280 research outputs found

    Acral myxoinflammatory fibroblastic sarcoma with hybrid features of hemosiderotic fibrolipomatous tumor occurring 10 years after renal transplantation.

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    Myxoinflammatory fibroblastic sarcoma is a rare malignant soft tissue neoplasm that typically arises on the distal extremities of adults. It usually behaves in a low-grade manner and its characteristic histology is of a lobulated proliferation of moderately atypical spindled to epithelioid cells, vacuolated cells, and enlarged or bizarre cells with prominent nucleoli, dispersed within myxoid stroma containing a mixed inflammatory cell infiltrate. The etiology of myxoinflammatory fibroblastic sarcoma remains unknown with no definite causal factors identified. We describe a case of myxoinflammatory fibroblastic sarcoma arising in the foot of a 77-year-old female, which rapidly recurred locally after initial excision and which arose 10 years after renal transplantation. The neoplasm also showed intermingled areas of hemosiderotic fibrolipomatous tumor. The patient also had multifocal areas of squamous cell carcinoma in situ of the foot and hand, in keeping with the clinical context of immune deficiency. This is the second case of myxoinflammatory fibroblastic sarcoma reported to occur after transplantation, but additionally shows hybrid features of hemosiderotic fibrolipomatous tumor, highlights immunocompromise/immunosuppressive therapy as a possible etiologic factor in their development, and adds to the growing number of myxoinflammatory fibroblastic sarcoma that has demonstrated aggressive behavior

    OX40 and 4-1BB delineate distinct immune profiles in sarcoma.

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    Systemic relapse after radiotherapy and surgery is the major cause of disease-related mortality in sarcoma patients. Combining radiotherapy and immunotherapy is under investigation as a means to improve response rates. However, the immune contexture of sarcoma is understudied. Here, we use a retrospective cohort of sarcoma patients, treated with neoadjuvant radiotherapy, and TCGA data. We explore therapeutic targets of relevance to sarcoma, using genomics and multispectral immunohistochemistry to provide insights into the tumor immune microenvironment across sarcoma subtypes. Differential gene expression between radioresponsive myxoid liposarcoma (MLPS) and more radioresistant undifferentiated pleomorphic sarcoma (UPS) indicated UPS contained higher transcript levels of a number of immunotherapy targets (CD73/NT5E, CD39/ENTPD1, CD25/IL2RA, and 4-1BB/TNFRSF9). We focused on 4-1BB/TNFRSF9 and other costimulatory molecules. In TCGA data, 4-1BB correlated to an inflamed and exhausted phenotype. OX40/TNFRSF4 and 4-1BB/TNFRSF9 were highly expressed in sarcoma subtypes versus other cancers. Despite OX40 and 4-1BB being described as Treg markers, we identified that they delineate distinct tumor immune profiles. This was true for sarcoma and other cancers. While only a limited number of samples could be analyzed, spatial analysis of OX40 expression identified two diverse phenotypes of OX40+ Tregs, one associated with and one independent of tertiary lymphoid structures (TLSs). Patient stratification is of intense interest for immunotherapies. We provide data supporting the viewpoint that a cohort of sarcoma patients, appropriately selected, are promising candidates for immunotherapies. Spatial profiling of OX40+ Tregs, in relation to TLSs, could be an additional metric to improve future patient stratification

    Prospective Prediction of Body Mass Index Trajectories using Multi-task Gaussian Processes

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    Clinicians often investigate the body mass index (BMI) trajectories of children to assess their growth with respect to their peers, as well as to anticipate future growth and disease risk. While retrospective modelling of BMI trajectories has been an active area of research, prospective prediction of continuous BMI trajectories from historical growth data has not been well investigated. Using weight and height measurements from birth to age 10 years from a longitudinal mother-offspring cohort, we leveraged a multi-task Gaussian processes model, called MagmaClust, to derive probabilistic predictions for BMI trajectories over various forecasting periods. Experiments were conducted to evaluate the accuracy, sensitivity to missing values, and number of clusters. The results were compared with cubic B-spline regression and a parametric Jenss-Bayley mixed effects model. A downstream tool computing individual overweight probabilities was also proposed and evaluated. In all experiments, MagmaClust outperformed conventional models in prediction accuracy while correctly calibrating uncertainty regardless of the missing data amount (up to 90\% missing) or the forecasting period (from 2 to 8 years in the future). Moreover, the overweight probabilities computed from MagmaClust's uncertainty quantification exhibited high specificity (0.940.94 to 0.960.96) and accuracy (0.860.86 to 0.940.94) in predicting the 10-year overweight status even from age 2 years. MagmaClust provides a probabilistic non-parametric framework to prospectively predict BMI trajectories, which is robust to missing values and outperforms conventional BMI trajectory modelling approaches. It also clusters individuals to identify typical BMI patterns (early peak, adiposity rebounds) during childhood. Overall, we demonstrated its potential to anticipate BMI evolution throughout childhood, allowing clinicians to implement prevention strategies.Comment: 17 pages, 9 figures, 5 table

    Associations of gestational glycemia and prepregnancy adiposity with offspring growth and adiposity in an Asian population

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    10.3945/ajcn.115.117614American Journal of Clinical Nutrition10251104-1112GUSTO (Growing up towards Healthy Outcomes

    Determinants of cord blood adipokines and association with neonatal abdominal adipose tissue distribution

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    Background Cord blood leptin and adiponectin are adipokines known to be associated with birth weight and overall infant adiposity. However, few studies have investigated their associations with abdominal adiposity in neonates. We examined maternal factors associated with cord blood leptin and adiponectin, and the association of these adipokines with neonatal adiposity and abdominal fat distribution measured by magnetic resonance imaging (MRI) in an Asian mother-offspring cohort. Methods Growing Up in Singapore Towards healthy Outcomes (GUSTO), is a prospective mother-offspring birth cohort study in Singapore. Cord blood plasma leptin and adiponectin concentrations were measured using Luminex and Enzyme-Linked Immunosorbent Assay respectively in 816 infants. A total of 271 neonates underwent MRI within the first 2-weeks after delivery. Abdominal superficial (sSAT), deep subcutaneous (dSAT), and intra-abdominal (IAT) adipose tissue compartment volumes were quantified from MRI images. Multivariable regression analyses were performed. Results Indian or Malay ethnicity, female sex, and gestational age were positively associated with cord blood leptin and adiponectin concentrations. Maternal gestational diabetes (GDM) positively associated with cord blood leptin concentrations but inversely associated with cord blood adiponectin concentrations. Maternal pre-pregnancy body mass index (BMI) showed a positive relationship with cord blood leptin but not with adiponectin concentrations. Each SD increase in cord blood leptin was associated with higher neonatal sSAT, dSAT and IAT; differences in SD (95% CI): 0.258 (0.142, 0.374), 0.386 (0.254, 0.517) and 0.250 (0.118, 0.383), respectively. Similarly, each SD increase in cord blood adiponectin was associated with higher neonatal sSAT and dSAT; differences in SD (95% CI): 0.185 (0.096, 0.274) and 0.173 (0.067, 0.278), respectively. The association between cord blood adiponectin and neonatal adiposity was observed in neonates of obese mothers only. Conclusions Cord blood leptin and adiponectin concentrations were associated with ethnicity, maternal BMI and GDM, sex and gestational age. Both adipokines showed positive association with neonatal abdominal adiposity.Peer reviewe

    Ethnic differences in effects of maternal prepregnancy and pregnancy adiposity on offspring size and adiposity

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    10.1210/jc.2015-1728The Journal of Clinical Endocrinology & Metabolism100103641–3650GUSTO (Growing up towards Healthy Outcomes
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