RESUMEN
Male breast cancer (MBC) is rare and poorly understood. Like female breast cancer (FBC), MBCs are highly sensitive to hormonal changes, and hyperestrogenism, specifically, represents a major risk factor for MBC. MBC is considered similar to late-onset, post-menopausal estrogen/progesteron receptors positive FBC (ER+/PR+). Sulfotransferase 1A1 (SULT1A1) is an enzyme involved in the metabolism of estrogens. Recently, SULT1A1 common functional polymorphism Arg(213)His (638G>A) variant has been found to be associated with increased breast cancer (BC) risk, particularly in post-menopausal women. For this reason, we decided to explore whether SULT1A1 Arg(213)His could exert an effect on MBC development. The primary aim of this study was to evaluate the influence of the SULT1A1 Arg(213)His polymorphism on MBC risk. The secondary aim was to investigate possible associations with relevant clinical-pathologic features of MBC. A total of 394 MBC cases and 786 healthy male controls were genotyped for SULT1A1 Arg(213)His polymorphism by PCR-RFLP and high-resolution melting analysis. All MBC cases were characterized for relevant clinical-pathologic features. A significant difference in the distribution of SULT1A1 Arg(213)His genotypes was found between MBC cases and controls (P < 0.0001). The analysis of genotype-specific risk showed a significant increased MBC risk in individuals with G/A (OR 1.97, 95% CI 1.50-2.59; P < 0.0001) and A/A (OR 3.09, 95% CI 1.83-5.23; P < 0.0001) genotypes in comparison to wild-type genotype, under co-dominant model. A significant association between SULT1A1 risk genotypes and HER2 status emerged. Results indicate that SULT1A1 Arg(213)His may act as a low-penetrance risk allele for developing MBC and could be associated with a specific tumor subtype associated with HER2 overexpression.
Asunto(s)
Arilsulfotransferasa/genética , Neoplasias de la Mama Masculina/genética , Estudios de Asociación Genética , Predisposición Genética a la Enfermedad , Pueblo Asiatico , Neoplasias de la Mama Masculina/patología , Regulación Neoplásica de la Expresión Génica , Frecuencia de los Genes , Genotipo , Humanos , Italia , Masculino , Persona de Mediana Edad , Polimorfismo de Nucleótido Simple , Receptor ErbB-2/biosíntesis , Factores de RiesgoRESUMEN
Assessing the genetic variability of the tick Ixodes ricinus-an important vector of pathogens in Europe-is an essential step for setting up antitick control methods. Here, we report the first identification of a set of SNPs isolated from the genome of I. ricinus, by applying a reduction in genomic complexity, pyrosequencing and new bioinformatics tools. Almost 1.4 million of reads (average length: 528 nt) were generated with a full Roche 454 GS FLX run on two reduced representation libraries of I. ricinus. A newly developed bioinformatics tool (DiscoSnp), which isolates SNPs without requiring any reference genome, was used to obtain 321 088 putative SNPs. Stringent selection criteria were applied in a bioinformatics pipeline to select 1768 SNPs for the development of specific primers. Among 384 randomly SNPs tested by Fluidigm genotyping technology on 464 individuals ticks, 368 SNPs loci (96%) exhibited the presence of the two expected alleles. Hardy-Weinberg equilibrium tests conducted on six natural populations of ticks have shown that from 26 to 46 of the 384 loci exhibited significant heterozygote deficiency.
Asunto(s)
Genética de Población/métodos , Genómica/métodos , Ixodes/genética , Polimorfismo de Nucleótido Simple , Animales , Biología Computacional , Europa (Continente) , Análisis de Secuencia de ADNRESUMEN
It is well-known that male breast cancer (MBC) susceptibility is mainly due to high-penetrance BRCA1/2 mutations. Here, we investigated whether common low-penetrance breast cancer (BC) susceptibility alleles may influence MBC risk in Italian population and whether variant alleles may be associated with specific clinicopathological features of MBCs. In the frame of the Italian Multicenter Study on MBC, we genotyped 413 MBCs and 745 age-matched male controls at 9 SNPs annotating known BC susceptibility loci. By multivariate logistic regression models, we found a significant increased MBC risk for 3 SNPs, in particular, with codominant models, for rs2046210/ESR1 (OR = 1.71; 95 % CI: 1.43-2.05; p = 0.0001), rs3803662/TOX3 (OR = 1.59; 95 % CI: 1.32-1.92; p = 0.0001), and rs2981582/FGFR2 (OR = 1.26; 95 % CI: 1.05-1.50; p = 0.013). Furthermore, we showed that the prevalence of the risk genotypes of ESR1 tended to be higher in ER- tumors (p = 0.062). In a case-case multivariate analysis, a statistically significant association between ESR1 and ER- tumors was found (OR = 1.88; 95 % CI: 1.03-3.49; p = 0.039). Overall, our data, based on a large and well-characterized MBC series, support the hypothesis that common low-penetrance BC susceptibility alleles play a role in MBC susceptibility and, interestingly, indicate that ESR1 is associated with a distinct tumor subtype defined by ER-negative status.
Asunto(s)
Neoplasias de la Mama Masculina/genética , Predisposición Genética a la Enfermedad , Adulto , Anciano , Anciano de 80 o más Años , Alelos , Proteínas Reguladoras de la Apoptosis , Neoplasias de la Mama Masculina/epidemiología , Neoplasias de la Mama Masculina/etiología , Estudios de Casos y Controles , Receptor alfa de Estrógeno/genética , Proteínas del Grupo de Alta Movilidad , Humanos , Italia/epidemiología , Masculino , Persona de Mediana Edad , Análisis Multivariante , Polimorfismo de Nucleótido Simple , Receptor Tipo 2 de Factor de Crecimiento de Fibroblastos/genética , Receptores de Estrógenos/metabolismo , Receptores de Progesterona/genética , TransactivadoresRESUMEN
The aim of this pictorial essay is to illustrate the morphological [computed tomography (CT) and magnetic resonance imaging (MRI)], vascular (angiography) and functional (nuclear medicine) features of paragangliomas, uncommon lesions of the head and neck region and even more of the thorax, abdomen and pelvis, arising in an endemic area in northern Italy. These hypervascular, well-circumscribed masses usually have innocuous clinical manifestations as slowly enlarging soft-tissue lesions; however, more rarely, they can cause cranial-nerve palsy, particularly lesions arising near the skull base, or symptoms related to their secreting activity. Most paragangliomas are benign and their prognosis is directly related to the location of the tumour: those arising at the carotid body have the best outcome, whereas those located at the skull base have a less favourable prognosis. Angiography is required preoperatively in larger paragangliomas for surgical planning (vascular mapping) and, rarely, for preoperative embolisation. Morphological and functional imaging is also mandatory for surgical and/or radiometabolic treatment planning and follow-up.
Asunto(s)
Neoplasias de Cabeza y Cuello/diagnóstico , Paraganglioma Extraadrenal/diagnóstico , Neoplasias Abdominales/diagnóstico , Angiografía , Enfermedades de los Nervios Craneales/etiología , Neoplasias de Cabeza y Cuello/diagnóstico por imagen , Humanos , Imagen por Resonancia Magnética , Paraganglioma Extraadrenal/complicaciones , Paraganglioma Extraadrenal/diagnóstico por imagen , Neoplasias Pélvicas/diagnóstico , Pronóstico , Cintigrafía , Neoplasias Torácicas/diagnóstico , Tomografía Computarizada por Rayos XRESUMEN
OBJECTIVES: Surrogate measures of screening performance [e.g. interval cancer (IC) proportional incidence] allow timely monitoring of sensitivity and quality. This study explored measures using large (T2+) breast cancers as potential indicators of screening performance. METHODS: The proportional incidence of T2+ cancers (observed/expected cases) in a population-based screening programme (Trento, 2001-2009) was estimated. A parallel review of 'negative' preceding mammograms for screen-detected T2+ and for all ICs, using 'blinded' independent readings and case-mixes (54 T2+, 50 ICs, 170 controls) was also performed. RESULTS: T2+ cancers were observed in 168 screening participants: 48 at first screen, 67 at repeat screening and 53 ICs. The T2+ estimated proportional incidence was 68% (observed/expected = 168/247), corresponding to an estimated 32% reduction in the rate of T2+ cancers in screening participants relative to that expected without screening. Majority review classified 27.8% (15/54) of T2+ and 28% (14/50) of ICs as screening error (P = 0.84), with variable recall rates amongst radiologists (8.8-15.2%). CONCLUSIONS: T2+ review could be integrated as part of quality monitoring and potentially prove more feasible than IC review for some screening services. KEY POINTS: ⢠Interval breast cancers, assumed as screening failures, are monitored to estimate screening performance ⢠Large (T2+) cancers at screening may also represent failed prior screening detection ⢠Analysis of T2+ lesions may be more feasible than assessing interval cancers ⢠Analysis of T2+ cancers is a potential further measure of screening performance.
Asunto(s)
Neoplasias de la Mama/diagnóstico por imagen , Neoplasias de la Mama/epidemiología , Mamografía/estadística & datos numéricos , Tamizaje Masivo/estadística & datos numéricos , Evaluación de Resultado en la Atención de Salud/estadística & datos numéricos , Anciano , Biomarcadores , Femenino , Humanos , Incidencia , Italia/epidemiología , Persona de Mediana Edad , Evaluación de Programas y Proyectos de Salud , Reproducibilidad de los Resultados , Sensibilidad y EspecificidadRESUMEN
PURPOSE: The aim of this study was to assess the performance of the mammography screening programme in Trento Province, Italy, by analysing the interval cancers (IC) observed from 2001 to 2008. MATERIAL AND METHODS: IC were identified by linking screening archives with local cancer registry and pathology archives as well as with hospital discharge records. Proportional incidence was determined according to breast cancers expected in the absence of screening, estimated on the basis of patients/year at risk and age-specific incidence. The review of screening mammograms preceding ICs was performed by an external (three radiologists) and an internal (five radiologists) panel and aimed at assessing the proportion of IC reviewed as screening errors. Results were compared with European Community (EC) recommended standards. RESULTS: IC proportional incidence was 15.90% for the first year (EC standard <30%) and 25.77% for the second year (EC standard <50%) of the interval. At external review, 18.4% of cases were reviewed as screening errors (identified by at least two of three reviewers), whereas at internal review (identified by at least three of five reviewers) it was 17.4% (EC standard <20%). No significant difference was observed between external and internal review (mean recall rate 8.3% vs. 9.0%; mean identification rate 19.7% vs 19.6%). CONCLUSIONS: The study confirms good performance of the mammography screening programme in Trento Province, Italy. Comparable results of external and internal reviews suggest that the latter, no doubt easier to be implemented, might be adopted as a routine procedure to assess this early efficacy indicator.
Asunto(s)
Neoplasias de la Mama/diagnóstico por imagen , Neoplasias de la Mama/epidemiología , Mamografía , Tamizaje Masivo , Anciano , Algoritmos , Detección Precoz del Cáncer , Femenino , Humanos , Incidencia , Italia/epidemiología , Persona de Mediana Edad , Proyectos Piloto , Vigilancia de la Población , Valor Predictivo de las Pruebas , Evaluación de Programas y Proyectos de Salud , Calidad de la Atención de Salud , Proyectos de Investigación , Estudios Retrospectivos , Sensibilidad y EspecificidadRESUMEN
BACKGROUND: Single-nucleotide polymorphisms (SNPs) in genes involved in DNA repair are good candidates to be tested as phenotypic modifiers for carriers of mutations in the high-risk susceptibility genes BRCA1 and BRCA2. The base excision repair (BER) pathway could be particularly interesting given the relation of synthetic lethality that exists between one of the components of the pathway, PARP1, and both BRCA1 and BRCA2. In this study, we have evaluated the XRCC1 gene that participates in the BER pathway, as phenotypic modifier of BRCA1 and BRCA2. METHODS: Three common SNPs in the gene, c.-77C>T (rs3213245) p.Arg280His (rs25489) and p.Gln399Arg (rs25487) were analysed in a series of 701 BRCA1 and 576 BRCA2 mutation carriers. RESULTS: An association was observed between p.Arg280His-rs25489 and breast cancer risk for BRCA2 mutation carriers, with rare homozygotes at increased risk relative to common homozygotes (hazard ratio: 22.3, 95% confidence interval: 14.3-34, P<0.001). This association was further tested in a second series of 4480 BRCA1 and 3016 BRCA2 mutation carriers from the Consortium of Investigators of Modifiers of BRCA1 and BRCA2. CONCLUSIONS AND INTERPRETATION: No evidence of association was found when the larger series was analysed which lead us to conclude that none of the three SNPs are significant modifiers of breast cancer risk for mutation carriers.
Asunto(s)
Neoplasias de la Mama/genética , Carcinoma/genética , Proteínas de Unión al ADN/fisiología , Epistasis Genética/fisiología , Genes BRCA1 , Genes BRCA2 , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Neoplasias de la Mama/epidemiología , Carcinoma/epidemiología , Proteínas de Unión al ADN/genética , Femenino , Grupos Focales , Genes BRCA1/fisiología , Genes BRCA2/fisiología , Predisposición Genética a la Enfermedad , Heterocigoto , Humanos , Persona de Mediana Edad , Fenotipo , Polimorfismo de Nucleótido Simple , Proteína 1 de Reparación por Escisión del Grupo de Complementación Cruzada de las Lesiones por Rayos X , Adulto JovenRESUMEN
BACKGROUND: defective DNA repair has a causal role in hereditary colorectal cancer (CRC). Defects in the base excision repair gene MUTYH are responsible for MUTYH-associated polyposis and CRC predisposition as an autosomal recessive trait. Numerous reports have suggested MUTYH mono-allelic variants to be low penetrance risk alleles. We report a large collaborative meta-analysis to assess and refine CRC risk estimates associated with bi-allelic and mono-allelic MUTYH variants and investigate age and sex influence on risk. METHODS: MUTYH genotype data were included from 20 565 cases and 15 524 controls. Three logistic regression models were tested: a crude model; adjusted for age and sex; adjusted for age, sex and study. RESULTS: all three models produced very similar results. MUTYH bi-allelic carriers demonstrated a 28-fold increase in risk (95% confidence interval (CI): 6.95-115). Significant bi-allelic effects were also observed for G396D and Y179C/G396D compound heterozygotes and a marginal mono-allelic effect for variant Y179C (odds ratio (OR)=1.34; 95% CI: 1.00-1.80). A pooled meta-analysis of all published and unpublished datasets submitted showed bi-allelic effects for MUTYH, G396D and Y179C (OR=10.8, 95% CI: 5.02-23.2; OR=6.47, 95% CI: 2.33-18.0; OR=3.35, 95% CI: 1.14-9.89) and marginal mono-allelic effect for variants MUTYH (OR=1.16, 95% CI: 1.00-1.34) and Y179C alone (OR=1.34, 95% CI: 1.01-1.77). CONCLUSIONS: overall, this large study refines estimates of disease risk associated with mono-allelic and bi-allelic MUTYH carriers.
Asunto(s)
Neoplasias Colorrectales/genética , ADN Glicosilasas/genética , Adulto , Anciano , Neoplasias Colorrectales/etiología , Femenino , Predisposición Genética a la Enfermedad , Humanos , Masculino , Persona de Mediana Edad , Mutación , Factores de RiesgoRESUMEN
It is now recognised that a part of the inherited risk of colorectal cancer (CRC) can be explained by the co-inheritance of low-penetrance genetic variants. The accumulated experience to date in identifying these variants has served to highlight difficulties in conducting statistically and methodologically rigorous studies and follow-up analyses. The COGENT (COlorectal cancer GENeTics) consortium includes 20 research groups in Europe, Australia, the Americas, China and Japan. The overarching goal of COGENT is to identify and characterise low-penetrance susceptibility variants for CRC through association-based analyses. In this study, we review the rationale for identifying low-penetrance variants for CRC and our proposed strategy for establishing COGENT.
Asunto(s)
Neoplasias Colorrectales/genética , Polimorfismo Genético , Predisposición Genética a la Enfermedad , Humanos , Penetrancia , Pronóstico , Riesgo , Factores de RiesgoRESUMEN
BACKGROUND: In this study we aimed to evaluate the role of a SNP in intron 1 of the ERCC4 gene (rs744154), previously reported to be associated with a reduced risk of breast cancer in the general population, as a breast cancer risk modifier in BRCA1 and BRCA2 mutation carriers. METHODS: We have genotyped rs744154 in 9408 BRCA1 and 5632 BRCA2 mutation carriers from the Consortium of Investigators of Modifiers of BRCA1/2 (CIMBA) and assessed its association with breast cancer risk using a retrospective weighted cohort approach. RESULTS: We found no evidence of association with breast cancer risk for BRCA1 (per-allele HR: 0.98, 95% CI: 0.93-1.04, P = 0.5) or BRCA2 (per-allele HR: 0.97, 95% CI: 0.89-1.06, P = 0.5) mutation carriers. CONCLUSION: This SNP is not a significant modifier of breast cancer risk for mutation carriers, though weak associations cannot be ruled out.
Asunto(s)
Proteínas de Unión al ADN/genética , Genes BRCA1 , Genes BRCA2 , Heterocigoto , Mutación , Polimorfismo de Nucleótido Simple , Estudios de Cohortes , Femenino , Humanos , Estudios RetrospectivosRESUMEN
The close functional relationship between p53 and the breast cancer susceptibility genes BRCA1 and BRCA2 has promoted the investigation of various polymorphisms in the p53 gene as possible risk modifiers in BRCA1/2 mutation carriers. Specifically, two polymorphisms in p53, c.97-147ins16bp and p.Arg72Pro have been analysed as putative breast cancer susceptibility variants, and it has been recently reported that a p53 haplotype combining the absence of the 16-bp insertion and the presence of proline at codon 72 (No Ins-72Pro) was associated with an earlier age at the onset of the first primary tumour in BRCA2 mutation carriers in the Spanish population. In this study, we have evaluated this association in a series of 2932 BRCA1/2 mutation carriers from the Consortium of Investigators of Modifiers of BRCA1 and BRCA2.
Asunto(s)
Proteína BRCA1/genética , Proteína BRCA2/genética , Neoplasias de la Mama/genética , Mutación de Línea Germinal/genética , Polimorfismo Genético/genética , Proteína p53 Supresora de Tumor/genética , Adulto , Neoplasias de la Mama/patología , Femenino , Predisposición Genética a la Enfermedad , Genotipo , Haplotipos , Heterocigoto , Humanos , Neoplasias Ováricas/genética , Neoplasias Ováricas/patología , Factores de RiesgoRESUMEN
The SH2 domain-containing tyrosine phosphatase PTPN6 (SHP-1, PTP1C, HCP) is a 68 kDa cytoplasmic protein primarily expressed in hematopoietic cell development, proliferation and receptor-mediated mitogenic signaling pathways. By means of direct dephosphorylation, it down-regulates a broad spectrum of growth-promoting receptors, including the Kit tyrosine kinase, activated to elicit a prominent cascade of intracellular events by stem cell factor binding. The pivotal contribution of PTPN6 in modulating myeloid cell signaling has been revealed by the finding that shp-1 mutation is responsible for the overexpansion and inappropriate activation of myelomonocytic populations in motheaten (me/me) and motheaten viable (me(v)/me(v)) mice. Association of PTPN6 with c-Kit and negative modulation of the myeloid leukocyte signal transduction pathways prompted us to examine the expression of the protein tyrosine phosphatase PTPN6 gene in CD34(+)/CD117(+) blasts from acute myeloid leukemia patients. We identified and cloned cDNAs representing novel PTPN6 mRNA species, derived from aberrant splicing within the N-SH2 domain leading to retention of intron 3. Sequence analysis of cDNA clones revealed multiple A-->G editing conversions. The editing of PTPN6 mRNA mainly occurred as an A-->G conversion of A(7866), which represents the putative branch site in IVS3 of PTPN6 mRNA. Evidence that editing of A(7866) abrogates splicing has been obtained in vitro by using an edited clone and its backward clone generated by site-directed mutagenesis. The level of the aberrant intron-retaining splice variant, evaluated by semi-quantitative RT-PCR, was lower in CD117(+)-AML bone marrow mononuclear cells at remission than at diagnosis, suggesting the involvement of post-transcriptional PTPN6 processing in leukemogenesis.
Asunto(s)
Empalme Alternativo , Leucemia Mieloide/genética , Proteínas Tirosina Fosfatasas/genética , Edición de ARN , Enfermedad Aguda , Secuencia de Bases , Células HL-60 , Humanos , Péptidos y Proteínas de Señalización Intracelular , Intrones , Datos de Secuencia Molecular , Proteína Tirosina Fosfatasa no Receptora Tipo 11 , Proteína Tirosina Fosfatasa no Receptora Tipo 6 , Proteínas Tirosina Fosfatasas/metabolismo , ARN Mensajero/análisis , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , Proteínas Tirosina Fosfatasas con Dominio SH2 , Análisis de Secuencia de ARN , Células Tumorales CultivadasRESUMEN
We studied a 67-year-old woman with a sporadic form of hyperekplexia, who experienced 8-10 excessive startle responses to unexpected stimuli per month. Therapy with fluoxetine had a definite beneficial effect. This finding supports the hypothesis that serotonergic mechanisms play a role in this disorder.
Asunto(s)
Antidepresivos de Segunda Generación/uso terapéutico , Fluoxetina/uso terapéutico , Trastornos Mentales/tratamiento farmacológico , Reflejo de Sobresalto/efectos de los fármacos , Anciano , Femenino , Humanos , Trastornos Mentales/metabolismo , Trastornos Mentales/psicología , Serotonina/fisiologíaAsunto(s)
Leucemia Mieloide Aguda/genética , Mutación Puntual , Proteínas Proto-Oncogénicas c-kit/genética , Adolescente , Adulto , Anciano , Sustitución de Aminoácidos , Antígenos CD/análisis , Inversión Cromosómica , Cromosomas Humanos Par 21 , Cromosomas Humanos Par 8 , Femenino , Antígenos HLA-DR , Humanos , Inmunofenotipificación , Cariotipificación , Leucemia Mieloide Aguda/inmunología , Masculino , Persona de Mediana Edad , Translocación GenéticaRESUMEN
The authors report a case of giant cell tumour of the mandibular condyle, which is a rare finding. This tumour, studied using the main three radiological modalities (plain radiography, CT and MRI) showed characteristic radiological features of "giant cell tumour".
Asunto(s)
Tumor Óseo de Células Gigantes/diagnóstico por imagen , Cóndilo Mandibular/diagnóstico por imagen , Neoplasias Mandibulares/diagnóstico por imagen , Adulto , Biopsia , Femenino , Tumor Óseo de Células Gigantes/diagnóstico , Tumor Óseo de Células Gigantes/patología , Humanos , Imagen por Resonancia Magnética , Cóndilo Mandibular/patología , Neoplasias Mandibulares/diagnóstico , Neoplasias Mandibulares/patología , Tomografía Computarizada por Rayos XAsunto(s)
Calcinosis/diagnóstico por imagen , Hueso Occipital/diagnóstico por imagen , Enfermedad Celíaca/diagnóstico por imagen , Niño , Diagnóstico Diferencial , Epilepsia/diagnóstico por imagen , Femenino , Humanos , Masculino , Síndrome de Sturge-Weber/diagnóstico por imagen , Síndrome , Tomografía Computarizada por Rayos XRESUMEN
A retrospective study of patients at the Trento S. Chiara Hospital in the period 1982-86 showed up 8 cases of malignant mesothelioma (7 pleural and 1 peritoneal). The histology was re-examined for each case and clinical records was also looked at so as to identify onset symptomatology, diagnostic procedures and treatment. A standard questionnaire given to patients or close relations revealed previous exposure to asbestos in 2 of 3 males and in none of the 5 females. There was also a significant delay in formulation of correct diagnosis, attributable on the hand to the nonspecificity of the symptomatology of onset and on the other to the inadequacy of currently available clinical and radiological procedures. Only histology with the aid of immunocytochemical procedures was able to pinpoint correct diagnosis, in life. The ineffectiveness of conventional therapies and the poor overall prognosis for these patients is confirmed.
Asunto(s)
Mesotelioma/diagnóstico , Neoplasias Peritoneales/diagnóstico , Neoplasias Pleurales/diagnóstico , Adulto , Femenino , Humanos , Inmunohistoquímica , Italia , Masculino , Mesotelioma/mortalidad , Mesotelioma/patología , Persona de Mediana Edad , Neoplasias Peritoneales/mortalidad , Neoplasias Peritoneales/patología , Peritoneo/patología , Pleura/patología , Neoplasias Pleurales/mortalidad , Neoplasias Pleurales/patología , Pronóstico , Estudios RetrospectivosRESUMEN
From March 1977 to December 1982, 142 patients with varicocele of various sizes underwent preoperative antegrade or retrograde phlebography of the left spermatic vein. In 8 of them both procedures were carried out. A retrospective analysis of 68 preoperative antegrade venographies in supine (0 degree) and upright (30 degrees, 45 degrees and 90 degrees) positions was made and compared with 66 retrograde venograms. The preoperative 'dynamic' antegrade phlebography has been performed in order to study the hemodynamic conditions of the varicocele, avoiding any pressure interference on the valvular function of the venous renospermatic area. This technique has allowed us to get useful anatomoradiological and physiopathological information about the spontaneous reflux into the internal spermatic vein by its positional filling and emptying. It has also permitted a good visualization of collateral channels, particularly in the pelvic, femorosaphenous and scrotal areas. We could, at the same time, simultaneously sample blood from the cubital and intrascrotal spermatic veins to determine the testosterone, cortisol and serotonin levels, in different positions; the evaluation of these biochemical data is being pursued. In our opinion, this diagnostic procedure is easy to perform and inexpensive. The procedure and the results are discussed in detail.