Publications of Carla COIMBRA MARQUES
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See detailLa réhabilitation améliorée après chirurgie colorectale
HARDY, Pierre-Yves ULiege; MEUNIER, Anne ULiege; COIMBRA MARQUES, Carla ULiege et al

in Revue Médicale de Liège (2020), 75(5-6), 286-291

La réhabilitation améliorée après chirurgie (RAC) colorectale est une prise en charge multidisciplinaire et multimodale, centrée sur le patient. La mise en place de mesures pré-, per- et postopératoires ... [more ▼]

La réhabilitation améliorée après chirurgie (RAC) colorectale est une prise en charge multidisciplinaire et multimodale, centrée sur le patient. La mise en place de mesures pré-, per- et postopératoires réduit la réponse au stress chirurgical, la réaction inflammatoire et leurs conséquences. Ce protocole de soins, basé sur des preuves scientifiques, permet une récupération améliorée et accé- lérée. L’incidence des complications médicales est, secondairement, réduite de 50 %. La réhabilitation améliorée se traduit par une diminution significative de la durée d’hos- pitalisation, une diminution des complications infectieuses et, probablement, par un impact positif sur la survie après chirurgie oncologique. Il n’y a pas de contre-indication à la RAC qui doit donc être proposée à tous les patients devant subir une chirurgie colorectale. Une adaptation du protocole sera néanmoins nécessaire en cas de chirurgie urgente. [less ▲]

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See detailSLC12A2 as a potential histological marker of ulcerative colitis associated colorectal dysplasia
Merli, Angela-Maria ULiege; Vieujean, Sophie ULiege; Massot, Charlotte et al

Conference (2020, March 04)

Introduction: Patients suffering from ulcerative colitis (UC) are at increased risk of developing dysplasia (DAI) and colorectal cancer (CAC). Differentiating DAI from inflammation remains difficult for ... [more ▼]

Introduction: Patients suffering from ulcerative colitis (UC) are at increased risk of developing dysplasia (DAI) and colorectal cancer (CAC). Differentiating DAI from inflammation remains difficult for both endoscopists and anatomopathologists due to macro and microscopic features shared by these lesions. Aim: The aim of our work was to confirm, by histological evaluation, a potential proteomic biomarker discriminating early DAI lesions from chronic inflamed and normal tissues in UC. Methods: We included 15 paired tissues from UC patients (n=5) presenting low-grade DAI. Epithelial cells were isolated by laser capture microdissection and analyzed by label-free proteomics. We selected one protein differentially distributed between DAI, inflamed (I) and normal (N) tissues for confirmation by immunochemistry (IHC). IHC characterization was performed using both the staining intensity score (0 to 4) and the staining pattern: “gradient” (staining intensity increasing from the epithelium lumen to the bottom of the crypts) or “no gradient” (homogenous staining). UC patients with DAI (n=28), dysplastic lesion in non-inflammatory colon (DSp) (n=9), CAC (n=14) and at high risk of CAC (>10 years of UC duration) but free of dysplasia or cancer (n=23) were included. We further studied this potential marker tissue distribution in the mouse model of CAC (AOM/DSS treated mice) to trace its presentation at different evolution stages and assessed low (n=51), high-grade DAI (n=35) and CAC (n=38), as well as relevant paired control tissues. This potential tissue marker was finally evaluated in sporadic precancerous colorectal lesions of UC-free patients with low (n=19) and highgrade (n=16) adenomas and cancerous lesions (CRC): pT1 to pT4 (n=82) and compared to paired normal tissues when available. Results: Proteomics identified 1070 proteins among which 19 showed a differential distribution between DAI and I or N. The sodium chloride co-transporter SLC12A2 was only identified in DAI. SLC12A2 IHC “no gradient” staining pattern was associated to DAI and DSp compared to I or N (with p <0.0001 and 0.0002 respectively). The IHC score was also higher for DAI, DSp and CAC compared to paired I and N (p<0.0001 and 0.0084 respectively). These results were confirmed from low-grade dysplasia to more advanced lesions in the AOM/DSS mice model. The “no gradient” pattern was also significantly associated to low and high-grade adenomas, and CRC of UC-free patients compared to normal control tissues. The sensitivity and specificity of SLC12A2 histological pattern reached 89% and 95% for DAI versusI; 90% and 93% for CAC and/or DAI versus I. In addition, the sensitivity and specificity reached 99% and 87% for all precancerous and cancerous lesions (DAI, DSp, CAC and CRC) versus N and I (including also non-progressing UC patients). Conclusions: A specific histological pattern for SLC12A2 is associated to precancerous and cancerous colorectal lesions, and is able to be discriminate these lesions from inflammation and normal tissue in UC. The continuous upregulation of SLC12A2 in advanced colorectal lesionsin the CAC mice model also suggests a role of this protein in the pathophysiology of inflammation-associated colon neoplasia. [less ▲]

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See detailEvolution en chirurgie abdominale. Avancées techniques, collaboration intra et inter hospitalière.
KOHNEN, Laurent ULiege; MEURISSE, Nicolas ULiege; DECKER, Emmanuel ULiege et al

in Revue medicale de Liege (2020), 75(5-6), 280-285

During the last decade minimal invasive approach progressed in all sectors of abdominal surgery. Technological improvements allowed to perform more complex procedures laparoscopically with increased ... [more ▼]

During the last decade minimal invasive approach progressed in all sectors of abdominal surgery. Technological improvements allowed to perform more complex procedures laparoscopically with increased safety. The implementation of pre-, per- and postoperative protocols with an adaptation of surgical, anesthetic and analgesia methods and the patient's involvement in the healing process led to enhanced recovery after surgery. The centralization of complex esophageal and pancreatic surgery established the CHU of Liège as a tertiary referral institution for complex oncological surgery thanks to a large cooperation with regional hospitals. [less ▲]

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See detailFacteurs anatomo-cliniques influançant la collecte ganglionnaire dans les pièces de résection chirurgicale pour cancer colorectal
LEDUC, G; BAWIN, Maxime; KESTEMAN, M et al

in Revue Médicale de Liège (2019), 74:10

Dans la stadification de l’adénocarcinome colorectal, le statut ganglionnaire anatomopathologique constitue une information capitale pour le clinicien et doit être défini avec un maximum d’exactitude ... [more ▼]

Dans la stadification de l’adénocarcinome colorectal, le statut ganglionnaire anatomopathologique constitue une information capitale pour le clinicien et doit être défini avec un maximum d’exactitude. L’analyse de la pièce de résection chirurgicale requiert la collecte au sein du méso du plus grand nombre possible de ganglions lymphatiques. Dans cette étude, nous avons analysé une série de facteurs anatomo-cliniques pouvant influencer la collecte ganglionnaire. Un total de 239 patients a été inclus dans notre étude. Les facteurs avec une influence statistiquement significative sur la collecte ganglionnaire (p < 0,05) ont été l’âge et le sexe du patient, la taille de la tumeur primitive, la taille de la pièce d’exérèse, le degré d’activité du chirurgien et le laboratoire d’anatomie pathologique. La présence ou non d’une radiochimiothérapie néoadjuvante n’a pas eu d’impact sur le nombre de ganglions prélevés. Cette étude souligne l’importance de la collecte ganglionnaire au sein des pièces de résection chirurgicale d’un cancer colo-rectal. [less ▲]

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See detailCurious intra-rectal “laterally spreading tumor” in immunosuppressed patient with ulcerative colitis
VIEUJEAN, Sophie ULiege; LATOUR, Pascale ULiege; COIMBRA MARQUES, Carla ULiege et al

Conference (2018, February)

A 46-year-old man was admitted in June 2015 for the first time in our department for a colonoscopy in a context of ulcerative colitis, diagnosed 4 years earlier (ulcerative proctitis). At time of ... [more ▼]

A 46-year-old man was admitted in June 2015 for the first time in our department for a colonoscopy in a context of ulcerative colitis, diagnosed 4 years earlier (ulcerative proctitis). At time of diagnosis (2011), he was treated by oral Mesalazine, 5ASA suppositories and enema, Budesonide enema and then Azathioprine. Patient was asymptomatic for a long time but no follow-up had been achieved for at least 3 years. A colonoscopy was performed prior to potential immunosuppressive treatment discontinuation. This examination showed a kind of circumferential “laterally spreading tumor” with villous appearance located in the rectum 4 to 7 centimeters from the anal margin with a little triangular extension to the dentate line. Surprisingly rectal biopsies revealed a condyloma acuminatum with very focally high-grade intra-epithelial lesion and an overexpression of the p16 protein (cell marker induced by oncogenic HPV). Azathioprine was stopped and a transanal surgical resection was performed. This led to a scarring rectal substenosis and further rectoscopies permitted destruction of some little condylomatous persistent lesions. At guided anamnesis on sexual behavior, patient confirmed to be an active “men who have sex with men” (MSM). No recurrence of active ulcerative proctitis occured despite Azathioprine discontinuation. Condyloma acuminatum is a manifestation of Human Papillomavirus (HPV) infection and usually occurs in the genital and perianal regions. Involvement of the rectal mucosa is a rare condition and treatment strategy is not well established. This may have been in this case promoted by immunosuppressive treatment. As sexually transmitted anorectal disease may mimic inflammatory bowel disease, first diagnosis of ulcerative proctitis may be questioned even more with absence of recurrence despite treatment. [less ▲]

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See detailFDG PET/CT radiomics for predicting the outcome of locally advanced rectal cancer.
LOVINFOSSE, Pierre ULiege; POLUS, Marc ULiege; VAN DAELE, Daniel ULiege et al

in European Journal of Nuclear Medicine and Molecular Imaging (2018)

PURPOSE: The aim of this study was to investigate the prognostic value of baseline 18F-FDG PET/CT textural analysis in locally-advanced rectal cancer (LARC). METHODS: Eighty-six patients with LARC ... [more ▼]

PURPOSE: The aim of this study was to investigate the prognostic value of baseline 18F-FDG PET/CT textural analysis in locally-advanced rectal cancer (LARC). METHODS: Eighty-six patients with LARC underwent 18F-FDG PET/CT before treatment. Maximum and mean standard uptake values (SUVmax and SUVmean), metabolic tumoral volume (MTV), total lesion glycolysis (TLG), histogram-intensity features, as well as 11 local and regional textural features, were evaluated. The relationships of clinical, pathological and PET-derived metabolic parameters with disease-specific survival (DSS), disease-free survival (DFS) and overall survival (OS) were assessed by Cox regression analysis. Logistic regression was used to predict the pathological response by the Dworak tumor regression grade (TRG) in the 66 patients treated with neoadjuvant chemoradiotherapy (nCRT). RESULTS: The median follow-up of patients was 41 months. Seventeen patients (19.7%) had recurrent disease and 18 (20.9 %) died, either due to cancer progression (n = 10) or from another cause while in complete remission (n = 8). DSS was 95% at 1 year, 93% at 2 years and 87% at 4 years. Weight loss, surgery and the texture parameter coarseness were significantly associated with DSS in multivariate analyses. DFS was 94 % at 1 year, 86 % at 2 years and 79 % at 4 years. From a multivariate standpoint, tumoral differentiation and the texture parameters homogeneity and coarseness were significantly associated with DFS. OS was 93% at 1 year, 87% at 2 years and 79% after 4 years. cT, surgery, SUVmean, dissimilarity and contrast from the neighborhood intensity-difference matrix (contrastNGTDM) were significantly and independently associated with OS. Finally, RAS-mutational status (KRAS and NRAS mutations) and TLG were significant predictors of pathological response to nCRT (TRG 3-4). CONCLUSION: Textural analysis of baseline 18F-FDG PET/CT provides strong independent predictors of survival in patients with LARC, with better predictive power than intensity- and volume-based parameters. The utility of such features, especially coarseness, should be confirmed by larger clinical studies before considering their potential integration into decisional algorithms aimed at personalized medicine. [less ▲]

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See detailPotential diagnostic biomarkers of Ulcerative colitis-associated colorectal dysplasia
Merli, Angela-Maria ULiege; MASSOT, Charlotte ULiege; BLETARD, Noëlla ULiege et al

in Acta Gastro-Enterologica Belgica (2018)

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See detailInnovative methodology for the identification of soluble biomarkers in fresh tissues.
Costanza, Brunella ULiege; Turtoi, Andrei ULiege; Bellahcene, Akeila ULiege et al

in Oncotarget (2018), 9(12), 10665-10680

The identification of diagnostic and prognostic biomarkers from early lesions, measurable in liquid biopsies remains a major challenge, particularly in oncology. Fresh human material of high quality is ... [more ▼]

The identification of diagnostic and prognostic biomarkers from early lesions, measurable in liquid biopsies remains a major challenge, particularly in oncology. Fresh human material of high quality is required for biomarker discovery but is often not available when it is totally required for clinical pathology investigation. Hence, all OMICs studies are done on residual and less clinically relevant biological samples. Here after, we present an innovative, simple, and non-destructive, procedure named EXPEL that uses rapid, pressure-assisted, interstitial fluid extrusion, preserving the specimen for full routine clinical pathology investigation. In the meantime, the technique allows a comprehensive OMICs analysis (proteins, metabolites, miRNAs and DNA). As proof of concept, we have applied EXPEL on freshly collected human colorectal cancer and liver metastases tissues. We demonstrate that the procedure efficiently allows the extraction, within a few minutes, of a wide variety of biomolecules holding diagnostic and prognostic potential while keeping both tissue morphology and antigenicity unaltered. Our method enables, for the first time, both clinicians and scientists to explore identical clinical material regardless of its origin and size, which has a major positive impact on translation to the clinic. [less ▲]

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See detailOLFM4, KNG1 and Sec24C identified by proteomics and immunohistochemistry as potential markers of early colorectal cancer stages
QUESADA-CALVO, Florence ULiege; MASSOT, Charlotte ULiege; Bertrand, Virginie ULiege et al

in Clinical Proteomics (2017), 24(9),

Abstract Background: Despite recent advances in colorectal cancer (CRC) diagnosis and population screening programs, the identification of patients with preneoplastic lesions or with early CRC stages ... [more ▼]

Abstract Background: Despite recent advances in colorectal cancer (CRC) diagnosis and population screening programs, the identification of patients with preneoplastic lesions or with early CRC stages remains challenging and is important for reducing CRC incidence and increasing patient’s survival. Methods: We analysed 76 colorectal tissue samples originated from early CRC stages, normal or inflamed mucosa by label-free proteomics. The characterisation of three selected biomarker candidates was performed by immunohisto‑ chemistry on an independent set of precancerous and cancerous lesions harbouring increasing CRC stages. Results: Out of 5258 proteins identified, we obtained 561 proteins with a significant differential distribution among groups of patients and controls. KNG1, OLFM4 and Sec24C distributions were validated in tissues and showed differ‑ ent expression levels especially in the two early CRC stages compared to normal and preneoplastic tissues. Conclusion: We highlighted three proteins that require further investigations to better characterise their role in early CRC carcinogenesis and their potential as early CRC markers. [less ▲]

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See detailProteomic differential distribution of 53BP1 in serrated and conventional adenomas validated by histological characterisation
QUESADA-CALVO, Florence ULiege; Merli, Angela-Maria ULiege; MASSOT, Charlotte ULiege et al

Poster (2017, February 10)

INTRODUCTION: Sessile serrated adenoma/polyp (SSA/p) is a precancerous lesion, mostly located in the right side of the colon (cecum, ascending and transverse colon). The difficulty is to visualize this ... [more ▼]

INTRODUCTION: Sessile serrated adenoma/polyp (SSA/p) is a precancerous lesion, mostly located in the right side of the colon (cecum, ascending and transverse colon). The difficulty is to visualize this lesion during colonoscopy because of its subtle appearance. MATERIAL AND METHOD: We compared proteomes of serrated polyps (SSA/p) and conventional adenomas using residual human formalin fixed paraffin embedded (FFPE) samples. FFPE-FASP method was applied on samples before label free proteomic analysis. Immunohistochemistry (IHC) characterisation of one candidate marker was performed for tissue validation on an independent set of samples including: conventional adenomas (low and high-grade dysplasia), serrated polyps (hyperplastic polyps, SSA/p and traditional serrated adenoma) and finally normal colon (taken at the margin of colorectal cancer (CRC) or of diverticular disease). RESULTS: Proteomics provided 765 proteins (out of 5992 proteins identified) significantly discriminating conventional adenomas from serrated lesions. We selected 53BP1 (Tumor suppressor p53-binding protein 1) among these for IHC validation, because of its tumor suppressor gene function and role as a mediator of DNA damage checkpoint. 53BP1 appeared significantly up-regulated in proteomes of low and high grade adenomas compared to these of normal tissue and SSA/p. 53BP1 IHC signal was located in the nucleus and the percentage of positive nucleus decreased in serrated polyps, especially in crypts and in the border epithelium, confirming part of the proteomic results. CONCLUSION: This study highlights potential marker proteins, including 53BP1 from which IHC signal was strongly decreased in some serrated polyps. The loss of 53BP1 has been associated with tumour progression and poor prognosis, while little is currently known about its involvement in precancerous CRC lesions. 53BP1 decrease of expression in the nucleus and therefore possible loss of function in some epithelial cells could reflect important changes occurring during dysplasia to neoplasia progression in serrated lesions. [less ▲]

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See detailComment j'explore ... la maladie de Crohn par imagerie.
DESIR, Colin ULiege; COIMBRA MARQUES, Carla ULiege; Decker, M. et al

in Revue Médicale de Liège (2017), 72(1), 51-56

Crohn's disease is a chronic inflammatory condition characterized by recurrent and/or chronic lesions, leading to cumulative structural bowel damage. It is established that the correlation between ... [more ▼]

Crohn's disease is a chronic inflammatory condition characterized by recurrent and/or chronic lesions, leading to cumulative structural bowel damage. It is established that the correlation between symptoms and intestinal lesions is weak. Therefore, monitoring by frequent cross-sectional imaging is proposed to assess the disease activity. There is no consensus about the preferred imaging option. Priority is given to non-radiating modalities, such as ultrasonography and MRI. Tomodensitometry will be reserved for emergency cases. Ultrasonography can be useful, in emergency as well as for the monitoring of lesions of known topography. Entero-MRI is henceforth considered the standard imaging technique for the diagnosis and follow-up of Crohn's disease. Its high contrast resolution allows an accurate assessment of disease activity, therapeutic efficacy, cumulative structural bowel damage and complications. [less ▲]

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See detailLe cas clinique du mois. Actinomycose pelvienne pseudo-tumorale : il fallait y penser
KAKKOS, Athanasios ULiege; GONNE, Elodie ULiege; COIMBRA MARQUES, Carla ULiege et al

in Revue Médicale de Liège (2017), 72(1), 10-13

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See detailEXPEL: A Novel Non-Destructive Method for Mining Soluble Tumor Biomarkers
Costanza, Brunella ULiege; Blomme, Arnaud ULiege; Bellahcene, Akeila ULiege et al

in Acta Gastro-Enterologica Belgica (2016), 79(1), 11

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See detailPrevalence, characteristics and risk factors of chronic post surgical pain after laparoscopic colorectal surgery: retrospective analysis
JORIS, Jean ULiege; GEORGES, MATHIEU; MEDJAHED, KAMEL et al

in European Journal of Anaesthesiology (2015)

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See detailWAIST TO HIP RATIO BETTER PREDICTS ONCOLOGICAL SHORT - AND LONG-TERM OUT-COME AFTER RECTAL CANCER SURGERY THAN BODY MASS INDEX
Léonard, D; Kartheuser, A; Hetsch, N et al

in Acta Chirurgica Belgica (2015), 115

Detailed reference viewed: 51 (4 ULiège)
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See detailDe l'"Evidence-based Medecine" à la médecine personnalisée dans la maladie de Crohn
Louis, Edouard ULiege; REENAERS, Catherine ULiege; VAN KEMSEKE, Catherine ULiege et al

in Revue Médicale de Liège (2015), 70(5-6), 316-320

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See detailOverlap syndrome consisting of PSC-AIH with concomitant presence of a membranous glomerulonephritis and ulcerative colitis
Warling, Odile ULiege; BOVY, Christophe ULiege; COIMBRA MARQUES, Carla ULiege et al

in World Journal of Gastroenterology (2014), 20(16), 4811-4816

Abstract The association of primary sclerosing cholangitis (PSC) and autoimmune hepatitis (AIH) is known as an overlap syndrome (OS). OS can also be described in the setting of concomitant presence of AIH ... [more ▼]

Abstract The association of primary sclerosing cholangitis (PSC) and autoimmune hepatitis (AIH) is known as an overlap syndrome (OS). OS can also be described in the setting of concomitant presence of AIH and PSC. These diseases can in some cases be associated with ulcerative colitis. In this case report we describe, to our knowledge, the first case in the literature of a young Caucasian male suffering from ulcerative colitis and an overlap syndrome consisting of an association between PSC-AIH, with the concomitant presence of a membranous glomerulonephritis. [less ▲]

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