Publications by authors named "D Montezuma"

19 Publications

A Multiplex Test Assessing and in Urine Accurately Discriminates Bladder Cancer from Inflammatory Conditions.

J Clin Med 2020 Feb 24;9(2). Epub 2020 Feb 24.

Cancer Biology and Epigenetics Group-Research Center (CI-IPOP), Portuguese Oncology Institute of Porto (IPO Porto), and Porto Comprehensive Cancer Center (P.CCC), Maimonides Biomedical Research Institute of Cordoba, 14004 Cordoba, Spain.

Bladder cancer (BlCa) is a common malignancy with significant morbidity and mortality. Current diagnostic methods are invasive and costly, showing the need for newer biomarkers. Although several epigenetic-based biomarkers have been proposed, their ability to discriminate BlCa from common benign conditions of the urinary tract, especially inflammatory diseases, has not been adequately explored. Herein, we sought to determine whether VIM and miR663a might accurately discriminate those two conditions, using a multiplex test. Performance of VIM and miR663a in tissue samples and urines in testing set confirmed previous results (96.3% sensitivity, 88.2% specificity, area under de curve (AUC) 0.98 and 92.6% sensitivity, 75% specificity, AUC 0.83, respectively). In the validation sets, VIM-miR663a multiplex test in urine discriminated BlCa patients from healthy donors or patients with inflammatory conditions, with 87% sensitivity, 86% specificity and 80% sensitivity, 75% specificity, respectively. Furthermore, positive likelihood ratio (LR) of 2.41 and negative LR of 0.21 were also disclosed. Compared to urinary cytology, VIM-miR663a multiplex panel correctly detected 87% of the analysed cases, whereas cytology only forecasted 41%. Furthermore, high miR663a independently predicted worse clinical outcome, especially in patients with invasive BlCa. We concluded that the implementation of this panel might better stratify patients for confirmatory, invasive examinations, ultimately improving the cost-effectiveness of BlCa diagnosis and management. Moreover, miR663a analysis might provide relevant information for patient monitoring, identifying patients at higher risk for cancer progression.
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http://dx.doi.org/10.3390/jcm9020605DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7073678PMC
February 2020

Is it "hybrid" or "intermediate"?-more than just a semantic issue in oncocytic renal cell tumors.

Ann Transl Med 2019 Dec;7(Suppl 8):S356

Cancer Biology & Epigenetics Group, Research Center (CI-IPOP), Portuguese Oncology Institute of Porto, Porto, Portugal.

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http://dx.doi.org/10.21037/atm.2019.09.54DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6976401PMC
December 2019

Variants of Papillary Thyroid Carcinoma: An Algorithmic Cytomorphology-Based Approach to Cytology Specimens.

Acta Cytol 2020 21;64(4):288-298. Epub 2019 Oct 21.

Instituto de Investigação e Inovação em Saúde, University of Porto, Porto, Portugal.

Background: Thyroid cancer accounts for 1% of cancer cases in developed countries, in which papillary thyroid carcinoma (PTC) is the most common type. There are multiple variants of PTC described to date, some of them with aggressive behavior and poor clinical outcome. These variants are well described and accepted in recent guidelines of many international societies, and the prognostic and management implications are well laid out. Due to their established clinical importance and to guide appropriate surgical management, it is now imperative in clinical practice, including cytopathology, to differentiate aggressive variants from nonaggressive ones. This review aims to describe the variants of PTC and to provide a practical algorithmic approach to facilitate the cytological diagnosis of these variants.

Summary: Subtyping PTC variants on fine needle aspiration cytology (FNAC) is challenging even for the most experienced cytopathologist. To facilitate a correct subtyping on FNAC, we propose a stepwise approach that is mainly designed for conventional smear methodology. This approach requires first to stratify the lesions into oncocytic and nononcocytic features before analyzing further details in cell morphology and pattern. Key Messages: (1) Subtyping in PTC is possible on cytopathology. (2) The main aim of the cytopathologist is to differentiate aggressive from nonaggressive variants. (3) The subtyping of PTC can help in the surgical management of the patients.
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http://dx.doi.org/10.1159/000503576DOI Listing
July 2020

Breast Fine Needle Aspiration Biopsy Cytology Using the Newly Proposed IAC Yokohama System for Reporting Breast Cytopathology: The Experience of a Single Institution.

Acta Cytol 2019 Feb 15:1-6. Epub 2019 Feb 15.

Institute of Molecular Pathology and Immunology, University of Porto, Porto, Portugal,

Objective: Recently the International Academy of Cytology (IAC) proposed a new reporting system for breast fine needle aspiration biopsy (FNAB) cytology. We aimed to categorize our samples according to this classification and to assess the risk of malignancy (ROM) for each category as well as the diagnostic yield of breast FNAB.

Study Design: Breast FNAB specimens obtained between January 2007 and December 2017 were reclassified according to the newly proposed IAC Yokohama reporting system. The ROM for each category was determined. Diagnostic yield was evaluated based on a three-category approach, benign versus malignant.

Results: The samples were distributed as follows: insufficient material 5.77%, benign 73.38%, atypical 13.74%, suspicious for malignancy 1.57%, and malignant 5.54%. Of the 3,625 cases collected, 776 (21.4%) had corresponding histology. The respective ROM for each category was 4.8% for category 1 (insufficient material), 1.4% for category 2 (benign), 13% for category 3 (atypical), 97.1% for category 4 (suspicious for malignancy), and 100% for category 5 (malignant). When only malignant cases were considered positive tests, the sensitivity, specificity, and diagnostic accuracy were 97.56, 100, and 99.11%, respectively.

Conclusions: Our study is the first to categorize breast FNAB cytology samples according to the proposed IAC reporting system and to evaluate patient outcomes based on this categorization.
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http://dx.doi.org/10.1159/000492638DOI Listing
February 2019

"The other side of the coin": understanding noninvasive follicular tumor with papillary-like nuclear features in unifocal and multifocal settings.

Hum Pathol 2019 04 8;86:136-142. Epub 2018 Dec 8.

IPATIMUP, Institute of Molecular Pathology and Immunology of University of Porto, Porto, 4200-135, Portugal; I3S, Instituto de Investigação e Inovação em Saúde, University of Porto, Porto, 4200-135, Portugal; Department of Pathology, Medical Faculty of Porto University, Porto, 4200-319, Portugal. Electronic address:

The recent description of noninvasive follicular tumor with papillary-like nuclear features (NIFTP) creates several diagnostic and therapeutic challenges for both the pathologist and the attending clinician. Given the concern about overtreatment of these neoplasms, the best way to manage the patients by a surgical procedure and postsurgical follow-up is still under discussion. We aimed to identify predictors of synchronous disease (eg, bilateral cancers) that can influence the appropriate type of surgery and long-term surveillance. We reevaluated the original diagnosis and the presence of contralateral lesions in 94 cases retrieved from our archives that were seen between 2010 and 2017. In 74 cases, the diagnosis was NIFTP, and in 20 cases, the diagnosis was infiltrative follicular variant of papillary thyroid carcinoma (IFVPTC). Bilateral disease was found in 17% of the cases. In 13 (18%) of those cases, NIFTP was the primary lesion, and in 3 (15%), it was IFVPTC. The contralateral disease was predominantly invasive: 6 cases of micropapillary carcinoma, 5 of papillary thyroid carcinoma, 3 of IFVPTC, and 2 of NIFTP. Despite the higher frequency of contralateral disease in NIFTP, there was no statistically significant difference with IFVPTC. In the patients with multifocal NIFTP, 2 (15%) of the contralateral malignancies showed microscopic extrathyroidal extension (P < .05). We conclude that close monitoring of the contralateral lobe is appropriate in patients with FVPTC, particularly NIFTP, if they are not submitted to total thyroidectomy.
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http://dx.doi.org/10.1016/j.humpath.2018.10.040DOI Listing
April 2019