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Diedenhofen G, Morgia A, Sinnona N, Pacchiarotti A, Fiaschetti A, Forte V, Tosoni M, Liberati F, Boschetto S, Zepponi E, Marogna P, Manca A, Bisail M, Vestri A, Rossi A. Screening for colorectal cancer by full colonoscopy in first-degree relatives of colorectal cancer patients: a multicentric study by the Italian League for the Fight against Cancer. Ann Ig 2024. [PMID: 38465396 DOI: 10.7416/ai.2024.2618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 03/12/2024]
Abstract
Background Colorectal cancer currently presents the third-highest incidence of cancers worldwide, making secondary prevention through screening programs for colorectal cancer, usually by Fecal Occult Blood Testing, an essential preventive medicine intervention. First-degree relatives of colorectal cancer patients are a particularly at-risk group, with indications to consider direct screening by full colonoscopy. Colonoscopy is considered the gold standard for diagnosing colorectal cancer, as it has high sensitivity and specificity, and is both a diagnostic and therapeutic tool. However, it requires significant organizational and financial resources, and has a small but relatively higher risk of complications as opposed to fecal occult blood testing. The present study aimed to assess the appropriateness of a screening program without age restrictions of CRC by full colonoscopy in asymptomatic, first-degree adult relatives of patients with colorectal cancer, aiming both to actively increase screening coverage and to determine the detection rate of precancerous lesions and colorectal cancer in this population. Study Design Uncontrolled interventional study - colorectal cancer screening by full colonoscopy for at-risk population. Methods The Italian League for the Fight against Cancer started a colorectal cancer screening program by full colonoscopy for first-degree relatives of colorectal cancer patients in 1998 in the province of Latina, Lazio Region, Italy. The program was expanded to the provinces of Rieti, Lazio Region, and Sassari, Sardinia Region, in 2014 and 2016 respectively, and was concluded in 2018. Subjects were actively and voluntarily recruited by the study's working group. Subjects that had already been subjected to a full colonoscopy in the preceding 5 years were excluded from this study. Identified neoplastic lesions were treated either directly or referred to the Day Hospital setting, and histologically diagnosed following World Health Organization guidelines. Results In total, 2,288 subjects (age range 15-88, mean 52.3 yrs, M/F = 946/1,204) were screened by colonoscopy, of which 103 (4.5%) were incomplete and 2,173 (95.0%) complete, with data on colonoscopy performance missing for 12 participants. Out of 468 positive outcomes on colonoscopy, diagnosis for 422 (204M/173F), 19.4% of total subjects, was adenomatous polyps and 46 (20M/20F), 2.1% of total subjects, was colorectal cancer. Female sex was a protective factor against a positive test outcome, with a 35% reduction compared to male sex, with OR=0.64 95%CI (0.52-0.80). On the other hand, being over 50 years of age was found to be a risk factor, making a positive outcome more than twice as likely, with OR=2.3 95%CI (1.8-2.9). Subjects over 50 also had significantly more instances of multiple adenomas being found, however the size distribution of found adenomas was not significantly different between subjects under and over 50, despite size being a predictor of risk of neoplastic progression. Conclusions Given the high detection rate of precancerous lesions and colorectal cancer in the studied population, it is our opinion that guidelines should continue to recommend earlier and more frequent screening in first-degree relatives of patients with colorectal cancer, and, barring the introduction of more cost-effective and/or lower risk procedures with a similar efficacy profile, maintain the use of colonoscopy as the main screening option.
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Affiliation(s)
- Giacomo Diedenhofen
- Department of Public Health and Infectious Diseases, Specialization School in Health Statistics and Biometrics, Sapienza University of Rome, Italy
| | - Augusto Morgia
- Department of Public Health and Infectious Diseases, Specialization School in Health Statistics and Biometrics, Sapienza University of Rome, Italy
| | | | | | | | | | | | | | | | - Enrico Zepponi
- San Camillo de' Lellis Hospital, Rieti, Italy
- LILT Rieti, Italy
| | | | | | - Marco Bisail
- Sassari University Hospital, Sassari, Italy
- LILT Sassari, Italy
| | - Annarita Vestri
- Department of Public Health and Infectious Diseases, Specialization School in Health Statistics and Biometrics, Sapienza University of Rome, Italy
| | - Alessandro Rossi
- San Marco Clinic, Latina, Italy
- LILT Latina, Santa Maria Goretti Hospital, Latina, Italy
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Floris M, Pira G, Castiglia P, Idda M, Steri M, De Miglio M, Piana A, Cossu A, Azara A, Arru C, Deiana G, Putzu C, Sanna V, Carru C, Serra A, Bisail M, Muroni M. Impact on breast cancer susceptibility and clinicopathological traits of common genetic polymorphisms in TP53, MDM2 and ATM genes in Sardinian women. Oncol Lett 2022; 24:331. [PMID: 36039053 PMCID: PMC9404703 DOI: 10.3892/ol.2022.13451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Accepted: 06/22/2022] [Indexed: 11/06/2022] Open
Abstract
Common variants of genes involved in DNA damage correction [tumor protein p53 (TP53), murine double 2 homolog oncoprotein (MDM2) and ataxia-telengiectasia mutated (ATM)] may serve a role in cancer predisposition. The purpose of the present study was to investigate the association of five variants in these genes with breast cancer risk and clinicopathological traits in a cohort of 261 women from northern Sardinia. Polymorphic variants in TP53 (rs17878362, rs1042522 and rs1625895), MDM2 (rs2279744) and ATM (rs1799757) were determined by PCR and TaqMan single nucleotide polymorphism assay in patients with breast cancer (n=136) and healthy controls (n=125). Association with clinicopathological (e.g., age at diagnosis, lymph node involvement, clinical stage) and lifestyle factors (e.g., smoking status, alcohol intake, contraceptive use) was also evaluated. TP53 rs17878362 and rs1625895 polymorphisms were associated with decreased risk of BC diagnosis in patients older than 50 years (codominant and recessive models) and post-menopause (recessive model). Furthermore, there was a significant association between lymph node status (positive vs. negative) and ATM rs1799757-delT in dominant and additive models and between MDM2 rs2279744-allele and use of oral contraceptives. This analysis suggested that TP53 rs17878362 and rs1625895 may affect age of onset of breast cancer and ATM rs1799757 and MDM2 rs2279744 may be associated with lymph node status and prolonged use of oral contraceptives, respectively.
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Affiliation(s)
- Matteo Floris
- Department of Biomedical Sciences, Surgery and Pharmacy, University of Sassari, Sassari, I-07100 Sardinia, Italy
| | - Giovanna Pira
- Department of Biomedical Sciences, Surgery and Pharmacy, University of Sassari, Sassari, I-07100 Sardinia, Italy
| | - Paolo Castiglia
- Department of Medicine, Surgery and Pharmacy, University of Sassari, Sassari, I-07100 Sardinia, Italy
| | - Maria Idda
- Institute for Genetic and Biomedical Research, National Research Council, Monserrato, Cagliari, I-09121 Sardinia, Italy
| | - Maristella Steri
- Institute for Genetic and Biomedical Research, National Research Council, Monserrato, Cagliari, I-09121 Sardinia, Italy
| | - Maria De Miglio
- Department of Medicine, Surgery and Pharmacy, University of Sassari, Sassari, I-07100 Sardinia, Italy
| | - Andrea Piana
- Department of Medicine, Surgery and Pharmacy, University of Sassari, Sassari, I-07100 Sardinia, Italy
| | - Andrea Cossu
- Department of Medicine, Surgery and Pharmacy, University of Sassari, Sassari, I-07100 Sardinia, Italy
| | - Antonio Azara
- Department of Medicine, Surgery and Pharmacy, University of Sassari, Sassari, I-07100 Sardinia, Italy
| | - Caterina Arru
- Department of Biomedical Sciences, Surgery and Pharmacy, University of Sassari, Sassari, I-07100 Sardinia, Italy
| | - Giovanna Deiana
- Department of Biomedical Sciences, Surgery and Pharmacy, University of Sassari, Sassari, I-07100 Sardinia, Italy
| | - Carlo Putzu
- Division of Medical Oncology, Azienda Ospedaliera Universitaria, Sassari, I-07100 Sardinia, Italy
| | - Valeria Sanna
- Division of Medical Oncology, Azienda Ospedaliera Universitaria, Sassari, I-07100 Sardinia, Italy
| | - Ciriaco Carru
- Department of Biomedical Sciences, Surgery and Pharmacy, University of Sassari, Sassari, I-07100 Sardinia, Italy
| | - Antonello Serra
- Unit of Occupational Medicine, Azienda Ospedaliera Universitaria, Sassari, I-07100 Sardinia, Italy
| | - Marco Bisail
- Lega Italiana per la Lotta contro i Tumori, Sassari, I-07100 Sardinia, Italy
| | - Maria Muroni
- Institute for Genetic and Biomedical Research, National Research Council, Monserrato, Cagliari, I-09121 Sardinia, Italy
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3
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Floris M, Sanna D, Castiglia P, Putzu C, Sanna V, Pazzola A, De Miglio MR, Sanges F, Pira G, Azara A, Lampis E, Serra A, Carru C, Steri M, Costanza F, Bisail M, Muroni MR. MTHFR, XRCC1 and OGG1 genetic polymorphisms in breast cancer: a case-control study in a population from North Sardinia. BMC Cancer 2020; 20:234. [PMID: 32192442 PMCID: PMC7083022 DOI: 10.1186/s12885-020-06749-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Accepted: 03/12/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Despite conflicting results, considerable evidence suggests the association between single nucleotide polymorphisms in MTHFR, XRCC1 and OGG1 genes and, risk of developing breast cancer. Here a case-control study is reported, including 135 breat cancer patients and 112 healthy women, all representative of Northern Sardinian population. METHODS Polymerase chain reaction/restriction fragment length polymorphism method was used to determine the genotypes of five polymorphisms: MTHFR C677T (rs1801133) and A1298C (rs1801131), XRCC1 Arg194Trp (rs1799782) and Arg399Gln (rs25487) and OGG1 Ser326Cys (rs1052133). Allelic, genotypic and haplotype association analyses with disease risk and clinicopathological parameters were performed. RESULTS A nominally significant association with breast cancer risk was observed for MTHFR C677T polymorphism heterozygous genotype in the codominant model (OR: 0.57, 95% CI: 0.32-1.00, p = 0.049) and for Cys/Cys genotype of the OGG1 Ser326Cys polymorphism in the recessive model (OR: 0.23, 95% CI: 0.05-1.11, p = 0.0465). No significant differences were found at genotype-level for A1298C polymorphism of the MTHFR gene and Arg194Trp and Arg399Gln of the XRCC1 gene. Furthermore, the OGG1 and XRCC1 rs25487 polymorphisms were nominally associated with PgR, Her2 status and with sporadic breast cancer, respectively. CONCLUSIONS Based on genetic characteristics of individuals included in this study, results suggest that MTHFR CT and OGG1 Cys/Cys genotypes have a protective effect that may have an influence on breast cancer risk in a representative Northern Sardinian population.
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Affiliation(s)
- Matteo Floris
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy.
| | - Daria Sanna
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Paolo Castiglia
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Carlo Putzu
- Division of Medical Oncology, AOU Sassari, Sassari, Italy
| | - Valeria Sanna
- Division of Medical Oncology, AOU Sassari, Sassari, Italy
| | | | - Maria Rosaria De Miglio
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Francesca Sanges
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Giovanna Pira
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Antonio Azara
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Emanuele Lampis
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | | | - Ciriaco Carru
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Maristella Steri
- Institute for Genetic and Biomedical Research, National Research Council (CNR), Monserrato, Cagliari, Italy
| | - Flavia Costanza
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | | | - Maria Rosaria Muroni
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy.
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Castiglia P, Sanna V, Azara A, De Miglio MR, Murgia L, Pira G, Sanges F, Fancellu A, Carru C, Bisail M, Muroni MR. Methylenetetrahydrofolate reductase (MTHFR) C677T and A1298C polymorphisms in breast cancer: a Sardinian preliminary case-control study. Int J Med Sci 2019; 16:1089-1095. [PMID: 31523170 PMCID: PMC6743281 DOI: 10.7150/ijms.32162] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Accepted: 04/12/2019] [Indexed: 02/05/2023] Open
Abstract
Two common polymorphisms in the MTHFR gene, C677T and A1298C, are associated with reduced enzyme activity and may be associated with breast cancer susceptibility. We performed a case-control study to investigate the association between the two SNPs in the MTHFR gene and risk of breast cancer. In total, 58 breast cancer patients and 58 unaffected controls were enrolled in the study. Polymerase chain reaction/restriction fragment length polymorphism technique (PCR-RFLP) was conducted to determine the genotypes. No significant differences were found in the genotypes of the two polymorphisms of the MTHFR gene between cases and controls. The OR and 95% CI for the 677CC, 677CT and 677TT genotypes were 1.00, 0.95 (0.39-2.31) and 0.87 (0.27-2.80), respectively; those of the 1298AA, 1298AC and 1298CC genotypes were 1.00, 0.59 (0.26-1.36) and 0.78 (1.32-4.66) respectively. Furthermore, it has been shown in patients with breast cancer a risk of presenting with an aggressive biophenotype about twice or three times higher in the presence of the C677T and A1298C polymorphisms, respectively. Finally, the A1298Cpolymorphism is significantly associated with increased recurrence risk of lymph node-positive breast cancer. Our study has not shown a significant association between MTHFR gene polymorphisms and breast cancer risk. However, it highlighted the key-role played by the presence of mutant alleles for both polymorphisms in increasing the risk of developing more aggressive phenotypes; moreover, specifically in A1298C, it might also lead to a higher risk of developing lymph node metastasis.
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Affiliation(s)
- Paolo Castiglia
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Via P. Manzella, 4 - 07100 Sassari, Italy
| | - Valeria Sanna
- Division of Medical Oncology, AOU Sassari, Via E. De Nicola - 07100 Sassari, Italy; Sassari, Italy
| | - Antonio Azara
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Via P. Manzella, 4 - 07100 Sassari, Italy
| | - Maria R De Miglio
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Via P. Manzella, 4 - 07100 Sassari, Italy
| | - Luciano Murgia
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Via P. Manzella, 4 - 07100 Sassari, Italy
| | - Giovanna Pira
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Via P. Manzella, 4 - 07100 Sassari, Italy
| | - Francesca Sanges
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Via P. Manzella, 4 - 07100 Sassari, Italy
| | - Alessandro Fancellu
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Via P. Manzella, 4 - 07100 Sassari, Italy
| | - Ciriaco Carru
- Department of Biomedical Sciences, University of Sassari, Viale San Pietro 43 - 07100 Sassari, Italy
| | - Marco Bisail
- LILT, Sassari, Via Amendola, 40/L - 07100 Sassari, Italy
| | - Maria Rosaria Muroni
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Via P. Manzella, 4 - 07100 Sassari, Italy
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5
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Bisail M, Nieddu S, Sarobba MG, Sanna G, Milia V, Ghì MG, Farris A. [The labelling index as a prognostic marker in breast carcinoma]. Minerva Med 1994; 85:141-4. [PMID: 8028740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
In this work assess the labelling index in sixty patients affected by breast cancer and treated with only local surgical therapy, without subsequent chemo- or radiotherapy. We had considered L.I. a single prognostic factor and in relation with other common prognostic factors of this neoplasia. The patients with a high L.I. have shown a greater probability of relapses, also in absence of lymph nodal metastases.
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Autoradiography
- Biomarkers, Tumor/analysis
- Breast Neoplasms/mortality
- Breast Neoplasms/pathology
- Breast Neoplasms/surgery
- Carcinoma, Ductal, Breast/mortality
- Carcinoma, Ductal, Breast/pathology
- Carcinoma, Ductal, Breast/surgery
- Carcinoma, Lobular/mortality
- Carcinoma, Lobular/pathology
- Carcinoma, Lobular/surgery
- Female
- Follow-Up Studies
- Humans
- Italy/epidemiology
- Lymphatic Metastasis
- Middle Aged
- Neoplasm Recurrence, Local/epidemiology
- Neoplasm Recurrence, Local/pathology
- Prognosis
- Thymidine
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Affiliation(s)
- M Bisail
- Cattedra di Oncologia Clinica, Università di Sassari
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Farris A, Bisail M, Sarobba MG, Sanna G, Scotto T, Valzelli S, Intini C. Cisplatin-VP16 alternating with cyclophosphamide-epirubicin versus cyclophosphamide-epirubicin-vincristine in small cell lung cancer. J Chemother 1993; 5:344-7. [PMID: 8106908 DOI: 10.1080/1120009x.1993.11741080] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
In the hope of increasing the incidence of objective remissions and the survival time of patients with small cell lung cancer, we conducted a randomized study designed to compare a treatment scheme of alternating chemotherapy featuring cisplatin+etoposide followed by cyclophosphamide+epirubicin versus conventional chemotherapy with cyclophosphamide+epirubicin+vincristine, in a total of 113 patients (56 treated with the alternating regime and 57 treated conventionally). Patients receiving the alternating drug regimen showed some increase in objective remission rates, and above all increased mean survival time (297 days versus 232). The higher incidence of side effects encountered was effectively controlled by the usual medical therapy.
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Affiliation(s)
- A Farris
- Chair of Clinical Oncology, University of Sassari, Italy
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7
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Bisail M, Cassisa L, Manca M, Casula S, Fele G, Malavasi A. [Discordance between clinical and immunological aspects in a case of chronic B-type lymphoproliferative syndrome]. Minerva Med 1991; 82:405-7. [PMID: 2067715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Chronic lymphoproliferative disorders are extremely heterogeneous from a clinical, morphological and immunological point of view. The paper reports the case of a woman with chronic prolymphocytic leukemia. The neoplastic clone revealed the typical immunological features of pre-B lymphocytes, which are at an earlier stage of differentiation in respect to prolymphocytes. After polychemotherapy (CEOP) the phenotype of the neoplastic cells shifted to an immunological pattern typical of B lymphocytes.
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Affiliation(s)
- M Bisail
- Università degli Studi di Sassari, Istituto di Clinica Medica, Ospedale Civile, Sassari
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8
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Teatini G, Meloni F, Bisail M, Milia V, Sanna G, Sarobba MG, Massidda B, Scotto T, Farris A. Neoadjuvant chemotherapy with cisplatinum and 5-fluorouracil in advanced head and neck cancer. J Chemother 1990; 2:394-6. [PMID: 2093113 DOI: 10.1080/1120009x.1990.11739051] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Forty-one patients affected by solid tumors of the head and neck were treated with neoadjuvant therapy before radiotherapy or surgery. All patients received therapy with cisplatinum 100 mg/m2 day 1 and 5-fluorouracil 1000 mg/day for days 1-5 by continuous infusion with a portable chronoinfusor. After three cycles, we observed an objective response in 34/41 patients (82.9%), with 9 (21.9%) complete remissions and 25 (61%) partial remissions. The main side effects were few and controllable. In our experience, neoadjuvant chemotherapy was able to induce a significant remission in 4/5 of patients, with better prospects for subsequent surgery and/or radiotherapy.
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Affiliation(s)
- G Teatini
- Department of Otorhinolaryngology, University of Sassari, Italy
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9
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Bisail M, Satta A, Serra G, Bertrand G, Abdulsattar G, Farris A. Carcinoma of Vater's papilla in patient affected by multiple myeloma. Haematologica 1990; 75:484. [PMID: 2097269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
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10
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Bisail M, Cossu A, Massarelli G, Tanda F, Agnetti V, Traccis S, Cassisa L, Puliga MV, Bartoli E. POEMS syndrome: a case report. Haematologica 1990; 75:384-6. [PMID: 2276681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
A case of POEMS syndrome in a 43-year-old male with polyneuropathy, osteolytic lesion of the basin due to solitary IgA-lambda plasmacytoma, cutaneous scleroderma-like changes, diffuse lymphadenopathy and hepatosplenomegaly is described. Liver biopsy showed a regenerative process of the parenchyma without laboratory and histologic evidence of necrosis. A peculiar finding was the onset of a right hemiparesis in the absence of signs of vascular disease or other predisposing factors. The possible links between the peculiar elements of the POEMS syndrome are briefly analyzed and discussed.
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Affiliation(s)
- M Bisail
- Department of Medicine, University of Sassari, Italy
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