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Browsing by Author "Gordetsky, Jennifer B."
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Item Clinicopathologic and molecular spectrum of testicular sex cord-stromal tumors not amenable to specific histopathologic subclassification(Elsevier, 2022-12) Siegmund , Stephanie E.; Sholl , Lynette M.; Tsai , Harrison K.; Yang, Yiying; Vasudevaraja, Varshini; Tran, Ivy; Snuderl, Matija; Fletcher, Christopher D. M.; Cornejo, Kristine M.; Idrees, Muhammad T.; Al-Obaidy, Khaleel I.; Collins , Katrina; Gordetsky, Jennifer B.; Wobker, Sara E.; Hirsch, Michelle S.; Trpkov , Kiril; Yilmaz , Asli; Anderson, William J.; Quiroga-Garza, Gabriela; Magi-Galluzzi, Cristina; Canete-Portillo, Sofia; Acosta , Andres M.; Pathology and Laboratory Medicine, School of MedicineA subset of testicular sex cord-stromal tumors (SCST), which includes neoplasms with mixed histology, cannot be classified into a specific histologic subtype. This study evaluated the clinicopathologic, immunophenotypic and molecular features of 26 SCST not amenable to specific classification by expert uropathologists. Median age at diagnosis was 43 years and median tumor size was 2.4 cm. Follow-up information was available for 18 (69%) patients, with evidence of an aggressive clinical course in 6 patients (4 alive with disease, 2 dead of disease 3 months and 6 months after orchiectomy). Microscopically, SCST not amenable to specific classification demonstrated monophasic epithelioid (9/26, 35%), monophasic spindle cell (5/26, 19%), and biphasic or mixed histology (12/26, 46%). One or more aggressive histopathologic features were seen in 11 cases. DNA sequencing was successful in 22 tumors. Pathogenic CTNNB1 and APC alterations were seen in 7 (33%) and 2 (10%) cases, respectively, with additional variants (e.g., CDKN2A, RB1, TP53, BRCA2) being identified in individual cases. Combined evaluation of morphology, sequencing data and beta-catenin immunohistochemistry resulted in reclassification of 6 (23%) tumors as Sertoli cell tumor, not otherwise specified. This was supported by comparing the methylation profiles of a subset of these tumors and those of typical Sertoli cell tumors. Additionally, a subset of 5 neoplasms (19%) with spindle cell or biphasic histology and SMA expression was characterized by hyperdiploid genomes with recurrent chromosomal gains and absence of driver mutations, possibly representing a distinct tumor type. The SCST that remained not amenable to specific histologic classification (15/26, 58%) were enriched for aggressive histologic features and malignant clinical behavior. In conclusion, this study demonstrated that a subset of testicular SCST that were originally not amenable to specific classification could be reclassified by combined evaluation of morphology, immunohistochemistry and molecular data.Item Genetic Factors Associated with Prostate Cancer Conversion from Active Surveillance to Treatment(Elsevier, 2022) Jiang, Yu; Meyers, Travis J.; Emeka, Adaeze A.; Folgosa Cooley, Lauren; Cooper, Phillip R.; Lancki, Nicola; Helenowski, Irene; Kachuri, Linda; Lin, Daniel W.; Stanford, Janet L.; Newcomb, Lisa F.; Kolb, Suzanne; Finelli, Antonio; Fleshner, Neil E.; Komisarenko, Maria; Eastham, James A.; Ehdaie, Behfar; Benfante, Nicole; Logothetis, Christopher J.; Gregg, Justin R.; Perez, Cherie A.; Garza, Sergio; Kim, Jeri; Marks, Leonard S.; Delfin, Merdie; Barsa, Danielle; Vesprini, Danny; Klotz, Laurence H.; Loblaw, Andrew; Mamedov, Alexandre; Goldenberg, S. Larry; Higano, Celestia S.; Spillane, Maria; Wu, Eugenia; Carter, H. Ballentine; Pavlovich, Christian P.; Mamawala, Mufaddal; Landis, Tricia; Carroll, Peter R.; Chan, June M.; Cooperberg, Matthew R.; Cowan, Janet E.; Morgan, Todd M.; Siddiqui, Javed; Martin, Rabia; Klein, Eric A.; Brittain, Karen; Gotwald, Paige; Barocas, Daniel A.; Dallmer, Jeremiah R.; Gordetsky, Jennifer B.; Steele, Pam; Kundu, Shilajit D.; Stockdale, Jazmine; Roobol, Monique J.; Venderbos, Lionne D.F.; Sanda, Martin G.; Arnold, Rebecca; Patil, Dattatraya; Evans, Christopher P.; Dall’Era, Marc A.; Vij, Anjali; Costello, Anthony J.; Chow, Ken; Corcoran, Niall M.; Rais-Bahrami, Soroush; Phares, Courtney; Scherr, Douglas S.; Flynn, Thomas; Karnes, R. Jeffrey; Koch, Michael; Dhondt, Courtney Rose; Nelson, Joel B.; McBride, Dawn; Cookson, Michael S.; Stratton, Kelly L.; Farriester, Stephen; Hemken, Erin; Stadler, Walter M.; Pera, Tuula; Banionyte, Deimante; Bianco, Fernando J., Jr.; Lopez, Isabel H.; Loeb, Stacy; Taneja, Samir S.; Byrne, Nataliya; Amling, Christopher L.; Martinez, Ann; Boileau, Luc; Gaylis, Franklin D.; Petkewicz, Jacqueline; Kirwen, Nicholas; Helfand, Brian T.; Xu, Jianfeng; Scholtens, Denise M.; Catalona, William J.; Witte, John S.; Urology, School of MedicineMen diagnosed with low-risk prostate cancer (PC) are increasingly electing active surveillance (AS) as their initial management strategy. While this may reduce the side effects of treatment for PC, many men on AS eventually convert to active treatment. PC is one of the most heritable cancers, and genetic factors that predispose to aggressive tumors may help distinguish men who are more likely to discontinue AS. To investigate this, we undertook a multi-institutional genome-wide association study (GWAS) of 5,222 PC patients and 1,139 other patients from replication cohorts, all of whom initially elected AS and were followed over time for the potential outcome of conversion from AS to active treatment. In the GWAS we detected 18 variants associated with conversion, 15 of which were not previously associated with PC risk. With a transcriptome-wide association study (TWAS), we found two genes associated with conversion (MAST3, p = 6.9 × 10−7 and GAB2, p = 2.0 × 10−6). Moreover, increasing values of a previously validated 269-variant genetic risk score (GRS) for PC was positively associated with conversion (e.g., comparing the highest to the two middle deciles gave a hazard ratio [HR] = 1.13; 95% confidence interval [CI] = 0.94–1.36); whereas decreasing values of a 36-variant GRS for prostate-specific antigen (PSA) levels were positively associated with conversion (e.g., comparing the lowest to the two middle deciles gave a HR = 1.25; 95% CI, 1.04–1.50). These results suggest that germline genetics may help inform and individualize the decision of AS—or the intensity of monitoring on AS—versus treatment for the initial management of patients with low-risk PC.