[MALDI imaging: a new technology to discover and validate new biomarkers]. / Imagerie MALDI: une nouvelle technologie pour découvrir et valider de nouveaux biomarqueurs.

Within the growing field of proteomics, mass spectrometry is now established as a powerful tool for peptide and protein identification and discovery from purified samples. A new era is now beginning, with the development of MALDI imaging, maintaining the sensitivity and efficacy of both discovery and identification while additionally preserving the anatomical integrity of biomolecules like peptides, proteins, oligonucleotides and lipids within tissues. Crucial developments for sample preparations have made leaps and bounds, as it is now possible to work with freezed conserved biopsies (- 80 degrees c) of more than 6 months or even conserved after paraformaldehyde fixation and paraffin embedding. The latter development has opened the door to archived tissues in hospital libraries and biomarkers hunting from tissues derived from these libraries are now a key objective. The relationship between MALDI imaging and immunocytochemistry used by the pathologist is important. The development of specific MALDI imaging using probes with a tag (peptide or organic) called << Tag-Mass >> adds a whole new perspective. It is possible henceforth to localize a protein with its specific mRNA and more specifically, with its signalling pathway on the same sections or within a pathology expression phenotype from a biopsy. Development of such a technology is similar to the one that occurred several years ago for nuclear magnetic resonance (NMR) that leads the development of imaging technologies called MRI in hospital which is intensively used for pathology diagnostics.

Management of multicentric lesions of the lower genital tract.

OBJECTIVES: To report management and outcome of multicentric lesions of the lower genital tract. To define risk factors of recurrence. STUDY DESIGN: Retrospective review of multicentric dysplasias treated in our colposcopic clinic between 1996 and 2003. Multicentric dysplasias included CIN with VAIN and/or VIN. After primary treatment, follow-up was colposcopic, cytologic and virologic. RESULTS: Forty-four patients presented multicentric lesions out of 998 patients referred for CIN (4.4%). The average age was 36.8 years. Immunologic disorders were present in 20.4%. Ninety-one percent had cervicovaginal or cervicovulvar lesions, only 9% had three sites of genital dysplasia. 53.3% of lesions were concomitant. 79.5% of CIN were high grade, 62.5% of VAIN low grade and 62.5% of VIN high grade. Therapeutic modalities were as follows: conization for CIN (70.4%), CO2 laser for VAIN (33.3%) and surgery for VIN (41.7%). Forty patients were followed and had at least one post-treatment cytologic control; 55% of them had residual disease. Out of the 23 patients with at least two negative controls after treatment, 43.5% presented recurrence. Risk of recurrence was not statistically bound to such parameters as tabagism, immunologic disorder, high grade lesions, non-surgical treatment, and persistence of HPV infection after treatment. CONCLUSION: Multicentric dysplasias are associated with high rate of residual lesion and recurrence. Management of these lesions require long term follow-up.