Clinical and pathological implications of miRNA in bladder cancer.

MicroRNAs (miRNAs) are small, noncoding RNA species with a length of 20-22 nucleotides that are recognized as essential regulators of relevant molecular mechanisms, including carcinogenesis. Current investigations show that miRNAs are detectable not only in different tissue types but also in a wide range of biological fluids, either free or trapped in circulating microvesicles. miRNAs were proven to be involved in cell communication, both in pathological and physiological processes. Evaluation of the global expression patterns of miRNAs provides key opportunities with important practical applications, taking into account that they modulate essential biological processes such as epithelial to mesenchymal transition, which is a mechanism relevant in bladder cancer. miRNAs collected from biological specimens can furnish valuable evidence with regard to bladder cancer oncogenesis, as they also have been linked to clinical outcomes in urothelial carcinoma. Therefore, a single miRNA or a signature of multiple miRNAs may improve risk stratification of patients and may supplement the histological diagnosis of urological tumors, particularly for bladder cancer.

Solid parotid tumors: an individual and integrative analysis of various ultrasonographic criteria. A prospective and observational study.

OBJECTIVES: The purpose of the study is to identify and validate ultrasound criteria for parotid tumors evaluation, as well as to elaborate a multimodal, multi-criteria and integrative ultrasound approach for allowing tumor discrimination in a non-invasive manner. MATERIAL AND METHOD: Twenty patients with solid parotid tumors (12 benign, 8 malignant) were examined by ultrasound: real-time "grey scale" ultrasound, Doppler ultrasound, elastography, harmonic ultrasound imaging with i.v. contrast (CEUS). The study focused on tumor morphology and circulation. The analysis of the results was observational, enhanced by statistical methods and artificial intelligence (decision trees). RESULTS: All malignant tumors showed increased hypoechogenicity, tumoral cervical adenopathies, increased stiffness and "in block" mobility with the parotid gland upon palpation with the transducer, uneven distribution of the contrast material during the arterial phase (8/8). To varying degrees, they showed imprecise delineation (7/8), structural heterogeneity (6/8) and disorganized flow pattern (6/8). All cases of benign tumors showed heterogeneous echostructure, clear delineation and no capsule (12). They also showed moderate hypoechogenicity (9/12), no cervical lymph nodes (11/12) and variable rigidity (increased 6/12; low 3/12). A selection and ranking of relevant ultrasound parameters was also made. Some of them were included in a transparent and easy-to-use decision tree model with 100% data accuracy. CONCLUSIONS: The characterization and discrimination of solid parotid tumors require a multimodal and multicriteria approach. Ultrasound criteria can be divided into criteria of certainty and criteria of diagnosis probability. CEUS examination of parotid tumors did not reveal significant differences between benign and malignant circulatory bed. Decision trees discovered by artificial intelligence from the data may represent intelligent diagnosis support systems with very high accuracy, up to 100%.