1. The prognostic significance of tumor-immune microenvironment in ascites of patients with high-grade serous carcinomaSimona Miceska, Erik Škof, Simon Buček, Cvetka Grašič-Kuhar, Gorana Gašljević, Špela Smrkolj, Veronika Kloboves-Prevodnik, 2023, izvirni znanstveni članek Povzetek: Background: High-grade serous carcinoma (HGSC) is often associated with ascites at presentation. Our objective was to quantify immune cells (ICs) in ascites prior to any treatment was given and evaluate their impact on progression-free survival (PFS) and overall survival (OS). Patients and methods: Forty-seven patients with primary HGSC and ascites were included. Flow-cytometric analysis was performed to detect percentages of CD3+ T cells (CD4+, CD8+, Tregs, and NKT cells), B cells, NK cells (CD56brightCD16- and CD56dimCD16+ subsets), macrophages and dendritic cells (DCs). Furthermore, CD103 expression was analyzed on T cells and their subsets, while PD-1 and PD-L1 expression on all ICs. Cut-off of low and high percentages of ICs was determined by the median of variables, and correlation with PFS and OS was calculated. Results: CD3+ cells were the predominant ICs (median 51%), while the presence of other ICs was much lower (median ≤10%). CD103+ expression was mostly present on CD8+, and not CD4+ cells. PD-1 was mainly expressed on CD3+ T cells (median 20%), lower expression was observed on other ICs (median ≤10%). PD-L1 expression was not detected. High percentages of CD103+CD3+ T cells, PD-1+ Tregs, CD56brightCD16- NK cells, and DCs correlated with prolonged PFS and OS, while high percentages of CD8+ cells, macrophages, and PD-1+CD56brightCD16- NK cells, along with low percentages of CD4+ cells, correlated with better OS only. DCs were the only independent prognostic marker among all ICs. Conclusions: Our results highlight the potential of ascites tumor-immune microenvironment to provide additional prognostic information for HGSC patients. However, a larger patient cohort and longer follow-up are needed to confirm our finBackground: High-grade serous carcinoma (HGSC) is often associated with ascites at presentation. Our objective was to quantify immune cells (ICs) in ascites prior to any treatment was given and evaluate their impact on progression-free survival (PFS) and overall survival (OS). Patients and methods: Forty-seven patients with primary HGSC and ascites were included. Flow-cytometric analysis was performed to detect percentages of CD3+ T cells (CD4+, CD8+, Tregs, and NKT cells), B cells, NK cells (CD56brightCD16- and CD56dimCD16+ subsets), macrophages and dendritic cells (DCs). Furthermore, CD103 expression was analyzed on T cells and their subsets, while PD-1 and PD-L1 expression on all ICs. Cut-off of low and high percentages of ICs was determined by the median of variables, and correlation with PFS and OS was calculated. Results: CD3+ cells were the predominant ICs (median 51%), while the presence of other ICs was much lower (median ≤10%). CD103+ expression was mostly present on CD8+, and not CD4+ cells. PD-1 was mainly expressed on CD3+ T cells (median 20%), lower expression was observed on other ICs (median ≤10%). PD-L1 expression was not detected. High percentages of CD103+CD3+ T cells, PD-1+ Tregs, CD56brightCD16- NK cells, and DCs correlated with prolonged PFS and OS, while high percentages of CD8+ cells, macrophages, and PD-1+CD56brightCD16- NK cells, along with low percentages of CD4+ cells, correlated with better OS only. DCs were the only independent prognostic marker among all ICs. Conclusions: Our results highlight the potential of ascites tumor-immune microenvironment to provide additional prognostic information for HGSC patients. However, a larger patient cohort and longer follow-up are needed to confirm our findings.dings.
Ključne besede: high-grade serous carcinoma, immune cells, prognostic markers
Objavljeno v DiRROS: 26.07.2024; Ogledov: 436; Prenosov: 186
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2. Does tumor rupture during robot-assisted partial nephrectomy have an impact on mid-term tumor recurrences?Simon Hawlina, Kosta Cerović, Andraž Kondža, Peter Popović, Jure Bizjak, Tomaž Smrkolj, 2023, izvirni znanstveni članek Povzetek: Background: Intraoperative kidney tumor rupture (TR) can occur during robot-assisted partial nephrectomy (RAPN) in daily clinical practice, but there are no solid guidelines on the management and implications of it. The purpose of the study was to investigate the impact of TR on tumor recurrences, what a surgeon should do if this adverse event occurs, and how to avoid it. Patients and methods: We retrospectively analyzed the first 100 patients who underwent RAPN at University Medical Centre Ljubljana, between 2018 and 2021. Patients were stratified into 2 groups (TR and no-TR) and were compared according to patient, tumor, pathologic, perioperative and postoperative characteristics and tumor recurrences, using the Mann-Whitney U test and chi-squared test. Results: Of the 100 patients, 14 had TR (14%); this occurred in tumors with higher RENAL nephrometry scores (P = 0.028) and mostly with papillary renal cell carcinomas (P = 0.043). Median warm ischemia time was longer for the TR group (22 vs. 15 min, P = 0.026). In terms of studied outcomes, there were no cases of local or distant recurrence after a median observation time of 39 months (interquartile range, 31-47 months) in both groups. We observed positive surgical margins on the final oncologic report in one case in the no-TR group. Conclusions: Tumor rupture during RAPN seems to be of no mid-term oncologic importance. According to presented results, we would recommend surgeons to proceed with tumor resection if this event occurs and abstain from conversion to radical nephrectomy or open partial nephrectomy. However, more similar cases should be studied to make more solid conclusions.
Ključne besede: enucleation, renal cell carcinoma, robot-assisted partial nephrectomy, tumor recurrence, tumor rupture, warm ischemia time
Objavljeno v DiRROS: 25.07.2024; Ogledov: 208; Prenosov: 148
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3. The performance of the Xpert Bladder Cancer Monitor Test and voided urinary cytology in the follow-up of urinary bladder tumorsTomaž Smrkolj, Urška Čegovnik Primožič, Teja Fabjan, Saša Šterpin, Joško Osredkar, 2021, izvirni znanstveni članek Povzetek: Background: Cystoscopy in complement with urinary cytology represents the gold standard for the follow-up of patients with urinary bladder tumours. Xpert Bladder Cancer Monitor Test (XBC) is a novel mRNA-based urine test for bladder cancer surveillance. The aim of the study was to evaluate the performance of the XBC and voided urinary cytology (VUC) in the follow-up of bladder tumours. Patients and methods. The XBC was performed on stabilized voided urine and VUC was performed on urine samples. The results were compared to cystoscopic findings and histopathological results after transurethral resection of the bladder lesion. Results. For the prediction of malignant histopathological result sensitivity, the specificity and negative predictive value were 76.9%, 97.5% and 93.0% for the XBC and 38.4%, 97.5% and 83.3%, respectively for VUC. For the prediction of suspicious or positive cystoscopic finding sensitivity, the specificity and negative predictive value were 75.0%, 95.2%, and 93.0% respectively for the XBC and 41.7%, 97.6%, and 85.4% for VUC. The sensitivities for papilary urothelial neoplasms of low malignant potential (PUNLMP), low- and high-grade tumours were 0.0%, 66.7% and 100.0% for the XBC and 0.0%, 66.7% and 42.9%, respectively for VUC. Conclusions: The XBC showed significantly higher overall sensitivity and negative predictive value than VUC and could be used to increase the recommended follow-up cystoscopy time intervals. Complementing the XBC and voided urinary cytology does not improve performance in comparison to the XBC alone.
Ključne besede: cystoscopy, Xpert BC monitor test, urinary bladder neoplasm, voided urinary cytology
Objavljeno v DiRROS: 19.07.2024; Ogledov: 240; Prenosov: 109
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4. Current and innovative approaches in the treatment of non-muscle invasive bladder cancer : the role of transurethral resection of bladder tumor and organoidsMilena Taskovska, Mateja Erdani-Kreft, Tomaž Smrkolj, 2020, pregledni znanstveni članek Povzetek: Background. Bladder cancer is the 7th most common cancer in men. About 75% of all bladder cancer are nonmuscle invasive (NMIBC). The golden standard for definite diagnosis and first-line treatment of NMIBC is transurethral resection of bladder tumour (TURB). Historically, the monopolar current was used first, today bipolar current is preferred by most urologists. Following TURB, depending on the tumour grade, additional intravesical chemo- or/and immunotherapy is indicated, in order to prevent recurrence and need for surgical resection. Development of new technologies, molecular and cell biology, enabled scientists to develop organoids % systems of human cells that are cultivated in the laboratory and have characteristics of the tissue from which they were harvested. In the field of urologic cancers, the organoids are used mainly for studying the course of different diseases, however, in the field of bladder cancer the data are scarce. Conclusions. Different currents - monopolar and bipolar, have different effect on urothelium, that is important for oncological results and pathohistological interpretation. Specimens of bladder cancer can be used for preparation of organoids that are further used for studying carcinogenesis. Bladder organoids are step towards personalised medicine, especially for testing effectiveness of chemo-/immunotherapeutics.
Ključne besede: bladder cancer, transurethral resection of bladder tumour, monopolar/bipolar current, consensus molecular subtype
Objavljeno v DiRROS: 12.07.2024; Ogledov: 196; Prenosov: 107
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5. Obnovitveni kolposkopski tečaj : e-zbornik : Ljubljana, 18. februar 20222022, ni določena Povzetek: Kolposkopija še ostaja zelo pomemben del presejalnih programov raka materničnega vratu. Vloga in pomen kakovostne kolposkopske obravnave bosta še izrazitejši v bližnji prihodnosti, ko bodo na preizkušnji podaljšani intervali in HPV problematika v triažnem in morda presejalnem pomenu. Te spremembe sicer veliko obetajo, a hkrati zahtevajo pogoje za kakovostno opravljanje kolposkopske dejavnosti, ki se v Sloveniji vse prepočasi uveljavljajo. V pričujoči publikaciji najpomembnejši slovenski strokovnjaki s tega področja predstavljajo najnovejša spoznanja in smernice za presejanje in diagnostiko bolezni.
Objavljeno v DiRROS: 10.05.2022; Ogledov: 1000; Prenosov: 513
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7. Programske smernice Državnega programa ZORAUrška Ivanuš, Edita Arh, Sonja Bebar, Branko Cvjetičanin, Dušan Deisinger, Mojca Florjančič, Aljoša Frelih, Urška Gašper, Biljana Grčar-Kuzmanov, Nina Jančar, Tine Jerman, Kaja Kališnik, Silvestra Kašnik-Čas, Veronika Kloboves-Prevodnik, Borut Kobal, Amela Duratović Konjević, Jerneja Kos, Gabrijela Kupljen, Mateja Lasič Pecev, Mateja Marčec, Leon Meglič, Sebastjan Merlo, Marko Mlinarič, Nataša Nolde, Irena Oblak, Maja Pakiž, Boštjan Pirš, Ana Pogačnik, Maja Primic-Žakelj, Alenka Repše-Fokter, Luka Roškar, Uršula Salobir Gajšek, Špela Sitar, Špela Smrkolj, Vivijana Snoj, Margareta Strojan Fležar, Tadeja Štrumbelj, Iztok Takač, Renata Toff-Jovan, Tomaž Tušek, Andreja Uštar, 2022, strokovna monografija Ključne besede: predrakave spremembe, zgodnja diagnostika, presejanje, presejalni programi, nacionalni programi, postopki, elektronske knjige
Objavljeno v DiRROS: 10.03.2022; Ogledov: 1165; Prenosov: 591
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