Lester Layfield

Publications (9)12.04 Total impact

• Article: Identification of factors predictive of malignancy in patients with atypical biliary brushing results obtained via ERCP.

  Benjamin L Witt, R N Kristen Hilden, Courtney Scaife, Barbara Chadwick, Lester Layfield, W Cory Johnston, Maryam Safaee, Ali Siddiqui, Douglas G Adler
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  ABSTRACT: Biliary brushings obtained during ERCP can have one of three cellular interpretations: benign, malignant, or "atypical." Atypical interpretations usually result in further testing, and may cause controversy over management and increases in cost. We evaluated a large cohort of patients with atypical biliary brushings for analysis and risk stratification. All biliary brushing specimens collected between January 1, 2001 and December 31, 2010 that had an atypical result were included. Hospital electronic records were reviewed for these patients to include: demographics, indication for ERCP, endoscopist/pathologist impressions, serologic testing, stricture site, and information relating to the final clinical diagnosis. Eighty-six patients were included. Totally, 60/86 patients (70%) had malignancies while 26/86 (30%) had no evidence of malignancy during long term follow up. Univariate analysis showed that the risk of malignant outcomes was significantly associated with older age, suspicious/malignant endoscopic impression, pancreatic mass, indications including jaundice and/or dilated bile ducts, stricture location within the common bile duct, PSC, and CA 19-9 levels >300 U/mL. We created a novel scoring system for prediction of malignancy based on clinical and endoscopic factors. We identified parameters that are typically available to the clinician to categorize patients with an "atypical" bile duct brushing results into "high risk" and "lower risk" classifications. Our proposed scoring system would allow such risk stratification to take place. Diagn. Cytopathol. 2012. © 2012 Wiley Periodicals, Inc.
  Diagnostic Cytopathology 09/2012; · 1.16 Impact Factor
• Article: Detection of human papillomavirus using hybrid capture 2 in oral brushings from patients with oropharyngeal squamous cell carcinoma.

  Elke A Jarboe, Mark Willis, Brandon Bentz, Luke Buchmann, Jason Hunt, Gary Ellis, Lester Layfield
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  ABSTRACT: Detection of high-risk (HR) human papillomavirus (HPV) in oropharyngeal squamous cell carcinoma (SCC) has important prognostic implications; patients exhibit improved survival compared with patients with HPV- SCC. Oral brushing and rinsing samples were obtained from patients with oropharyngeal, oral cavity, or hypopharyngeal SCC and tested for HR-HPV using Hybrid Capture 2 (HC2; QIAGEN, Valencia, CA). HR-HPV in situ hybridization (ISH) was performed on biopsy tissue samples from the same patients. Oral cytologic samples from 16 SCCs were tested by HC2. Biopsy tissue samples were available for ISH in 11 cases. Five oropharyngeal SCCs were HR-HPV+ by ISH and HC2 (oral brushing). Of the oropharyngeal SCCs, 2 were positive by HC2 (oral brushing) and negative or equivocal by ISH. We found that 2 oral cavity carcinomas and 2 hypopharyngeal carcinomas were negative by HC2. One hypopharyngeal cancer was positive by ISH. All oral rinsing samples were negative by HC2. HC2 may be an effective method of determining HR-HPV status in patients with oropharyngeal SCC.
  American Journal of Clinical Pathology 05/2011; 135(5):766-9. · 2.60 Impact Factor
• Article: Medical image. A case of recurrent hypoglycaemia. Insulinoma.

  Scott Swendsen, Lester Layfield, Douglas G Adler
  The New Zealand medical journal 08/2010; 123(1320):94-5.
• Article: Lack of BRAF activating mutations in prostate adenocarcinoma: a study of 93 cases.

  Ting Liu, Carlynn Willmore-Payne, Lester J Layfield, Joseph A Holden
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  ABSTRACT: Oncogenic activating mutations in the cytosolic serine/threonine kinase, BRAF, have been reported in a variety of neoplasms. BRAF relays signals from membrane-bound RAS downstream through the MAP/ERK (mitogen-activated protein kinase/extracellular signal-regulated kinase) signaling pathway. The presence of BRAF activating mutations suggests the importance of the MAP/ERK kinase pathway for tumor growth and points to possible therapeutic interventions. Recently, BRAF mutations were reported to characterize a series of prostate adenocarcinomas. In this study, we used DNA melting analysis with high-resolution technology to screen a series of 93 prostate carcinomas for BRAF mutations. None were found. This suggests that BRAF mutations may not play an important role in the oncogenesis or therapy of prostate adenocarcinoma.
  Applied immunohistochemistry & molecular morphology: AIMM / official publication of the Society for Applied Immunohistochemistry 12/2008; 17(2):121-5. · 1.63 Impact Factor
• Article: Monoplex LightCycler polymerase chain reaction quantitation of the HER2 gene for quality assurance of HER2/neu testing by immunohistochemistry and fluorescence in situ hybridization.

  Lester J Layfield, Carlynn Willmore-Payne, Gary Isom, Joseph A Holden
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  ABSTRACT: Assessment of HER2 by immunohistochemistry (IHC) or fluorescence in situ hybridization (FISH) is a standard practice for breast carcinomas. Testing is associated with a 20% disagreement between laboratories. The College of American Pathologists (CAP) guidelines for HER2 testing include validation of HER2 test methods by achieving 95% concordance with another validated method. Our laboratory requires IHC 3+ FISH nonamplified specimens to undergo retesting by polymerase chain reaction (PCR). A random sample of IHC 2+ cases are routinely tested by PCR. We found this practice useful for resolving discrepancies in HER2 testing. At clinician request, seventy-nine 3+ and one hundred forty-eight 2+ cases were tested by FISH. In 22 cases, IHC was 3+ but FISH was nonamplified. These 22 cases underwent HER2 LightCycler monoplex polymerase chain reaction (MPCR) testing. Seventeen 2+ nonamplified cases were tested by MPCR. Twenty-one 3+, FISH nonamplified cases were found to be MPCR nonamplified. One IHC 3+, FISH nonamplified case was MPCR amplified. Seventeen 2+, FISH nonamplified cases were MPCR nonamplified. In all but one case, FISH and MPCR were concordant. American Society of Clinical Oncology/CAP guidelines propose validation of testing procedures by showing 95% concordance with a validated test for positive and negative assays. Specific actions are not recommended to resolve discordances between tests. Our laboratory uses 3 different modalities for HER2 testing. We have found that our 2 methods for testing gene amplification status show a higher degree of concordance between themselves than either did with IHC. Review of the 3+ IHC nonamplified cases showed them to have a dark, granular circumferential staining pattern.
  Applied immunohistochemistry & molecular morphology: AIMM / official publication of the Society for Applied Immunohistochemistry 11/2008; 16(6):562-7. · 1.63 Impact Factor
• Article: Fluorescence in situ hybridization determination of aneusomy: criteria and technical considerations.

  Barbara Chadwick, Carlynn Willmore-Payne, Joseph Holden, Lester Layfield
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  ABSTRACT: To investigate a series of tissues to determine if proliferation rate can affect chromosome counts by fluorescence in situ hybridization (FISH). We studied 9 non-neoplastic tissues and a trisomy 7 and tetrasomy 13 cell line by FISH. For each sample, 100 cells were analyzed for chromosome 7 and 13 number and MIB-1 expression. Centrometric enumeration probe (CEP) 7 counts were correlated with proliferation index. Average CEP 7 number showed a relationship to proliferation index, with higher CEP 7 averages associated with higher proliferation indices. Specimens of brain tissue demonstrated average CEP 7 counts between 1.64 and 1.75. Tissues with high proliferation indices (23-66%) demonstrated CEP 7 counts between 2.14 and 2.31. The average CEP 7 count for the trisomy 7 cell line was 2.61. The average LSI 13 count for the tetrasomy 13 cell line was 3.65. Chromosome 7 FISH counts demonstrated overlap between diploid tissues with high proliferation and triploid chromosome 7 tissues. This overlap was seen when 95% CI limits were used. The trisomic 7 and tetrasomic 13 cell lines demonstrated average CEP 7 and CEP 13 levels below 3 and 4, respectively. Definitions used for determination of polysomy should take into account tissue proliferation and section thicknesses.
  Analytical and quantitative cytology and histology / the International Academy of Cytology [and] American Society of Cytology 01/2008; 29(6):351-7. · 0.41 Impact Factor
• Article: Malignant fibrous histiocytoma of soft tissue: an abandoned diagnosis.

  R Lor Randall, Karen H Albritton, Brandon J Ferney, Lester Layfield
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  ABSTRACT: Malignant fibrous histiocytoma (MFH) has been regarded as the most common soft-tissue sarcoma of adult life. Since it was first recognized in the early 1960s, however, MFH has been plagued by controversy in terms of both its histogenesis and its validity as a clinicopathologic entity. The latest World Health Organization classification no longer includes MFH as a distinct diagnostic category but rather as subtypes of an undifferentiated pleomorphic sarcoma. In this article, we review the current understanding of the histologic subtype classification of tumors previously diagnosed as MFH and its relation to clinical outcomes.
  American journal of orthopedics (Belle Mead, N.J.) 01/2005; 33(12):602-8.
• Article: Endolymphatic sac tumors in patients with and without von Hippel-Lindau disease: the role of genetic mutation, von Hippel-Lindau protein, and hypoxia inducible factor-1alpha expression.

  Randy L Jensen, David Gillespie, Paul House, Lester Layfield, Clough Shelton
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  ABSTRACT: Endolymphatic sac (ELS) tumors are low-grade malignancies of the temporal bone that are associated with von Hippel-Lindau (VHL) disease but can also occur sporadically. The VHL gene product VHL protein is important in the regulation of hypoxia inducible factor (HIF)-1alpha, which controls expression of molecules that are important in angiogenesis and cell metabolism. In this study the authors examine the role of VHL and HIF-1 in ELS tumors. The ELS tumors from three patients were examined using the following method: DNA from tumor tissue was isolated, amplified by polymerase chain reaction and the VHL gene sequence was compared with the known wild-type sequence. Loss of heterozygosity (LOH) studies were performed to confirm the sequencing data. Immunohistochemical evaluation for VHL, HIF-1alpha, vascular endothelial growth factor (VEGF), and carbonic anhydrase IX (CA IX) was performed. Snap-frozen tumor tissue was examined using Western blot and HIF-1 immunoassays for HIF-1alpha and VHL expression. Two patients had sporadic ELS tumors and the other one suffered from VHL disease. Results of VHL gene sequencing were normal in the tissue derived from the sporadic ELS tumors. The ELS tumor, pheochromocytoma, and spinal hemangioblastoma were heterozygous for the same C-to-A transversion found in the germline carried by the patient with VHL disease. No LOH was detected in the tumor tissue obtained in the patient with VHL disease. Expression of HIF-1alpha, VEGF, and CA IX evaluated using immunohistochemical studies was elevated in the VHL-associated tumors. Nevertheless, Western blots and immunoassays for HIF-1alpha did not show elevated expression in these tumors. The sporadic and VHL disease-associated ELS tumors in this study had normal VHL-mediated HIF-1 regulation. This is a result of normal VHL gene expression in the case of the sporadic ELS tumor. In the VHL-associated ELS tumor, this is due to one normal copy of the VHL gene and adequate VHL gene expression.
  Journal of Neurosurgery 04/2004; 100(3):488-97. · 2.96 Impact Factor
• Article: MRI appearance of pseudoangiomatous stromal hyperplasia causing asymmetric breast enlargement.

  Henry Baskin, Lester Layfield, Glen Morrell
  The Breast Journal 13(2):209-10. · 1.64 Impact Factor