Perez-Segura, P. (Pedro)

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    Role of flow cytometry immunophenotyping in the diagnosis of leptomeningeal carcinomatosis
    (Oxford University Press (OUP), 2012-01) Gil-Bazo, I. (Ignacio); Perez-Segura, P. (Pedro); Domine, M. (Manuel); Illan, J. (Julia); Serrano, C. (Cristina); Subira, D. (Dolores); Bruna, J. (Jordi); Martinez-Garcia, M. (María); Aparisi, F. (Francisco); Navarro, M. (Miguel); Pardo, J. (Javier); Castañon, S. (Susana); Gil, M. (Miguel); Millastre, E. (Esther); Raquel
    PURPOSE: To explore the contribution of flow cytometry immunophenotyping (FCI) in detecting leptomeningeal disease in patients with solid tumors. EXPERIMENTAL DESIGN: Cerebrospinal fluid (CSF) samples from 78 patients who received a diagnosis of epithelial-cell solid tumors and had clinical data suggestive of leptomeningeal carcinomatosis (LC) were studied. A novel FCI protocol was used to identify cells expressing the epithelial cell antigen EpCAM and their DNA content. Accompanying inflammatory cells were also described. FCI results (positive or negative for malignancy) were compared with those from CSF cytology and with the diagnosis established by the clinicians: patients with LC (n = 49), without LC (n = 26), and undetermined (n = 3). RESULTS: FCI described a wide range of EpCAM-positive cells with a hyperdiploid DNA content in the CSF of patients with LC. Compared with cytology, FCI showed higher sensitivity (75.5 vs 65.3) and negative predictive value (67.6 vs 60.5), and similar specificity (96.1 vs 100) and positive predictive value (97.4 vs 100). Concordance between cytology and FCI was high (Kp = 0.83), although misdiagnosis of LC did not show differences between evaluating the CSF with 1 or 2 techniques (P = .06). Receiver-operator characteristic curve analyses showed that lymphocytes and monocytes had a different distribution between patients with and without LC. CONCLUSION: FCI seems to be a promising new tool for improving the diagnostic examination of patients with suspicion of LC. Detection of epithelial cells with a higher DNA content is highly specific of LC, but evaluation of the nonepithelial cell compartment of the CSF might also be useful for supporting this diagnosis.
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    Prognostic value of human leukocyte antigen G expression in solid tumors: a systematic review and meta-analysis
    (2023) Perez-Segura, P. (Pedro); Ocaña, A. (Alberto); Benítez-Fuentes, J.D. (Javier David); Mittal, A. (Abhenil); Amir, E. (Eitan); Fernández-Hinojal, G. (Gonzalo); Molto, C. (Consolación); Bartolome, J. (Javier); Manzano, A. (Aranzazu); Tamimi, F. (Faris)
    Introduction Identification of modulators of the immune response with inhibitory properties that could be susceptible for therapeutic intervention is a key goal in cancer research. An example is the human leukocyte antigen G (HLA-G), a nonclassical major histocompatibility complex (MHC) class I molecule, involved in cancer progression.Methods In this article we performed a systematic review and meta-analysis on the association between HLA-G expression and outcome in solid tumors. This study was performed in accordance with PRISMA guidelines and registered in PROSPERO.Results A total of 25 studies met the inclusion criteria. These studies comprised data from 4871 patients reporting overall survival (OS), and 961 patients, reporting disease free survival (DFS). HLA-G expression was associated with worse OS (HR 2.09, 95% CI = 1.67 to 2.63; P < .001), that was higher in gastric (HR = 3.40; 95% CI = 1.64 to 7.03), pancreatic (HR = 1.72; 95% CI = 0.79 to 3.74) and colorectal (HR = 1.55; 95% CI = 1.16 to 2.07) cancer. No significant differences were observed between the most commonly utilized antibody (4H84) and other methods of detection. HLA-G expression was associated with DFS which approached but did not meet statistical significance.Discussion In summary, we describe the first meta-analysis associating HLA-G expression and worse survival in a variety of solid tumors.
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    Cancer-associated thrombosis: Beyond clinical practice guidelines-A multidisciplinary (SEMI-SEOM-SETH) expert consensus
    (Thieme, 2018) Muñoz, A. (Andrés); Perez-Segura, P. (Pedro); Font, C. (C.); Gallardo, E. (Enrique); Maestre, A. (Ana); Trujillo-Santos, J. (Javier); Pachón, V. (Vanessa); Mateo, J. (José); Peris, M.L. (María Luisa); Gonzalez-Porras, J.R. (José Ramón); Domènech, P. (Pere); Lecumberri, R. (Ramón)
    Despite the growing interest and improved knowledge about venous thromboembolism in cancer patients in the last years, there are still many unsolved issues. Due to the limitations of the available literature, evidence-based clinical practice guidelines are not able to give solid recommendations for challenging scenarios often present in the setting of cancer-associated thrombosis (CAT). A multidisciplinary expert panel from three scientific societies—Spanish Society of Internal Medicine (SEMI), Spanish Society of Medical Oncology (SEOM), and Spanish Society Thrombosis and Haemostasis (SETH) —agreed on 12 controversial questions regarding prevention and management of CAT, which were thoroughly reviewed to provide further guidance. The suggestions presented herein may facilitate clinical decisions in specific complex circumstances, until these can be made leaning on reliable scientific evidence.