/11/2024
ISSN (electronic): 2075-4426
Publisher: MDPI
URL: https://doi.org/10.3390/jpm12050727
DOI: 10.3390/jpm12050727
Data Access Statement: Not applicable.
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