Publications by authors named "Lodewijk Brosens"

Background: Common variable immunodeficiency (CVID) is characterized by hypogammaglobulinemia and recurrent infections. Significant morbidity and mortality are caused by immune dysregulation complications (CVIDid), which affect around one-third of CVID patients and have a poorly understood etiology. Here, we investigate the hypothesis that gut microbial dysbiosis contributes to the inflammation underlying CVIDid.

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Pancreatic ductal adenocarcinoma (PDAC) is a lethal disease. About 10% of affected individuals have an inherited component. Deleterious germline variants increase the lifetime risk for PDAC and are often associated with an elevated risk for extra-pancreatic malignancies.

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Several extra-colonic manifestations, including duodenal polyposis and desmoid tumors, are well-described manifestations in familial adenomatous polyposis (FAP). More recently, an increase in gastric cancer diagnoses has been observed in FAP. This case series presents nine patients with FAP who were diagnosed with gastric cancer at our FAP expertise center, of whom eight were diagnosed between 2017 and 2023, while before 2017 the only diagnosis of gastric cancer was in 2001.

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Introduction: In patients with pancreatic cancer, the risk of venous thromboembolism (VTE) is high compared to other cancer types, suggesting that tumor-intrinsic features drive hypercoagulability. Tumor gene expression analysis may help unravel the pathogenesis of VTE in these patients and help to identify high-risk patients.

Aim: To evaluate the association between tumor gene expression patterns and VTE in patients with pancreatic cancer.

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Multiple endocrine neoplasia type 1 (MEN1) is a hereditary tumor syndrome characterized by endocrine tumors, typically from parathyroid, pancreatic, or anterior pituitary origin. In addition, benign cutaneous soft tissue tumors are prevalent in MEN1 patients. Although sarcomas have been reported in MEN1 patients it is unclear if these tumors should be considered as part of the MEN1 syndrome.

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Article Synopsis
  • - The review discusses pancreatic neuroendocrine neoplasms (PanNENs), which are diverse tumors that can be classified into well-differentiated pancreatic neuroendocrine tumors (PanNETs) and poorly differentiated pancreatic neuroendocrine carcinomas (PanNECs), using specific neuroendocrine markers for diagnosis.
  • - Diagnostic markers like chromogranin A, synaptophysin, and INSM1 help confirm neuroendocrine differentiation, with the World Health Organization classifying PanNENs based on differentiation and proliferative activity, using the Ki-67 index.
  • - Prognostic factors such as ATRX and DAXX loss indicate a higher risk of metastasis and recurrence in
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  • Current research lacks clarity in distinguishing between primary ovarian neuroendocrine tumors (PON) and neuroendocrine ovarian metastases (NOM), prompting a study of patient data spanning 1991 to 2023, which identified 71 NOM and 17 PON cases.
  • Analysis revealed that PON tumors are usually unilateral, often found in teratomas, while NOM are predominantly bilateral and not associated with teratomas.
  • The findings suggest a need for different treatment approaches; unilateral PON within teratomas should be treated as PON, while PON without teratoma components show similarities to midgut NET metastases, requiring thorough imaging to check for hidden midgut NET.
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  • Detection of lymphovascular invasion (LVI) in T1 colorectal cancer (CRC) varies across Dutch laboratories and significantly influences treatment decisions, particularly surgical resection rates.
  • Patients diagnosed in laboratories with high LVI detection rates had higher surgical resection rates and a greater proportion of lymph node metastasis-negative surgeries compared to those from lower detection rate labs.
  • However, despite these differences in surgical approach, high LVI detection did not lead to significantly better cancer recurrence outcomes, indicating potential risks without improved benefits for patients.
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  • Glucagonomas are special tumors in the pancreas that cause a syndrome and were studied in six patients to understand their features better.
  • These tumors were mostly large and showed a common skin symptom called necrolytic migratory erythema in all patients.
  • The tumors had specific changes in their genes and were linked to serious aggressive behavior, which means they can spread or grow badly in some patients.
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Background: The effectiveness of radiotherapy for pancreatic cancer is debated. Patient-derived organoids (PDOs) already mimicked clinical radiation response in other cancer types, which could be valuable in pancreatic cancer as well. This study aimed to investigate whether PDOs can be used to model RT response in pancreatic cancer and to explore the presence of a dose-response correlation.

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  • - The JES microvessel classification was proposed for evaluating early esophageal squamous cell neoplasia (ESCN) based on the assessment of intrapapillary capillary loops, aiming to determine eligibility for endoscopic resection in Western patients.
  • - A study analyzed 113 Western ESCN lesions with assessments from nine endoscopists of different experience levels, revealing good interobserver agreement among experts but only moderate agreement among residents-in-training.
  • - The overall accuracy of the classification was found to be low, especially among Western endoscopists and trainees, with highlighted limitations in effectively predicting invasion depth, though experienced endoscopists showed some success in identifying superficial layers without B3 vessels.
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Mismatch repair (MMR)-deficient cancer evolves through the stepwise erosion of coding homopolymers in target genes. Curiously, the MMR genes MutS homolog 6 (MSH6) and MutS homolog 3 (MSH3) also contain coding homopolymers, and these are frequent mutational targets in MMR-deficient cancers. The impact of incremental MMR mutations on MMR-deficient cancer evolution is unknown.

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Intraductal oncocytic papillary neoplasm (IOPN) of the pancreas is a recently recognized pancreatic tumor. Here, we aimed to determine its most essential features with the systematic review tool. PubMed, Scopus, and Embase were searched for studies reporting data on pancreatic IOPN.

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Background And Aims: Endoscopic retrograde cholangiopancreatography (ERCP) with brush cytology is an important tool in the diagnosis of hepatobiliary malignancies. However, reported sensitivity of brush cytology is suboptimal and differs markedly per study. The aim of this study is to analyze the optimal technique of endobiliary brushing during ERCP.

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Objectives: To assess 3-Tesla (3-T) ultra-small superparamagnetic iron oxide (USPIO)-enhanced MRI in detecting lymph node (LN) metastases for resectable adenocarcinomas of the pancreas, duodenum, or periampullary region in a node-to-node validation against histopathology.

Methods: Twenty-seven consecutive patients with a resectable pancreatic, duodenal, or periampullary adenocarcinoma were enrolled in this prospective single expert centre study. Ferumoxtran-10-enhanced 3-T MRI was performed pre-surgery.

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Radiomics features can reveal hidden patterns in a tumor but usually lack an underlying biologic rationale. In this work, we aimed to investigate whether there is a correlation between radiomics features extracted from [F]FDG PET images and histologic expression patterns of a glycolytic marker, monocarboxylate transporter-4 (MCT4), in pancreatic cancer. A cohort of pancreatic ductal adenocarcinoma patients ( = 29) for whom both tumor cross sections and [F]FDG PET/CT scans were available was used to develop an [F]FDG PET radiomics signature.

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Purpose: This study aims to introduce an innovative multi-step pipeline for automatic tumor-stroma ratio (TSR) quantification as a potential prognostic marker for pancreatic cancer, addressing the limitations of existing staging systems and the lack of commonly used prognostic biomarkers.

Methods: The proposed approach involves a deep-learning-based method for the automatic segmentation of tumor epithelial cells, tumor bulk, and stroma from whole-slide images (WSIs). Models were trained using five-fold cross-validation and evaluated on an independent external test set.

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Objective: To investigate the association between perineural invasion (PNI) and overall survival (OS) in a nationwide cohort of patients with resected pancreatic ductal adenocarcinoma (PDAC), stratified for margin negative (R0) or positive (R1) resection and absence or presence of lymph node metastasis (pN0 or pN1-N2, respectively).

Background: Patients with R0 and pN0 resected PDAC have a relatively favorable prognosis. As PNI is associated with worse OS, this might be a useful factor to provide further prognostic information for patients counselling.

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This study evaluated the relationship between apparent diffusion coefficient (ADC) values in pancreatic ductal adenocarcinoma (PDAC) and tumor grades based on WHO, Adsay, and Kalimuthu classifications, using whole-mount pancreatectomy specimens. If glandular formation plays a key role in the degree of diffusion restriction, diffusion-weighted imaging could facilitate non-invasive grading of PDAC. A freehand region of interest (ROI) was drawn along tumor borders on the preoperative ADC map in each tumor-containing slice.

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Background: Novel definitions suggest that resectability status for pancreatic ductal adenocarcinoma (PDAC) should be assessed beyond anatomical criteria, considering both biological and conditional factors. This has, however, yet to be validated on a nationwide scale. This study evaluated the prognostic value of biological and conditional factors for staging of patients with resectable PDAC.

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Background & Aims: Cytologic and histopathologic diagnosis of non-ductal pancreatic neoplasms can be challenging in daily clinical practice, whereas it is crucial for therapy and prognosis. The cancer methylome is successfully used as a diagnostic tool in other cancer entities. Here, we investigate if methylation profiling can improve the diagnostic work-up of pancreatic neoplasms.

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Background: Although endoscopic submucosal dissection (ESD) is established as first-choice treatment for early esophageal squamous cell carcinoma (ESCC) worldwide, most data are derived from Asian studies. We aimed to evaluate the long-term outcomes of ESD for patients with early ESCC in a Western cohort.

Methods: In this retrospective cohort study, patients with early ESCC amenable to ESD were included from four tertiary referral hospitals in the Netherlands between 2012 and 2017.

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Infiltrating ductal adenocarcinoma of the pancreas, referred to here as "pancreatic cancer," is one of the deadliest of all of the solid malignancies. The five-year survival rate in the United States for individuals diagnosed today with pancreatic cancer is a dismal 12%. Many invasive cancers, including pancreatic cancer, however, arise from histologically and genetically well-characterized precursor lesions, and these precancers are curable.

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Gastrointestinal polyposis disorders are a group of syndromes defined by clinicopathologic features that include the predominant histologic type of colorectal polyp and specific inherited gene mutations. Adenomatous polyposis syndromes comprise the prototypical familial adenomatous polyposis syndrome and other recently identified genetic conditions inherited in a dominant or recessive manner. Serrated polyposis syndrome is defined by arbitrary clinical criteria.

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Article Synopsis
  • Signet ring cell carcinoma (SRCC) and diffuse type adenocarcinoma of the stomach and gastroesophageal junction have poor prognosis, and the impact of neoadjuvant chemotherapy (nCT) and chemoradiotherapy (nCRT) on patient outcomes is uncertain.
  • A study analyzed data from 2046 patients with diffuse type carcinoma, comparing those who received nCT versus those who underwent primary surgery, finding that nCT significantly reduced all-cause mortality both within 90 days and beyond after surgery.
  • The research concluded that nCT is associated with improved survival rates for patients with gastric and gastroesophageal junction cancers, including those with SRCC.
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