Edward J Gutmann

Dartmouth–Hitchcock Medical Center, Lebanon, New Hampshire, United States

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Publications (9)26.94 Total impact

  • Jonathan D Marotti, John D Seigne, Edward J Gutmann
    Diagnostic Cytopathology 11/2011; · 1.49 Impact Factor
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    ABSTRACT: Pancreatic ductal adenocarcinoma (PDAC) is a lethal malignancy. Diagnosis and management of PDAC are hampered by the absence of sensitive and specific disease biomarkers. MicroRNAs (miRNA) are noncoding regulatory RNAs involved in initiation and progression of human cancers. In this study, we sought to determine whether miR-10b could serve as a biomarker for PDAC. miRNA expression was characterized by fluorescence-based in situ hybridization using locked nucleic acid-modified DNA probes against miR-10b, miR-21, miR-155, miR-196a, and miR-210, followed by codetection of proteins by immunohistochemistry on the same tissue sections. miRNA expression in surgically resected PDAC tissues and in endoscopic ultrasonography (EUS)-guided fine-needle aspirate (EUS-FNA) samples was analyzed in cytokeratin 19 (CK19)-positive epithelial cells using optical intensity analysis. In 10 resected PDAC samples, miR-10b was the most frequently and consistently overexpressed miRNA among characterized miRNAs, exhibiting a four-fold increase in the cancer cells (P = 0.012). Given this preferential overexpression of miR-10b, we sought to determine whether miR-10b expression was clinically relevant. Accordingly, miR-10b expression was examined in 106 EUS-FNA samples obtained from pancreatic lesions. miR-10b expression was increased in cancer cells compared with CK19-positive epithelial cells in benign lesions (P = 0.0001). In patients with PDACs, lower levels of miR-10b were associated with improved response to multimodality neoadjuvant therapy, likelihood of surgical resection, delayed time to metastasis, and increased survival. miR-10b is a novel diagnostic biomarker for PDACs when assessing pancreatic lesions. Expression of miR-10b is predictive of response to neoadjuvant therapy and outcome in this disease.
    Clinical Cancer Research 06/2011; 17(17):5812-21. · 7.84 Impact Factor
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    ABSTRACT: MicroRNAs (miRNAs) are RNA molecules that are involved in the regulation of many cellular processes, including those related to human cancers. The aim of this study was to determine, as a proof of principle, whether specific candidate miRNAs could be detected in fine-needle aspirate (FNA) biopsies of pancreatic ductal adenocarcinoma (PDAC) and could accurately differentiate malignant from benign pancreatic tissues. We used TaqMan(R) assays to quantify miRNA levels in FNA samples collected in RNARetain (n = 16) and compared the results with a training set consisting of frozen macrodissected pancreatic samples (n = 20). Quantitative reverse-transcription PCR analysis confirmed that miRNA levels are affected in PDAC FNAs and correlate well with the changes observed in the training set of frozen pancreatic samples. Analysis of the amounts produced for a few specific miRNAs enabled identification of PDAC samples. The combination of miR-196a and miR-217 biomarkers further improved the ability to distinguish between healthy tissue, PDAC, and chronic pancreatitis in the training set (P = 8.2 x 10(-10)), as well as segregate PDAC FNA samples from other FNA samples (P = 1.1 x 10(-5)). Furthermore, we showed that miR-196a production is likely specific to PDAC cells and that its incidence paralleled the progression of PDAC. To the best of our knowledge, this study is the first to evaluate the diagnostic potential of miRNAs in a clinical setting and has shown that miRNA analysis of pancreatic FNA biopsy samples can aid in the pathologic evaluation of suspicious cases and may provide a new strategy for improving the diagnosis of pancreatic diseases.
    Clinical Chemistry 09/2008; 54(10):1716-24. · 7.15 Impact Factor
  • Edward J Gutmann
    Human pathology 08/2008; 39(8):1125-7. · 3.03 Impact Factor
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    ABSTRACT: Human polyomavirus infection, which can be detected morphologically on Pap-stained routine urine cytology specimens, is most commonly encountered in immunocompromised patients and is a well-described complication of renal transplantation. We present a case of an immunocompetent 5-year-old boy with a sudden onset of dysuria and hematuria due to a self-limited polyomavirus urinary tract infection detected on routine urine cytology and confirmed with real-time PCR. Although rare cases of nonhemorrhagic cystitis have been reported, to the best of our knowledge this is the first case of hemorrhagic cystitis occurring in this setting.
    Diagnostic Cytopathology 07/2008; 36(6):375-8. · 1.49 Impact Factor
  • Edward J Gutmann
    Diagnostic Cytopathology 01/2007; 34(12):824-5. · 1.49 Impact Factor
  • Edward J Gutmann, Arief Suriawinata, Stuart Gordon
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    ABSTRACT: An endoscopic ultrasound examination, performed to rule out invasive esophageal carcinoma in a patient with a history of Barrett's esophagus with high-grade dysplasia, disclosed an enlarged paraesophageal lymph node which was aspirated. The aspirate contained markedly atypical clustered large cells that displayed prominent nucleoli and mitoses, as well as lymphoid cells, suggestive of adenocarcinoma metastatic to a lymph node. The neoplastic-appearing cells were, in fact, dysplastic glandular cells that the needle traversed en route to a reactive lymph node. The case represents a rare instance in which Barrett's esophagus with high-grade dysplasia was discerned on fine needle aspiration (FNA) biopsy and highlights a potential pitfall in FNA.
    Diagnostic Cytopathology 08/2006; 34(7):507-10. · 1.49 Impact Factor
  • Bryan Coffing, Edward J Gutmann
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    ABSTRACT: Lymphangiomas are uncommon in the posterior mediastinum. We report a case of a lymphangioma in this location that was diagnosed by computed tomographic-guided fine-needle aspiration biopsy. The cell block of the lesion closely simulated a normal structure immediately adjacent to the target and could have been misdiagnosed as "normal tissue." On-site evaluation of the aspirate by a cytopathologist promoted pathologist-radiologist communication that helped prevent the potential error and facilitated making the correct diagnosis in the case.
    Diagnostic Cytopathology 01/2006; 33(6):412-5. · 1.49 Impact Factor
  • Edward J Gutmann, Justin M M Cates
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    ABSTRACT: It is uncommon for breast carcinoma to present as a malignant serous effusion. Here, we describe a case in which the initial diagnosis of an occult invasive ductal carcinoma of the breast was made via cytological examination of a pleural effusion. Recognition of a cribriform architecture with intraluminal necrosis and microcalcifications in a cell block preparation was critical in making that diagnosis. To our knowledge, this specific morphological pattern of breast carcinoma in a cell block preparation from an effusion has not been reported previously.
    Diagnostic Cytopathology 04/2005; 32(3):177-81. · 1.49 Impact Factor