Possible involvement of androgen receptor alterations in hepatocarcinogenesis.

BACKGROUND: Androgen receptors (ARs) act as transcription factors. An increased AR activity could be due either to mutations or to an increased expression of the receptor. AR mutations involving the hormone binding domain could increase AR function and promote carcinogenesis, as suggested for prostate cancer. AIMS: Herein, we evaluated qualitative (point mutations involving the hormone binding domain) and quantitative AR alterations and their possible correlation with cell proliferation and tumour grading. MATERIALS: Carcinomatous and non-cancerous surrounding liver tissue was collected from 14 Caucasian patients with hepatocarcinoma. They were all affected by cirrhosis with different aetiologies. METHODS: AR missense mutations, AR mRNA and protein levels, AR distribution in the liver, liver cell proliferation, and tumour staging were evaluated by DNA sequencing, quantitative real-time PCR, Western blot analysis, immunofluorescence, PCNA immunostaining, and conventional histological techniques, respectively. RESULTS: AR gene regions encoding the hormone binding domain did not contain any missense mutation. AR mRNA and protein levels were increased in hepatocarcinoma compared to non-cancerous surrounding tissue. Cell proliferation was significantly increased in the tumour compared to non-cancerous surrounding tissue. CONCLUSIONS: Mutations of the AR regions studied were not involved in hepatocarcinogenesis. Elevated AR levels in transformed cells could have a tumour promoting effect by stimulating cell growth.

[Avascular jaw osteonecrosis in a hemodialysis patient treated with bisphosphonates]. / Osteonecrosi avascolare mandibolare in un paziente in trattamento emodialitico sostitutivo trattato con bifosfonati.

Bisphosphonates are molecules derived from pyrophosphates,but, unlike pyrophosphates, they are resistant to enzymatic hydrolysis. Bisphosphonates are used in the treatment of Paget's disease, cancer-related osteolysis, myeloma, primary hyperparathyroidism, and osteoporosis. In dialysis patients bisphosphonates may be used to reduce bone pain due to renal osteodystrophy. We describe the case of a 60-year-old woman with a history of breast cancer who had been on dialysis for 8 years. She had been receiving clodronic acid at 100 mg per week intravenously for the last 2 years. A year ago, the patient underwent surgical extraction of the lower right second molar. Her jaw pain increased in the following days. An orthopanthograph and a CT scan of the head showed osteolysis, and a surgical osteotomy was performed. Histological examination led to a diagnosis of avascular osteonecrosis of the jaw. Avascular osteonecrosis is typically described in the jaw. In this case, prolonged bisphosphonate treatment may have worsened the osteonecrosis.

Brain tumor death risk in mental patients.

Several investigators have previously reported a low cancer mortality in mental patients. They hypothesized there were possibilities of actual exclusion between cancer and psychosis. On the other hand, some Authors warned that the reported association between psychiatric illness and cancer death might vary, depending on the used statistical methods. To clarify this problem, we have examined the incidence of deaths caused by malignant neoplasm, particularly from brain tumor, in the chronic patients of Bisceglie Psychiatric Hospital, evaluating either absolute or relative mortality rate analysis. Our results seem to suggest an increased absolute mortality from malignant brain tumor in mental patients.