Immuno markers in newly diagnosed glioblastoma patients underwent Stupp protocol after neurosurgery: a retrospective series.

PURPOSE: The aims of our retrospective study investigated the role of immune system in glioblastoma (GBM), which is the most aggressive primary brain tumor in adults characterized by a poor prognosis. The recurrence rate remains high, probably due to "immune-desert" tumor microenvironment (TME) making GBM hidden from the anti-tumoral immune clearance. Considering this, we aimed to create a panel of prognostic markers from blood and tumor tissue correlating with overall survival (OS) and progression-free survival (PFS). METHODS: Firstly, we analyzed the inflammatory markers NLR and PLR as the ratio of the absolute neutrophil count and absolute platelet count by the absolute lymphocyte count respectively, collected at different time points in the peripheral blood of 95 patients. Furthermore, in 31 patients of the same cohort, we analyzed the formalin-fixed paraffin embedded samples to further compare the impact of circulating and inflammatory markers within the TME. RESULTS: Patients aged < 60 years and with methylated MGMT showed better OS. While, pre-chemotherapy Systemic Inflammatory Index (SII) < 480 was related to a better OS and PFS, we observed that only CD68+macrophage and CD66b+neutrophils expressed in vascular/perivascular area (V) showed a statistically significant prognostic role in median OS and PFS. CONCLUSIONS: Thus, we underscored a role of SII as predictive value of response to STUPP protocol. Regarding the TME-related markers, we suggested to take into consideration for future studies with new immunotherapy combinations, each component relating to expression of immune infiltrating subsets.

Histological changes in odontogenic parakeratinized keratocysts treated with marsupialization followed by enucleation

BACKGROUND: The purpose of this study was to evaluate whether marsupialization treatment induces changes in the histology of odontogenic keratocyst epithelium and to compare our experience with the literature. MATERIAL AND METHODS: A retrospective revision of histological samples was performed. 5 patients with odontogen-ic keratocyst treated with marsupialization follow by enucleation were selected. Histologic evaluation analyzed the changes in the keratocyst epithelium after marsupialization in terms of type of keratinization, thickness of the epithelium and connective tissue, the presence of acanthosis, the presence and grade of fibrosis, the type and grade of inflammation and the presence and number of mitotic figures and daughter cysts. RESULTS: In our case series, a variation of para-keratinized into ortho-keratinized keratocyst was found in one case, and no significant increases were observed in the epithelium and capsule thickness, or even in the level of inflammation. However, we observed an increase in fibrosis and qualitative changes in inflammation type. CONCLUSIONS: Minor and major histological changes were associated with reduction in cyst volume, which resulted in a simpler and less invasive cystic enucleation after marsupialization

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Use of 1070 nm fiber lasers in oral surgery: preliminary ex vivo study with FBG temperature monitoring.

BACKGROUND AND AIMS: The aim of this ex vivo study was to demonstrate the performances of 1070 nm fiber lasers for the ablation of oral tissues through the evaluation of the histological modifications made by a blind pathologist and the measurement of the thermal elevation during laser irradiation by a sensor based on a fiber Bragg grating. MATERIALS AND METHODS: The source used was a pulsed fiber laser emitting at 1070 nm, with 20 W maximum average output power and 100 ns fixed pulse duration. Different tests were performed by changing the laser parameters, particularly the peak power of the pulses and the repetition rate. RESULTS: The tissue of the measurements demonstrated that the best properties in term of cutting capability and, at the same time, the lower thermal damages to the tissues can be obtained with a peak power of 3 kW, a repetition rate of 50 kHz and a speed of 5 mm/s. CONCLUSIONS: This ex vivo study showed that 1070 nm fiber lasers can be very useful in oral surgery, since they provide a reduced thermal elevation in the irradiated tissues, thus consequently respecting their biological structures. Moreover, this work demonstrates that FBG sensors, based on the optical fiber technology as the laser source considered for the tests, may be good instruments to record thermal elevation when applied to the ex vivo studies on animal models.