Publications by authors named "Nicolas Piton"

The purpose of this article is to provide a simple explanation of the accreditation process applied to the field of pathology. After defining some basic notions in the field of quality in health, and then detailing the accreditation process in general, we focus on the specific field of pathology with the implementation of the quality management system, the validation or verification of the methods and then the audit of the structure by the French committee for accreditation COFRAC. We end with some general considerations, insisting on the benefits brought by the entry of a structure into this accreditation process.

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Recurrent mutations in the CTNNB1 or APC genes leading to the activation of the Wnt/betacatenin pathway are observed in adnexal tumors with matrical differentiation. While most pilomatricomas arise sporadically and harbor CTNNB1 mutations, cutaneous hybrid cysts combining epidermal and matrical differentiations have been mostly reported in a context of the familial adenomatosis polyposis/Gardner's syndrome related to germinal mutations of APC. The objective of this study is to understand the pathogenesis of hybrid cysts combining epidermal and matrical differentiations.

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Background And Objective: Expression of programmed death-ligand 1 (PD-L1) in tumour cells (TCs) is predictive of immunotherapy efficacy in non-small cell lung cancer (NSCLC). Small biopsy samples collected by bronchoscopy are often used to diagnose peripheral lung cancer. It is questionable whether these small samples from radial endobronchial ultrasonography (r-EBUS) procedures are representative of PD-L1 expression in TCs.

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Purpose: Immune checkpoint inhibitors (ICIs) are now one of the standards of care for patients with lung cancer and have greatly improved both progression-free and overall survival, although of the patients respond to the treatment, and some face acute adverse events. Although a few predictive biomarkers have integrated the clinical workflow, they require additional modalities on top of whole-slide images and lack efficiency or robustness. In this work, we propose a biomarker of immunotherapy outcome derived solely from the analysis of histology slides.

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Micronodular arrangement of epithelial cells and lymphoid B-cell hyperplasia with follicles are both peculiar histological features in thymic tissue. Such features may especially occur in thymic epithelial tumors. The most common form is called micronodular thymoma with lymphoid stroma.

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Background: Alveolar soft part sarcoma is a rare tumour of soft tissues, mostly localized in muscles or deep soft tissues of the extremities. In rare occasions, this tumour develops in deep tissues of the abdomen or pelvis.

Case Presentation: In this case report, we described the case of a 46 year old man who developed a primary splenic alveolar soft part sarcoma.

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Article Synopsis
  • DNA genotyping from plasma for NSCLC has a high false-negative rate, showing a need for improved methods, especially for hard-to-reach tumors.
  • This study compared DNA analysis from guide sheath flush fluid during r-EBUS bronchoscopy with plasma and tumor biopsies in 65 patients with peripheral NSCLC, finding that it allows for better mutation detection.
  • The guide sheath flush method detected mutations in 61.8% of cases, significantly outperforming the 33% detection rate of plasma-based genotyping, suggesting it's a more sensitive approach for tumor DNA analysis.
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Lynch syndrome is the most common autosomal dominant inherited cancer predisposing syndrome, due to mutations in DNA mismatch repair genes. The key feature of cancers in Lynch syndrome is microsatellite instability and a high risk of developing mainly colorectal and uterine cancers. However, cancers with microsatellite instability outside this spectrum, for example, lung cancer, are extremely rare.

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Article Synopsis
  • * Immune checkpoint inhibitors and targeted therapies have transformed treatment for NSCLC, offering better outcomes than traditional chemotherapy, although issues with acquired resistance remain.
  • * Thoracic surgery has improved through minimally invasive techniques and precision surgery, emphasizing comprehensive patient care from pre-operative support through post-treatment follow-up and potential salvage surgery options.
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  • Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is enhanced by a new technique called EBUS intranodal forceps biopsy (EBUS-IFB), aimed at increasing diagnostic accuracy for lymph node analysis.
  • A study of 50 patients showed that the combination of EBUS-TBNA and EBUS-IFB yielded a diagnostic success rate of 94%, compared to 77% for EBUS-TBNA alone.
  • While the combined methods were particularly effective in identifying nonmalignant conditions, the improvement for detecting malignancies was not statistically significant, indicating the benefit may primarily assist in diagnosing nonmalignant cases.
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  • Gene fusion testing is essential for diagnosing nonsquamous non-small cell lung cancer (NS-NSCLC), but challenges like tissue availability and lengthy testing delays often hinder timely treatment.
  • A study compared two ultrafast gene fusion assays (Idylla and Genexus) in 195 NS-NSCLC cases and found high accuracy rates (92.3% for Idylla and 93.1% for Genexus) in detecting various gene fusions, while some specific fusions showed lower sensitivity.
  • Both assay methods provide a feasible approach for quicker gene fusion detection, facilitating faster initiation of targeted therapies, but each has some limitations regarding specific fusion detection sensitivities.
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Background: Various advanced bronchoscopy methods have been developed to reach peripheral lung lesions (PLL). In a large cohort, we aimed to assess a standardized procedure of first-line radial-endobronchial ultrasound (r-EBUS) and virtual bronchoscopy planner for the diagnosis of peripheral lung cancer.

Methods: This retrospective, single center study included patients who had r-EBUS-guided bronchoscopy for the diagnosis of a PLL between 2008 and 2019.

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The routine use of mechanical circulatory support during lung transplantation (LTx) is still controversial. The use of prophylactic human albumin (HA) or hypertonic sodium lactate (HSL) prime in mechanical circulatory support during LTx could prevent ischemia−reperfusion (IR) injuries and pulmonary endothelial dysfunction and thus prevent the development of pulmonary graft dysfunction. The objective was to investigate the impact of cardiopulmonary bypass (CPB) priming with HA and HSL compared to a CPB prime with Gelofusine (GF) on pulmonary endothelial dysfunction in a lung IR rat model.

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Background: 3-9% of low-grade preinvasive bronchial lesions progress to cancer. This study assessed the usefulness of an intensive bronchoscopy surveillance strategy in patients with bronchial lesions up to moderate squamous dysplasia.

Methods: SELEPREBB (ClinicalTrials.

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Lung adenocarcinoma (LUAD) is the major subtype of non-small cell lung cancer, accounting for approximately 60% of cases. Molecular analysis of LUADs showed that the gene is mutated in up to 30% of cases; such cases were previously considered "undruggable". The KRAS G12C mutation has become a hot topic of research after initial, promising, phase I and II trials with targeted inhibitors.

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Background: The diagnosis of organizing pneumonia (OP) often requires histological confirmation. The aim of this retrospective study was to evaluate the diagnostic yield and complication rate of radial endobronchial ultrasound (r-EBUS) for OP.

Methods: All patients who had r-EBUS as a first diagnostic procedure for a peripheral pulmonary lesion at Rouen University Hospital, France, between April 2008 and December 2020 were included.

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Background: Immune checkpoint inhibitors (ICIs) are the standard of care for non-resectable non-small-cell lung cancer and are under investigation for resectable disease. Some authors have reported difficulties during lung surgery following ICI treatment. This retrospective study investigated the perioperative outcomes of lung resection in patients with preoperative ICI.

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Article Synopsis
  • This study compares two PET/CT tracers, FAZA and FMISO, for detecting hypoxic regions in non-small cell lung cancer (NSCLC) patients.
  • It included 19 patients and found that FMISO had a higher average SUVmax uptake (3) compared to FAZA (2.2), indicating it is more effective in identifying hypoxic areas.
  • Despite both tracers showing a strong correlation, FMISO is recommended as the superior tracer for defining hypoxic tumor volumes based on the study's findings.
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High throughput RNA sequencing, also know as RNAseq, can easily be performed on the gold-standard technique of formalin-fixed paraffin-embedded tissue, which has long been successfully used in routine practice by pathologists. For this reason, RNAseq has been fully adopted in a very short period of time in most French molecular platforms of cancer genotyping, generating "high throughput" data, both qualitative (mutations, fusions) and quantitative (gene expression profiles). This technique opens new perspectives in oncology practice: from a diagnostic point of view (some gene fusions are specific of some diagnoses, some transcriptomic signatures suggest some types of cancer), but also from a prognostic point of view (gene expression profile of an aggressive tumor, or conversely of an indolent one), and above all from a predictive point of view, guiding the choice of potential targeted therapies (example of ALK, ROS1 or NTRK translocations).

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Anti-PD1/PD-L1 immunotherapy has emerged as a standard of care for stage III-IV non-small cell lung cancer (NSCLC) over the past decade. Patient selection is usually based on PD-L1 expression by tumor cells and/or tumor mutational burden. However, mutations in oncogenic drivers such as , , , or modify the immune tumor microenvironment and may promote anti-PD1/PD-L1 resistance.

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Micronodular thymic carcinoma with lymphoid hyperplasia (MNTCLH) is a rare form of thymic carcinoma. We present the experience of RYTHMIC, the French national network devoted to the treatment of thymic epithelial tumors through multidisciplinary tumor boards with a review of all tumors by pathologists for classification and staging. Six cases of MNTCLH were diagnosed during a review of 1007 thymic epithelial tumors.

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Theranostic translocations may be difficult to detect by routine techniques, especially when specimens are exiguous. We recently demonstrated in a series of translocated lung adenocarcinomas that LD-RT-PCR (ligation-dependent reverse transcription polymerase chain reaction) assay could identify ALK, ROS1 and RET rearrangements with 64% sensitivity and 100% specificity. Here, we report an upgraded version of this assay used in a routine prospective cohort of lung carcinomas.

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