Prognostic Value of Liquid-Biopsy-Based Biomarkers in Upper Tract Urothelial Carcinoma.

Currently, there are no reliable prognostic factors to determine which upper tract urothelial carcinoma (UTUC) patients will progress after radical nephroureterectomy (RNU). We aim to evaluate whether liquid-biopsy-based biomarkers (circulating tumor cells (CTCs), cell-free DNA (cfDNA), and circulating tumor DNA (ctDNA)) were able to predict clinical outcomes in localized UTUC patients undergoing RNU. Twenty patients were prospectively enrolled between 2021 and 2023. Two blood samples were collected before RNU and three months later. CTCs and cfDNA were isolated and evaluated using the IsoFlux system and Quant-iT PicoGreen dsDNA kit, respectively. Droplet digital PCR was performed to determine ctDNA status. Cox regression analysis was performed on CTCs, cfDNA, and ctDNA at two different follow-up time points to examine their influence on tumor progression and cancer-specific survival (CSS). During a median follow-up of 18 months, seven (35%) patients progressed and three (15%) died. Multivariate analysis demonstrated that cfDNA levels three months after RNU are a significant predictor of tumor progression (HR = 1.085; p = 0.006) and CSS (HR = 1.168; p = 0.029). No associations were found between CTC enumeration and ctDNA status with any of the clinical outcomes evaluated. The evaluation of cfDNA levels in clinical practice could improve the disease management of UTUC patients.

Papel de la dieta mediterránea en la reducción de factores de riesgocardiovascular / Role of the Mediterranean diet in the reduction of cardiovascular risk factors

Introducción: Las enfermedades cardiovasculares son un grupo heterogéneo de trastornos cuya causa subyacente de desarrollo suele ser la aterosclerosis. Se estima que los factores dietéticos son responsables de la mayor contribución, entre todos los factores de riesgo conductuales, al riesgo de mortalidad por las enfermedades cardiovascularesa nivel poblacional en toda Europa. Es por ello, que un patrón dietético adecuado y ajustado individualmente a las características clínicas de cada paciente como es el de dieta mediterránea, podría ayudar a reducir las comorbilidades cardiovasculares e incluso a prevenirlas y tratarlas cuando ya existen. Objetivo: El principal objetivo de esta revisión es analizar el papel de la dieta mediterránea en la reducción de factores de riesgo cardiovascular y la morbimortalidad cardiovascular en general, centrándonos en su actuación sobre la hipertensión arterial, obesidad, dislipemia y diabetes mellitus tipo 2. Resultados: Se han realizado estudios en los que se comparan distintos tipos de dietas para la prevención y manejo de estos eventos, siendo la MedDiet la que ha demostrado un mayor beneficio. Es capaz de influir positivamente sobre comorbilidades cardiovasculares como hipertensión arterial, obesidad, dislipemia y diabetes mellitus tipo 2 si existe un nivel alto de adhesión hacia ella, que es lo más complicado ya que hoy en día existen influencias que promueven el cambio de las dietas tradicionales a dietas occidentalizadas. Conclusión: Un patrón alimentario adecuado, como la dieta mediterránea, es una de las medidas más importantes para prevenir la principal causa de muerte a nivel mundial, como son las enfermedades cardiovasculares y sus comorbilidades asociadas.(AU)

Introduction: Cardiovascular diseases (CVD) are a heterogeneous group of disorders whose underlying cause of development is usually atherosclerosis. It is estimated that dietary factors are responsible for the principal contribution, among all behavioral risk factors, to the risk of CVD mortality at the population level throughout Europe. Therefore, an appropriate dietary pattern individually adjusted to the clinical characteristics of each patient, such as the Mediterranean diet, could help to reduce cardiovascular comorbidities and even prevent and treat them when they already exist. Objective: The principal aim of this review is to analyze the role of the Mediterranean diet in reducing cardiovascular risk factors and overall cardiovascular morbidity and mortality, focusing on its impact on arterial hypertension, obesity, dyslipidemia and diabetes mellitus type 2. Results: Studies have been carried out comparing different diets for prevention and management, with the MedDiet being the one that has shown the most benefit. It can positively influence cardiovascular comorbidities such as arterial hypertension, obesity, dyslipidemia, and type 2 diabetes mellitus if there is a high level of adherence to it, which is the most complicated aspect since nowadays there are influences that promote the change from traditional diets to Westernized diets. Conclusion: An adequate dietary pattern, such as the Mediterranean diet, is one of the most important measures to prevent the leading cause of death worldwide, such as cardiovascular diseases and their associated comorbidities.(AU)

Prognostic classifier for predicting biochemical recurrence in localized prostate cancer patients after radical prostatectomy.

OBJECTIVE: The purpose of the study was to develop an improved classifier for predicting biochemical recurrence (BCR) in clinically localized PCa patients after radical prostatectomy. METHODS AND MATERIALS: Retrospective study including 122 PCa patients who attended our department between 2000 and 2007. Gene expression patterns were analyzed in 21 samples from 7 localized, 6 locally advanced, and 8 metastatic PCa patients using Illumina microarrays. Expression levels of 41 genes were validated by quantitative PCR in 101 independent PCa patients who underwent radical prostatectomy. Logistic regression analysis was used to identify individual predictors of BCR. A risk score for predicting BCR including clinicopathological and gene expression variables was developed. Interaction networks were built by GeneMANIA Cytoscape plugin. RESULTS: A total of 37 patients developed BCR (36.6%) in a median follow-up of 120 months. Expression levels of 7,930 transcripts differed between clinically localized and locally advanced-metastatic PCa groups (FDR < 0.1). We found that expression of ASF1B and MCL1 as well as Gleason score, extracapsular extension, seminal vesicle invasion, and positive margins were independent prognostic factors of BCR. A risk score generated using these variables was able to discriminate between 2 groups of patients with a significantly different probability of BCR (HR 6.24; CI 3.23-12.4, P< 0.01), improving the individual discriminative performance of each of these variables on their own. Direct interactions between the 2 genes of the model were not found. CONCLUSION: Combination of gene expression patterns and clinicopathological variables in a robust, easy-to-use, and reliable classifier may contribute to improve PCa risk stratification.