RESUMEN
OBJECTIVE: The aim of this study was to assess the synergistic effect of non-adherence to the Mediterranean Diet (MD) and lifestyle habits on the occurrence of breast cancer (BC). PATIENTS AND METHODS: A case-control study was carried out from September 2018 to February 2019 at the Teaching Hospital "Umberto I" in Rome. A Food Frequency Questionnaire was used for assessing the level of adherence to MD, the IPAQ Questionnaire to measure physical activity, and AUDIT-C to estimate alcohol consumption. The possible interaction between risk factors was tested using the synergism index. RESULTS: A total of 94 cases and 88 controls were enrolled (median age 55.8 for cases and 57.9 for controls). The MD Score over 6 was associated with low odds of having breast cancer (OR = 0.29; 95% CI: 0.12-0.69). There is a clear indication for the additivity and synergism between non-adherence to MD and many risk factors on the occurrence of BC: current smoker (S = 2.02; 95% CI 0.62-8.07), physical inactivity (S = 2.14; 95% CI 0.71 2-8.28) and alcohol consumption (S = 3.02; 95% CI 0.91-12.95). CONCLUSIONS: Primary prevention of BC can benefit from intervention targeting nutritional and lifestyle factors that act synergistically.
Asunto(s)
Neoplasias de la Mama/epidemiología , Dieta Mediterránea/estadística & datos numéricos , Hábitos , Estilo de Vida , Cooperación del Paciente/estadística & datos numéricos , Anciano , Neoplasias de la Mama/prevención & control , Estudios de Casos y Controles , Femenino , Humanos , Italia/epidemiología , Persona de Mediana EdadRESUMEN
BACKGROUND: Basal cell cancer is a malignant tumor of the skin most common in Caucasians and more common in the areas of the head and neck. At the moment there are many suggested treatment methods, however the surgical approach remains the technique most often applied. It includes excision of the oncological safety margins and the subsequent reconstructive phase can utilize local flaps or cutaneous grafts. This study aims to select the best technique for the reconstructive phase after removal of basal cell cancer from the region of the nasal pyramid, evaluation was made in terms of functional performance and aesthetics. We have evaluated 30 patients, of whom 15 treated with cutaneous grafting and 15 with flaps.
Asunto(s)
Carcinoma Basocelular/cirugía , Neoplasias Nasales/cirugía , Neoplasias Cutáneas/cirugía , Trasplante de Piel/métodos , Colgajos Quirúrgicos/trasplante , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Resultado del TratamientoRESUMEN
Metastatic growth in breast cancer (BC) has been proposed as an exclusive property of cancer stem cells (CSCs). However, formal proof of their identity as cells of origin of recurrences at distant sites and the molecular events that may contribute to tumor cell dissemination and metastasis development are yet to be elucidated. In this study, we analyzed a set of patient-derived breast cancer stem cell (BCSC) lines. We found that in vitro BCSCs exhibit a higher chemoresistance and migratory potential when compared with differentiated, nontumorigenic, breast cancer cells (dBCCs). By developing an in vivo metastatic model simulating the disease of patients with early BC, we observed that BCSCs is the only cell population endowed with metastatic potential. Gene-expression profile studies comparing metastagenic and non-metastagenic cells identified TAZ, a transducer of the Hippo pathway and biomechanical cues, as a central mediator of BCSCs metastatic ability involved in their chemoresistance and tumorigenic potential. Overexpression of TAZ in low-expressing dBCCs induced cell transformation and conferred tumorigenicity and migratory activity. Conversely, loss of TAZ in BCSCs severely impaired metastatic colonization and chemoresistance. In clinical data from 99 BC patients, high expression levels of TAZ were associated with shorter disease-free survival in multivariate analysis, thus indicating that TAZ may represent a novel independent negative prognostic factor. Overall, this study designates TAZ as a novel biomarker and a possible therapeutic target for BC.
Asunto(s)
Neoplasias de la Mama/genética , Péptidos y Proteínas de Señalización Intracelular/genética , Metástasis de la Neoplasia/genética , Recurrencia Local de Neoplasia/genética , Animales , Biomarcadores de Tumor/genética , Neoplasias de la Mama/tratamiento farmacológico , Neoplasias de la Mama/patología , Línea Celular Tumoral , Supervivencia sin Enfermedad , Femenino , Regulación Neoplásica de la Expresión Génica , Humanos , Péptidos y Proteínas de Señalización Intracelular/biosíntesis , Ratones , Metástasis de la Neoplasia/patología , Recurrencia Local de Neoplasia/patología , Células Madre Neoplásicas , Transactivadores , Factores de Transcripción , Proteínas Coactivadoras Transcripcionales con Motivo de Unión a PDZ , Ensayos Antitumor por Modelo de XenoinjertoRESUMEN
Tumor cell infiltration causes the remodelling of peritumoral tissues, determined by an increased lytic activity of extracellular matrix exerted by the neoplastic invasive phenotype. Among the principal lytic enzymes produced by tumor cells and mainly involved in invasion process there are the matrix metalloproteases (MMPs). The Authors compared the plasmatic values of MMPs 2, 3, 9 from patients with breast carcinomas and fibroadenomas in order to evaluate whether there was a significant difference between the two groups of patients. MMPs 2, 3, 9 values were quantified by ELISA test from plasma collected 24 hours before surgery in 50 breast carcinomas and 30 fibroadenomas. MMP2 mean value from the patients with carcinomas resulted significantly higher as compared to that from the patients with fibroadenomas; while for MMP 3 and 9 mean values was not possible to find a significant difference between the two groups of malignant and benign breast tumors. These data confirm the main role played by MMPs during the tumor invasion process. Therefore, it is possible to propose the future inclusion of MMP2 test, together to other biological and clinical data, for prognostic evaluation of neoplastic breast lesions.
Asunto(s)
Biomarcadores de Tumor/sangre , Neoplasias de la Mama/enzimología , Carcinoma/enzimología , Fibroadenoma/enzimología , Metaloproteinasa 2 de la Matriz/sangre , Metaloproteinasa 3 de la Matriz/sangre , Metaloproteinasa 9 de la Matriz/sangre , Adulto , Neoplasias de la Mama/patología , Carcinoma/patología , Femenino , Fibroadenoma/patología , Humanos , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Pronóstico , Estudios Retrospectivos , Sensibilidad y EspecificidadRESUMEN
The authors describe their surgical technique for pilonidal sinus outpatient total excision with local anaesthesia and primary repair of surgical wound. The results for recurrences and off work short time are good. Fewer complications and recurrences are observed in comparison to patients treated with general anaesthesia. For decreasing recurrence rate, the Authors stress the importance of body weight control and correct local hygiene. Local anaesthesia is safe e cost-effectiveness for outpatient treatment of the pilonidal sinus.
Asunto(s)
Procedimientos Quirúrgicos Ambulatorios , Seno Pilonidal/cirugía , Adolescente , Adulto , Anestesia Local , Análisis Costo-Beneficio , Femenino , Estudios de Seguimiento , Humanos , Masculino , Recurrencia , Resultado del TratamientoRESUMEN
The Authors report the results of the tumescent anesthesia in 187 patients submitted to various outpatient surgical procedures comparing with those in patients submitted to local anesthesia by direct infiltration.
Asunto(s)
Procedimientos Quirúrgicos Ambulatorios , Anestesia Local/métodos , Anestésicos Locales/administración & dosificación , Lidocaína/administración & dosificación , Adulto , Anestesia Local/efectos adversos , Bicarbonatos/administración & dosificación , Epinefrina/administración & dosificación , Femenino , Humanos , Masculino , Persona de Mediana Edad , Satisfacción del Paciente , Reproducibilidad de los Resultados , Estudios RetrospectivosRESUMEN
Cancer of supernumerary breast or ectopic breast tissue has haigher incidence than the cancer on ortotopic breast. This finding puts some problems about the diagnosis and therapy of ectopic breast cancer. The Authors describe their personal experience in three patients surgically treated and discuss about problems and solutions of this pathology.
Asunto(s)
Axila/patología , Mama , Carcinoma Ductal de Mama/diagnóstico , Carcinoma Ductal de Mama/cirugía , Coristoma/patología , Neoplasias de los Tejidos Blandos/diagnóstico , Neoplasias de los Tejidos Blandos/cirugía , Pared Torácica/patología , Adulto , Anciano , Axila/cirugía , Biomarcadores de Tumor/análisis , Calcinosis/diagnóstico por imagen , Calcinosis/patología , Carcinoma Ductal de Mama/química , Coristoma/cirugía , Femenino , Humanos , Mamografía , Persona de Mediana Edad , Palpación , Neoplasias de los Tejidos Blandos/química , Neoplasias de los Tejidos Blandos/patología , Pared Torácica/cirugíaRESUMEN
The Authors present a rare association of gastric adenocarcinoma and somatostatin-producing duodenal carcinoid. The pre-operative abdominal CT scan revealed the gastric lesions and a duodenal polypoid lesion, giving an important indication to perform a subtotal gastrectomy and a duodenal resection. The definitive diagnosis was possible with histological examination.
Asunto(s)
Adenocarcinoma , Neoplasias Duodenales , Neoplasias Primarias Múltiples , Somatostatinoma , Neoplasias Gástricas , Adenocarcinoma/diagnóstico , Adenocarcinoma/cirugía , Anciano , Neoplasias Duodenales/diagnóstico , Neoplasias Duodenales/cirugía , Humanos , Masculino , Neoplasias Primarias Múltiples/diagnóstico , Neoplasias Primarias Múltiples/cirugía , Somatostatinoma/diagnóstico , Somatostatinoma/cirugía , Neoplasias Gástricas/diagnóstico , Neoplasias Gástricas/cirugíaRESUMEN
The Authors present a singular case of seroma which developed in residual fibrous capsule after explantation of breast prostheses without replacement. Mammographic and sonographic findings of the seroma make difficult the diagnosis: mammograms revealed a radiopaque, well-circumscribed mass anterior to the pectoralis major muscle in the region of the prior sub-glandular implant, that was initially misinterpreted as breast implant radiographic feature. It is particularly important review and carefully correlate mammographic and sonographic findings with patient's surgical history for a correct diagnosis.
Asunto(s)
Enfermedades de la Mama/diagnóstico , Enfermedades de la Mama/etiología , Implantes de Mama/efectos adversos , Remoción de Dispositivos/efectos adversos , Seroma/diagnóstico , Seroma/etiología , Enfermedades de la Mama/diagnóstico por imagen , Femenino , Humanos , Mamoplastia/métodos , Mamografía , Persona de Mediana Edad , Reoperación , Seroma/diagnóstico por imagen , Geles de Silicona/efectos adversos , Resultado del Tratamiento , Ultrasonografía MamariaRESUMEN
Authors review their outpatient lymph node biopsies in order to verify safety and diagnostic accuracy. They didn't observe any complication and in every case, the procedure provided the correct diagnosis. Lymph node biopsy is the procedure of choice to study the pharmacologic therapy non responsive lymph node pathology that is not surely defined by fine needle aspiration, as almost always in lymphomas.
Asunto(s)
Atención Ambulatoria , Biopsia con Aguja Fina/métodos , Ganglios Linfáticos/patología , Linfoma/patología , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Linfoma/diagnóstico , Linfoma no Hodgkin/patología , Masculino , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Pronóstico , Estudios Retrospectivos , Sensibilidad y EspecificidadAsunto(s)
Interferón-alfa/uso terapéutico , Cromosoma Filadelfia , Leucemia-Linfoma Linfoblástico de Células Precursoras/tratamiento farmacológico , Inducción de Remisión , Adulto , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Humanos , Persona de Mediana Edad , Leucemia-Linfoma Linfoblástico de Células Precursoras/cirugía , Trasplante de Células Madre , Acondicionamiento PretrasplanteAsunto(s)
Leucemia Mielógena Crónica BCR-ABL Positiva/patología , Piperazinas/uso terapéutico , Pirimidinas/uso terapéutico , Adulto , Anciano , Benzamidas , Médula Ósea/patología , Recuento de Células , Femenino , Humanos , Mesilato de Imatinib , Leucemia Mielógena Crónica BCR-ABL Positiva/tratamiento farmacológico , Masculino , Persona de Mediana Edad , Inducción de RemisiónRESUMEN
Multiple and ripetitive mammary fibroadenomas represent a rare disease. The etiology is uncertain. The diagnostic radiology is able to allow a correct diagnosis. The authors report a case of a woman 22 years old undergone a surgical treatment many times to remove multiple and ripetitive mammary fibroadenomas. The proposed management provides for periodic radiological exams; the surgical treatment is proposed only for the lesions with a rapid growth.
Asunto(s)
Neoplasias de la Mama/cirugía , Fibroadenoma/cirugía , Neoplasias Primarias Múltiples/cirugía , Adulto , Femenino , HumanosAsunto(s)
Trasplante de Células Madre Hematopoyéticas/métodos , Leucemia Mielógena Crónica BCR-ABL Positiva/terapia , Piperazinas/uso terapéutico , Pirimidinas/uso terapéutico , Adulto , Benzamidas , Trasplante de Células Madre Hematopoyéticas/efectos adversos , Humanos , Mesilato de Imatinib , Persona de Mediana Edad , Recurrencia , Trasplante HomólogoRESUMEN
Examination of more than 700 cutaneous melanoma cases, the authors have identified 19 so-called thin melanomas, which have evolved in the long time in metastases. Two tumor distinctive features, vascularization and regression, correlated between them, seem to be particularly important in outlining the future tumor behavior, and so these two parameters must be analysed and included in the histological report. In these cases it is undoubted the need to make a strict surveillance protocol, also more than 10 years. According to our opinion, surgical treatment can immediately provides, in selected cases, the use of sentinel lymph node technique or the integration with other therapies (immuno-treatment).
Asunto(s)
Melanoma/cirugía , Neoplasias Cutáneas/cirugía , Femenino , Humanos , Masculino , Melanoma/patología , Persona de Mediana Edad , Neoplasias Cutáneas/patologíaRESUMEN
Of unknown etiology, mainly located on the upper limbs, the nodular fasciitis nowadays is considered as a reactive inflammatory lesion more than a neoplastic one. With very few symptoms, it can be diagnosed through histology and the extent of the excision is related to the report of the pathological examination.
Asunto(s)
Fascitis/patología , Adulto , Femenino , Humanos , Masculino , Sarcoma/patologíaRESUMEN
By clinical observation and surgical treatment of a patient with a primitive lymphoma of the breast, the authors describe the nosological approach, the correct diagnosis and the relative surgical treatment in that disease.
Asunto(s)
Neoplasias de la Mama , Linfoma , Anciano de 80 o más Años , Neoplasias de la Mama/diagnóstico , Neoplasias de la Mama/cirugía , Femenino , Humanos , Linfoma/diagnóstico , Linfoma/cirugíaRESUMEN
Imatinib mesylate (STI571), a specific Bcr-Abl inhibitor, has shown a potent antileukemic activity in clinical studies of chronic myeloid leukemia (CML) patients. Early prediction of response to imatinib cannot be anticipated. We used a standardized quantitative reverse-transcriptase polymerase chain reaction (QRT-PCR) for BCR-ABL transcripts on 191 out of 200 late-chronic phase CML patients enrolled in a phase II clinical trial with imatinib 400 mg/day. Bone marrow samples were collected before treatment, after 12, 20 and at the end of study treatment (52 weeks) while peripheral blood samples were obtained after 2, 3, 6, 10, 14, 20 and 52 weeks of therapy. The amount of BCR-ABL transcript was expressed as the ratio of BCR-ABL to beta2-microglobulin (beta2M). We show that, following initiation of imatinib, the early BCR-ABL level trends in both bone marrow and peripheral blood samples made it possible to predict the subsequent cytogenetic outcome and response. We propose this method as the method of choice for monitoring patients on imatinib therapy. QRT-PCR studies may be able to identify degrees of molecular response that predict both complete cytogenetic response and long term stability, as well as patterns of response that provide an early indication of relapse and imatinib resistance.
Asunto(s)
Antineoplásicos/uso terapéutico , Proteínas de Fusión bcr-abl/genética , Leucemia Mielógena Crónica BCR-ABL Positiva/tratamiento farmacológico , Piperazinas/uso terapéutico , Pirimidinas/uso terapéutico , ARN Mensajero/genética , Benzamidas , Femenino , Humanos , Mesilato de Imatinib , Leucemia Mielógena Crónica BCR-ABL Positiva/genética , Masculino , Inducción de Remisión , Reacción en Cadena de la Polimerasa de Transcriptasa InversaRESUMEN
BACKGROUND: Although imatinib is the standard treatment for chronic myeloid leukaemia, not all patients reach complete cytogenetic remission (CCR) and most maintain detectable disease at the molecular level. We investigated whether a vaccine targeting the BCR-ABL-derived p210 fusion protein was an active and specific immunotherapy. METHODS: We recruited 16 patients who had chronic myeloid leukaemia (with the b3a2 fusion point of p210), stable residual disease, a minimum treatment of 12 months of imatinib or 24 months of interferon alfa, and no further reduction of residual disease for at least 6 months preceding enrollment. They were given six vaccinations with a peptide vaccine derived from the sequence p210-b3a2 plus molgramostim and QS-21 as adjuvants (CMLVAX100) before assessment of immunological and disease response, which included detecting amounts of b3a2 transcripts by standardised quantitative real-time reverse-transcriptase PCR. RESULTS: Of ten patients on imatinib, nine started CMLVAX100 having had a median of 10 months' stable cytogenetic disease (median 10% Philadelphia-chromosome-positive metaphases), whereas one started in stable CCR. All patients' cytogenetic responses improved after six vaccinations, with five reaching CCR. Notably, three of these five patients also had undetectable amounts of b3a2 transcript (BCR-ABL:beta2 microglobulin ratio <0.00001). Six patients on interferon alfa treatment with a median of 17 months' stable residual disease (median 13% Philadelphia-chromosome-positive cells) were also vaccinated. All but one had improved cytogenetic responses, and two reached CCR. Overall, we recorded peptide-specific delayed-type hypersensitivity (in 11 of 16 patients), CD4 cell proliferation (13 of 14 assessed), and interferon gamma production (five of five assessed). INTERPRETATION: Addition of CMLVAX100 to conventional treatment in patients with chronic myeloid leukaemia might favour further reduction of residual disease and increase the number of patients reaching a molecular response.