Routine Clinical-Pathologic Correlation of Pigmented Skin Tumors Can Influence Patient Management

Background

Several studies have demonstrated the benefit of integrating clinical with pathologic information, to obtain a confident diagnosis for melanocytic tumors. However, all those studies were conducted retrospectively and no data are currently available about the role of a clinical-pathologic correlation approach on a daily basis in clinical practice.

Aim of the Study

In our study, we evaluated the impact of a routine clinical-pathologic correlation approach for difficult skin tumors seen over 3 years in a tertiary referral center.

Results

Interestingly, a re-appraisal was requested for 158 out of 2015 (7.7%) excised lesions because clinical-pathologic correlation was missing. Of note, in 0.6% of them (13 out of 2045) the first histologic diagnosis was revised in the light of clinical information that assisted the Pathologist to re-evaluate the histopathologic findings that might be bland or inconspicuous per se.

Conclusion

In conclusion, our study demonstrated that an integrated approach involving clinicians and pathologists allows improving management of selected patients by shifting from a simply disease-focused management (melanoma versus nevus) to a patient-centered approach.     

K562 cell sensitization to 5-fluorouracil- or interferon-alpha-induced apoptosis via cordycepin (3'-deoxyadenosine): fine control of cell apoptosis via poly(A) polymerase upregulation

K562 cells represent a classical model for the study of drug resistance. Induction of apoptosis is accompanied by concomitant distinct modulations of poly(A) polymerase (PAP) and other proteins involved in mRNA maturation. Recent data suggest the involvement of mRNA stability in the induction of specific apoptosis pathways. In this study we used a specific polyadenylation inhibitor, cordycepin (3-deoxyadenosine), to investigate the involvement of polyadenylation in K562 cell apoptosis and drug resistance. The combination of cordycepin with either 5-fluorouracil or interferon-alpha sensitized chemoresistant K562 cells to apoptosis. This sensitization was followed by distinct PAP modulations before and after the appearance of characteristic apoptosis pointers (DNA laddering, DAPI staining, mitochondrial transmembrane potential). PAP modulations appeared essential for K562 sensitization. mRNA polyadenylation therefore seemed to be involved not only in apoptosis but also in drug resistance. Polyadenylation inhibition by cordycepin under certain conditions sensitized chemoresistant K562 cells to apoptosis and thus polyadenylation could prove to be a fine target for overcoming drug resistance.