Publications by authors named "Peter Ellery"

12 Publications

  • Page 1 of 1

Female Genital Tract Melanoma: 10 Years of Experience at a Single Tertiary Center.

J Low Genit Tract Dis 2021 Feb 10. Epub 2021 Feb 10.

Gynaecological Oncology Department, University College London Hospital, London, United Kingdom Department of Cellular Pathology, University College London Hospital, London, United Kingdom.

Objective: Malignant melanoma of the female genital tract is a rare disease with poor prognosis, with controversies remaining in its staging and management. In this study, we investigate clinical, pathological, and outcome data for patients referred to a tertiary cancer center with female genital tract melanoma over a decade.

Methods: Patients were retrospectively identified using a search of pathology reports to identify all cases of female genital tract melanoma from 2007 to 2019. Electronic patient records were used to record clinical information. Histopathology specimens were reviewed by a gynecological and dermatological pathology specialist.

Results: We identified 30 cases of genital tract melanoma, of which 19 were vulvar, 10 were vaginal, and 1 cervical. Overall survival at 1, 3, and 5 years was found to be 80%, 60%, and 57%. Patients who died were not significantly older at presentation than patients who survived (62 y vs 69 y, p = .215). No association was found between mortality and microscopic ulceration, lymphovascular invasion, pigmentation, resection margins, or radical versus local surgery.Nonvulvar lesions were significantly associated with mortality compared with vulvar lesions (p = .0018), despite similar age and Breslow thickness. Five patients were diagnosed at in situ stage, all of these were vulvar. Even after excluding these melanomas in situ, nonvulvar melanomas still had a significantly worse mortality rate (p = .048). A higher proportion of nonvulvar lesions than vulvar lesions displayed loss of pigmentation (p = .026).

Conclusions: Nonvulvar genital tract melanomas carry a significantly worse prognosis. Survival was not related to resection margins, supporting the use of more conservative surgical margins.
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http://dx.doi.org/10.1097/LGT.0000000000000591DOI Listing
February 2021

Drivers underpinning the malignant transformation of giant cell tumour of bone.

J Pathol 2020 Dec 6;252(4):433-440. Epub 2020 Oct 6.

Department of Pathology (research), University College London Cancer Institute, London, UK.

The rare benign giant cell tumour of bone (GCTB) is defined by an almost unique mutation in the H3.3 family of histone genes H3-3A or H3-3B; however, the same mutation is occasionally found in primary malignant bone tumours which share many features with the benign variant. Moreover, lung metastases can occur despite the absence of malignant histological features in either the primary or metastatic lesions. Herein we investigated the genetic events of 17 GCTBs including benign and malignant variants and the methylation profiles of 122 bone tumour samples including GCTBs. Benign GCTBs possessed few somatic alterations and no other known drivers besides the H3.3 mutation, whereas all malignant tumours harboured at least one additional driver mutation and exhibited genomic features resembling osteosarcomas, including high mutational burden, additional driver event(s), and a high degree of aneuploidy. The H3.3 mutation was found to predate the development of aneuploidy. In contrast to osteosarcomas, malignant H3.3-mutated tumours were enriched for a variety of alterations involving TERT, other than amplification, suggesting telomere dysfunction in the transformation of benign to malignant GCTB. DNA sequencing of the benign metastasising GCTB revealed no additional driver alterations; polyclonal seeding in the lung was identified, implying that the metastatic lesions represent an embolic event. Unsupervised clustering of DNA methylation profiles revealed that malignant H3.3-mutated tumours are distinct from their benign counterpart, and other bone tumours. Differential methylation analysis identified CCND1, encoding cyclin D1, as a plausible cancer driver gene in these tumours because hypermethylation of the CCND1 promoter was specific for GCTBs. We report here the genomic and methylation patterns underlying the rare clinical phenomena of benign metastasising and malignant transformation of GCTB and show how the combination of genomic and epigenomic findings could potentially distinguish benign from malignant GCTBs, thereby predicting aggressive behaviour in challenging diagnostic cases. © 2020 The Authors. The Journal of Pathology published by John Wiley & Sons, Ltd. on behalf of The Pathological Society of Great Britain and Ireland.
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http://dx.doi.org/10.1002/path.5537DOI Listing
December 2020

Hyperkeratotic Plaque on the Thigh of an Immunosuppressed Patient: Challenge.

Am J Dermatopathol 2020 Aug;42(8):e118-e119

Department of Dermatology, Hospital for Tropical Diseases, University College London Hospitals NHS Foundation Trust, London, United Kingdom.

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http://dx.doi.org/10.1097/DAD.0000000000001619DOI Listing
August 2020

Hyperkeratotic Plaque on the Thigh of an Immunosuppressed Patient: Answer.

Am J Dermatopathol 2020 Aug;42(8):618-619

Department of Dermatology, Hospital for Tropical Diseases, University College London Hospitals NHS Foundation Trust, London, United Kingdom.

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http://dx.doi.org/10.1097/DAD.0000000000001620DOI Listing
August 2020

Colonic metastases from lung adenocarcinoma: An unusual endoscopic finding.

Dig Liver Dis 2020 04 19;52(4):463. Epub 2020 Feb 19.

Gastroenterology Department, University College London Hospitals NHS Foundation Trust, 235 Euston Rd, London, NW1 2BU, UK.

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http://dx.doi.org/10.1016/j.dld.2020.01.011DOI Listing
April 2020

A Case of Hidroacanthoma Simplex in a Cardiac Transplant Recipient.

Transplantation 2020 03;104(3):e77-e78

Dermatology Department, University College London NHS Foundation Trust, London, United Kingdom.

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http://dx.doi.org/10.1097/TP.0000000000002988DOI Listing
March 2020

The Chemotherapy Response Score (CRS): Interobserver Reproducibility in a Simple and Prognostically Relevant System for Reporting the Histologic Response to Neoadjuvant Chemotherapy in Tuboovarian High-grade Serous Carcinoma.

Int J Gynecol Pathol 2017 Mar;36(2):172-179

Department of Cellular Pathology (I.S., A.Z.F., S.J., S.L.S.L., J.M., T.O.M., N.S.) Department of Medical Oncology (S.B.), Barts Health NHS Trust Department of Pathology (P.E., G.T.), University College Hospital NHS Trust, London Department of Cellular Pathology (J.B., R.G., L.H., R.M., J.V.), Birmingham Women's NHS Trust, Birmingham Department of Pathology (W.G.M.), Belfast Health and Social Care Trust, Royal Victoria Hospital, Belfast, UK Department of Anatomic Pathology (C.B.G.), Vancouver General Hospital, Vancouver, BC, Canada.

A 3-tier histopathologic scoring system, the chemotherapy response score (CRS), was previously devised for reporting the histologic response to neoadjuvant chemotherapy in interval debulking surgery specimens of stage IIIc/IV tuboovarian high-grade serous carcinoma. This has been shown to predict the outcome and offer additional information to other methods of assessing the treatment response. In the present study, the reproducibility of this scoring system was assessed by determining the interobserver agreement among reporting pathologists. A total of 5 groups each comprising 3 pathologists with different levels of expertise were selected. The participants underwent an online tutorial on how to apply the CRS system. 40 cases (38 cases in 2 appraiser groups) were scored individually by each of the 15 pathologists. The interobserver reproducibility was calculated using Fleiss' κ, Kendall's coefficient of concordance, and the absolute agreement between (a) individual pathologists within 1 group, (b) with the majority score agreement between all groups, and (c) with all individual scores. The CRS system was found to be highly reproducible among all the pathologists' groups (κ=0.761). The agreement in identifying the group of patients with the best response to chemotherapy was exceptionally high (κ=0.926). We conclude that CRS has a high interobserver reproducibility, especially in identifying the subgroup of patients with the best chemotherapy response, justifying its inclusion in clinical trials and reporting practice.
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http://dx.doi.org/10.1097/PGP.0000000000000307DOI Listing
March 2017

Next-Generation Sequencing-Assisted DNA-Based Digital PCR for a Personalized Approach to the Detection and Quantification of Residual Disease in Chronic Myeloid Leukemia Patients.

J Mol Diagn 2016 Mar 5;18(2):176-89. Epub 2016 Feb 5.

Imperial Molecular Pathology, Imperial Healthcare Trust, Hammersmith Hospital, London, United Kingdom; Centre for Haematology, Faculty of Medicine, Imperial College London, London, United Kingdom.

Recent studies indicate that 40% of chronic myeloid leukemia patients who achieve sustained undetectable BCR-ABL1 transcripts on tyrosine kinase inhibitor therapy remain disease-free after drug discontinuation. In contrast, 60% experience return of detectable disease and have to restart treatment, thus highlighting the need for an improved method of identifying patients with the lowest likelihood of relapse. Here we describe the validation of a personalized DNA-based digital PCR (dPCR) approach for quantifying very low levels of residual disease, which involves the rapid identification of t(9;22) fusion junctions using targeted next-generation sequencing coupled with the use of a dPCR platform. t(9;22) genomic breakpoints were successfully mapped in samples from 32 of 32 patients with early stage disease. Disease quantification by DNA-based dPCR was performed using the Fluidigm BioMark platform on 46 follow-up samples from 6 of the 32 patients, including 36 samples that were in deep molecular remission. dPCR detected persistent disease in 81% of molecular-remission samples, outperforming both RT-dPCR (25%) and DNA-based quantitative PCR (19%). We conclude that dPCR for BCR-ABL1 DNA is the most sensitive available method of residual-disease detection in chronic myeloid leukemia and may prove useful in the management of tyrosine kinase inhibitor withdrawal.
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http://dx.doi.org/10.1016/j.jmoldx.2015.09.005DOI Listing
March 2016

TTF-1 positive breast cancer: a cautionary tale.

J Clin Pathol 2015 Aug 27;68(8):665-6. Epub 2015 Apr 27.

Department of Cellular Pathology, University College London Hospitals NHS Foundation Trust, London, UK.

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http://dx.doi.org/10.1136/jclinpath-2015-202998DOI Listing
August 2015

Interstitial 3p25 deletion in a patient with features of 3p deletion syndrome: further evidence for the role of SRGAP3 in mental retardation.

Clin Dysmorphol 2014 Jan;23(1):29-31

North West Thames Regional Genetics Service, North West London Hospitals NHS Trust, Northwick Park & St Marks Hospital, Harrow, UK.

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http://dx.doi.org/10.1097/MCD.0000000000000017DOI Listing
January 2014

Computers as a formal continuing education tool: moving beyond intention.

Am J Health Behav 2007 May-Jun;31(3):312-22

Fisher Institute for Wellness and Gerontology, Ball State University, Muncie, IN 47306, USA.

Objective: To identify factors related to health promotion professionals' decisions to use computer-mediated instruction for continuing education (CMI-CE).

Methods: Employing a cross-sectional survey design, data were collected from 500 respondents using an online survey.

Results: Among respondents having positive intentions toward CMI-CE, characteristics distinguishing between individuals with positive and negative CMI-CE behavior included perceived behavioral control, license/ certification, lack of programs and relevant program topics, and availability of technical support.

Conclusions: Health promotion professionals have positive intentions toward CMI-CE, and introducing relevant programs accompanied by strong technical support teams will help move them beyond intention and into action.
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http://dx.doi.org/10.5555/ajhb.2007.31.3.312DOI Listing
November 2007

Perceived psychological stress among high school basketball officials.

Percept Mot Skills 2004 Oct;99(2):463-9

University of South Florida, Tampa, 33620-5650, USA.

The purpose of this study was to survey certified high school basketball officials during midseason to assess whether the sources and magnitude of perceived psychological stress would be consistent with previous studies of officials in other sports. The sources and magnitude of perceived psychological stress were measured among 324 high school basketball officials (N=324; 312 men, 12 women) using a revised version of the Ontario Soccer Officials Survey. The mean age was 37.6 yr. (SD= 9.4), and the mean years of basketball refereeing experience was 11.7 yr. (SD=8.3). A random sample (N=498) of all basketball officials in a midwestern state (N=1,011) was used, and 324 of the surveys were returned (65%). The overall variance accounted for with the four factors was 84.7%. The magnitude of stress for these factors ranged from below mild to moderate.
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http://dx.doi.org/10.2466/pms.99.2.463-469DOI Listing
October 2004