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Article ; Online: Molecular Classifications in Gastric Cancer: A Call for Interdisciplinary Collaboration.

Díaz Del Arco, Cristina / Fernández Aceñero, María Jesús / Ortega Medina, Luis

International journal of molecular sciences

2024 Volume 25, Issue 5

Abstract: Gastric cancer (GC) is a heterogeneous disease, often diagnosed at advanced stages, with a 5-year survival rate of approximately 20%. Despite notable technological advancements in cancer research over the past decades, their impact on GC management and ... ...

Abstract	Gastric cancer (GC) is a heterogeneous disease, often diagnosed at advanced stages, with a 5-year survival rate of approximately 20%. Despite notable technological advancements in cancer research over the past decades, their impact on GC management and outcomes has been limited. Numerous molecular alterations have been identified in GC, leading to various molecular classifications, such as those developed by The Cancer Genome Atlas (TCGA) and the Asian Cancer Research Group (ACRG). Other authors have proposed alternative perspectives, including immune, proteomic, or epigenetic-based classifications. However, molecular stratification has not yet transitioned into clinical practice for GC, and little attention has been paid to alternative molecular classifications. In this review, we explore diverse molecular classifications in GC from a practical point of view, emphasizing their relationships with clinicopathological factors, prognosis, and therapeutic approaches. We have focused on classifications beyond those of TCGA and the ACRG, which have been less extensively reviewed previously. Additionally, we discuss the challenges that must be overcome to ensure their impact on patient treatment and prognosis. This review aims to serve as a practical framework to understand the molecular landscape of GC, facilitate the development of consensus molecular categories, and guide the design of innovative molecular studies in the field.
MeSH term(s)	Humans ; Stomach Neoplasms/pathology ; Proteomics
Language	English
Publishing date	2024-02-24
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2019364-6
ISSN	1422-0067 ; 1422-0067 ; 1661-6596
ISSN (online)	1422-0067
ISSN	1422-0067 ; 1661-6596
DOI	10.3390/ijms25052649
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Article ; Online: Liquid biopsy for gastric cancer: Techniques, applications, and future directions.

Díaz Del Arco, Cristina / Fernández Aceñero, M Jesús / Ortega Medina, Luis

World journal of gastroenterology

2024 Volume 30, Issue 12, Page(s) 1680–1705

Abstract: After the study of circulating tumor cells in blood through liquid biopsy (LB), this technique has evolved to encompass the analysis of multiple materials originating from the tumor, such as nucleic acids, extracellular vesicles, tumor-educated platelets, ...

Abstract	After the study of circulating tumor cells in blood through liquid biopsy (LB), this technique has evolved to encompass the analysis of multiple materials originating from the tumor, such as nucleic acids, extracellular vesicles, tumor-educated platelets, and other metabolites. Additionally, research has extended to include the examination of samples other than blood or plasma, such as saliva, gastric juice, urine, or stool. LB techniques are diverse, intricate, and variable. They must be highly sensitive, and pre-analytical, patient, and tumor-related factors significantly influence the detection threshold, diagnostic method selection, and potential results. Consequently, the implementation of LB in clinical practice still faces several challenges. The potential applications of LB range from early cancer detection to guiding targeted therapy or immunotherapy in both early and advanced cancer cases, monitoring treatment response, early identification of relapses, or assessing patient risk. On the other hand, gastric cancer (GC) is a disease often diagnosed at advanced stages. Despite recent advances in molecular understanding, the currently available treatment options have not substantially improved the prognosis for many of these patients. The application of LB in GC could be highly valuable as a non-invasive method for early diagnosis and for enhancing the management and outcomes of these patients. In this comprehensive review, from a pathologist's perspective, we provide an overview of the main options available in LB, delve into the fundamental principles of the most studied techniques, explore the potential utility of LB application in the context of GC, and address the obstacles that need to be overcome in the future to make this innovative technique a game-changer in cancer diagnosis and treatment within clinical practice.
MeSH term(s)	Humans ; Stomach Neoplasms/diagnosis ; Stomach Neoplasms/therapy ; Neoplasm Recurrence, Local ; Liquid Biopsy ; Body Fluids ; Plasma
Language	English
Publishing date	2024-03-27
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2185929-2
ISSN	2219-2840 ; 1007-9327
ISSN (online)	2219-2840
ISSN	1007-9327
DOI	10.3748/wjg.v30.i12.1680
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Article: A Cytological Review of Follicular Dendritic Cell-Derived Tumors with Emphasis on Follicular Dendritic Cell Sarcoma and Unicentric Castleman Disease.

Jiménez-Heffernan, José A / Díaz Del Arco, Cristina / Adrados, Magdalena

Diagnostics (Basel, Switzerland)

2022 Volume 12, Issue 2

Abstract: Follicular dendritic cells (FDCs) are antigen-presenting cells located in the germinal centers of the lymph nodes. Among the few tumors showing FDC differentiation are follicular dendritic cell sarcoma (FDCS) and Castleman disease (CD), more precisely ... ...

Abstract	Follicular dendritic cells (FDCs) are antigen-presenting cells located in the germinal centers of the lymph nodes. Among the few tumors showing FDC differentiation are follicular dendritic cell sarcoma (FDCS) and Castleman disease (CD), more precisely the unicentric hyaline vascular (HV) variant. Both are relatively rare tumors, and the diagnostic cytological experience is limited to descriptions of isolated cases or small series. The purpose of this review is to bring together all the available cytological published information, and our personal experience, in order to obtain a global idea of the cytological features of these peculiar FDC-derived tumors. The different descriptions of FDCS are very similar, reflecting a tumor that shows repetitive and characteristic cytological features. It shows a dimorphic population of mature lymphocytes and large tumoral cells with partial spindle morphology. Most cases of HV variant of CD can be recognized as benign upon cytology, however a precise diagnosis seems more difficult. It is characterized by reactive lymphocytes mixed with vessels and FDCs, either single or forming syncytial aggregates. Both, FDCS and CD are challenging for cytological diagnosis in which a high index of suspicion is necessary for a correct preoperative assessment. Cytology is very useful for follow-up of recurrences and metastases.
Language	English
Publishing date	2022-02-04
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2662336-5
ISSN	2075-4418
ISSN	2075-4418
DOI	10.3390/diagnostics12020406
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Article ; Online: Androgen and Estrogen β Receptor Expression Enhances Efficacy of Antihormonal Treatments in Triple-Negative Breast Cancer Cell Lines.

Crespo, Belen / Illera, Juan Carlos / Silvan, Gema / Lopez-Plaza, Paula / Herrera de la Muela, María / de la Puente Yagüe, Miriam / Diaz Del Arco, Cristina / Illera, Maria Jose / Caceres, Sara

International journal of molecular sciences

2024 Volume 25, Issue 3

Abstract: The triple-negative breast cancer (TNBC) subtype is characterized by the lack of expression of ERα (estrogen receptor α), PR (progesterone receptor) and no overexpression of HER-2. However, TNBC can express the androgen receptor (AR) or estrogen receptor ...

Abstract	The triple-negative breast cancer (TNBC) subtype is characterized by the lack of expression of ERα (estrogen receptor α), PR (progesterone receptor) and no overexpression of HER-2. However, TNBC can express the androgen receptor (AR) or estrogen receptor β (ERβ). Also, TNBC secretes steroid hormones and is influenced by hormonal fluctuations, so the steroid inhibition could exert a beneficial effect in TNBC treatment. The aim of this study was to evaluate the effect of dutasteride, anastrozole and ASP9521 in in vitro processes using human TNBC cell lines. For this, immunofluorescence, sensitivity, proliferation and wound healing assays were performed, and hormone concentrations were studied. Results revealed that all TNBC cell lines expressed AR and ERβ; the ones that expressed them most intensely were more sensitive to antihormonal treatments. All treatments reduced cell viability, highlighting MDA-MB-453 and SUM-159. Indeed, a decrease in androgen levels was observed in these cell lines, which could relate to a reduction in cell viability. In addition, MCF-7 and SUM-159 increased cell migration under treatments, increasing estrogen levels, which could favor cell migration. Thus, antihormonal treatments could be beneficial for TNBC therapies. This study clarifies the importance of steroid hormones in AR and ERβ-positive cell lines of TNBC.
MeSH term(s)	Humans ; Androgens/pharmacology ; Receptors, Estrogen ; Triple Negative Breast Neoplasms/drug therapy ; Triple Negative Breast Neoplasms/metabolism ; Estrogen Receptor beta/genetics ; Estrogen Receptor beta/metabolism ; Cell Line, Tumor ; Estrogens/pharmacology ; Receptors, Androgen/metabolism ; Steroids/pharmacology ; Estrogen Receptor alpha ; Cell Proliferation
Chemical Substances	Androgens ; Receptors, Estrogen ; Estrogen Receptor beta ; Estrogens ; Receptors, Androgen ; Steroids ; Estrogen Receptor alpha
Language	English
Publishing date	2024-01-25
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2019364-6
ISSN	1422-0067 ; 1422-0067 ; 1661-6596
ISSN (online)	1422-0067
ISSN	1422-0067 ; 1661-6596
DOI	10.3390/ijms25031471
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Article: Agnathia-microstomia-synotia syndrome (otocephaly).

Díaz Del Arco, Cristina / Oliva, Agustín / Pelayo Alarcón, Adela

Autopsy & case reports

2020 Volume 10, Issue 1, Page(s) e2020152

Language	English
Publishing date	2020-02-28
Publishing country	Brazil
Document type	Journal Article
ZDB-ID	2815488-5
ISSN	2236-1960
ISSN	2236-1960
DOI	10.4322/acr.2020.152
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Article ; Online: Noninvasive Follicular Thyroid Neoplasm with Papillary-Like Nuclear Features: Can Cytology Face the Challenge of Diagnosis in the Light of the New Classification?

Díaz Del Arco, Cristina / Fernández Aceñero, M Jesús

Acta cytologica

2018 Volume 62, Issue 4, Page(s) 265–272

Abstract: Objectives: To assess the cytological findings of noninvasive follicular thyroid neoplasms with papillary-like nuclear features (NIFTP), conventional papillary thyroid carcinomas (C-PTC), and invasive follicular variants of papillary thyroid carcinomas ( ...

Abstract	Objectives: To assess the cytological findings of noninvasive follicular thyroid neoplasms with papillary-like nuclear features (NIFTP), conventional papillary thyroid carcinomas (C-PTC), and invasive follicular variants of papillary thyroid carcinomas (IFV-PTC) to determine if there are cytological differences between groups. Study design: We have reviewed all thyroid fine-needle aspiration cytology samples diagnosed between 2000 and 2017. We have included all NIFTP cases (n = 6) and randomly selected cases of C-PTC (n = 14) and IFV-PTC (n = 8). Results: Comparing NIFTP and C-PTC cases, NIFTP cases showed significantly less papillary or pseudopapillary architecture, more bidimensional groups and microfollicles, and less tridimensionality, giant cells, and nuclear folds. We observed a trend towards significance for smear cellularity and amount of cytoplasm. Presence of nuclear folds was the only significant difference between NIFTP and IFV-PTC cases. The differences between groups in percent papillary or pseudopapillary architecture, cellularity, and tridimensionality showed a trend towards significance. Amount of colloid, dirty background, pleomorphism or atypia, nuclear pseudoinclusions, type of chromatin, and nucleolus were not significant. Conclusions: No cytopathological feature can differentiate between invasive and encapsulated IFV-PTC. In accordance with the recently accepted category, PTC smears with cells arranged in a predominantly follicular architecture should be reported as Bethesda IV category with descriptive terms to avoid false-positive cases.
MeSH term(s)	Adenocarcinoma, Follicular/classification ; Adenocarcinoma, Follicular/pathology ; Adult ; Aged ; Aged, 80 and over ; Biopsy, Fine-Needle ; Carcinoma, Papillary/classification ; Carcinoma, Papillary/pathology ; Cell Nucleus/pathology ; Diagnosis, Differential ; False Positive Reactions ; Female ; Humans ; Male ; Middle Aged ; Neoplasm Invasiveness ; Predictive Value of Tests ; Terminology as Topic ; Thyroid Cancer, Papillary ; Thyroid Neoplasms/classification ; Thyroid Neoplasms/pathology
Language	English
Publishing date	2018-06-01
Publishing country	Switzerland
Document type	Comparative Study ; Journal Article
ZDB-ID	80003-x
ISSN	1938-2650 ; 0001-5547
ISSN (online)	1938-2650
ISSN	0001-5547
DOI	10.1159/000488579
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Zs.A 358: Show issues

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Article ; Online: Molecular diagnostic techniques in cytopathology: From the bench to the patient's bedside.

Díaz Del Arco, Cristina / Fernández Aceñero, Mª Jesús

Diagnostic cytopathology

2018 Volume 46, Issue 7, Page(s) 620–623

Abstract: Molecular techniques are increasingly used in everyday practice for patient diagnosis and also to guide therapy. Their application in cytological specimens can allow a more cost-effective management with fewer risks. However, standardized protocols are ... ...

Abstract	Molecular techniques are increasingly used in everyday practice for patient diagnosis and also to guide therapy. Their application in cytological specimens can allow a more cost-effective management with fewer risks. However, standardized protocols are needed to guarantee accurate and reproducible results. We herein report five practical examples of the application of ancillary techniques in cytopathology and review the literature on the issue, highlighting the practical aspects of sample management.
MeSH term(s)	Adenocarcinoma/pathology ; Adult ; Aged ; Anemia, Iron-Deficiency/pathology ; Carcinoma, Squamous Cell/pathology ; Diagnosis, Differential ; Endoscopic Ultrasound-Guided Fine Needle Aspiration/methods ; Endoscopic Ultrasound-Guided Fine Needle Aspiration/standards ; Female ; Humans ; Lung Neoplasms/pathology ; Male ; Middle Aged ; Tuberculosis, Lymph Node/pathology ; Uterine Cervical Neoplasms/pathology
Language	English
Publishing date	2018-02-15
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	632710-2
ISSN	1097-0339 ; 8755-1039
ISSN (online)	1097-0339
ISSN	8755-1039
DOI	10.1002/dc.23903
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Zs.A 2117: Show issues

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Article ; Online: Preoperative Diagnosis of Neoplastic or Malignant Hürthle Cell Lesions: A Chimera?

Díaz Del Arco, Cristina / Fernández Aceñero, M Jesús

Acta cytologica

2018 Volume 62, Issue 3, Page(s) 193–203

Abstract: Objective: We aimed to review all cytological specimens with Hürthle cells (HC) diagnosed in our institution, identify cytological features related to neoplastic (adenoma or carcinoma) and malignant histology, and discuss the role of clinicopathological ...

Abstract	Objective: We aimed to review all cytological specimens with Hürthle cells (HC) diagnosed in our institution, identify cytological features related to neoplastic (adenoma or carcinoma) and malignant histology, and discuss the role of clinicopathological findings and clinical management in these cases. Study design: We included 359 thyroid fine-needle aspiration cytology cases in our study. We reviewed the clinical and cytological features of surgical cases and correlated them with histological diagnosis. We also reviewed the literature on this issue. Results: We found a significant association between neoplasia and highly cellular smears, the absence of colloid, the presence of microfollicles, large-cell dysplasia, prominent nucleoli or macronucleoli, coarse chromatin, nuclear grooves and inclusions, nuclear irregularity, and pleomorphism. The absence of colloid, high cellularity, > 25% of isolated HC, the presence of tridimensional groups, transgressing vessels, nuclear irregularity, prominent nucleoli or macronucleoli, coarse chromatin, hyperchromatism, pleomorphism, and diffuse large-cell dysplasia were features significantly associated with malignancy. Conclusions: No cytological feature alone can predict histological outcome, but all findings related to a neoplastic or malignant histology must be assessed. Individualized management protocols should be developed in each institution.
MeSH term(s)	Adenoma, Oxyphilic/diagnosis ; Adenoma, Oxyphilic/surgery ; Adult ; Aged ; Aged, 80 and over ; Biopsy, Fine-Needle ; Diagnosis, Differential ; Female ; Humans ; Male ; Middle Aged ; Preoperative Period ; Retrospective Studies ; Thyroid Gland/pathology ; Thyroid Neoplasms/diagnosis ; Thyroid Neoplasms/surgery ; Young Adult
Language	English
Publishing date	2018
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	80003-x
ISSN	1938-2650 ; 0001-5547
ISSN (online)	1938-2650
ISSN	0001-5547
DOI	10.1159/000488441
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Fatal Autoimmune Storm After a Single Cycle of Anti-PD-1 Therapy: A Case of Lethal Toxicity but Pathological Complete Response in Metastatic Lung Adenocarcinoma.

Fuentes-Antrás, Jesús / Peinado, Paloma / Guevara-Hoyer, Kissy / Díaz Del Arco, Cristina / Sánchez-Ramón, Silvia / Aguado, Carlos

Hematology/oncology and stem cell therapy

2022 Volume 15, Issue 1, Page(s) 63–67

Abstract: As immunotherapy agents are incorporated into the routine oncological practice, the number of patients at the risk of immune-related adverse events has increased dramatically. However, the prompt identification and effective management of severe ... ...

Abstract	As immunotherapy agents are incorporated into the routine oncological practice, the number of patients at the risk of immune-related adverse events has increased dramatically. However, the prompt identification and effective management of severe autoimmune complications remain a challenge. We report the case of a patient with metastatic lung adenocarcinoma who experienced a fatal autoimmune storm 3 weeks after the first dose of anti-programmed death receptor-1 (PD-1) agent pembrolizumab, which included thyroiditis, hepatitis, myositis, myocarditis, pneumonitis, and myasthenia gravis. Aggressive autoimmunity was supported by extensive T-cell and macrophage tissue infiltrates and autoantibody positivity. Remarkably, no residual tumor was found at autopsy. This case illustrates the potential harm caused by immunotherapy and our limited knowledge on its prevention, treatment, and association to antitumor efficacy.
MeSH term(s)	Humans ; Antineoplastic Agents, Immunological/adverse effects ; Adenocarcinoma of Lung/drug therapy ; Adenocarcinoma of Lung/chemically induced ; Immunotherapy/adverse effects ; Myasthenia Gravis ; Immunologic Factors ; Lung Neoplasms/drug therapy
Chemical Substances	Antineoplastic Agents, Immunological ; Immunologic Factors
Language	English
Publishing date	2022-03-01
Publishing country	England
Document type	Case Reports ; Journal Article
ZDB-ID	2651893-4
ISSN	1658-3876
ISSN	1658-3876
DOI	10.1016/j.hemonc.2020.04.006
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Zs.A 6950: Show issues

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Article ; Online: Actualización en cáncer gástrico. Nuevas clasificaciones moleculares.

Díaz Del Arco, Cristina / Estrada Muñoz, Lourdes / Ortega Medina, Luis / Fernández Aceñero, Ma Jesús

Revista espanola de patologia : publicacion oficial de la Sociedad Espanola de Anatomia Patologica y de la Sociedad Espanola de Citologia

2020 Volume 54, Issue 2, Page(s) 102–113

Abstract: Gastric cancer (GC) is an aggressive tumor, which is usually diagnosed at an advanced stage and shows high mortality rates. Several GC classifications have been published, based on features such as tumor location, endoscopic features or microscopic ... ...

Title translation	Update on gastric cancer. New molecular classifications.
Abstract	Gastric cancer (GC) is an aggressive tumor, which is usually diagnosed at an advanced stage and shows high mortality rates. Several GC classifications have been published, based on features such as tumor location, endoscopic features or microscopic architecture. However, TNM stage remains the mainstay of GC management and treatment. In the last years, technical advances have allowed us to investigate the biological heterogeneity of GC and develop new molecular classifications. This knowledge may enhance current classifications, and has the potential to refine GC management and aid in the identification of new molecular targets. In this literature review we have summarized the main findings in epidemiology, screening, classification systems and treatment of GC, focusing on the molecular alterations and new molecular classifications published in the last years.
MeSH term(s)	Early Detection of Cancer/methods ; Female ; Gene Dosage ; Gene Expression Profiling ; Helicobacter Infections/complications ; Helicobacter pylori ; Herpesvirus 4, Human ; Humans ; Japan ; Male ; Mass Screening/organization & administration ; Mutation ; Neoplasm Staging ; Neoplastic Syndromes, Hereditary/epidemiology ; Republic of Korea ; Stomach Neoplasms/classification ; Stomach Neoplasms/epidemiology ; Stomach Neoplasms/genetics ; Stomach Neoplasms/surgery
Language	Spanish
Publishing date	2020-07-24
Publishing country	Spain
Document type	Journal Article ; Review
ZDB-ID	2463888-2
ISSN	1988-561X ; 1988-561X
ISSN (online)	1988-561X
ISSN	1988-561X
DOI	10.1016/j.patol.2020.06.002
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