Non-Coding RNAs and Endometrial Cancer.

Non-coding RNAs (ncRNAs) are involved in the regulation of cell metabolism and neoplastic transformation. Recent studies have tried to clarify the significance of these information carriers in the genesis and progression of various cancers and their use as biomarkers for the disease; possible targets for the inhibition of growth and invasion by the neoplastic cells have been suggested. The significance of ncRNAs in lung cancer, bladder cancer, kidney cancer, and melanoma has been amply investigated with important results. Recently, the role of long non-coding RNAs (lncRNAs) has also been included in cancer studies. Studies on the relation between endometrial cancer (EC) and ncRNAs, such as small ncRNAs or micro RNAs (miRNAs), transfer RNAs (tRNAs), ribosomal RNAs (rRNAs), antisense RNAs (asRNAs), small nuclear RNAs (snRNAs), Piwi-interacting RNAs (piRNAs), small nucleolar RNAs (snoRNAs), competing endogenous RNAs (ceRNAs), lncRNAs, and long intergenic ncRNAs (lincRNAs) have been published. The recent literature produced in the last three years was extracted from PubMed by two independent readers, which was then selected for the possible relation between ncRNAs, oncogenesis in general, and EC in particular.

Perineural invasion in prostatic carcinoma treated with radical prostatectomy: the role of TR systematic biopsy.

Perineural invasion (PNI) is a morphological entity which has been known for many years, though its significance in prostatic neoplasms has only been studied recently. Therefore, we tried to assess, with the help our experience, its presence and its significance. Ninety-four patients, aged between 49 and 74 (average 65.8)--with a PSA between 2.69 and 52 ng/ml (average 11.44)--underwent RP for prostatic carcinoma; 58 patients had stage T2 and 36 had T3. 48 patients had Gleason 7 or higher, and 46 had G 6 or lower. Fifty patients (53,1%) were PNI+ and 44 (46,9%) PNI-. Between the two groups there was no significant difference as to age (1" group: average age 67 years; 2nd group: 68) and PSA (1st group: average 9.73 ng/ml, 2nd group: average 8,17) (Z 0,639). The distribution according to the stage showed that 24 patients (48%) PNI+ were T2 and 26 (52%) PNI+ T3, 34 (77.2%) PNI- T2 and 10 (22%) PNI- T3 and therefore 72,23% of the T3's were PNI+ and 41.3% of the T2's were PNI+; 34 patients (70.8%) with G>7 were PNI+ and 14 (29.16%) PNI-, 16 patients (34,78%) with G<6 were PNI+ and 30 (65.2%) PNI-. Among the PNI+ 50 patients, 36 had undergone biopsy in our hospital, and therefore we re-examined the operation tissue and found out that 16 (44%) were biopsy PNI+ while for 22 (55.5%) it was not possible to assess the PNI on the biopsy tissue. PNI is an important morphological element in the staging of prostatic cancer and is connected with the disease negative prognostic factors: in fact, it can be traced with a high frequency in stage diseases and higher Gleasons. It does not seem to be connected with PSA, above all for values between 4 and 20 ng/ml. We think that a very important element to be stressed is the fact that this condition is not always detected with biopsy (about 45%) and this does not allow, in such cases, an adequate therapy plan. Also our experience seems to confirm that, therefore, in spite of the above said limits, it is advisable to search PNI both with biopsy--in order to have a further prognostic element and therefore arrange the most suitable therapy plan--and on the surgery piece, in order to better determine the biological nature of the disease and to be able to suggest adequate integrative therapies.

The association of TR systematic echobiopsy of the prostate with power Doppler (PDU) in borderline PSA patients.

OBJECTIVE: TR systematic biopsy of the prostate is currently a method to diagnose prostate cancer, though with limited reliability. Many ancillary procedures have been put forward to improve its effectiveness, and PDU appears a very promising one Wehave attempted to verify whether PDU and eighth core TR biopsy together can ihcrease reliability especially in those patients with PSA values between 4 and 10 ng/ml. MATERIAL AND METHODS: Two groups of patients suffering from altered PSA and/or a palpable prostatic nodule underwent eighth core TR biopsy of the prostate. The first group was composed by 56 patients aged 55-82 (av.69.39) with PSA values ranging between 0.87 and 94.91 ng/ml (11.45 +/- 10.14) of which 29 had a palpable nodule. The second group was constituted by 96 patients aged 49-84 (av.69.84) with PSA values ranging between 1.14 and 59.7 ng/ml (12.8 +/- 11.66) of which 55 had a palpable nodule. The first group underwent eighth core TR biopsy, the second group TR biopsy and PDU. RESULTS: Twenty-five patients of the first group (44.64%) showed prostate cancer and 48 of the second (50%) were prostate cancer positive. We then divided them according to their PSA: 33 belonging to the first group (biopsy without PDU) had PSA values ranging between 4 and 9.6 ng/ml (7.59 +/- 1.61) and 13 (39.39%) were positive to Ca; 56 patients belonging to the second group (biopsy with PDU) had PSA values ranging between 4.09 and 9.66 ng/ml (7.02 +/- 1.56) and 26 (46.42%) were positive to Ca. We also ran tests with other groups of patients according to their PSA values although the above findings remained the most significant. CONCLUSIONS: Compared to other similarly interesting but more complex procedures, PD is easy to learn and easy to perform. Literature already shows how it can effectively be associated with systematic TR biopsy. On the basis of the above data we can conclude that PDU realistically improves reliability of eighth core TR biopsy--though not replace it--especially for those patients with PSA values between 4 and 10 ng/ml.

[The meaning and usefulness of spiral CT for radiolucent ureteric stones diagnosis: our experience]. / The meaning and usefulness of spiral TC for radiolucent ureteric stones diagnostic: our experience.

The aim of this work was to report some case histories on the usefulness of spiral TC, used for several years both to diagnose renal colic and urinary lithiasis and to study radio lucent stones that are often difficult to be detected with traditional radiology. 13 patients, aged between 31 and 76 (average age: 54.2), were therefore examined. Eight of them had a ureteral colic when examined, while five patients had shown symptoms some days before being hospitalised in our ward. In all cases, ultrasonography showed a significant hydronephrosis, while direct radiography of the urinary tract could not detect any images that could be associated with radio-opaque lithiasis. All patients therefore underwent an abdominal spiral TC with no contrast medium within 24 hours after hospitalisation. The confrontation between the results obtained by ultrasonography and those obtained by spiral TC, showed the usefulness of the former method to detect stones located in the proximal ureter or in its intramural tract, while the latter could detect the lithiasis of the proximal ureter in 3 cases (23%), of the mid ureter in 2 cases (15.3%), and of the distal ureter in 8 cases (61%). The stones had, approximately, a 5 mm diameter in 5 cases. In 6 cases the diameter was between 6 and 10 mm, and more than 1 cm in 2 cases. Both methods proved to be equally accurate in the assessment of the hydronephrosis degree and of the thickness of the renal parenchyma. The therapy was medical in 2 cases and open surgery in 3 cases, while 8 patients were treated with ureterolitholapaxy with a ballistic searcher. The usefulness of TC in the study of urolithiasis nowadays is supported by a large literature which clearly supplies with documentary evidence the high sensitivity and specificity of such a method in diagnosing the presence of urolithiasis in general and above all of ureteric stones. Such a method not only makes an accurate evaluation of the stones location possible, but it can also assess the calculi dimensions and the indirect signs of the functionality of the kidney affected, without having to use the contrast medium. This method needs very limited execution times and allows a diagnostic of possible collateral pathologies. The main disadvantage of spiral TC, if compared to conventional radiology, is that the patient is exposed to a larger quantity of ionizing radiations, although such an inconvenience will be overcome by the new and more technologically advanced machines. According to our experience, though based on a limited number of cases, spiral TC allowed us to get a quick diagnosis of radio-lucent lithiasis, to see the seat and dimensions of the calculi and finally to chose the most effective treatment. We can therefore think of a diagnostic protocol, for ureteral colics with hydronephrosis or complicated by hyperpyrexia or sepsis, with spiral TC in order to have a quick diagnosis and start the most effective therapy in case an ultrasonographic research should not result diriment.

[Acceptability and safety of transrectal prostatic 8-core biopsy]. / Accettabilità e sicurezza della biopsia prostatica TR per ottavi.

The safety of sextant prostate biopsy has already been documented since the end of the 90's. As a higher efficacy of biopsy has been proved when increasing the number of samples taken, we have tried to assess the safety and tolerability of prostatic 8-core biopsy. From January to December 2001, 204 patients, aged between 50 and 88 (average 70) with a PSA between 0.74 and 196 ng/ml (10 +/- 9.25), underwent in 8-core prostate biopsy. After biopsy, the patients were given an oral antibacterial for 3 days. After taking the samples, patients were interviewed about the tolerability of the biopsy, and especially about the following: I. A feeling of irritation (77 patients, 37.7%); 2. A slight pain (72 patients, 35.29%); 3. A moderate pain (32 patients, 15.68%); 4. Intense pain (23 patients 11.27%). After 20 days all patients came back and were interviewed again about possible complications (biopsy was Ca positive in 86 cases, 42.15%). 153 patients (75%) reported a slight hematuria for an average period of 5 days; 88 patients (43.13%) showed slight anal-rectal hematic discharges, mainly after defecation efforts. It was never necessary to hospitalize any patients because of complications. 71 patients (34.8%) reported a perineal pain which disappeared after 24-48 hours. 175 patients reported having had an ejaculation after biopsy and 158 (90.2%) of them showed hematospermia. 4 patients (2%) had a short period temperature and only 2 (0.98%) were hospitalized for hyperpyrexia with symptoms of genitourinary sepsis. It has been proved that TR prostate biopsy is almost exclusively followed by minor complications, major ones being an exception. A biopsy with more than six samples (8-10-12) shows a higher number of minor complications (hematospermia and hematuria). The fact that a higher number of samples proves this method to be significantly more suitable, pays off all the problems. Also, such a casistics makes us think that prostatic 8-core biopsy is generally well tolerated (73% of patients reported either irritation or slight pain) and fairly safe, as complications are mainly minor ones. We must therefore underline the suitability, good tolerability and safety of the TR prostatic 8-core biopsy.