- Browse by Author
Browsing by Author "Koay, Eugene J."
Now showing 1 - 2 of 2
Results Per Page
Sort Options
Item Diminished Immune Surveillance during Histologic Progression of Intraductal Papillary Mucinous Neoplasms Offers a Therapeutic Opportunity for Cancer Interception(American Association for Cancer Research, 2022) Hernandez, Sharia; Parra, Edwin Roger; Uraoka, Naohiro; Tang, Ximing; Shen, Yu; Qiao, Wei; Jiang, Mei; Zhang, Shanyu; Mino, Barbara; Lu, Wei; Pandurengan, Renganayaki; Haymaker, Cara; Affolter, Kajsa; Scaife, Courtney L.; Yip-Schneider, Michele; Schmidt, C. Max; Firpo, Matthew A.; Mulvihill, Sean J.; Koay, Eugene J.; Wang, Huamin; Wistuba, Ignacio I.; Maitra, Anirban; Solis, Luisa M.; Sen, Subrata; Surgery, School of MedicinePurpose: Intraductal papillary mucinous neoplasms (IPMN) are bona fide precursors to pancreatic ductal adenocarcinoma (PDAC). While genomic alterations during multistep IPMN progression have been well cataloged, the accompanying changes within the tumor immune microenvironment (TIME) have not been comprehensively studied. Herein, we investigated TIME-related alterations during IPMN progression, using multiplex immunofluorescence (mIF) coupled with high-resolution image analyses. Experimental design: Two sets of formalin-fixed, paraffin-embedded tissue samples from surgically resected IPMNs were analyzed. The training set of 30 samples consisted of 11 low-grade IPMN (LG-IPMN), 17 high-grade IPMN (HG-IPMN), and 2 IPMN with PDAC, while a validation set of 93 samples comprised of 55 LG-IPMN and 38 HG-IPMN. The training set was analyzed with two panels of immuno-oncology-related biomarkers, while the validation set was analyzed with a subset of markers found significantly altered in the training set. Results: Cell types indicative of enhanced immune surveillance, including cytotoxic and memory T cells, and antigen-experienced T cells and B cells, were all found at higher densities within isolated LG-IPMNs compared with HG-IPMNs. Notably, the TIME of LG-IPMNs that had progressed at the time of surgical resection (progressor LGD) resembled that of the synchronous HG-IPMNs, underscoring that attenuated immune surveillance occurs even in LG-IPMNs destined for progression. Conclusions: Our findings provide a basis for interception of cystic neoplasia to PDAC, through maintenance of sustained immune surveillance using vaccines and other prevention approaches.Item Image Fusion Involving Real-Time Transabdominal or Endoscopic Ultrasound for Gastrointestinal Malignancies: Review of Current and Future Applications(MDPI, 2022-12-19) Singh, Ben S.; Cazacu, Irina M.; Deza, Carlos A.; Rigaud, Bastien S.; Saftoiu, Adrian; Gruionu, Gabriel; Guionu, Lucian; Brock, Kristy K.; Koay, Eugene J.; Herman, Joseph M.; Bhutani, Manoop S.; Medicine, School of MedicineImage fusion of CT, MRI, and PET with endoscopic ultrasound and transabdominal ultrasound can be promising for GI malignancies as it has the potential to allow for a more precise lesion characterization with higher accuracy in tumor detection, staging, and interventional/image guidance. We conducted a literature review to identify the current possibilities of real-time image fusion involving US with a focus on clinical applications in the management of GI malignancies. Liver applications have been the most extensively investigated, either in experimental or commercially available systems. Real-time US fusion imaging of the liver is gaining more acceptance as it enables further diagnosis and interventional therapy of focal liver lesions that are difficult to visualize using conventional B-mode ultrasound. Clinical studies on EUS guided image fusion, to date, are limited. EUS-CT image fusion allowed for easier navigation and profiling of the target tumor and/or surrounding anatomical structure. Image fusion techniques encompassing multiple imaging modalities appear to be feasible and have been observed to increase visualization accuracy during interventional and diagnostic applications.