Philipp Ströbel

Georg-August-Universität Göttingen, Göttingen, Lower Saxony, Germany

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Publications (215)953.09 Total impact

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    ABSTRACT: Background: Malignant germ cell tumours are the most common malignant tumours in young men. They are histologically divided into seminomas and non-seminomas. Non-seminomas are further subdivided into embryonic carcinomas, yolk sac tumours, chorionic carcinomas, and teratomas. For the therapeutic management it is essential to differentiate between these histological subtypes. Methods: Investigated cases included normal testis (n=50), intratubular germ cell neoplasia (n=25), seminomas (n=67), embryonic carcinomas (n=56), yolk sac tumours (n=29), chorionic carcinomas (n=2), teratomas (n=7) and four metastases of YST's for their CK19 expression. In addition Leydig cell- (n=10) and Sertoli cell- tumours (n=4) were included in this study. Results: All investigated seminomas, embryonic carcinomas as well as normal testis and intratubular germ cell neoplasias did not express CK19. In contrast, all investigated yolk sac tumours strongly expressed CK19 protein. These findings became also evident in mixed germ cell tumours consisting of embryonic carcinomas and yolk sac tumours, although CK19-expression could also be observed in analysed chorionic carcinomas and epithelial components of teratomas. Conclusion: CK19 proved to be a sensitive marker to identify yolk sac tumours of the testis and to distinguish them from other germ cell tumours, especially seminomas and embryonic carcinomas. Virtual slides: The virtual slide(s) for this article can be found here:
    Diagnostic Pathology 12/2015; 10(1). DOI:10.1186/s13000-015-0243-y · 2.60 Impact Factor
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    ABSTRACT: Background: Stewart-Treves syndrome is a rare complication of breast cancer treatment, representing a lymphangiosarcoma commonly associated with lymphedema and severely impacting patient's outcome. The tumor typically develops in the atrophic, pachydermatous, hyperkeratotic skin of limbs affected by long-standing lymphedema. Clinical data associated with Stewart-Treves syndrome and lymphedema management have rarely been published. Methods and results: In the period between 1980 and 2009, ten patients with Stewart-Treves syndrome were diagnosed and treated at the Foeldiklinik, Hinterzarten, Germany. Nine of the ten patients were female. Five patients had previously suffered from breast cancer (and were treated with mastectomy); two from other malignancies; two patients had primary lymphedema, and one had undergone lower extremity lymphadenectomy. All cancer patients had undergone radiation treatment. In all cases, the sarcoma developed in non-irradiated areas 6-48 years (average 16.3 years) after the onset of lymphedema. None of the patients had received complex decongestive physical therapy (CDT). Two patients had above-elbow amputation, one had shoulder exarticulation, two patients had wide excision and skin grafting, two patients had above-knee amputation procedure, two patients had a below-knee amputation procedure, and one patient had no surgical treatment at all. The time to recurrence after surgery, time to metastasis, patient survival and CDT were recorded. Conclusions: Patients with lymphedema should be closely examined starting 5 years from the time of lymphedema onset, paying special attention to those with associated malignancies. Only early diagnosis and treatment by radical ablative surgery confers a reasonable prognosis with this rare but aggressive disease. A potential effect of CDT on lymphangiosarcoma has to be studied in a greater patient cohort.
    Lymphatic Research and Biology 11/2015; DOI:10.1089/lrb.2015.0006 · 1.71 Impact Factor
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    ABSTRACT: Purpose: Binding of (68)Ga-PSMA-HBED-CC ((68)Ga-PSMA) at prostate cancer (PC) cells increases over time. A biphasic protocol may help separating benign from tumor lesions. The aim of this study was the retrospective evaluation of a diagnostic incremental value of a dual-time point (biphasic) (68)Ga-PSMA-PET/CT in patients with prostate cancer. Methods: Retrospective analysis of 35 consecutive patients (49-78 years, median 71) with newly diagnosed PC (12/35) or recurrence of PC (23/35). PET/CT (Gemini TF16, Philips) was acquired 1 h and 3 h p. i. of 140-392 MBq (300 MBq median) (68)Ga-PSMA, followed by a diagnostic contrast CT. PET findings were correlated with histology or unequivocal CT findings. Semiquantitative PET data (SUVmax, SUV mean) were acquired and target-to-background-ratios (T/B-ratio) were calculated for benign and malign lesions for both time points. Size of lymph nodes (LN) on diagnostic CT was recorded. Statistical analysis was performed for assessment of significant changes of semiquantitative PET-parameters over time and for correlation of size and uptake of lymph nodes. Results: One hundred and four lesions were evaluated. Sixty lesions were referenced by histology or unequivocal CT findings, including eight (13.3 %) histopathologically benign lymph nodes, 12 (20 %) histopathologically lymph node metastases, 12 (20 %) primary tumors, three (5 %) local recurrences, and 25 (41.7 %) bone metastases. Forty-four lesions were axillary LN with normal CT-appearance. Benign lesions had significantly lower SUVmax and T/B-ratios compared with malignant findings. Malign lesions showed a significant increase of both parameters over time compared to benign findings. There was no correlation between LN size and SUVmax. The sensitivity, specificity, the positive predictive value and negative predictive value of PET/CT regarding pelvic LN was 94 %, 99 %, 89 %, and 99.5 %, respectively. Conclusions: In contrast to benign tissues, the uptake of proven tumor lesions increases on (68)Ga-PSMA-PET/CT over time. A biphasic PET-study may lead to a better detection of tumor lesions in unequivocal findings.
    European Journal of Nuclear Medicine 11/2015; DOI:10.1007/s00259-015-3251-y · 5.38 Impact Factor
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    ABSTRACT: Background: Testicular germ cell tumors (TGCT) are the most common cancer entities in young men with increasing incidence observed in the last decades. For therapeutic management it is important, that TGCT are divided into several histological subtypes. MED15 is part of the multiprotein Mediator complex which presents an integrative hub for transcriptional regulation and is known to be deregulated in several malignancies, such as prostate cancer and bladder cancer role, whereas the role of the Mediator complex in TGCT has not been investigated so far. Aim of the study was to investigate the implication of MED15 in TGCT development and its stratification into histological subtypes. Methods: Immunohistochemical staining (IHC) against Mediator complex subunit MED15 was conducted on a TGCT cohort containing tumor-free testis (n = 35), intratubular germ cell neoplasia unclassified (IGCNU, n = 14), seminomas (SEM, n = 107) and non-seminomatous germ cell tumors (NSGCT, n = 42), further subdivided into embryonic carcinomas (EC, n = 30), yolk sac tumors (YST, n = 5), chorionic carcinomas (CC, n = 5) and teratomas (TER, n = 2). Quantification of MED15 protein expression was performed through IHC followed by semi-quantitative image analysis using the Definiens software. Results: In tumor-free seminiferous tubules, MED15 protein expression was absent or only low expressed in spermatogonia. Interestingly, the precursor lesions IGCNU exhibited heterogeneous but partly very strong MED15 expression. SEM weakly express the Mediator complex subunit MED15, whereas NSGCT and especially EC show significantly enhanced expression compared to tumor-free testis. Conclusions: In conclusion, MED15 is differentially expressed in tumor-free testis and TGCT. While MED15 is absent or low in tumor-free testis and SEM, NSGCT highly express MED15, hinting at the diagnostic potential of this marker to distinguish between SEM and NSGCT. Further, the precursor lesion IGCNU showed increased nuclear MED15 expression in the preinvasive precursor cells, which may provide diagnostic value to distinguish between benign and pre-malignant testicular specimen, and may indicate a role for MED15 in carcinogenesis in TGCT.
    Diagnostic Pathology 09/2015; 10(1):165. DOI:10.1186/s13000-015-0398-6 · 2.60 Impact Factor
  • Michael A den Bakker · Alexander Marx · Kiyoshi Mukai · Philipp Ströbel ·
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    ABSTRACT: This is the second part of a two-part review on soft tissue tumours which may be encountered in the mediastinum. This review is based on the 2013 WHO classification of soft tissue tumours and the 2015 WHO classification of tumours of the lung, pleura, thymus and heart and provides an updated overview of mesenchymal tumours that have been reported in the mediastinum.
    Archiv für Pathologische Anatomie und Physiologie und für Klinische Medicin 09/2015; DOI:10.1007/s00428-015-1832-6 · 2.65 Impact Factor
  • Michael A den Bakker · Alexander Marx · Kiyoshi Mukai · Philipp Ströbel ·
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    ABSTRACT: The mediastinum is an anatomically defined space in which organs and major blood vessels reside with surrounding soft tissue elements. The thymus is an important organ in the mediastinum, and many of the masses encountered in the mediastinum are related to this organ. Most neoplasms diagnosed in the mediastinum are epithelial tumours (thymomas and thymic carcinomas), lymphomas or germ cell tumours. In contrast, soft tissue tumours of the mediastinum are rare. In 1963, Pachter and Lattes systematically reviewed soft tissue pathology of the mediastinum, covering the hitherto described [2, 226, 227] In this review, based on the 2013 WHO classification of soft tissue tumours and the 2015 WHO classification of tumours of the lung, pleura, thymus and heart, we provide an updated overview of mesenchymal tumours that may be encountered in the mediastinum.
    Archiv für Pathologische Anatomie und Physiologie und für Klinische Medicin 09/2015; DOI:10.1007/s00428-015-1830-8 · 2.65 Impact Factor
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    ABSTRACT: This overview of the 4 edition of the WHO Classification of thymic tumors has two aims. First, to comprehensively list the established and new tumour entities and variants that are described in the new WHO Classification of thymic epithelial tumors, germ cell tumors, lymphomas, dendritic cell and myeloid neoplasms, and soft tissue tumors of the thymus and mediastinum; second, to highlight major differences in the new WHO Classification that result from the progress that has been made since the 3 edition in 2004 at immunohistochemical, genetic and conceptual levels. Refined diagnostic criteria for type A, AB, B1-B3 thymomas and thymic squamous cell carcinoma are given and will hopefully improve the reproducibility of the classification and its clinical relevance. The clinical perspective of the classification has been strengthened by involving experts from radiology, thoracic surgery and oncology; by incorporating state-of-the-art PET/CT images; and by depicting prototypic cytological specimens. This makes the thymus section of the new WHO Classification of Tumours of the Lung, Pleura, Thymus and Heart a valuable tool for pathologists, cytologists and clinicians alike. The impact of the new WHO Classification on therapeutic decisions is exemplified in this overview for thymic epithelial tumors and mediastinal lymphomas, and future perspectives and challenges are discussed.
    Journal of thoracic oncology: official publication of the International Association for the Study of Lung Cancer 08/2015; DOI:10.1097/JTO.0000000000000654 · 5.28 Impact Factor
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    ABSTRACT: Tumours of ovarian-epithelial type of the testis, including serous borderline tumours, represent very rare entities. They are identical to the surface epithelial tumours of the ovary and have been reported in patients from 14 to 68 years of age. We describe two cases of a 46- and a 39-year old man with incidental findings of intratesticular masses of the left respectively right testis. Under the assumption of a malignant testicular tumour the patients were subjected to inguinal orchiectomy. Histologically, the tumours were identical to their ovarian counterparts: They showed a cystic configuration with a fibrous wall and irregular papillary structures lined by partially multistratified columnar cells and areas of hobnail cells. Furthermore, there was mild cytological atypia with a proliferative activity of below 5% as proved by Ki67 staining; mitoses could not be detected. Immunohistochemically, the tumour cells displayed expression of pan-cytokeratin AE3, progesterone receptor, Wilms' tumour protein (WT1), and PAX8 (Paired box gene 8). Estrogen receptor was expressed in one case. Octamer-binding transcription factor-4 (OCT4), calretinin, thrombomodulin, and D2-40 were not expressed. Mutation testing of BRAF revealed a BRAF V600E mutation in one case, while testing for KRAS mutations proved to be negative in both. The BRAF mutated tumour showed strong cytosolic and membranous positivity for B-Raf also on immunohistochemical analysis. Comparative genomic hybridization of one case could not reveal any chromosomal aberrations.
    Diagnostic Pathology 07/2015; 10(1):118. DOI:10.1186/s13000-015-0342-9 · 2.60 Impact Factor
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    ABSTRACT: Germ cell tumors (GCTs) are the most common malignancies in young men. Most patients with GCT can be cured with cisplatin-based combination chemotherapy, even in metastatic disease. In case of therapy resistance, prognosis is usually poor. We investigated the potential of N-cadherin inhibition as a therapeutic strategy. We analyzed the GCT cell lines NCCIT, NTERA-2, TCam-2, and the cisplatin-resistant sublines NCCIT-R and NTERA-2R. Effects of a blocking antibody or siRNA against N-cadherin on proliferation, migration, and invasion were investigated. Mouse xenografts of GCT cell lines were analyzed by immunohistochemistry for N-cadherin expression. All investigated GCT cell lines were found to express N-cadherin protein in vitro and in vivo. Downregulation of N-cadherin in vitro leads to a significant inhibition of proliferation, migration, and invasion. N-cadherin-downregulation leads to a significantly higher level of pERK. N-cadherin-inhibition resulted in significantly higher rates of apoptotic cells in caspase-3 staining. Expression of N-cadherin is preserved in cisplatin-resistant GCT cells, pointing to an important physiological role in cell survival. N-cadherin-downregulation results in a significant decrease of proliferation, migration, and invasion and stimulates apoptosis in cisplatin-naive and resistant GCT cell lines. Therefore, targeting N-cadherin may be a promising therapeutic approach, particularly in cisplatin-resistant, therapy refractory and metastatic GCT.
    Oncotarget 07/2015; 6(32). DOI:10.18632/oncotarget.5288 · 6.36 Impact Factor
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    ABSTRACT: Preoperative chemoradiotherapy with infusional fluorouracil, total mesorectal excision surgery, and postoperative chemotherapy with fluorouracil was established by the German CAO/ARO/AIO-94 trial as a standard combined modality treatment for locally advanced rectal cancer. Here we compare the previously established regimen with an investigational regimen in which oxaliplatin was added to both preoperative chemoradiotherapy and postoperative chemotherapy. In this multicentre, open-label, randomised, phase 3 study we randomly assigned patients with rectal adenocarcinoma, clinically staged as cT3-4 or any node-positive disease, to two groups: a control group receiving standard fluorouracil-based combined modality treatment, consisting of preoperative radiotherapy of 50·4 Gy in 28 fractions plus infusional fluorouracil (1000 mg/m(2) on days 1-5 and 29-33), followed by surgery and four cycles of bolus fluorouracil (500 mg/m(2) on days 1-5 and 29); or to an investigational group receiving preoperative radiotherapy of 50·4 Gy in 28 fractions plus infusional fluorouracil (250 mg/m(2) on days 1-14 and 22-35) and oxaliplatin (50 mg/m(2) on days 1, 8, 22, and 29), followed by surgery and eight cycles of oxaliplatin (100 mg/m(2) on days 1 and 15), leucovorin (400 mg/m(2) on days 1 and 15), and infusional fluorouracil (2400 mg/m(2) on days 1-2 and 15-16). Randomisation was done with computer-generated block-randomisation codes stratified by centre, clinical T category (cT1-3 vs cT4), and clinical N category (cN0 vs cN1-2) without masking. The primary endpoint was disease-free survival, defined as the time between randomisation and non-radical surgery of the primary tumour (R2 resection), locoregional recurrence after R0/1 resection, metastatic disease or progression, or death from any cause, whichever occurred first. Survival and cumulative incidence of recurrence analyses followed the intention-to-treat principle; toxicity analyses included all patients treated. Enrolment of patients in this trial is completed and follow-up is ongoing. This study is registered with, number NCT00349076. Of the 1265 patients initially enrolled, 1236 were assessable (613 in the investigational group and 623 in the control group). With a median follow-up of 50 months (IQR 38-61), disease-free survival at 3 years was 75·9% (95% CI 72·4-79·5) in the investigational group and 71·2% (95% CI 67·6-74·9) in the control group (hazard ratio [HR] 0·79, 95% CI 0·64-0·98; p=0·03). Preoperative grade 3-4 toxic effects occurred in 144 (24%) of 607 patients who actually received fluorouracil and oxaliplatin during chemoradiotherapy and in 128 (20%) of 625 patients who actually received fluorouracil chemoradiotherapy. Of 445 patients who actually received adjuvant fluorouracil and leucovorin and oxaliplatin, 158 (36%) had grade 3-4 toxic effects, as did 170 (36%) of 470 patients who actually received adjuvant fluorouracil. Late grade 3-4 adverse events in patients who received protocol-specified preoperative and postoperative treatment occurred in 112 (25%) of 445 patients in the investigational group, and in 100 (21%) of 470 patients in the control group. Adding oxaliplatin to fluorouracil-based neoadjuvant chemoradiotherapy and adjuvant chemotherapy (at the doses and intensities used in this trial) significantly improved disease-free survival of patients with clinically staged cT3-4 or cN1-2 rectal cancer compared with our former fluorouracil-based combined modality regimen (based on CAO/ARO/AIO-94). The regimen established by CAO/ARO/AIO-04 can be deemed a new treatment option for patients with locally advanced rectal cancer. German Cancer Aid (Deutsche Krebshilfe). Copyright © 2015 Elsevier Ltd. All rights reserved.
    The Lancet Oncology 07/2015; 16(8). DOI:10.1016/S1470-2045(15)00159-X · 24.69 Impact Factor
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    ABSTRACT: Oral tongue squamous cell carcinoma (OTSCC) is associated with poor prognosis. To improve prognostication, we analyzed four gene probes (TERC, CCND1, EGFR, and TP53) and the centromere probe CEP4 as a marker of chromosomal instability, using fluorescence in situ hybridization (FISH) in single cells from the tumors of sixty-five OTSCC patients (Stage I, n=15; Stage II, n=30; Stage III, n=7; Stage IV, n=13). Unsupervised hierarchical clustering of the FISH data distinguished three clusters related to smoking status. Copy number increases of all five markers were found to be correlated to non-smoking habits, while smokers in this cohort had low-level copy number gains. Using the phylogenetic modeling software FISHtrees, we constructed models of tumor progression for each patient based on the four gene probes. Then, we derived test statistics on the models that are significant predictors of disease-free and overall survival, independent of tumor stage and smoking status in multivariate analysis. The patients whose tumors were modeled as progressing by a more diverse distribution of copy number changes across the four genes have poorer prognosis. This is consistent with the view that multiple genetic pathways need to become deregulated in order for cancer to progress. This article is protected by copyright. All rights reserved. © 2015 UICC.
    International Journal of Cancer 07/2015; 138(1). DOI:10.1002/ijc.29691 · 5.09 Impact Factor
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    ABSTRACT: Plakophilin (PKP) 1 is frequently downregulated in prostate cancer and therefore may play a tumor-suppressive role. In the present study, we stably knocked down PKP1 in the non-neoplastic, prostatic BPH-1 cell line. In the PKP1-deficient cells, the expression of keratin 14 was lost, and the apoptosis rate was significantly reduced indicating that the cells acquired new biological capabilities. Moreover, we analyzed the gene expression profile of the PKP1-deficient BPH-1 cells. Among the genes that were significantly altered upon PKP1 knockdown, we noticed several extracellular matrix (ECM)-related genes and identified sparc/osteonectin, cwcv, and kazal-like domains proteoglycan 1 (SPOCK1/testican-1) as a gene of interest. SPOCK1 is a component of the ECM and belongs to a matricellular protein family named secreted protein, acidic, cysteine-rich (SPARC). The role of SPOCK1 in prostate cancer has not been clearly elucidated. We analyzed SPOCK1 mRNA expression levels in different cancer databases and characterized its expression in 136 prostatic adenocarcinomas by immunohistochemistry and western blot. SPOCK1 revealed a cytoplasmic localization in the glandular epithelium of the prostate and showed a significant upregulation of mRNA and protein in prostate tumor samples. Our findings support the hypothesis that PKP1 may have a tumor-suppressive function and suggest an important role of SPOCK1 in prostate tumor progression. Collectively, altered expression of PKP1 and SPOCK1 appears to be a frequent and critical event in prostate cancer.
    Tumor Biology 07/2015; DOI:10.1007/s13277-015-3628-3 · 3.61 Impact Factor
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    ABSTRACT: Objective The capacity of thymomas to generate mature CD4+ effector T cells from immature precursors inside the tumor and export them to the blood is associated with thymoma-associated myasthenia gravis (TAMG). Why TAMG(+) thymomas generate and export more mature CD4+ T cells than MG(−) thymomas is unknown.Methods Unfixed thymoma tissue, thymocytes derived thereof, peripheral blood mononuclear cells (PBMCs), T-cell subsets and B cells were analysed using qRT-PCR and western blotting. Survival of PBMCs was measured by MTT assay. FAS-mediated apoptosis in PBMCs was quantified by flow cytometry. NF-κB in PBMCs was inhibited by the NF-κB-Inhibitor, EF24 prior to FAS-Ligand (FASLG) treatment for apoptosis induction.ResultsExpression levels of the apoptosis inhibitor cellular FLICE-like inhibitory protein (c-FLIP) in blood T cells and intratumorous thymocytes were higher in TAMG(+) than in MG(−) thymomas and non-neoplastic thymic remnants. Thymocytes and PBMCs of TAMG patients showed nuclear NF-κB accumulation and apoptosis resistance to FASLG stimulation that was sensitive to NF-κB blockade. Thymoma removal reduced cFLIP expression in PBMCs.InterpretationWe conclude that thymomas induce cFLIP overexpression in thymocytes and their progeny, blood T cells. We suggest that the stronger cFLIP overexpression in TAMG(+) compared to MG(−) thymomas allows for the more efficient generation of mature CD4+ T cells in TAMG(+) thymomas. cFLIP overexpression in thymocytes and exported CD4+ T cells of patients with TAMG might contribute to the pathogenesis of TAMG by impairing central and peripheral T-cell tolerance.
    05/2015; 2(9):n/a-n/a. DOI:10.1002/acn3.210
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    ABSTRACT: In-depth analyses of cancer cell proteomes are needed to elucidate oncogenic pathomechanisms, as well as to identify potential drug targets and diagnostic biomarkers. However, methods for quantitative proteomic characterization of patient-derived tumors and in particular their cellular subpopulations are largely lacking. Here we describe an experimental set-up that allows quantitative analysis of proteomes of cancer cell subpopulations derived from either liquid or solid tumors. This is achieved by combining cellular enrichment strategies with quantitative Super-SILAC-based mass spectrometry followed by bioinformatic data analysis. To enrich specific cellular subsets, liquid tumors are first immunophenotyped by flow cytometry followed by FACS-sorting; for solid tumors, laser-capture microdissection is used to purify specific cellular subpopulations. In a second step, proteins are extracted from the purified cells and subsequently combined with a tumor-specific, SILAC-labeled spike-in standard that enables protein quantification. The resulting protein mixture is subjected to either gel electrophoresis or Filter Aided Sample Preparation (FASP) followed by tryptic digestion. Finally, tryptic peptides are analyzed using a hybrid quadrupole-orbitrap mass spectrometer, and the data obtained are processed with bioinformatic software suites including MaxQuant. By means of the workflow presented here, up to 8,000 proteins can be identified and quantified in patient-derived samples, and the resulting protein expression profiles can be compared among patients to identify diagnostic proteomic signatures or potential drug targets.
    Journal of Visualized Experiments 02/2015; DOI:10.3791/52435 · 1.33 Impact Factor
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    ABSTRACT: Thymoma-associated Myasthenia gravis (TAMG) is one of the anti-acetylcholine receptor MG (AChR-MG) subtypes. The clinico-pathological features of TAMG and its pathogenesis are described here in comparison with pathogenetic models suggested for the more common non-thymoma AChR-MG subtypes, early onset MG and late onset MG. Emphasis is put on the role of abnormal intratumorous T cell selection and activation, lack of intratumorous myoid cells and regulatory T cells as well as deficient expression of the autoimmune regulator (AIRE) by neoplastic thymic epithelial cells. We review spontaneous and genetically engineered thymoma models in a spectrum of animals and the extensive clinical and immunological overlap between canine, feline and human TAMG. Finally, limitations and perspectives of the transplantation of human and murine thymoma tissue into nude mice, as potential models for TAMG, are addressed. Copyright © 2015. Published by Elsevier Inc.
    Experimental Neurology 02/2015; 270. DOI:10.1016/j.expneurol.2015.02.010 · 4.70 Impact Factor
  • C. Wittekind · P. Ströbel ·
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    ABSTRACT: Hintergrund und Ziele Vor dem sich ändernden Profil der Pathologie nehmen die Anforderungen an das Fach zu. Besondere Aspekte ergeben sich im Umgang mit dem Gewebe von Patienten, die einer neoadjuvanten Therapie zugeführt wurden. In diesem Beitrag wird vornehmlich auf Entwicklungen aus der translationalen Forschung eingegangen, welche die klinische Betrachtung und die histopathologische Gewebediagnostik bei Patienten mit Rektumkarzinomen beeinflussen. Methoden Anhand einer manuellen Literaturrecherche deutsch- und englischsprachiger Artikel der Jahre 2002 bis 2014 wurden wichtige neue Aspekte der molekularen Karzinogenese des Rektumkarzinoms ermittelt und deren Relevanz für die Diagnostik, Therapie und pathologischen Klassifikationen zusammengefasst. Ergebnisse Nach neoadjuvanter Therapie des Rektumkarzinoms müssen zahlreiche Besonderheiten mit klinischen Konsequenzen bei der makroskopischen Begutachtung, dem Präparatezuschnitt und der Tumorklassifikation beachtet werden. Trotz neuer Erkenntnisse über die molekulare Karzinogenese des Rektumkarzinoms existieren bislang keine außerhalb von Studien etablierten Biomarker, die das Ansprechen auf eine neoadjuvante Therapie vorhersagen. Schlussfolgerungen Durch Anwendung neoadjuvanter Therapieverfahren bei Patienten mit Rektumkarzinomen wird eine Vielzahl von Effekten erzielt, deren Auswirkungen weder lokal noch systemisch bisher vollständig verstanden sind. Letztlich werden Strategien und Behandlungskonzepte, die auf einem besseren Verständnis der Tumor- und Systembiologie basieren, zu Fortschritten in der Prognosebeurteilung und durch hierauf abgestimmte zielgerichtete Behandlungen auch zu einer Verbesserung der Therapieresultate verhelfen.
    Der Onkologe 02/2015; 21(2):136-142. DOI:10.1007/s00761-014-2764-5 · 0.14 Impact Factor
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    ABSTRACT: The rarity of thymomas and lack of multi-institutional studies have hampered therapeutic progress for decades. To overcome this, the members of the International Thymic Malignancy Interest Group created a worldwide retrospective database. This database was analyzed regarding the demographic and geographic distribution of thymomas and the impact of different variables on survival and recurrence. This study analyzed 4221 thymomas diagnosed between 1983 and 2012 with World Health Organization histotype information from the International Thymic Malignancy Interest Group database. Associations to survival and recurrence were studied by univariate and multivariate analyses. Type B2 thymoma is the most common (28%) and type A the least common (12%) histotypes. They are significantly more frequent in Europe and the United States than Asia. Type A and AB occur at significantly higher age than other thymomas (64 and 57 years, respectively). There are no differences in gender distribution. Stage is lower in type A (90% in stages I-II) and AB than B1 to B3 thymomas (38% of type B3 in stage III). In univariate analysis, recurrence is significantly less frequent among stage I/II tumors, in type A and AB (recurrence rates, 1-2%) than B1 to B3 thymomas (2-7%). Multivariate analysis reveals an impact of age, stage, and resection status on survival and recurrence, whereas for histology there is only a significant impact on recurrence. New findings are (1) geographic differences such as a lower incidence of type A and B2 thymoma in Asia; and (2) impact of stage and histology, the latter partially limited to early stage disease, on recurrence.
    Journal of thoracic oncology: official publication of the International Association for the Study of Lung Cancer 02/2015; 10(2):367-372. DOI:10.1097/JTO.0000000000000393 · 5.28 Impact Factor
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  • T Martini · P Ströbel · A Steidler · N Petrakopoulou · P Erben · C Bolenz ·
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    ABSTRACT: Hintergrund Die lymphovaskuläre Invasion (LVI) gilt als wichtiger Prognosefaktor für die Rezidivbildung bei Patienten mit lokal begrenztem Urothelkarzinom der Harnblase (UCB) nach radikaler Zystektomie (RZE). Wir untersuchten die Bedeutung des immunhistochemischen (IHC-)Markers D2-40 für die Detektion einer LVI im Vergleich zur konventionellen Hämatoxylin-Eosin- (HE-)Färbung. Material und Methoden Es erfolgten HE- und IHC-Färbungen mittels D2-40-Antikörper repräsentativer Schnitte von 80 Patienten nach RZE. Alle Tumorschnitte wurden reevaluiert und verblindet auf das Vorhandensein einer LVI untersucht. Ergebnisse In der in HE-Färbung zeigten 53 Patienten (66,3 %) und in der IHC 44 Patienten (55 %) eine LVI. 13 Patienten (16,3 %) wiesen eine LVI nur in der HE-Färbung (HE-Färbung falsch-positiv; IHC als Referenz betrachtet) auf. Mittels D2-40 konnte bei 4 zusätzlichen Patienten (5 %) eine LVI diagnostiziert werden (falsch-negativ). 52 Patienten (65 %) wurden als pN0 klassifiziert, davon zeigten 21 (40,4 %) eine LVI in der HE- und 16 (30,8 %) eine LVI in der IHC-Färbung. Bei 9 Patienten im Stadium pN0 (17,3 %) wurde eine LVI durch IHC nicht bestätigt (falsch-positiv). Die IHC detektierte bei 4 zusätzlichen Patienten (7,7 %) eine LVI (falsch-negativ). Von diesen erlitten 3 Patienten ein Rezidiv des UCB. Bei Patienten mit Krankheitsrezidiv (n = 35) und pN0 zum Zeitpunkt der RZE zeigte die HE-Färbung bezüglich einer LVI falsch-positive Resultate bei 2 (5,7 %) und falsch-negative Ergebnisse bei 3 Patienten (8,6 %). Schlussfolgerung Die IHC mit D2-40 verändert die Detektionsraten der LVI im Vergleich zur konventionellen HE-Färbung. Ein routinemäßiger Einsatz der D2-40-IHC kann die Risikostratifizierung von Patienten ohne Lymphknotenmetastasen verbessern und für das Design innovativer klinischer Studien dienen.
    Der Urologe 11/2014; 54(1). DOI:10.1007/s00120-014-3646-6 · 0.44 Impact Factor

  • Cancer Research 10/2014; 74(19 Supplement):4203-4203. DOI:10.1158/1538-7445.AM2014-4203 · 9.33 Impact Factor

Publication Stats

4k Citations
953.09 Total Impact Points


  • 2013-2015
    • Georg-August-Universität Göttingen
      • Faculty of Medicine
      Göttingen, Lower Saxony, Germany
    • Universitair Medisch Centrum Groningen
      Groningen, Groningen, Netherlands
  • 2012-2015
    • Universitätsklinikum Freiburg
      • • Institute of Pathology
      • • Department of General and Visceral Surgery
      Freiburg an der Elbe, Lower Saxony, Germany
  • 2013-2014
    • Universitätsmedizin Göttingen
      • Department of Pathology
      Göttingen, Lower Saxony, Germany
  • 2008-2014
    • Universität Heidelberg
      • • Department of Pathology
      • • Institute of Pathology (Heidelberg)
      • • Institute of Papyrology
      Heidelburg, Baden-Württemberg, Germany
  • 2001-2013
    • University of Wuerzburg
      • Institute for Pathology
      Würzburg, Bavaria, Germany
  • 2007-2012
    • Universität Mannheim
      Mannheim, Baden-Württemberg, Germany
  • 2009-2011
    • Universitätsmedizin Mannheim
      Mannheim, Baden-Württemberg, Germany
    • Université Victor Segalen Bordeaux 2
      Burdeos, Aquitaine, France
  • 2008-2011
    • Memorial Sloan-Kettering Cancer Center
      New York, New York, United States
  • 2010
    • University of Münster
      • Department of Urology
      Muenster, North Rhine-Westphalia, Germany