Histopathology is the gold standard method for staging and grading human tumors and provides critical information for the oncoteam’s decision making. Highly-trained pathologists are needed for careful microscopic analysis of the slides produced from tissue taken from biopsy. This is a time-consuming process. A reliable decision support system would assist healthcare systems that often suffer from a shortage of pathologists. Recent advances in digital pathology allow for high-resolution digitalization of pathological slides. Digital slide scanners combined with modern computer vision models, such as convolutional neural networks, can help pathologists in their everyday work, resulting in shortened diagnosis times. In this study, 200 digital whole-slide images are published which were collected via hematoxylin-eosin stained colorectal biopsy. Alongside the whole-slide images, detailed region level annotations are also provided for ten relevant pathological classes. The 200 digital slides, after pre-processing, resulted in 101,389 patches. A single patch is a 512 × 512 pixel image, covering 248 × 248 μm2 tissue area. Versions at higher resolution are available as well. Hopefully, HunCRC, this widely accessible dataset will aid future colorectal cancer computer-aided diagnosis and research.

Bevezetés: A SARS-CoV-2 (súlyos akut légzőszervi szindrómát előidéző koronavírus) okozta COVID–19 világszerte sajnálatosan nagy halálozással jár. A fertőzés kimutatása elsősorban polimeráz-láncreakcióval (PCR) történik élőben vagy a halál után, amely azonban nem ad információt arról, hogy a vírus mely sejtekben, szövetekben van jelen. A SARS-CoV-2 tüske- és nukleokapszid-proteinjeinek, valamint a vírus-ribonukleinsavnak (RNS) az in situ kimutatása igazolhatja a vírus jelenlétét, valamint adatot szolgáltathat annak direkt vagy indirekt sejtpusztulást okozó mechanizmusáról. Jelenleg számos SARS-CoV-2-tüske- és -nukleokapszid fehérjeellenes antitest van kereskedelmi forgalomban, melyek eltérő eredménnyel képesek a megfelelő antigének kimutatására. Célkitűzés: A jelen munka célja a megfelelő, megbízhatóan működő antitest kiválasztása volt. Módszer: COVID–19-ben elhunyt 3 egyén formalinfixált, paraffinba ágyazott, SARS-CoV-2-PCR-pozitív tüdejének anyagai, valamint fertőzött placenta anonim módon jelölt mintái kerültek vizsgálatra, megfelelő negatív kontrollal. Az immunhisztokémiai reakciók intenzitását és specificitását hasonlították össze négy hazai orvostudományi egyetemi patológiai intézet részvételével, különböző antitesteket és hígításokat alkalmazva. Az elvégzett immunhisztokémiai reakciók szkennelt, kódolt metszeteken kerültek értékelésre, majd az eredmények összesítése után statisztikai elemzésre. Eredmények: A vizsgálatok alapján meghatározhatók voltak azon antitestek, amelyek a jelölt hígításban és módszerrel megfelelő intenzitású, megbízható eredményt adtak. Következtetés: A vizsgálat alapot ad arra, hogy a SARS-CoV-2 egyes komponensei biopsziás/sebészi anyagban és az elhunytak szöveteiben nagy pontossággal és reprodukálható módon kimutathatók legyenek a COVID–19-ben megbetegedett, elhunyt egyének élőben vagy halál után eltávolított szöveteiben, sejtjeiben. Orv Hetil. 2022; 163(25): 975–983.

Administration of targeted therapies provides a promising treatment strategy for rare cancers such as urachal adenocarcinoma (UrC) or primary bladder adenocarcinoma (PBAC), however, the selection of appropriate drugs remains difficult. Therefore, in the present study, we aimed to establish a routine compatible methodological pipeline for the identification of the most important therapeutic targets and potentially effective drugs for UrC and PBAC. Next-generation sequencing using a 161 cancer driver gene panel was performed on 41 UrC and 13 PBAC samples. Clinically relevant alterations were filtered by four publicly available databases. Therapeutic interpretation has been performed by in silico evaluation of drug-gene interactions using an evidence-based decision support tool. After data processing, 45/54 samples (33 UrC and 12 PBAC) passed the quality control. The sequencing analyses revealed a total of 191 pathogenic SNVs in 68 genes. The most frequent gain-of-function mutations in UrC were found in KRAS (33%), MYC (15%), EGFR (9%) and ERBB2 (9%), while in PBAC KRAS (25%), MYC (25%), FLT3 (17%) and TERT (17%) were recurrently affected. The most frequently affected pathways in both tumour types were related to cell cycle regulation, DNA damage control and the MAPK/RAS pathway. Actionable mutations with at least one available, regulatory agency-approved drug could be identified for 31/33 (94%) of UrC and 8/12 (67%) of PBAC patients. In this study, we used a commercially available assay and developed a data processing pipeline for the detection and therapeutic interpretation of genetic alterations in two rare cancers. Our analyses revealed actionable mutations in a high rate of cases, including EGFR, BRCA, CCND1/2/3, ERBB2, METex14 suggesting a potentially feasible strategy for both UrC and PBAC treatment.

Context Increasing diagnostic sensitivity in the detection of thyroid cancer has led to uncertainties in the optimal surgical approach of the smaller, low risk tumors. Current ATA guidelines consider lobectomy safe between 1 and 4 cm, while ETA advocates for primary total thyroidectomy to avoid reoperation, as final risk stratification is based on the histological results. Objective Our aim was to compare the differences in outcomes that are potentially achievable with adherence to the different guidelines, and also to examine the predictive value of clinical parameters on the incidence of postoperative risk factors. Methods We performed a retrospective cohort database analysis to identify the different surgical outcomes (based on postoperative risk factors) using ATA and ETA guidelines; the hypothetical rate of completion thyroidectomy when ATA or ETA recommends lobectomy; the accuracy of our preoperative evaluation; the utility of preoperative findings in predicting the optimal surgical strategy using binary logistic regression. Results Out of 248 patients, 152 (ATA) and 23 (ETA) cases would have been recommended for initial lobectomy. Following the guidelines, a postoperative risk factor would have been present in 61.8, and 65.2% of the cases, respectively. Except for angioinvasion, tumor size was not a significant predictor for the presence of postoperative risk factors. Conclusion Current pre-operative criteria are inadequate to accurately determine the extent of initial surgery and our postoperative findings verify the frequent need for completion thyroidectomy using both guidelines. As a consequence, in the absence of effective pre-operative set of criteria, we advocate primary total thyroidectomy in most cases.

There have been a number of notable strides in Hungary in the field of population pharmacogenomics. This paper aims to summarize and share the recent experiences in population genomics and personalized medicine in Hungary with leaders of the Genomic National Technology Platform. The present day Hungary differs from other populations in the region as Hungary was established some 1100 years ago, with founders of the ancestral Hungarian population originating from the east side of the Urals. Additionally, the Roma population of about 700,000 represents the largest ethnic minority living in Hungary. In a series of investigations, we found significant differences between the Hungarian and Roma populations in clinically relevant pharmacogenomics targets such as VKORC1 and CYP2C9 genes. Pharmacogenomics applications are also of interest from the standpoint of biomarker-guided drug discovery in Hungary which we highlight briefly in this paper. Regulatory, ethical and economic aspects of genomics are other dimensions crucial for efficient transition of basic genomics discoveries from laboratory to the clinic. Importantly, Hungary has a Parliamental Act for regulation of genetic diagnostic and research test procedures, and for regulation of biobanks since 2008. Diagnostic molecular pharmacogenomics tests are reimbursed from the same insurance budget as with the other molecular biology based tests in Hungary. Personalized medicine diagnostics require further considerations on how best to integrate and reimburse them in routine healthcare as this new field evolves in Hungary.