Cutaneous squamous cell carcinoma with incomplete margins demonstrate higher tumour grade on re-excision.

BACKGROUND: We retrospectively evaluated all our cases of re-excised cutaneous squamous cell carcinomas (CSCCs) in the last 10 years to examine whether they change grade in re-excision histology reports. METHODS: The medical files of 525 patients, which had surgical excision of CSCCs in the Plastic Surgery Department of Aristotle University of Thessaloniki between January 2007 and December 2017 were retrospectively evaluated. All primary and recurrent tumours that were incompletely excised were included in the study. The tumour's grade of both the initial and re-excision histological reports (Broders classification: well, moderate, or poor), age, sex, tumour location, size, infiltration borders (deep or lateral), and perineural invasion was documented. RESULTS: From a total number of 525 CSCCs, 24 patients with 24 incompletely excised lesions were identified. Perineural invasion was noticed in 16 (66%) of patients. In 15 cases (62, 5%), poorer differentiation was recorded following re-excision (group A), whilst in nine patients (37, 5%), the grade remained the same (group B). No statistical significance was observed on age (P = 0.106), tumour size (P = 0.382) and perineural invasion (P = 0.658) in both groups. A positive correlation between male gender and infiltrated border location (deep) and change of grade was observed (P = 0.014, P = 0.000). CONCLUSIONS: We would strongly advise re-excision in incompletely excised lesions except in patients that are unwilling or unfit to undergo another surgical procedure as incompletely excised lesions may change into a poorer degree of differentiation in re-excision histology reports.

MiRNAs: regulators of human disease.

MicroRNAs (miRNAs) represent the mediators of important leading biological functions of molecular pathways in humans. They are a class of very small, non-coding RNAs; their function is the balance of the protein levels at the post-transcriptional stage. They are implicated in molecular processes and diseases, including diabetes, metabolism, autoimmune diseases, angiogenesis and tumorigenesis, and female fertility, exhibiting an altered expression profile. Any process taking place in the human organism is intertwined by miRNAs. MiRNAs have an impact on the biochemistry of pathways of the invisible molecular world. They circulate in a stable chemical configuration in body fluids (tears, serum, plasma, amniotic fluid, ascetic fluid, urine) with their molecular sequence specificity remaining unchanged. Their indisputable molecular stability ranks them as extremely vigorous potential markers in human disease. MiRNAs demonstrate a specific expressive signature, representative of the tissue specificity and the clinical staging. The shift on the concentration and expression of a miRNA reflects the course of a disease. MiRNAs may operate as oncogenes (tumor growth) or tumor suppressor (tumor reduction) genes in cancer pathways. In malignant disease, proliferation, maintenance, and progression of cancer cells is induced by the stimulation of the oncogenes or complete deactivation of the tumor suppressor gene activity.

Lanarkshire Oximetry Index as a diagnostic tool for peripheral arterial disease in type 2 diabetes: a pilot study.

We evaluated the Lanarkshire Oximetry Index (LOI) for the diagnosis of peripheral arterial disease (PAD) in type 2 diabetic patients, using the Ankle-Brachial Index (ABI) as gold standard. We included 161 patients (71 men, mean age 63.1 +/- 9.8 years). Peripheral arterial disease was defined as ABI < 0.9. Two cut-off values of LOI (<0.9 and <0.8) were assessed for the diagnosis of PAD. Sensitivity and specificity for PAD were 93.3% and 89.1%, respectively, using a LOI cut-off value of 0.9, while they were 40% and 99.3%, respectively, using a LOI cut-off value of 0.8. Agreement between LOI and ABI was moderate (P < .001). There was a significant positive correlation between ABI and LOI (r = .377, P < .001). Lanarkshire Oximetry Index is a potentially useful alternative diagnostic test for PAD in type 2 diabetes. A cut-off value of 0.9 has high sensitivity and modest specificity. Agreement between LOI and ABI is moderate.