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Vetrugno L, Deana C, Spadaro S, Cammarota G, Grieco DL, Tullio A, Bove T, Di Loreto C, Maggiore SM, Orsaria M, Study Group D. Diaphragmatic morphological post-mortem findings in critically ill COVID-19 patients: an observational study. Monaldi Arch Chest Dis 2024. [PMID: 38656318 DOI: 10.4081/monaldi.2024.2829] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 03/18/2024] [Indexed: 04/26/2024] Open
Abstract
Our study investigates the post-mortem findings of the diaphragm's muscular structural changes in mechanically ventilated COVID-19 patients. Diaphragm samples of the right side from 42 COVID-19 critically ill patients were analyzed and correlated with the type and length of mechanical ventilation (MV), ventilatory parameters, prone positioning, and use of sedative drugs. The mean number of fibers was 550±626. The cross-sectional area was 4120±3280 μm2, while the muscular fraction was 0.607±0.126. The overall population was clustered into two distinct populations (clusters 1 and 2). Cluster 1 showed a lower percentage of slow myosin fiber and higher fast fiber content than cluster 2, 68% versus 82%, p<0.00001, and 29.8% versus 18.8%, p=0.00045 respectively. The median duration of MV was 180 (41-346) hours. In cluster 1, a relationship between assisted ventilation and fast myosin fiber percentage (R2=-0.355, p=0.014) was found. In cluster 2, fast fiber content increased with increasing the length of the controlled MV (R2=0.446, p=0.006). A high grade of fibrosis was reported. Cluster 1 was characterized by fibers' atrophy and cluster 2 by hypertrophy, supposing different effects of ventilation on the diaphragm but without excluding a possible direct viral effect on diaphragmatic fibers.
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Affiliation(s)
- Luigi Vetrugno
- Department of Medical, Oral and Biotechnological Sciences, Gabriele d'Annunzio University of Chieti Pescara, Chieti; Department of Anesthesiology, Critical Care Medicine and Emergency, Annunziata Hospital, Chieti.
| | - Cristian Deana
- Department of Anesthesia and Intensive Care, Health Integrated Agency Friuli Centrale, Academic Hospital of Udine.
| | - Savino Spadaro
- Department of Translational Medicine, University of Ferrara; Intensive Care Unit, Azienda Ospedaliera Universitaria Sant'Anna, Ferrara.
| | - Gianmaria Cammarota
- Department of Translational Medicine, Università degli Studi del Piemonte Orientale, Novara; Department of Anesthesiology and Intensive Care, Azienda Ospedaliero-Universitaria "Maggiore della Carità", Novara.
| | - Domenico Luca Grieco
- Department of Emergency, Intensive Care Medicine and Anesthesia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome; Department of Anesthesiology and Intensive Care Medicine, Catholic University of The Sacred Heart, Rome.
| | - Annarita Tullio
- Health Integrated Agency Friuli Centrale, Academic Hospital of Udine.
| | - Tiziana Bove
- Department of Anesthesia and Intensive Care, Health Integrated Agency Friuli Centrale, Academic Hospital of Udine; Department of Medicine, University of Udine.
| | - Carla Di Loreto
- Department of Medicine, University of Udine; Institute of Anatomic Pathology, Health Integrated Agency Friuli Centrale, Academic Hospital of Udine.
| | - Salvatore Maurizio Maggiore
- Department of Anesthesiology, Critical Care Medicine and Emergency, Annunziata Hospital, Chieti; Department of Innovative Technologies in Medicine and Dentistry, Gabriele d'Annunzio University of Chieti Pescara, Chieti.
| | - Maria Orsaria
- Institute of Anatomic Pathology, Health Integrated Agency Friuli Centrale, Academic Hospital of Udine.
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Zanin V, Driul L, Zoletto S, Restaino S, Tulisso A, Bulfoni M, Orsaria M. Intrauterine fetal death in a COVID positive pregnant woman. Minerva Obstet Gynecol 2024; 76:205-210. [PMID: 36255162 DOI: 10.23736/s2724-606x.22.05149-1] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
SARS-CoV-2 disease mechanisms are not yet fully understood, especially in cases affecting pregnant women. In fact, although they suffer from the same symptoms as non-pregnant women, they are more susceptible to-adverse outcomes of COVID-19 as well as pregnancy complications leading to stillbirth, premature rupture of membrane, or intrauterine fetal demise (IUFD). The consequences on pregnancy are not clearly correlated with the severity of the infection. We present a case of fetal death in a 30-year-old woman with a confirmed SARS-CoV-2 infection without any other significant clinical or obstetric disorders. A histopathological examination of the placenta indicated massive and diffuse intervillar fibrinoid deposits associated with chronic histiocytic intervillositis that can be associated with SARS-CoV-2 placentitis. Given the high rates of SARS-CoV-2 infections in pregnancy, it is important to understand the factors that determine negative pregnancy outcomes, regardless of the severity of the patient's symptoms.
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Affiliation(s)
- Valentina Zanin
- Department of Medicine, University of Udine, Udine, Italy -
- Department of Gynecology and Obstetrics, ASUFC University-Hospital of Friuli Centrale, Udine, Italy -
| | - Lorenza Driul
- Department of Medicine, University of Udine, Udine, Italy
- Department of Gynecology and Obstetrics, ASUFC University-Hospital of Friuli Centrale, Udine, Italy
| | - Silvia Zoletto
- Department of Medicine, University of Udine, Udine, Italy
- Department of Gynecology and Obstetrics, ASUFC University-Hospital of Friuli Centrale, Udine, Italy
| | - Stefano Restaino
- Department of Medicine, University of Udine, Udine, Italy
- Department of Gynecology and Obstetrics, ASUFC University-Hospital of Friuli Centrale, Udine, Italy
| | - Angelica Tulisso
- Department of Medicine, University of Udine, Udine, Italy
- Department of Pathological Anatomy, ASUFC University-Hospital of Friuli Centrale, Udine, Italy
| | - Michela Bulfoni
- Department of Medicine, University of Udine, Udine, Italy
- Department of Pathological Anatomy, ASUFC University-Hospital of Friuli Centrale, Udine, Italy
| | - Maria Orsaria
- Department of Medicine, University of Udine, Udine, Italy
- Department of Pathological Anatomy, ASUFC University-Hospital of Friuli Centrale, Udine, Italy
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Xodo S, Londero AP, Orsaria M, Marzinotto S, Colussi G, Cagnacci A, Mariuzzi L, Gri G. Examining the Aryl Hydrocarbon Receptor Network in the Placental Tissues of Pregnancies Complicated by Pre-Eclampsia: An Explorative Case-Control Analysis. Life (Basel) 2023; 13:2122. [PMID: 38004262 PMCID: PMC10672047 DOI: 10.3390/life13112122] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 10/20/2023] [Accepted: 10/23/2023] [Indexed: 11/26/2023] Open
Abstract
Severe maternal and newborn morbidity and mortality associated with pre-eclampsia, which are caused partly by premature delivery, affect a factual proportion of pregnancies. Despite its prevalence, the underlying causes of pre-eclampsia remain elusive, with emerging evidence implicating the aryl hydrocarbon receptor (AhR) in its pathogenesis. This study sought to elucidate the involvement of the AhR and its associated pathway in pre-eclampsia by comparing placental components of the AhR pathway in pregnant individuals with and without pre-eclampsia. This case-control investigation was conducted at the University Hospital of Udine from May 2021 to February 2023. The AhR was assessed using immunohistochemistry and immunofluorescence, and its mRNA was evaluated using a Real-Time Quantitative Reverse Transcription PCR. Levels of mRNA expression were also estimated for other components of the AhR pathway (CYP1B1, IDO1, ARNT, TIPARP, S100A4, and AHRR). Our findings show decreased levels of expression of AhR, IDO1, ARNT, TiPARP, and S100A4 in the placental tissues of individuals with pre-eclampsia compared to controls (p < 0.05). The AhR exhibited a distinct localization within the syncytiotrophoblast (nuclei and cytoplasm) and CD45-positive cells (nuclei and cytoplasm). Furthermore, a significant positive correlation between the AhR and S100A4 (rho = 0.81) was observed in normal placentas, while CYP1B1 displayed a significant negative correlation with the AhR (rho = -0.72), within addition to its negative correlation with TiPARP (rho = -0.83). This study illuminates pre-eclampsia's molecular aberrations, suggesting new diagnostic, therapeutic, and mechanistic approaches. This study emphasizes the need for more research to validate and broaden these findings to improve the management of this complex pregnancy condition.
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Affiliation(s)
- Serena Xodo
- Clinic of Obstetrics and Gynecology, “Azienda Sanitaria Universitaria Integrata di Udine”, DAME, University of Udine, 33100 Udine, Italy
| | - Ambrogio P. Londero
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Infant Health, University of Genoa, 16132 Genova, Italy;
- Obstetrics and Gynecology Unit, IRCCS Istituto Giannina Gaslini, 16147 Genova, Italy
| | - Maria Orsaria
- Institute of Pathology, “Azienda Sanitaria Universitaria Integrata di Udine”, DAME, University of Udine, 33100 Udine, Italy; (M.O.)
| | - Stefania Marzinotto
- Institute of Pathology, “Azienda Sanitaria Universitaria Integrata di Udine”, DAME, University of Udine, 33100 Udine, Italy; (M.O.)
| | - Gianluca Colussi
- Hypertension Unit, Department of Medicine, ASFO “Santa Maria degli Angeli” Hospital of Pordenone, 33170 Pordenone, Italy;
| | - Angelo Cagnacci
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Infant Health, University of Genoa, 16132 Genova, Italy;
- Academic Unit of Obstetrics and Gynecology, IRCCS Ospedale San Martino, 16132 Genoa, Italy
| | - Laura Mariuzzi
- Institute of Pathology, “Azienda Sanitaria Universitaria Integrata di Udine”, DAME, University of Udine, 33100 Udine, Italy; (M.O.)
| | - Giorgia Gri
- DIMEC—Department of Medical and Surgical Sciences, University of Bologna, 40126 Bologna, Italy;
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Xodo S, Celante L, Liviero S, Orsaria M, Mariuzzi L, De Luca M, Damante G, Driul L, Cagnacci A, Ferino A, Di Giorgio E, Xodo L, Londero AP. Fetal growth at term and placental oxidative stress in a tissue micro-array model: a histological and immunohistochemistry study. Histochem Cell Biol 2023; 160:293-306. [PMID: 37306741 PMCID: PMC10509069 DOI: 10.1007/s00418-023-02212-6] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/20/2023] [Indexed: 06/13/2023]
Abstract
This study examines 8-hydroxyguanine (8-oxo-Gua) staining in placental tissue samples based on fetal size at birth as well as its relationships with placental histology and other pregnancy variables. This prospective cohort study included women > 18 years with a singleton pregnancy, a live fetus, fluency in Italian, and delivery at term. A total of 165 pregnancies were included in the study. The nuclear syncytiotrophoblast 8-oxo-Gua staining score in LGA was substantially greater than in late FGR (p < 0.05), although the cytoplasm score was lower in SGA and LGA than in AGA (p < 0.05). Furthermore, a sex-specific pattern of 8-oxo-Gua staining was discovered in single-term placentas, with more oxidative damage found in the nuclei of syncytiotrophoblast cells and stromal and endothelial cells in AGA males compared to AGA females (p < 0.05). Second, the histological pattern of late FGR placentae differed by gender. Finally, a significant correlation (p < 0.05) was found between high-intensity 8-oxo-Gua staining in the cytoplasm of syncytiotrophoblast cells and thrombi in the chorionic plate or villi in males. On the other hand, female fetuses demonstrated a significant connection (p < 0.05) between high-intensity 8-oxo-Gua staining in endothelial and stromal cells and high birthweight MoM values. Our findings indicated a significant variation in the oxidative stress pattern between male and female placentae, implying that fetal growth is regulated differently in the two sexes.
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Affiliation(s)
- Serena Xodo
- Clinic of Obstetrics and Gynecology, DAME, University of Udine, 33100, Udine, Italy.
| | - Lisa Celante
- Clinic of Obstetrics and Gynecology, DAME, University of Udine, 33100, Udine, Italy
| | - Stefania Liviero
- Clinic of Obstetrics and Gynecology, DAME, University of Udine, 33100, Udine, Italy
| | - Maria Orsaria
- Institute of Pathology, Academic Hospital "Azienda Sanitaria Universitaria Integrata di Udine", 33100, Udine, Italy
| | - Laura Mariuzzi
- Institute of Pathology, DAME, University of Udine, 33100, Udine, Italy
| | - Matteo De Luca
- Institute of Pathology, Academic Hospital "Azienda Sanitaria Universitaria Integrata di Udine", 33100, Udine, Italy
| | - Giuseppe Damante
- Institute of Medical Genetics, Academic Hospital "Azienda Sanitaria Universitaria Integrata di Udine", DAME, University of Udine, 33100, Udine, Italy
| | - Lorenza Driul
- Clinic of Obstetrics and Gynecology, DAME, University of Udine, 33100, Udine, Italy
| | - Angelo Cagnacci
- Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Infant Health, University of Genoa, Largo Rosanna Benzi 10, 16132, Genova, Italy
| | - Annalisa Ferino
- Laboratory of Biochemistry, Department of Medicine, University of Udine, 33100, Udine, Italy
| | - Eros Di Giorgio
- Laboratory of Biochemistry, Department of Medicine, University of Udine, 33100, Udine, Italy
| | - Luigi Xodo
- Laboratory of Biochemistry, Department of Medicine, University of Udine, 33100, Udine, Italy
| | - Ambrogio Pietro Londero
- Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Infant Health, University of Genoa, Largo Rosanna Benzi 10, 16132, Genova, Italy
- Obstetrics and Gynecology Unit, IRCCS Istituto Giannina Gaslini, 16147, Genova, GE, Italy
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Reverberi C, Orsaria M, Pegolo E, Mansutti I, Prisco A, Seriau L, Bertozzi S, Moretti E, Guernieri M, Scalchi PS, Zuiani C, Cedolini C, Di Loreto C, Trovo M. Single-Fraction Pre-Operative Stereotactic Radiosurgery for Early-Stage Breast Cancer: Pathological Findings. Int J Radiat Oncol Biol Phys 2023; 117:S137. [PMID: 37784350 DOI: 10.1016/j.ijrobp.2023.06.543] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) to assess pathological results after single-fraction pre-operative stereotactic radiosurgery of early-stage breast cancer. MATERIALS/METHODS A phase 2 clinical trial to investigate the feasibility of pre-operative radiosurgery for early-stage breast cancer was conducted. Eligible patients are women older than 50 years, with histologically proven breast invasive ductal carcinoma, hormonal receptors positive/human epidermal grow factor receptor 2 negative, any grade, tumor size < 3cm, unifocal, with no nodal involvement, and suitable for breast conservative surgery. An expert radiologist injected ultrasound-guided a fiducial marker to precisely identify tumor positioning. The Planning Target Volume (PTV) is created by adding a 3mm margin to the Gross Tumor Volume (GTV). A single fraction of 30-33 Gy is delivered to 95% of PTV. Patients had a breast MRI scan 6-12 weeks after treatment to evaluate the rate of radiological response. Surgery was performed at 9 to 16 weeks after irradiation. RESULTS From January 2022 to December 2022, 33 patients underwent single-fraction radiosurgery, of whom 29 had breast conserving surgery (BCS). BCS was performed at 9-10 weeks for the first 14 patients, at 14-16 weeks for 13 patients, and at 18-19 weeks for 2 patients. The pathological response was defined as complete response (pCR) if no residual tumor cells were found, partial response (pPR), or no response. The pPR were also subdivided into 3 subgroups according to the rate of residual disease: < 10%, 10-50%, and > 50%. Two patients (7%) achieved pCR, both treated with 33 Gy and operated at 14 weeks. Twenty-five patients (86%) had pPR, of which 7 patients (24%) had residual disease < 10%, 9 patients (31%) between 10-50% and 9 patients (31%) over 50%. Two patients (7%) had no pathological response. All patients had sentinel lymph node biopsy at the time of surgery. Positive micrometastatic nodal involvement was found in 3 patients (11%), of which 2 patients (7%) had macrometastases (pN1a) and received subsequent axillary lymph node dissection. All patients had negative surgical margins. Not any acute and sub-acute surgical complications were observed. CONCLUSION Single-fraction pre-operative stereotactic radiosurgery for early-stage breast cancer leads to a high rate of complete or partial pathological response with surgery performed at 2-4 months following irradiation.
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Affiliation(s)
- C Reverberi
- Department of Radiation Oncology, ASUFC "Santa Maria della Misericordia", Udine, Italy
| | - M Orsaria
- Institute of Anatomic Pathology, ASUFC "Santa Maria della Misericordia", Udine, Italy
| | - E Pegolo
- Institute of Anatomic Pathology, ASUFC "Santa Maria della Misericordia", Udine, Italy
| | - I Mansutti
- Institute of Radiology, University Hospital "Santa Maria della Misericordia", Udine, Italy
| | - A Prisco
- Department of Radiation Oncology, ASUFC "Santa Maria della Misericordia", Udine, Italy
| | - L Seriau
- Breast Unit, Department of Surgery, DAME, University Hospital of "Santa Maria della Misericordia", Udine, Italy
| | - S Bertozzi
- Breast Unit, Department of Surgery, DAME, University Hospital of "Santa Maria della Misericordia", Udine, Italy
| | - E Moretti
- Medical Physics Unit, ASUFC Santa Maria della Misericordia, Udine, Italy
| | - M Guernieri
- Medical Physics Unit, ASUFC Santa Maria della Misericordia, Udine, Italy
| | - P S Scalchi
- Medical Physics Unit, ASUFC Santa Maria della Misericordia, Udine, Italy
| | - C Zuiani
- Department of Medicine, Institute of Radiology, University of Udine "Santa Maria della Misericordia", Udine, Italy
| | - C Cedolini
- Breast Surgery, Department of Medicine (DAME), University Hospital of Udine, Udine, Italy
| | - C Di Loreto
- Institute of Anatomic Pathology, ASUFC "Santa Maria della Misericordia", Udine, Italy
| | - M Trovo
- Department of Radiation Oncology, ASUFC "Santa Maria della Misericordia", Udine, Italy
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Agostinis P, Cappello D, Riccardi N, Michelutti T, Orsaria M, Zerbato V, Di Bella S. A 25-Year-Old Woman With Long-Lasting Abdominal Pain and Spleen Abscess. Clin Infect Dis 2023; 77:795-798. [PMID: 37696671 DOI: 10.1093/cid/ciad047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/13/2023] Open
Affiliation(s)
- Paolo Agostinis
- Internal Medicine Unit, Sant'Antonio Abate Hospital, Azienda Sanitaria Universitaria Friuli Centrale, Tolmezzo, Italy
| | - Dario Cappello
- Internal Medicine Unit, Sant'Antonio Abate Hospital, Azienda Sanitaria Universitaria Friuli Centrale, Tolmezzo, Italy
| | - Niccolò Riccardi
- Department of Clinical and Experimental Medicine, Infectious Diseases Unit, Azienda Ospedaliera Universitaria Pisana, University of Pisa, Pisa, Italy
| | - Teresa Michelutti
- Institute of Clinical Pathology, Sant'Antonio Abate Hospital, Azienda Sanitaria Universitaria Friuli Centrale, Tolmezzo, Italy
| | - Maria Orsaria
- Institute of Pathology, University Hospital of Udine, Udine, Italy
| | - Verena Zerbato
- Infectious Diseases Unit, Trieste University Hospital (ASUGI), Trieste, Italy
| | - Stefano Di Bella
- Clinical Department of Medical, Surgical and Health Sciences, Trieste University, Trieste, Italy
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Restaino S, Pellecchia G, Poli A, Arcieri M, Andreetta C, Mariuzzi L, Orsaria M, Biasioli A, Della Martina M, Intini SG, Scambia G, Driul L, Vizzielli G. A Rare Case of Hepatocellular Carcinoma Recurrence in Ovarian Site after 12 Years Mimicking a Hepatoid Adenocarcinoma: Case Report. J Clin Med 2023; 12:jcm12072468. [PMID: 37048552 PMCID: PMC10095375 DOI: 10.3390/jcm12072468] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 03/12/2023] [Accepted: 03/20/2023] [Indexed: 04/14/2023] Open
Abstract
Hepatoid carcinoma of the ovary (HCO) is a tumor that resembles, both histologically and cytologically, hepatocarcinoma (HCC) in a patient with a non-cirrhotic liver not involved by the disease. Hepatoid carcinoma is an extremely rare histologic subtype of ovarian cancer and should be distinguished from metastatic HCC. Here, we report the rare case of a 67-year-old woman with ovarian recurrence of HCC 12 years after first diagnosis. The patient was being followed by oncologists because she had been diagnosed with HCV-related HCC (Edmonson and Stainer grade 2, pT2 N0 M0, G2, V1) in 2009. She had undergone surgery for enlarged left hepatectomy to the 4th hepatic segment with cholecystectomy and subsequent placement of a Kehr drain. The preoperative alpha-fetoprotein (AFP) level was 8600 ng/mL, while the postoperative value was only 2.7 ng/mL. At the first diagnosis, no other localizations of the disease, including the genital tract, were found. At the time of recurrence, however, the patient was completely asymptomatic: her liver function was within normal limits with negative blood indices, except for an increased blood dosage of AFP (467 ng/mL), and CA125, which became borderline (37.4 IU/mL). The oncologist placed an indication for a thoracic abdominal CT scan, which showed that the residual liver was free of disease, and the presence of a formation with a solid-cystic appearance and some calcifications at the left adnexal site. The radiological findings were confirmed on level II gynecological ultrasound. The patient then underwent a radical surgery of hysterectomy, bilateral oophorectomy, pelvic peritonectomy, and omentectomy by a laparotomic approach, with the sending of intraoperative extemporaneous histological examination on the annexus site of the tumor mass, obtaining RT = 0. Currently, the patient continues her gyneco-oncology follow-up simultaneously clinically, in laboratory, and instrumentally every 4 months. Our study currently represents the longest elapsed time interval between first diagnosis and disease recurrence, as evidenced by current data in the literature. This was a rather unique and difficult clinical case because of the rarity of the disease, the lack of scientific evidence, and the difficulty in differentiating the primary hepatoid phenotype of the ovary from an ovarian metastasis of HCC. Several multidisciplinary meetings for proper interpretation of clinical and anamnestic data, with the aid of immunohistochemistry (IHC) on histological slides were essential for case management.
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Affiliation(s)
- Stefano Restaino
- Department of Maternal and Child Health, University-Hospital of Udine, P.le S. Maria della Misericordia n°15, 33100 Udine, Italy
| | - Giulia Pellecchia
- Gynecology and Obstetrics Clinic, Department of Medicine, University of Udine, Via Colugna n° 50, 33100 Udine, Italy
| | - Alice Poli
- Gynecology and Obstetrics Clinic, Department of Medicine, University of Udine, Via Colugna n° 50, 33100 Udine, Italy
| | - Martina Arcieri
- Department of Maternal and Child Health, University-Hospital of Udine, P.le S. Maria della Misericordia n°15, 33100 Udine, Italy
- Department of Biomedical, Dental, Morphological and Functional Imaging Science, University of Messina, 98122 Messina, Italy
| | - Claudia Andreetta
- Department of Medical Oncology, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC)-Ospedale S. Maria della Misericordia, 33100 Udine, Italy
| | - Laura Mariuzzi
- Medical Area Department, Institute of Pathological Anatomy, University of Udine, Azienda Sanitaria Universitaria Friuli Centrale, 33100 Udine, Italy
| | - Maria Orsaria
- Medical Area Department, Institute of Pathological Anatomy, University of Udine, Azienda Sanitaria Universitaria Friuli Centrale, 33100 Udine, Italy
| | - Anna Biasioli
- Department of Maternal and Child Health, University-Hospital of Udine, P.le S. Maria della Misericordia n°15, 33100 Udine, Italy
| | - Monica Della Martina
- Department of Maternal and Child Health, University-Hospital of Udine, P.le S. Maria della Misericordia n°15, 33100 Udine, Italy
| | - Sergio Giuseppe Intini
- Department of General Surgery, Academic Hospital of Udine, University of Udine, 33100 Udine, Italy
| | - Giovanni Scambia
- Institute of Gynaecology and Obstetrics Clinic, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | - Lorenza Driul
- Department of Maternal and Child Health, University-Hospital of Udine, P.le S. Maria della Misericordia n°15, 33100 Udine, Italy
- Gynecology and Obstetrics Clinic, Department of Medicine, University of Udine, Via Colugna n° 50, 33100 Udine, Italy
- Department of Medical Area (DAME), University of Udine, Azienda Ospedaliera Universitaria Friuli Centrale, ASUFC, 33100 Udine, Italy
| | - Giuseppe Vizzielli
- Department of Maternal and Child Health, University-Hospital of Udine, P.le S. Maria della Misericordia n°15, 33100 Udine, Italy
- Gynecology and Obstetrics Clinic, Department of Medicine, University of Udine, Via Colugna n° 50, 33100 Udine, Italy
- Department of Medical Area (DAME), University of Udine, Azienda Ospedaliera Universitaria Friuli Centrale, ASUFC, 33100 Udine, Italy
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Xodo S, Orsaria M, Londero AP. What is the success rate of trial of labor in monochorionic diamniotic twins? A systematic review and meta-analysis of observational studies. Am J Obstet Gynecol MFM 2023; 5:100767. [PMID: 36220551 DOI: 10.1016/j.ajogmf.2022.100767] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 10/03/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE This meta-analysis aimed to evaluate the success rate of trial of labor in monochorionic diamniotic pregnancies and the impact of delivery mode on neonatal outcomes. DATA SOURCES Searches were performed in MEDLINE/PubMed, Embase, Scopus, Cochrane Central Register of Controlled Trials, ClinicalTrials.gov, and the International Clinical Trials Registry Platform from the inception of each database until April 2022. STUDY ELIGIBILITY CRITERIA Selection criteria included observational studies analyzing the delivery mode among monochorionic diamniotic gestations. METHODS All analyses were carried out using an intention-to-treat approach, evaluating women according to the delivery mode to which they were assigned in the original studies. RESULTS Seventeen studies met the eligibility criteria and were suitable for qualitative and quantitative analysis. In total, 4116 women were analyzed. This meta-analysis showed that trial of labor in monochorionic diamniotic pregnancies resulted in vaginal delivery of both twins in 75.5% of cases (95% confidence interval, 69.1-80.9). Failure to deliver the second twin vaginally occurred in 3.8% of cases (95% confidence interval, 2.5-5.7). In addition, the neonatal outcomes were comparable among women with monochorionic diamniotic pregnancy undergoing different planned delivery modes. Neonatal death occurred in 3.7 per 1000 cases in the planned cesarean delivery group and in 1.6 per 1000 cases in the planned vaginal delivery group. Perinatal death was observed in 7.5 per 1000 cases in the planned cesarean delivery group and in 5.8 per 1000 cases in the planned vaginal delivery group. Umbilical artery pH <7.00 occurred in 0 per 1000 cases in the planned cesarean delivery and 4.6 per 1000 cases in the planned vaginal delivery group. Neonatal intensive care unit stay of >72 hours had a prevalence of 59.7 per 1000 cases in the planned cesarean delivery and 42.8 per 1000 cases in the planned vaginal delivery group. CONCLUSION This meta-analysis showed that trial of labor in monochorionic diamniotic pregnancies is successful in most cases and relatively safe, considering that neonatal and perinatal mortality and severe morbidity were comparable between the trial of labor and planned cesarean delivery groups. Therefore, the choice of planned delivery mode in twin gestations should not be made a priori.
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Affiliation(s)
- Serena Xodo
- Department of Gynecology and Obstetrics, School of Medicine of Udine, Udine, Italy (Dr Xodo).
| | - Maria Orsaria
- Institute of Pathology, School of Medicine of Udine, Udine, Italy (Dr Orsaria)
| | - Ambrogio P Londero
- Academic Unit of Obstetrics and Gynaecology; Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Infant Health, University of Genoa, Genoa, Italy (Dr Londero)
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Restaino S, Pellecchia G, Tulisso A, Paglietti C, Orsaria M, Andreetta C, Poletto E, Arcieri M, Martina MD, Biasioli A, Mariuzzi L, Driul L, Scambia G, Vizzielli G. Mesonephric-Like Adenocarcinomas a Rare Tumor: The Importance of Diagnosis. Int J Environ Res Public Health 2022; 19:ijerph192114451. [PMID: 36361332 PMCID: PMC9657862 DOI: 10.3390/ijerph192114451] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 10/26/2022] [Accepted: 10/29/2022] [Indexed: 05/05/2023]
Abstract
Mesonephric-like adenocarcinomas (MLA) are rare neoplasms that arise in the uterine body and ovary and have been added to the World Health Organisation's recent 2020 classification of female genital cancers. The pathogenesis of MLA is unknown and it remains debated whether they represent mesonephric carcinomas (Wolffian) arising in the endometrium/ovary or endometrioid carcinomas (Müllerian) closely mimicking mesonephric carcinomas. Here we report the case of a 57-year-old woman with an initial misdiagnosis of endometrioid adenocarcinoma on diagnostic biopsy. The patient came to our clinical evaluation for the appearance of menometrorrhagia complicated by anemia for several months. Therefore, she underwent pelvic echo-flowmetry, with indication for diagnostic hysteroscopy with endometrial biopsy, which yielded a positive result for endometrioid endometrial adenocarcinoma. Following staging CT scan and targeted examinations on pulmonary findings, the patient underwent surgery with surprise of definitive diagnosis deponent for endometrial MLA. Our intention is to establish a brief review of the scientific evidence in the literature and the tools available for a correct histological diagnosis, in the light of the scant anatomopathological evidence. Our question gives rise to the motive for the publication: is immunohistochemistry the right way to resolve the diagnostic error at histology, which is usually the only source of diagnostic certainty? This case is intended to alert of diagnostic error that risked having the patient treated as a neoplasm with a favorable prognosis and low degree of aggressiveness instead of for a very aggressive and poor prognosis tumor such as MLA.
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Affiliation(s)
- Stefano Restaino
- Department of Medical Area (DAME), Clinic of Obstretics and Gynecology “Santa Maria della Misericordia”, University Hospital Azienda Sanitaria Universitaria Friuli Centrale, University of Udine, 33100 Udine, Italy
- Correspondence: ; Tel.: +39-0432-559635
| | - Giulia Pellecchia
- Department of Medical Area (DAME), Clinic of Obstretics and Gynecology “Santa Maria della Misericordia”, University Hospital Azienda Sanitaria Universitaria Friuli Centrale, University of Udine, 33100 Udine, Italy
| | - Angelica Tulisso
- Department of Medicine, Pathological Anatomy Section, University of Udine, 33100 Udine, Italy
| | - Chiara Paglietti
- Department of Medical Area (DAME), Clinic of Obstretics and Gynecology “Santa Maria della Misericordia”, University Hospital Azienda Sanitaria Universitaria Friuli Centrale, University of Udine, 33100 Udine, Italy
| | - Maria Orsaria
- Institute of Pathological Anatomy, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Presidio Ospedaliero “Santa Maria della Misericordia”, 33100 Udine, Italy
| | - Claudia Andreetta
- Department of Medical Oncology, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Ospedale S. Maria della Misericordia, 33100 Udine, Italy
| | - Elena Poletto
- Department of Medical Oncology, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Ospedale S. Maria della Misericordia, 33100 Udine, Italy
| | - Martina Arcieri
- Department of Medical Area (DAME), Clinic of Obstretics and Gynecology “Santa Maria della Misericordia”, University Hospital Azienda Sanitaria Universitaria Friuli Centrale, University of Udine, 33100 Udine, Italy
| | - Monica della Martina
- Department of Medical Area (DAME), Clinic of Obstretics and Gynecology “Santa Maria della Misericordia”, University Hospital Azienda Sanitaria Universitaria Friuli Centrale, University of Udine, 33100 Udine, Italy
| | - Anna Biasioli
- Department of Medical Area (DAME), Clinic of Obstretics and Gynecology “Santa Maria della Misericordia”, University Hospital Azienda Sanitaria Universitaria Friuli Centrale, University of Udine, 33100 Udine, Italy
| | - Laura Mariuzzi
- Medical Area Department, Institute of Pathological Anatomy, Director School of Specialisation in Pathological Anatomy, University of Udine, Azienda Sanitaria Universitaria Friuli Centrale, p.le S.Maria della Misericordia, 33100 Udine, Italy
| | - Lorenza Driul
- Department of Medical Area (DAME), Clinic of Obstretics and Gynecology “Santa Maria della Misericordia”, University Hospital Azienda Sanitaria Universitaria Friuli Centrale, University of Udine, 33100 Udine, Italy
| | - Giovanni Scambia
- Dipartimento per le Scienze Della Salute Della Donna, del Bambino e di Sanità Pubblica, UOC Ginecologia Oncologica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Roma, Italy
- Faculty of Medicine and Surgery, Università Cattolica del Sacro Cuore, 00168 Roma, Italy
| | - Giuseppe Vizzielli
- Department of Medical Area (DAME), Clinic of Obstretics and Gynecology “Santa Maria della Misericordia”, University Hospital Azienda Sanitaria Universitaria Friuli Centrale, University of Udine, 33100 Udine, Italy
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10
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Restaino S, Mauro J, Zermano S, Pellecchia G, Mariuzzi L, Orsaria M, Titone F, Biasioli A, Della Martina M, Andreetta C, Poletto E, Arcieri M, Buda A, Driul L, Vizzielli G. CUP-syndrome: Inguinal high grade serous ovarian carcinoma lymph node metastases with unknown primary origin – a case report and literature review. Front Oncol 2022; 12:987169. [PMID: 36300091 PMCID: PMC9589412 DOI: 10.3389/fonc.2022.987169] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 09/15/2022] [Indexed: 01/19/2023] Open
Abstract
Objective High-grade serous ovarian carcinoma (HGSC) often presents lymph node involvement. According to the paths of lymphatic drainage, the most common site of nodal metastasis is in the aortic area. However, pelvic lymph nodes are also involved and inguinal metastases are less frequent. Methods Our report concerns the case of a 78-year-old woman with an inguinal lymph node relapse of HGSC, with the prior positivity of a right inguinal lymph node, after the primary surgery. Ovaries and tubes were negative on histological examination. A comprehensive search of the literature published from January 2000 to October 2021 was conducted on PubMed and Scopus. The papers were selected following the PRISMA guidelines. Nine retrospective studies were evaluated. Results Overall, 67 studies were included in the initial search. Applying the screening criteria, 36 articles were considered eligible for full-text reading of which, after applying the exclusion criteria, 9 studies were selected for the final analysis and included in the systematic review. No studies were included for a quantitative analysis. We divided the results according to the relapse location: loco-regional, abdominal, and extra-abdominal recurrence. Conclusions Inguinal node metastasis is a rare but not unusual occurrence in HGSC. A reasonable level of suspicion should be maintained in patients with inguinal adenopathy and high CA125 values, especially in women with a history of gynecologic surgery, even in the absence of negative imaging for an ovarian origin.
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Affiliation(s)
- Stefano Restaino
- Department of Obstetrics, Gynecology and Pediatrics, Department of Medical Area DAME, Obstetrics and Gynecology Unit, Udine University Hospital, Udine, Italy
| | - Jessica Mauro
- Department of Medicine, University of Udine, Udine, Italy
| | - Silvia Zermano
- Department of Medicine, University of Udine, Udine, Italy
| | | | - Laura Mariuzzi
- Department of Medicine, University of Udine, Udine, Italy
| | - Maria Orsaria
- Department of Obstetrics, Gynecology and Pediatrics, Department of Medical Area DAME, Obstetrics and Gynecology Unit, Udine University Hospital, Udine, Italy
| | - Francesca Titone
- Department of Obstetrics, Gynecology and Pediatrics, Department of Medical Area DAME, Obstetrics and Gynecology Unit, Udine University Hospital, Udine, Italy
- Radiation Oncology Department, Academic Hospital of Udine, Udine, Italy
| | - Anna Biasioli
- Department of Obstetrics, Gynecology and Pediatrics, Department of Medical Area DAME, Obstetrics and Gynecology Unit, Udine University Hospital, Udine, Italy
| | - Monica Della Martina
- Department of Obstetrics, Gynecology and Pediatrics, Department of Medical Area DAME, Obstetrics and Gynecology Unit, Udine University Hospital, Udine, Italy
| | - Claudia Andreetta
- Department of Obstetrics, Gynecology and Pediatrics, Department of Medical Area DAME, Obstetrics and Gynecology Unit, Udine University Hospital, Udine, Italy
- Oncology Department, University Hospital of Udine, Udine, Italy
| | - Elena Poletto
- Department of Obstetrics, Gynecology and Pediatrics, Department of Medical Area DAME, Obstetrics and Gynecology Unit, Udine University Hospital, Udine, Italy
- Oncology Department, University Hospital of Udine, Udine, Italy
| | - Martina Arcieri
- Department of Obstetrics, Gynecology and Pediatrics, Department of Medical Area DAME, Obstetrics and Gynecology Unit, Udine University Hospital, Udine, Italy
| | - Alessandro Buda
- Division of Gynecologic Oncology, Michele e Pietro Ferrero Hospital, Verduno, Italy
| | - Lorenza Driul
- Department of Medicine, University of Udine, Udine, Italy
- *Correspondence: Lorenza Driul,
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11
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Londero AP, Orsaria M, Viola L, Marzinotto S, Bertozzi S, Galvano E, Andreetta C, Mariuzzi L. Survivin, Sonic hedgehog, Krüppel-like factors, and p53 pathway in serous ovarian cancer: an immunohistochemical study. Hum Pathol 2022; 127:92-101. [PMID: 35777700 DOI: 10.1016/j.humpath.2022.06.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 06/22/2022] [Accepted: 06/22/2022] [Indexed: 11/04/2022]
Abstract
OBJECTIVE Survivin was previously associated with tumor stage and grade in ovarian cancer and interfered with the tumor's drug sensitivity. In addition, Survivin expression was found to be regulated by the Sonic hedgehog (Shh) pathway, Krüppel-like factor (KLF) family proteins, and p53 pathway. The main aim of this study was to assess the prognostic values of immunohistochemical expression of Survivin, Klf5, Klf11, Shh, p53, p21, and Mdm2 in a cohort of high grade ovarian serous cancers. Other aims were comparison between high- and low-grade ovarian serous cancer and between platinum-resistant and the other cases. The last aim was to assess the correlations among the immunohistochemical expression of the studied proteins. METHODS Retrospective cohort study to assess immunohistochemical expression of Survivin, Klf5, Klf11, Shh, p53, p21, and Mdm2 in a tissue microarray of primary tumor samples among 73 women affected by high-grade ovarian serous cancer and 9 by low-grade ovarian serous cancer. RESULTS Klf5 and Shh cytoplasmic staining were associated to short overall survival (HR 6.38, CI.95 2.25 - 18.01, p<0.05 and 2.25, CI.95 1.19-4.23, p<0.05 respectively). In addition, cytoplasmic Klf5 staining, high Klf11 and p53 nuclear staining were associated with platinum resistance (p<0.05). Cytoplasmic Shh score was significantly correlated to the immunohistochemical expression of Klf5, Klf11, Mdm2, and Survivin. CONCLUSIONS Our data highlight the possible role of Klf5 and Shh as prognostic markers, meanwhile confirming the role of the KLF family proteins and p53 in ovarian cancer drug resistance. Moreover, Shh appeared to play an important role in the intracellular network of ovarian neoplasia.
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Affiliation(s)
- Ambrogio P Londero
- Academic Unit of Obstetrics and Gynaecology; Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Infant Health, University of Genoa, Genova, Italy; Ennergi Research (non-profit organization), 33050 Lestizza (UD).
| | - Maria Orsaria
- Institute of Pathologic Anatomy, DAME, University Hospital of Udine, 33100 Udine (UD)
| | - Luigi Viola
- Department of Radiology & Radiotherapy, University of Campania "Luigi Vanvitelli", 80100 Naples, Italy
| | - Stefania Marzinotto
- Institute of Pathologic Anatomy, DAME, University Hospital of Udine, 33100 Udine (UD)
| | - Serena Bertozzi
- Ennergi Research (non-profit organization), 33050 Lestizza (UD); Breast Unit, DAME, University Hospital of Udine, 33100 Udine (UD)
| | - Elena Galvano
- Lombardi Comprehensive Cancer Center (LCCC), Georgetown University, Washington, DC 20057, USA
| | | | - Laura Mariuzzi
- Institute of Pathologic Anatomy, DAME, University Hospital of Udine, 33100 Udine (UD)
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12
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Bertozzi S, Londero AP, Bulfoni M, Seriau L, Agakiza D, Pasqualucci A, Andretta M, Orsaria M, Mariuzzi L, Cedolini C. One-Step Nucleic Acid Amplification System in Comparison to the Intraoperative Frozen Section and Definitive Histological Examination Among Breast Cancer Patients: A Retrospective Survival Study. Front Oncol 2022; 12:847858. [PMID: 35664761 PMCID: PMC9158526 DOI: 10.3389/fonc.2022.847858] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 04/14/2022] [Indexed: 11/13/2022] Open
Abstract
Simple Summary Implementing intraoperative assessment of sentinel lymph nodes by one-step nucleic acid amplification in early breast cancer can reduce the surgical burden to the patient and the costs to the health system. However, only limited data are available in terms of long-term disease-free survival and overall survival. Therefore, this study aims to compare disease-free survival and overall survival between one-step nucleic acid amplification, frozen section, and definitive histology. These results could impact the healthcare community, adding further proof to the body of evidence supporting the broader adoption of this innovative technology that enables a safe reduction in patient surgical burden and healthcare costs. Background The one-step nucleic acid amplification (OSNA) system is a novel molecular technique, which consents to quick intraoperative detection of sentinel lymph node metastases by the amplification of cytokeratin 19 mRNA. Our study aims to evaluate the OSNA method in comparison with frozen section (FS) and definitive histological examination of the sentinel lymph node biopsy among early breast cancer patients considering disease-free survival (DFS) and overall survival (OS). Methods In this study, we included all women who underwent sentinel lymph node biopsy (SLNB) for breast cancers classified as TNM stage I and II in our center between January 2005 and January 2017, and the follow-up was collected up to January 2019. We divided patients among three groups based on SLNB evaluation: definitive histological examination, intra-operative FS, or OSNA. Results We included 2412 SLNBs: 727 by definitive histological examination, 697 by FS, and 988 by OSNA. Isolated tumor cells were found in 2.32% of cases, micrometastasis in 9.12%, and macrometastases in 13.64%. Surgical procedure duration was significantly shorter in OSNA than in FS (42.1 minutes ±5.1 vs. 70.1 minutes ±10.5, p <0.05). No significant differences have been observed among the three groups regarding OS, DSF, cumulative local, or distant metastases. In particular 5-year DFS was 96.38% in definitive histology (95% C.I. 95.02-97.75%), 96.37% in FS (95% C.I. 94.98-97.78%), and 96.51% in OSNA group (95% C.I. 95.32-97.72%). Conclusions No difference in OS and DFS was found comparing OSNA, FS, and definitive histology. Furthermore, reduced operative time was found in the OSNA group.
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Affiliation(s)
- Serena Bertozzi
- Breast Unit, University Hospital of Udine, Udine, Italy
- Ennergi Research, Lestizza, Italy
- Department of Medical Area (DAME), University of Udine, Udine, Italy
| | - Ambrogio P. Londero
- Ennergi Research, Lestizza, Italy
- Academic Unit of Obstetrics and Gynaecology, Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Infant Health, University of Genoa, Genova, Italy
| | - Michela Bulfoni
- Institute of pathology, University Hospital of Udine, Udine, Italy
| | - Luca Seriau
- Breast Unit, University Hospital of Udine, Udine, Italy
| | - Diane Agakiza
- Department of Medical Area (DAME), University of Udine, Udine, Italy
| | - Alberto Pasqualucci
- Department of Surgical and Biomedical Science, University of Perugia, Perugia, Italy
- Rashid Hospital, Trauma and Emergency Center, Dubai Health Authority, Dubai, United Arab Emirates
| | | | - Maria Orsaria
- Institute of pathology, University Hospital of Udine, Udine, Italy
| | - Laura Mariuzzi
- Department of Medical Area (DAME), University of Udine, Udine, Italy
- Institute of pathology, University Hospital of Udine, Udine, Italy
| | - Carla Cedolini
- Breast Unit, University Hospital of Udine, Udine, Italy
- Ennergi Research, Lestizza, Italy
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13
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Londero AP, Bertozzi S, Cedolini C, Neri S, Bulfoni M, Orsaria M, Mariuzzi L, Uzzau A, Risaliti A, Barillari G. Incidence and Risk Factors for Venous Thromboembolism in Female Patients Undergoing Breast Surgery. Cancers (Basel) 2022; 14:cancers14040988. [PMID: 35205736 PMCID: PMC8870485 DOI: 10.3390/cancers14040988] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 02/12/2022] [Accepted: 02/13/2022] [Indexed: 01/04/2023] Open
Abstract
Albeit it does not have the highest venous thromboembolism (VTE) incidence compared to other neoplasms, breast cancer contributes to many VTE events because it is the most diagnosed tumor in women. We aim to analyze the occurrence and timing of VTE during the follow-up of patients who underwent breast surgery, the possible correlated factors, and the overall survival. This retrospective study included all female patients diagnosed with mammary pathology and surgically treated in our clinic between January 2002 and January 2012. Of 5039 women who underwent breast surgery, 1056 were found to have no evidence of malignancy, whereas 3983 were diagnosed with breast cancer. VTE rate resulted significantly higher in patients with invasive breast cancer than in women with benign breast disease or carcinoma in situ. Invasive cancers other than lobular or ductal were associated with a higher VTE rate. In addition, chronic hypertension, high BMI, cancer type, and evidence of metastasis turned out to be the most significant risk factors for VTE in women who underwent breast surgery. Moreover, VTE occurrence significantly impacted survival in invasive breast cancer patients. Compared to women with benign mammary pathology, VTE prevalence in women with breast cancer is significantly higher. The knowledge about the risk factors of VTE could be helpful as prognostic information, but also to eventually target preventive treatment strategies for VTE, as far as the co-existence of invasive breast cancer and VTE has a significantly negative impact on survival.
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Affiliation(s)
- Ambrogio P. Londero
- Academic Unit of Obstetrics and Gynaecology, Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Infant Health, University of Genoa, 16132 Genova, Italy
- Ennergi Research (Non-Profit Organisation), 33050 Lestizza, Italy
- Correspondence: (A.P.L.); (S.B.)
| | - Serena Bertozzi
- Ennergi Research (Non-Profit Organisation), 33050 Lestizza, Italy
- Breast Unit, University Hospital of Udine, 33100 Udine, Italy;
- Correspondence: (A.P.L.); (S.B.)
| | - Carla Cedolini
- Breast Unit, University Hospital of Udine, 33100 Udine, Italy;
| | - Silvia Neri
- Clinic of Surgery, University Hospital of Udine, 33100 Udine, Italy; (S.N.); (A.R.)
| | - Michela Bulfoni
- Institute of Pathologic Anatomy, University Hospital of Udine, 33100 Udine, Italy; (M.B.); (M.O.); (L.M.)
| | - Maria Orsaria
- Institute of Pathologic Anatomy, University Hospital of Udine, 33100 Udine, Italy; (M.B.); (M.O.); (L.M.)
| | - Laura Mariuzzi
- Institute of Pathologic Anatomy, University Hospital of Udine, 33100 Udine, Italy; (M.B.); (M.O.); (L.M.)
- Department of Medical Area (DAME), University of Udine, 33100 Udine, Italy;
| | - Alessandro Uzzau
- Department of Medical Area (DAME), University of Udine, 33100 Udine, Italy;
| | - Andrea Risaliti
- Clinic of Surgery, University Hospital of Udine, 33100 Udine, Italy; (S.N.); (A.R.)
- Department of Medical Area (DAME), University of Udine, 33100 Udine, Italy;
| | - Giovanni Barillari
- Center for Hemorrhagic and Thrombotic Diseases, ASUFC “Santa Maria della Misericordia”, 33100 Udine, Italy;
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Viola L, Marzinotto S, Bertacchi M, Londero AP, Orsaria M, Bertozzi S, Driul L, Di Loreto C, Studer M, Mariuzzi L, Fruscalzo A. COUP-TFI deletion affects angiogenesis and apoptosis related gene expression in mouse placenta: results of an explorative study. CLIN EXP OBSTET GYN 2022. [DOI: 10.31083/j.ceog4901007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Fruscalzo A, Viola L, Orsaria M, Marzinotto S, Bulfoni M, Driul L, Londero AP, Mariuzzi L. STRA6 and Placental Retinoid Metabolism in Gestational Diabetes Mellitus. J Pers Med 2021; 11:1301. [PMID: 34945773 PMCID: PMC8708334 DOI: 10.3390/jpm11121301] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 11/01/2021] [Accepted: 11/25/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Recent reports indicate the potential role of the stimulated by retinoic acid 6 (STRA6) protein in developing insulin resistance. The study's objective was to assess placental STRA6 expression and staining pattern in human pregnancy complicated by gestational diabetes mellitus (GDM). The expression pattern of further relevant genes involved in retinoid metabolism was also evaluated. METHODS A retrospective case-control study on paraffin-embedded placental tissue. Twenty-two human pregnancies affected by GDM, namely, 11 insulin-treated (iGDM) and 11 diet-controlled (dGDM), were compared with 22 normal-developed pregnancies (controls). An RT-PCR was performed in a random sample of 18 patients (six iGDM, six dGDM, and six controls) to assess RNA expression of STRA6 and further markers of retinoid metabolism. A semi-quantitative intensity evaluation at immunohistochemistry was performed for STRA6 in all 44 recruited patients. RESULTS STRA6 showed a decreased placental staining (9.09% vs. 68.18% positively stained samples, p < 0.05) and augmented RNA expression in dGDM patients than controls (ΔCT expression 0.473, IQR 0.403-0.566 vs. 0.149, IQR 0.092-0.276, p < 0.05). The protein staining pattern in patients affected by iGDM was comparable to controls. A reduced RNA expression of LPL, LRP1, VLDLR, and MTTP besides an augmented expression of LDLR was found in dGDM, while overexpression of LRP1 and LPL was found in iGDM patients. Unlike in the control group, significant positive correlations were found between RXRα and the proteins involved in the intracellular uptake of ROH, such as STRA6, LRP1, LRP2, and VLDLR. CONCLUSIONS An altered placental expression and staining pattern of STRA6 were found in pregnancies complicated by GDM compared to the controls. These changes were coupled to an altered expression pattern of several other genes involved in the retinoid metabolism.
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Affiliation(s)
- Arrigo Fruscalzo
- Clinic of Obstetrics and Gynecology, University Hospital of Fribourg, 1708 Fribourg, Switzerland
| | - Luigi Viola
- Clinic of Radiology, University Federico II, 80138 Naples, Italy;
| | - Maria Orsaria
- Institute of Clinical Pathology, University of Udine, 33100 Udine, Italy; (M.O.); (S.M.); (M.B.); (L.M.)
| | - Stefania Marzinotto
- Institute of Clinical Pathology, University of Udine, 33100 Udine, Italy; (M.O.); (S.M.); (M.B.); (L.M.)
| | - Michela Bulfoni
- Institute of Clinical Pathology, University of Udine, 33100 Udine, Italy; (M.O.); (S.M.); (M.B.); (L.M.)
| | - Lorenza Driul
- Clinic of Obstetrics and Gynecology, University of Udine, 33100 Udine, Italy; (L.D.); (A.P.L.)
| | - Ambrogio P. Londero
- Clinic of Obstetrics and Gynecology, University of Udine, 33100 Udine, Italy; (L.D.); (A.P.L.)
- Ennergi Research (Non-Profit Organisation), 33050 Lestizza, Italy
| | - Laura Mariuzzi
- Institute of Clinical Pathology, University of Udine, 33100 Udine, Italy; (M.O.); (S.M.); (M.B.); (L.M.)
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16
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Bertozzi S, Londero AP, Viola L, Orsaria M, Bulfoni M, Marzinotto S, Corradetti B, Baccarani U, Cesselli D, Cedolini C, Mariuzzi L. TFEB, SIRT1, CARM1, Beclin-1 expression and PITX2 methylation in breast cancer chemoresistance: a retrospective study. BMC Cancer 2021; 21:1118. [PMID: 34663249 PMCID: PMC8524961 DOI: 10.1186/s12885-021-08844-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Accepted: 10/06/2021] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Breast cancer chemoresistance is attributed to a wide variety of mechanisms, including autophagy. Transcription factor EB (TFEB) has been recently identified and characterized as one major regulator of autophagy and lysosomal genesis. OBJECTIVE This study aims to evaluate the prognostic impact of TFEB and its pathway in breast cancer chemoresistance. METHODS This retrospective study analyzes the expression of TFEB, CARM1, SIRT1, and Beclin-1 and the methylation of PITX2 in breast carcinoma. A group of breast cancer patients treated with chemotherapy, who relapsed within 12 months from treatment initiation, were compared to a sub-cohort of chemo-treated patients who did not recur within 12 months of follow-up. The expression of TFEB, CARM1, SIRT1, and Belcin-1 was analyzed using immunohistochemistry or RT-PCR on formalin-fixed paraffin-embedded samples. PITX2 methylation was tested with the diagnostic CE-marked kit Therascreen PITX2 RGQ PCR. In the final model, 136 cases of chemo-treated breast cancer were included. RESULTS A higher TFEB and Beclin-1 expression correlate with shorter survival in patients with chemo-treated invasive breast cancer (respectively HR 3.46, CI.95 1.27-9.47, p < 0.05 and 7.11, CI.95 2.54-19.9). TFEB, CARM1, and SIRT1 are positively correlated with Beclin-1. The protein expression of SIRT1 is significantly associated with TFEB and CARM1 so that a very low SIRT1 expression (lower than the first quartile of the H-score distribution) correlates with a low expression of TFEB and CARM1 and with longer survival. SIRT1 seems to have a lower H-score in the basal-like and HER2-enriched tumors than the luminal subtypes. Beclin-1 and TFEB seem to have a higher H-score in the basal-like and HER2-enriched tumors than the luminal subtypes. PITX2 methylation analysis was feasible only in 65% of the selected samples, but no significant differences between cases and controls were found, and there was also no correlation with the expression of the TFEB pathway. CONCLUSIONS TFEB, SIRT1, and Beclin-1 seem to have a potential prognostic significance in patients with chemo-treated breast cancer, likely because of their role in the regulation of autophagy. In addition, no correlation between TFEB and PITX2 methylation was found, likely because they perform two different roles within the autophagy process.
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Affiliation(s)
- Serena Bertozzi
- Breast Unit, DAME, University Hospital of Udine, Piazza Santa Maria della Misericordia, 15, 33100, Udine, Italy.
- Ennergi Research (non-profit organisation), 33050, Lestizza, UD, Italy.
| | - Ambrogio P Londero
- Ennergi Research (non-profit organisation), 33050, Lestizza, UD, Italy.
- Clinic of Obstetrics and Gynecology, University Hospital of Udine, Piazza Santa Maria della Misericordia, 15, 33100, Udine, Italy.
| | - Luigi Viola
- Department of Radiology & Radiotherapy, University of Campania "Luigi Vanvitelli", 80100, Naples, Italy
| | - Maria Orsaria
- Institute of Pathology, DAME, University Hospital of Udine, 33100, Udine, UD, Italy
| | - Michela Bulfoni
- Institute of Pathology, DAME, University Hospital of Udine, 33100, Udine, UD, Italy
| | - Stefania Marzinotto
- Institute of Pathology, DAME, University Hospital of Udine, 33100, Udine, UD, Italy
| | - Bruna Corradetti
- Department of Nanotechnology, Houston Methodist Hospital, Houston, TX, USA
| | - Umberto Baccarani
- Clinic of Surgery, DAME, University Hospital of Udine, 33100, Udine, UD, Italy
| | - Daniela Cesselli
- Institute of Pathology, DAME, University Hospital of Udine, 33100, Udine, UD, Italy
| | - Carla Cedolini
- Breast Unit, DAME, University Hospital of Udine, Piazza Santa Maria della Misericordia, 15, 33100, Udine, Italy
| | - Laura Mariuzzi
- Institute of Pathology, DAME, University Hospital of Udine, 33100, Udine, UD, Italy
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17
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De Gennaro E, Orsaria M, Driul L. Placenta accreta in the first trimester: A case report. Clin Case Rep 2021; 9:e04615. [PMID: 34512978 PMCID: PMC8423128 DOI: 10.1002/ccr3.4615] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 05/25/2021] [Accepted: 06/16/2021] [Indexed: 11/11/2022] Open
Abstract
Placenta accreta is a severe complication of pregnancy normally diagnosed during the second trimester. Early detection could reduce the risk of hemorrhage during abortion or miscarriage; however, guidelines on first-trimester diagnosis are lacking. We describe a case of placenta accreta during the first trimester with its sonographic and histological features.
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Affiliation(s)
- Elena De Gennaro
- Clinic of Obstetrics and GynecologyHospital of UdineDAMEUniversity of UdineUdineItaly
| | - Maria Orsaria
- Institute of PathologyHospital of UdineDAMEUniversity of UdineUdineItaly
| | - Lorenza Driul
- Clinic of Obstetrics and GynecologyHospital of UdineDAMEUniversity of UdineUdineItaly
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18
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Londero AP, Orsaria M, Parisi N, Tassi A, Pittini C, Driul L, Mariuzzi L. In vitro fertilization is associated with placental accelerated villous maturation. Int J Clin Exp Pathol 2021; 14:734-740. [PMID: 34239675 PMCID: PMC8255202] [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] [Received: 02/05/2021] [Accepted: 03/31/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE Accelerated placental maturation is regarded as a sign of vascular malperfusion and is often interpreted as a compensatory response by the placenta. In vitro embryo culture affects placental development. This study assessed placental maturation in spontaneous conceived and in vitro conceived pregnancies. METHODS Retrospective cohort study on a single center between 2014 and 2017. For this study, preterm placentas of singleton pregnancies between 24 and 36 weeks were considered. Routine placental examinations were retrospectively reviewed. RESULTS During the considered period, 423 placentas of singleton pregnancies were assessed. Three hundred ninety-six placentas were from spontaneous conception and 20 from in vitro fertilization and embryo transfer (IVF/ET). IVF/ET was significantly associated with accelerated villous maturation (AVM) and distal villous hypoplasia (DVH) (P<0.05). CONCLUSIONS Placental AVM and DVH were significantly associated with in vitro fertilization in singleton pregnancies. This result supports the hypothesis that AVM is a compensatory response by the placenta to improve its transport capacity in specific settings such as in vitro fertilization.
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Affiliation(s)
- Ambrogio P Londero
- Clinic of Obstetrics and Gynecology, DAME, University of Udine, University Hospital of UdineItaly
| | - Maria Orsaria
- Institute of Pathology, DAME, University of Udine, University Hospital of UdineItaly
| | - Nadia Parisi
- Clinic of Obstetrics and Gynecology, DAME, University of Udine, University Hospital of UdineItaly
| | - Alice Tassi
- Clinic of Obstetrics and Gynecology, DAME, University of Udine, University Hospital of UdineItaly
| | - Carla Pittini
- Unit of Neonatology, University Hospital of UdineItaly
| | - Lorenza Driul
- Clinic of Obstetrics and Gynecology, DAME, University of Udine, University Hospital of UdineItaly
| | - Laura Mariuzzi
- Institute of Pathology, DAME, University of Udine, University Hospital of UdineItaly
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19
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Vetrugno L, Bignami E, Deana C, Bassi F, Vargas M, Orsaria M, Bagatto D, Intermite C, Meroi F, Saglietti F, Sartori M, Orso D, Robiony M, Bove T. Cerebral fat embolism after traumatic bone fractures: a structured literature review and analysis of published case reports. Scand J Trauma Resusc Emerg Med 2021; 29:47. [PMID: 33712051 PMCID: PMC7953582 DOI: 10.1186/s13049-021-00861-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 03/04/2021] [Indexed: 02/06/2023] Open
Abstract
Background The incidence of cerebral fat embolism (CFE) ranges from 0.9–11%, with a mean mortality rate of around 10%. Although no univocal explanation has been identified for the resulting fat embolism syndrome (FES), two hypotheses are widely thought: the ‘mechanical theory’, and the ‘chemical theory’. The present article provides a systematic review of published case reports of FES following a bone fracture. Methods We searched MEDLINE, Web of Science and Scopus to find any article related to FES. Inclusion criteria were: trauma patients; age ≥ 18 years; and the clinical diagnosis of CFE or FES. Studies were excluded if the bone fracture site was not specified. Results One hundred and seventy studies were included (268 cases). The male gender was most prominent (81.6% vs. 18.4%). The average age was 33 years (±18). The mean age for males (29 ± 14) was significantly lower than for females (51 ± 26) (p < 0.001). The femur was the most common fracture site (71% of cases). PFO was found in 12% of all cases. Univariate and multivariate regression analyses showed the male gender to be a risk factor for FES: RR 1.87 and 1.41, respectively (95%CI 1.27–2.48, p < 0.001; 95%CI 0.48–2.34, p < 0.001). Conclusions FES is most frequent in young men in the third decades of life following multiple leg fractures. FES may be more frequent after a burst fracture. The presence of PFO may be responsible for the acute presentation of cerebral embolisms, whereas FES is mostly delayed by 48–72 h. Supplementary Information The online version contains supplementary material available at 10.1186/s13049-021-00861-x.
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Affiliation(s)
- Luigi Vetrugno
- Department of Anesthesia and Intensive Care, Anesthesia and Intensive Care Clinic, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy. .,Department of Medicine, Anesthesia and Intensive Care Clinic, University of Udine, Udine, Italy.
| | - Elena Bignami
- Department of Medicine and Surgery, Unit of Anesthesiology, Parma University Hospital, Parma, Italy
| | - Cristian Deana
- Department of Anesthesia and Intensive Care, Anesthesia and Intensive Care Unit 1, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
| | - Flavio Bassi
- Department of Anesthesia and Intensive Care, Anesthesia and Intensive Care Unit 2, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
| | - Maria Vargas
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples "Federico II", Naples, Italy
| | - Maria Orsaria
- Department of Medicine, Surgical Pathology Section, University of Udine, Udine, Italy
| | - Daniele Bagatto
- Department of Diagnostic Imaging, Neuroradiology Unit, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
| | - Cristina Intermite
- Department of Medicine, Anesthesia and Intensive Care Clinic, University of Udine, Udine, Italy
| | - Francesco Meroi
- Department of Medicine, Anesthesia and Intensive Care Clinic, University of Udine, Udine, Italy
| | | | - Marco Sartori
- Department of Medicine, Anesthesia and Intensive Care Clinic, University of Udine, Udine, Italy
| | - Daniele Orso
- Department of Medicine, Anesthesia and Intensive Care Clinic, University of Udine, Udine, Italy
| | - Massimo Robiony
- Department of Medicine, Maxillofacial Surgery, University of Udine, Udine, Italy.,Azienda Sanitaria Universitaria Friuli Centrale, Maxillofacial Surgery, Udine, Italy
| | - Tiziana Bove
- Department of Anesthesia and Intensive Care, Anesthesia and Intensive Care Clinic, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy.,Department of Medicine, Anesthesia and Intensive Care Clinic, University of Udine, Udine, Italy
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20
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Monasta L, Giangreco M, Ancona E, Barbone F, Bet E, Boschian-Bailo P, Cacciaguerra G, Cagnacci A, Canton M, Casarotto M, Comar M, Contardo S, De Agostini M, De Seta F, Del Ben G, Di Loreto C, Driul L, Facchin S, Giornelli R, Ianni A, La Valle S, Londero AP, Manfè M, Maso G, Mugittu R, Olivuzzi M, Orsaria M, Pecile V, Pinzano R, Pirrone F, Quadrifoglio M, Ricci G, Ronfani L, Salviato T, Sandrigo E, Smiroldo S, Sorz A, Stampalija T, Urriza M, Vanin M, Verardi G, Alberico S. Retrospective study 2005-2015 of all cases of fetal death occurred at ≥23 gestational weeks, in Friuli Venezia Giulia, Italy. BMC Pregnancy Childbirth 2020; 20:384. [PMID: 32611322 PMCID: PMC7329413 DOI: 10.1186/s12884-020-03074-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Accepted: 06/23/2020] [Indexed: 11/25/2022] Open
Abstract
Background Intrauterine fetal death (IUFD) is a tragic event and, despite efforts to reduce rates, its incidence remains difficult to reduce. The objective of the present study was to examine the etiological factors that contribute to the main causes and conditions associated with IUFD, over an 11-year period in a region of North-East Italy (Friuli Venezia Giulia) for which reliable data in available. Methods Retrospective analysis of all 278 IUFD cases occurred between 2005 and 2015 in pregnancies with gestational age ≥ 23 weeks. Results The incidence of IUFD was 2.8‰ live births. Of these, 30% were small for gestational age (SGA), with immigrant women being significantly over-represented. The share of SGA reached 35% in cases in which a maternal of fetal pathological condition was present, and dropped to 28% in the absence of associated pathology. In 78 pregnancies (28%) no pathology was recorded that could justify IUFD. Of all IUFDs, 11% occurred during labor, and 72% occurred at a gestational age above 30 weeks. Conclusion The percentage of IUFD cases for which no possible cause can be identified is quite high. Only the adoption of evidence-based diagnostic protocols, with integrated immunologic, genetic and pathologic examinations, can help reduce this diagnostic gap, contributing to the prevention of future IUFDs.
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Affiliation(s)
- Lorenzo Monasta
- Institute for Maternal and Child Health - IRCCS Burlo Garofolo, Trieste, Italy.
| | - Manuela Giangreco
- Institute for Maternal and Child Health - IRCCS Burlo Garofolo, Trieste, Italy
| | - Emanuele Ancona
- SOC Ostetricia e Ginecologia, Policlinico S. Giorgio S.p.A, Pordenone, Italy
| | - Fabio Barbone
- Institute for Maternal and Child Health - IRCCS Burlo Garofolo, Trieste, Italy
| | - Elisa Bet
- SC Ostetricia e Ginecologia Pordenone, Azienda per l'Assistenza Sanitaria N. 5 - Friuli Occidentale, Pordenone, Italy
| | - Pierino Boschian-Bailo
- SC Ostetricia e Ginecologia Gorizia - Monfalcone, Azienda per l'Assistenza Sanitaria N. 2 - Bassa Friulana-Isontina, Gorizia, Italy
| | - Giovanna Cacciaguerra
- SC Ostetricia e Ginecologia Palmanova - Latisana, Azienda per l'Assistenza Sanitaria N. 2 - Bassa Friulana-Isontina, Gorizia, Italy
| | - Angelo Cagnacci
- Azienda Sanitaria Universitaria Integrata di Udine, Udine, Italy.,Dipartimento di Area Medica, Università degli Studi di Udine, Udine, Italy
| | - Melania Canton
- Institute for Maternal and Child Health - IRCCS Burlo Garofolo, Trieste, Italy
| | - Maddalena Casarotto
- SC Ostetricia e Ginecologia Pordenone, Azienda per l'Assistenza Sanitaria N. 5 - Friuli Occidentale, Pordenone, Italy
| | - Manola Comar
- Institute for Maternal and Child Health - IRCCS Burlo Garofolo, Trieste, Italy.,Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Simona Contardo
- SC Ostetricia e Ginecologia San Vito - Spilimbergo, Azienda per l'Assistenza Sanitaria N. 5 - Friuli Occidentale, Pordenone, Italy
| | - Michela De Agostini
- SC Ostetricia e Ginecologia Palmanova - Latisana, Azienda per l'Assistenza Sanitaria N. 2 - Bassa Friulana-Isontina, Gorizia, Italy
| | - Francesco De Seta
- Institute for Maternal and Child Health - IRCCS Burlo Garofolo, Trieste, Italy.,Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Giovanni Del Ben
- SOC Ostetricia e Ginecologia, Policlinico S. Giorgio S.p.A, Pordenone, Italy
| | - Carla Di Loreto
- Azienda Sanitaria Universitaria Integrata di Udine, Udine, Italy.,Dipartimento di Area Medica, Università degli Studi di Udine, Udine, Italy
| | - Lorenza Driul
- Azienda Sanitaria Universitaria Integrata di Udine, Udine, Italy.,Dipartimento di Area Medica, Università degli Studi di Udine, Udine, Italy
| | - Stefano Facchin
- SC Ostetricia e Ginecologia Palmanova - Latisana, Azienda per l'Assistenza Sanitaria N. 2 - Bassa Friulana-Isontina, Gorizia, Italy
| | - Roberta Giornelli
- SC Ostetricia e Ginecologia Gorizia - Monfalcone, Azienda per l'Assistenza Sanitaria N. 2 - Bassa Friulana-Isontina, Gorizia, Italy
| | - Annalisa Ianni
- SOC Ostetricia e Ginecologia San Daniele - Tolmezzo, Azienda per l'Assistenza Sanitaria N. 3 - Alto Friuli-Collinare-Medio Friuli, Gemona del Friuli, Udine, Italy
| | - Santo La Valle
- SOC Ostetricia e Ginecologia, Policlinico S. Giorgio S.p.A, Pordenone, Italy
| | | | - Marciano Manfè
- SOC Ostetricia e Ginecologia, Policlinico S. Giorgio S.p.A, Pordenone, Italy
| | - Gianpaolo Maso
- Institute for Maternal and Child Health - IRCCS Burlo Garofolo, Trieste, Italy
| | - Raffaela Mugittu
- SC Ostetricia e Ginecologia Gorizia - Monfalcone, Azienda per l'Assistenza Sanitaria N. 2 - Bassa Friulana-Isontina, Gorizia, Italy
| | - Monica Olivuzzi
- SOC Ostetricia e Ginecologia San Daniele - Tolmezzo, Azienda per l'Assistenza Sanitaria N. 3 - Alto Friuli-Collinare-Medio Friuli, Gemona del Friuli, Udine, Italy
| | - Maria Orsaria
- Azienda Sanitaria Universitaria Integrata di Udine, Udine, Italy
| | - Vanna Pecile
- Institute for Maternal and Child Health - IRCCS Burlo Garofolo, Trieste, Italy
| | - Roberta Pinzano
- SC Ostetricia e Ginecologia San Vito - Spilimbergo, Azienda per l'Assistenza Sanitaria N. 5 - Friuli Occidentale, Pordenone, Italy
| | - Francesco Pirrone
- SC Ostetricia e Ginecologia Pordenone, Azienda per l'Assistenza Sanitaria N. 5 - Friuli Occidentale, Pordenone, Italy
| | | | - Giuseppe Ricci
- Institute for Maternal and Child Health - IRCCS Burlo Garofolo, Trieste, Italy.,Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Luca Ronfani
- Institute for Maternal and Child Health - IRCCS Burlo Garofolo, Trieste, Italy
| | | | - Elisa Sandrigo
- SC Ostetricia e Ginecologia Gorizia - Monfalcone, Azienda per l'Assistenza Sanitaria N. 2 - Bassa Friulana-Isontina, Gorizia, Italy
| | - Silvia Smiroldo
- SOC Ostetricia e Ginecologia, Policlinico S. Giorgio S.p.A, Pordenone, Italy
| | - Alice Sorz
- Institute for Maternal and Child Health - IRCCS Burlo Garofolo, Trieste, Italy
| | - Tamara Stampalija
- Institute for Maternal and Child Health - IRCCS Burlo Garofolo, Trieste, Italy.,Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Marianela Urriza
- Institute for Maternal and Child Health - IRCCS Burlo Garofolo, Trieste, Italy
| | - Michele Vanin
- SOC Ostetricia e Ginecologia San Daniele - Tolmezzo, Azienda per l'Assistenza Sanitaria N. 3 - Alto Friuli-Collinare-Medio Friuli, Gemona del Friuli, Udine, Italy
| | - Giuseppina Verardi
- Institute for Maternal and Child Health - IRCCS Burlo Garofolo, Trieste, Italy
| | - Salvatore Alberico
- Institute for Maternal and Child Health - IRCCS Burlo Garofolo, Trieste, Italy
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21
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Biasioli A, Londero AP, Orsaria M, Scrimin F, Mangino FP, Bertozzi S, Mariuzzi L, Cagnacci A. Atypical polypoid adenomyoma follow-up and management: Systematic review of case reports and series and meta-analysis. Medicine (Baltimore) 2020; 99:e20491. [PMID: 32590732 PMCID: PMC7328951 DOI: 10.1097/md.0000000000020491] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Atypical polypoid adenomyoma (APA) is a rare uterine tumor typically found in fertile age and associated with infertility. Among young nullipara women, conservative treatment is proposed despite the high recurrence rate and the association with endometrial cancer.Our aim was to assess the risk of recurrence with different conservative treatments in fertile ages and the prevalence of malignant or pre-malignant associated lesions to better address an adequate patient counselling when treatment modalities are discussed. METHODS This study is a systematic review and meta-analysis of case reports and case series about APA management and follow-up. A literature search was carried from Medline and Scopus for studies published from January 1, 1980 to December 31, 2018. RESULTS We included 46 observational studies and 296 cases in fertile women. The prevalence of APA relapse was 44% (CI.95 33-57%) and was lower in cases treated with operative hysteroscopy (22%; CI.95 11-39%) than in cases treated with blind curettage and polypectomy (38%; CI.95 15-67%). The prevalence of the concomitant or during the follow-up diagnosis of endometrial carcinoma was 16% (CI.95 9-29%). The risk of cancer development during follow-up was significantly less in cases treated with histeroscopy (10.56% new cumulative diagnosis at 5 years follow up; CI.95 0-23.7%) than blind curettage and polypectomy (35.5% new cumulative diagnosis at 5 years; CI.95 11.65-52.92%; P < .05). Medical treatment with medroxyprogesterone acetate after surgery does not reduce APA recurrence. Pregnancy was observed in 79% cases in which the desire was expressed. CONCLUSION This review suggests that conservative treatment performed by operative hysteroscopy is the optimal choice because it lowers the risk of recurrence, improves the accuracy of concomitant carcinoma or hyperplasia diagnosis, and leaves the possibility of future pregnancies.
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Affiliation(s)
- Anna Biasioli
- Clinic of Obstetrics and Gynecology, University Hospital of Udine
| | - Ambrogio P. Londero
- Clinic of Obstetrics and Gynecology, University Hospital of Udine
- Ennergi Research
| | - Maria Orsaria
- Institute of Pathology, University Hospital of Udine
| | - Federica Scrimin
- Institute for Maternal and Child Health, IRCCS “Burlo Garofolo”, Trieste (TS)
| | | | - Serena Bertozzi
- Ennergi Research
- Department of Medical Area (DAME), University of Udine, Udine (UD)
| | - Laura Mariuzzi
- Institute of Pathology, University Hospital of Udine
- Department of Medical Area (DAME), University of Udine, Udine (UD)
| | - Angelo Cagnacci
- Clinic of Obstetrics and Gynecology, DINOGMI, IRCCS San Martino Hospital, University of Genova, Genova (GE), Italy
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22
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Arigliani M, Valentini E, Stocco C, De Pieri C, Castriotta L, Barbato V, Cuberli E, Orsaria M, Cattarossi L, Cogo P. Regional ventilation inhomogeneity in survivors of extremely preterm birth. Pediatr Pulmonol 2020; 55:1366-1374. [PMID: 32212328 DOI: 10.1002/ppul.24742] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Accepted: 03/13/2020] [Indexed: 11/08/2022]
Abstract
INTRODUCTION Survivors of extreme prematurity may have disrupted lung development. We hypothesized that the multiple breath washout (MBW) index Scond, which is intended to reflect ventilation inhomogeneity from the conducting airways, could be a sensitive marker of respiratory impairment in this group. METHODS Spirometry, TLco, and MBW were cross-sectionally evaluated at 8 to 14 years of age in children born at <28 weeks between 2004 and 2010 in Udine, Italy. Age-matched controls born at term were also included. Bronchopulmonary dysplasia (BPD) was defined as oxygen-dependence at 36 weeks postmenstrual age. The limits of normal were the 5th percentile of the reference population (Global Lung Initiative) for spirometry and TLco and the 95th percentile of controls for Lung Clearance Index, Scond, and Sacin from MBW. RESULTS Results were obtained in 47 extremely preterm children (53% boys, mean ± standard deviation age 11.3 ± 2.0 years, 40% with BPD) and 60 controls (50% boys, 11.6 ± 1.9 years). There were significant differences between preterm children and controls in all lung function outcomes, except for Sacin. Among children born <28 weeks, Scond tended to be frequently abnormal than FEV1 z-score (29% vs 14%, P = .06). At multivariable linear regression, in the preterm group, current asthma was significantly associated with a higher Scond (B = 0.019, 95% confidence interval, 0.000-0.038), whereas BPD was not. CONCLUSION Almost a third of extremely preterm children at school age showed Scond alterations that affected also children without BPD. Longitudinal studies should clarify the prognostic meaning of Scond abnormalities in this group.
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Affiliation(s)
- Michele Arigliani
- Department of Medicine, Division of Pediatrics, University Hospital of Udine, Udine, Italy
| | - Elena Valentini
- Department of Medicine, Division of Pediatrics, University Hospital of Udine, Udine, Italy
| | - Chiara Stocco
- Department of Medicine, Division of Pediatrics, University Hospital of Udine, Udine, Italy
| | - Carlo De Pieri
- Department of Medicine, Division of Pediatrics, University Hospital of Udine, Udine, Italy
| | - Luigi Castriotta
- Institute of Hygiene and Clinical Epidemiology, University Hospital of Udine, Udine, Italy
| | - Vincenzo Barbato
- Department of Medicine, Division of Pediatrics, University Hospital of Udine, Udine, Italy
| | - Elisa Cuberli
- Department of Medicine, Division of Pediatrics, University Hospital of Udine, Udine, Italy
| | - Maria Orsaria
- Department of Medicine, Surgical Pathology Section, University Hospital of Udine, Udine, Italy
| | - Luigi Cattarossi
- Department of Medicine, Neonatal Intensive Care Unit, University Hospital of Udine, Udine, Italy
| | - Paola Cogo
- Department of Medicine, Division of Pediatrics, University Hospital of Udine, Udine, Italy
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Viola L, Londero AP, Bertozzi S, Orsaria M, Marzinotto S, Antoniazzi F, Renda V, Cinel J, Fruscalzo A, Lellé RJ, Mariuzzi L. Prognostic Role of Krüppel-Like Factors 5, 9, and 11 in Endometrial Endometrioid Cancer. Pathol Oncol Res 2020; 26:2265-2272. [PMID: 32451988 DOI: 10.1007/s12253-020-00817-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Accepted: 04/28/2020] [Indexed: 12/01/2022]
Abstract
BACKGROUND AND OBJECTIVE Krüppel-like factors (KLFs) are transcription factors with the ability to mediate cross-talk with signaling pathways involved in cell proliferation control, apoptosis, migration, and differentiation. They also appear to influence steroid hormone signaling through transcriptional networks involving steroid hormone receptors and members of the nuclear receptor family of transcription factors. Our study aims to evaluate the potential prognostic role of KLF5, KLF9, and KLF11 in endometrial cancer, and their correlation with hormonal receptor status and cellular proliferation. MATERIALS AND METHODS Retrospective observational study on cases of endometrioid endometrial adenocarcinoma collected in the period January 2000-December 2011 at the University of Udine. Formalin-fixed, paraffin-embedded tissue samples were all submitted to tissue microarray immunohistochemical study. A survival analysis was performed. RESULTS One hundred forty seven patients were included in the study with a mean age at surgery of 65.6 years (±10.2). 80.3% of endometrial malignancies were classified as stage FIGO I (118/147). Radiation therapy and chemotherapy were administered in 62.3% (91/146) and 6.2% (9/145) of patients respectively. Five-year overall survival and disease-free survival resulted 85.4% (95% CI, 79.8-91.4%) and 79.4% (95% CI, 73.0-86.4%) respectively. A high Ki-67, cytoplasmatic KLF5 (HR 4.72, CI.95 1.61-13.89, p < 0.05), and nuclear KLF11 (HR 3.04, CI.95 0.99-9.36, p = 0.053) scores correlated with a shorter overall survival. In addition, a high nuclear KLF11 (HR 2.59, CI.95 1.13-5.95, p < 0.05) score correlated with a shorter disease-free survival. CONCLUSIONS In patients affected by endometrioid endometrial carcinoma, higher staining levels of KLF5 and KLF11 correlated with a poorer prognosis. However, further studies are required in order to better clarify the role of KLFs in the natural history of endometrial cancer.
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Affiliation(s)
- Luigi Viola
- Radiology Department, University of Campania "Luigi Vanvitelli", Naples, 80138, Italy
| | - Ambrogio P Londero
- Clinic of Obstetrics and Gynecology, DAME, Academic Hospital of Udine, University of Udine, Piazzale Santa Maria della Misericordia, 15, 33100, Udine, Italy. .,Ennergi Research (Non-Profit Organization), Lestizza, 33050, Italy.
| | - Serena Bertozzi
- Ennergi Research (Non-Profit Organization), Lestizza, 33050, Italy.,Breast Unit, DAME, Academic Hospital of Udine, University of Udine, 33100, Udine, Italy
| | - Maria Orsaria
- Institute of Pathology, DAME, Academic Hospital of Udine, University of Udine, Udine, 33100, Italy
| | - Stefania Marzinotto
- Institute of Pathology, DAME, Academic Hospital of Udine, University of Udine, Udine, 33100, Italy
| | - Fulvio Antoniazzi
- Institute of Pathology, DAME, Academic Hospital of Udine, University of Udine, Udine, 33100, Italy
| | - Valentina Renda
- Institute of Pathology, DAME, Academic Hospital of Udine, University of Udine, Udine, 33100, Italy
| | - Jacqueline Cinel
- Clinic of Surgery, Academic Hospital of Udine, University of Udine, 33100, Udine, Italy
| | - Arrigo Fruscalzo
- Clinic of Obstetrics and Gynecology, Christophorus-Kliniken, 48653, Coesfeld, Germany.,Clinic of Obstetrics and Gynecology, University Hospital of Münster, Albert-Schweitzer-Campus 1, Gebäude: A1, 48149, Münster, Germany
| | - Ralph J Lellé
- Clinic of Obstetrics and Gynecology, University Hospital of Münster, Albert-Schweitzer-Campus 1, Gebäude: A1, 48149, Münster, Germany
| | - Laura Mariuzzi
- Institute of Pathology, DAME, Academic Hospital of Udine, University of Udine, Udine, 33100, Italy
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24
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Fruscalzo A, Londero AP, Orsaria M, Marzinotto S, Driul L, Di Loreto C, Mariuzzi L. Placental fibronectin staining is unaffected in pregnancies complicated by late-onset intrauterine growth restriction and small for gestational age fetuses. Int J Gynaecol Obstet 2019; 148:253-260. [PMID: 31743426 DOI: 10.1002/ijgo.13060] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2018] [Revised: 06/26/2019] [Accepted: 11/18/2019] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To investigate the placental staining pattern of fibronectin, an extracellular matrix protein essential for trophoblastic invasion, in pre-eclampsia and fetal growth restriction. METHODS This was a retrospective study conducted at the University of Udine, including the placentas of women with pre-eclampsia and fetal growth restriction collected between January 1, 2001, and December 31, 2010. Fibronectin was evaluated in placental tissue micro-array by immunohistochemistry, describing localization and intensity of staining. RESULTS The study included the placentas of 36 women with early-onset (delivery <34 weeks of gestation) pre-eclampsia; 6 with early-onset HELLP syndrome; 17 with early-onset intrauterine growth restriction (IUGR); 14 with late-onset (delivery ≥34 weeks of gestation) pre-eclampsia; 35 with late-onset IUGR; 18 with small for gestational age (SGA) fetuses (birth weight <10th percentile); and 64 controls. Fibronectin was present both at the cell surface and in the cytoplasm. Cytoplasm staining intensity resulted higher in early forms of pregnancy-related complications compared to controls, although this was statistically significant (P<0.05) only for early-onset pre-eclampsia (P=0.085 for HELLP syndrome; P=0.091 for IUGR). Also, late-onset forms of pre-eclampsia had stronger cytoplasmic and pericellular staining compared to controls (P<0.05). Interestingly, staining of both late-onset IUGR and SGA was comparable to controls. CONCLUSION Fibronectin appeared to be unaffected in women with late-onset IUGR and SGA fetuses, suggesting a peculiar common pathogenetic pattern in these conditions.
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Affiliation(s)
- Arrigo Fruscalzo
- Clinic of Obstetrics and Gynecology, Christophorus-Kliniken, Coesfeld, Germany.,Clinic of Obstetrics and Gynecology, University of Münster, Münster, Germany
| | - Ambrogio P Londero
- Clinic of Obstetrics and Gynecology, DAME, University of Udine, Udine, Italy
| | - Maria Orsaria
- Institute of Pathology, DAME, University of Udine, Udine, Italy
| | | | - Lorenza Driul
- Clinic of Obstetrics and Gynecology, DAME, University of Udine, Udine, Italy
| | - Carla Di Loreto
- Institute of Pathology, DAME, University of Udine, Udine, Italy
| | - Laura Mariuzzi
- Institute of Pathology, DAME, University of Udine, Udine, Italy
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25
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Agostinis P, Antonello RM, Orsaria M, Luzzati R, Di Bella S. Isoniazid-induced Takayasu arteritis remission. Infez Med 2019; 27:436-440. [PMID: 31846995] [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] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
A 75-year-old man was admitted because of fever, unproductive cough, neck pain and upper limb claudication. The patient was febrile and hypotensive, and a cardiac systolic ejection murmur was heard. Blood tests showed normochromic anemia, elevated erythrocyte sedimentation rate, C-reactive protein, fibrinogen, and alpha-2 and beta-2 globulins. In order to investigate neck pain, an ultrasound examination of the carotid arteries was performed which showed a carotid intima-media thickness reaching the maximum value of 2.3 mm in both carotid arteries. Ultrasound examination of the temporal artery and its rami demonstrated wall thickening, both in the common superficial temporal artery and its frontal and parietal rami. A temporal artery biopsy was performed and was consistent with Takayasu arteritis. A positive interferon-γ release assay revealed latent tuberculosis infection and isoniazid 300 mg every 24 hours was commenced. Neither corticosteroids nor other drugs were prescribed at that time. Two weeks later, ultrasound examination showed a significant reduction in the thickening of all investigated arteries. To our knowledge, this is the first case of isoniazid-induced Takayasu arteritis remission. We believe that isoniazid deserves further investigation regarding its potential immunomodulatory properties.
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Affiliation(s)
- Paolo Agostinis
- Department of Medicine, San Antonio Abate Hospital, Tolmezzo (UD), Italy
| | | | - Maria Orsaria
- Institute of Pathology, Azienda Sanitaria Universitaria Integrata di Udine, Udine, Italy
| | - Roberto Luzzati
- Infectious Diseases Department, Azienda Sanitaria Universitaria Integrata di Trieste, Trieste, Italy
| | - Stefano Di Bella
- Infectious Diseases Department, Azienda Sanitaria Universitaria Integrata di Trieste, Trieste, Italy
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26
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Karolak JA, Vincent M, Deutsch G, Gambin T, Cogné B, Pichon O, Vetrini F, Mefford HC, Dines JN, Golden-Grant K, Dipple K, Freed AS, Leppig KA, Dishop M, Mowat D, Bennetts B, Gifford AJ, Weber MA, Lee AF, Boerkoel CF, Bartell TM, Ward-Melver C, Besnard T, Petit F, Bache I, Tümer Z, Denis-Musquer M, Joubert M, Martinovic J, Bénéteau C, Molin A, Carles D, André G, Bieth E, Chassaing N, Devisme L, Chalabreysse L, Pasquier L, Secq V, Don M, Orsaria M, Missirian C, Mortreux J, Sanlaville D, Pons L, Küry S, Bézieau S, Liet JM, Joram N, Bihouée T, Scott DA, Brown CW, Scaglia F, Tsai ACH, Grange DK, Phillips JA, Pfotenhauer JP, Jhangiani SN, Gonzaga-Jauregui CG, Chung WK, Schauer GM, Lipson MH, Mercer CL, van Haeringen A, Liu Q, Popek E, Coban Akdemir ZH, Lupski JR, Szafranski P, Isidor B, Le Caignec C, Stankiewicz P. Complex Compound Inheritance of Lethal Lung Developmental Disorders Due to Disruption of the TBX-FGF Pathway. Am J Hum Genet 2019; 104:213-228. [PMID: 30639323 DOI: 10.1016/j.ajhg.2018.12.010] [Citation(s) in RCA: 65] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Accepted: 12/13/2018] [Indexed: 12/24/2022] Open
Abstract
Primary defects in lung branching morphogenesis, resulting in neonatal lethal pulmonary hypoplasias, are incompletely understood. To elucidate the pathogenetics of human lung development, we studied a unique collection of samples obtained from deceased individuals with clinically and histopathologically diagnosed interstitial neonatal lung disorders: acinar dysplasia (n = 14), congenital alveolar dysplasia (n = 2), and other lethal lung hypoplasias (n = 10). We identified rare heterozygous copy-number variant deletions or single-nucleotide variants (SNVs) involving TBX4 (n = 8 and n = 2, respectively) or FGF10 (n = 2 and n = 2, respectively) in 16/26 (61%) individuals. In addition to TBX4, the overlapping ∼2 Mb recurrent and nonrecurrent deletions at 17q23.1q23.2 identified in seven individuals with lung hypoplasia also remove a lung-specific enhancer region. Individuals with coding variants involving either TBX4 or FGF10 also harbored at least one non-coding SNV in the predicted lung-specific enhancer region, which was absent in 13 control individuals with the overlapping deletions but without any structural lung anomalies. The occurrence of rare coding variants involving TBX4 or FGF10 with the putative hypomorphic non-coding SNVs implies a complex compound inheritance of these pulmonary hypoplasias. Moreover, they support the importance of TBX4-FGF10-FGFR2 epithelial-mesenchymal signaling in human lung organogenesis and help to explain the histopathological continuum observed in these rare lethal developmental disorders of the lung.
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MESH Headings
- DNA Copy Number Variations/genetics
- Female
- Fibroblast Growth Factor 10/genetics
- Fibroblast Growth Factor 10/metabolism
- Gene Expression Regulation
- Gestational Age
- Humans
- Infant, Newborn
- Infant, Newborn, Diseases/genetics
- Infant, Newborn, Diseases/metabolism
- Infant, Newborn, Diseases/mortality
- Infant, Newborn, Diseases/pathology
- Lung/embryology
- Lung/growth & development
- Lung Diseases/genetics
- Lung Diseases/metabolism
- Lung Diseases/mortality
- Lung Diseases/pathology
- Male
- Maternal Inheritance
- Organogenesis
- Paternal Inheritance
- Pedigree
- Polymorphism, Single Nucleotide/genetics
- Receptor, Fibroblast Growth Factor, Type 2/metabolism
- Signal Transduction/genetics
- T-Box Domain Proteins/genetics
- T-Box Domain Proteins/metabolism
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Affiliation(s)
- Justyna A Karolak
- Department of Molecular & Human Genetics, Baylor College of Medicine, Houston, TX 77030, USA; Department of Genetics and Pharmaceutical Microbiology, Poznan University of Medical Sciences, 60-781 Poznan, Poland
| | - Marie Vincent
- Service de Génétique Médicale, CHU de Nantes, 44000 Nantes, France; Inserm, CNRS, Univ Nantes, l'institut du thorax, 44000 Nantes, France
| | - Gail Deutsch
- Department of Pathology, Seattle Children's Hospital, Seattle, WA 98105, USA
| | - Tomasz Gambin
- Department of Medical Genetics, Institute of Mother and Child, 01-211 Warsaw, Poland; Institute of Computer Science, Warsaw University of Technology, 00-665 Warsaw, Poland
| | - Benjamin Cogné
- Service de Génétique Médicale, CHU de Nantes, 44000 Nantes, France; Inserm, CNRS, Univ Nantes, l'institut du thorax, 44000 Nantes, France
| | - Olivier Pichon
- Service de Génétique Médicale, CHU de Nantes, 44000 Nantes, France
| | | | - Heather C Mefford
- Department of Pediatrics, Division of Genetic Medicine, University of Washington, Seattle, WA 98195, USA
| | - Jennifer N Dines
- Department of Pediatrics, Division of Genetic Medicine, University of Washington, Seattle, WA 98195, USA; Department of Medicine, Division of Medical Genetics, University of Washington, Seattle, WA 98195, USA
| | - Katie Golden-Grant
- Division of Genetic Medicine, Seattle Children's Hospital, Seattle, WA 98105, USA
| | - Katrina Dipple
- Department of Pediatrics, Division of Genetic Medicine, University of Washington, Seattle, WA 98195, USA; Division of Genetic Medicine, Seattle Children's Hospital, Seattle, WA 98105, USA
| | - Amanda S Freed
- Department of Pediatrics, Division of Genetic Medicine, University of Washington, Seattle, WA 98195, USA; Department of Medicine, Division of Medical Genetics, University of Washington, Seattle, WA 98195, USA
| | - Kathleen A Leppig
- Genetic Services Kaiser Permanente of Washington, Seattle, WA 98112, USA
| | - Megan Dishop
- Pathology and Laboratory Medicine, Phoenix Children's Hospital, Phoenix, AZ 85016, USA
| | - David Mowat
- Centre for Clinical Genetics, Sydney Children's Hospital, Randwick Sydney, NSW 2031 Australia; School of Women's and Children's Health, The University of New South Wales, Sydney, NSW 2052, Australia
| | - Bruce Bennetts
- Discipline of Child & Adolescent Health, Sydney Medical School, University of Sydney, Sydney, NSW 2006, Australia; Molecular Genetics Department, Western Sydney Genetics Program, The Children's Hospital at Westmead, Sydney, NSW 2145, Australia; Discipline of Genetic Medicine, Sydney Medical School, University of Sydney, Sydney, NSW 2006, Australia
| | - Andrew J Gifford
- School of Women's and Children's Health, The University of New South Wales, Sydney, NSW 2052, Australia; Department of Anatomical Pathology, Prince of Wales Hospital, Randwick, NSW 2031, Australia
| | - Martin A Weber
- Department of Anatomical Pathology, Prince of Wales Hospital, Randwick, NSW 2031, Australia; School of Medical Sciences, University of New South Wales, Sydney, NSW 2052, Australia
| | - Anna F Lee
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC V6T 2B5, Canada
| | - Cornelius F Boerkoel
- Department of Medical Genetics, University of British Columbia, Vancouver, BC V6H 3N1, Canada
| | - Tina M Bartell
- Department of Genetics, Kaiser Permanente Sacramento Medical Center, Sacramento, CA 95815, USA
| | | | - Thomas Besnard
- Service de Génétique Médicale, CHU de Nantes, 44000 Nantes, France; Inserm, CNRS, Univ Nantes, l'institut du thorax, 44000 Nantes, France
| | - Florence Petit
- Service de Génétique Clinique, CHU Lille, 59000 Lille, France
| | - Iben Bache
- Department of Cellular and Molecular Medicine, University of Copenhagen, 2200 N Copenhagen, Denmark; Department of Clinical Genetics, Copenhagen University Hospital, Rigshospitalet, 2100 Ø Copenhagen, Denmark
| | - Zeynep Tümer
- Kennedy Center, Department of Clinical Genetics, Copenhagen University Hospital, Rigshospitalet, 2600 Glostrup, Copenhagen, Denmark; Deparment of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, 2200 N, Copenhagen, Denmark
| | | | | | - Jelena Martinovic
- Unit of Fetal Pathology, AP-HP, Antoine Beclere Hospital, 75000 Paris, France
| | - Claire Bénéteau
- Service de Génétique Médicale, CHU de Nantes, 44000 Nantes, France; Inserm, CNRS, Univ Nantes, l'institut du thorax, 44000 Nantes, France
| | - Arnaud Molin
- Service de Génétique Médicale, CHU Caen, 14000 Caen, France
| | - Dominique Carles
- Service d'anatomo-pathologie, CHU Bordeaux, 33000 Bordeaux, France
| | - Gwenaelle André
- Service d'anatomo-pathologie, CHU Bordeaux, 33000 Bordeaux, France
| | - Eric Bieth
- Service de génétique médicale, CHU Toulouse, France and UDEAR, UMR 1056 Inserm - Université de Toulouse, 31000 Toulouse, France
| | - Nicolas Chassaing
- Service de génétique médicale, CHU Toulouse, France and UDEAR, UMR 1056 Inserm - Université de Toulouse, 31000 Toulouse, France
| | | | | | | | - Véronique Secq
- Aix Marseille Univ, APHM, Hôpital Nord, Service d'anatomo-pathologie, 13000 Marseille, France
| | - Massimiliano Don
- Sant'Antonio General Hospital, Pediatric Care Unit, San Daniele del Friuli, 33100 Udine, Italy
| | - Maria Orsaria
- Department of Medical and Biological Sciences, Pathology Unit, University of Udine, Udine, Italy
| | - Chantal Missirian
- Aix Marseille Univ, APHM, INSERM, MMG, Marseille, Timone Hospital, 13000 Marseille, France
| | - Jérémie Mortreux
- Aix Marseille Univ, APHM, INSERM, MMG, Marseille, Timone Hospital, 13000 Marseille, France
| | - Damien Sanlaville
- Hospices Civils de Lyon, GHE, Genetics department, and Lyon University, 69000 Lyon, France
| | - Linda Pons
- Hospices Civils de Lyon, GHE, Genetics department, and Lyon University, 69000 Lyon, France
| | - Sébastien Küry
- Service de Génétique Médicale, CHU de Nantes, 44000 Nantes, France; Inserm, CNRS, Univ Nantes, l'institut du thorax, 44000 Nantes, France
| | - Stéphane Bézieau
- Service de Génétique Médicale, CHU de Nantes, 44000 Nantes, France; Inserm, CNRS, Univ Nantes, l'institut du thorax, 44000 Nantes, France
| | - Jean-Michel Liet
- Service de réanimation pédiatrique, CHU Nantes, 44000 Nantes, France
| | - Nicolas Joram
- Service de réanimation pédiatrique, CHU Nantes, 44000 Nantes, France
| | | | - Daryl A Scott
- Department of Molecular & Human Genetics, Baylor College of Medicine, Houston, TX 77030, USA; Texas Children's Hospital, Houston, TX 77030, USA; Department of Molecular Physiology and Biophysics, Baylor College of Medicine, Houston, TX 77030, USA
| | - Chester W Brown
- Department of Pediatrics, Genetics Division, University of Tennessee Health Science Center, Memphis, TN 38163, USA
| | - Fernando Scaglia
- Department of Molecular & Human Genetics, Baylor College of Medicine, Houston, TX 77030, USA; Texas Children's Hospital, Houston, TX 77030, USA; Joint BCM-CUHK Center of Medical Genetics, Prince of Wales Hospital, ShaTin, New Territories, Hong Kong SAR
| | - Anne Chun-Hui Tsai
- Department of Pediatrics, The Children's Hospital, University of Colorado School of Medicine, Aurora, CO 80045, USA
| | - Dorothy K Grange
- Department of Pediatrics, Division of Genetics and Genomic Medicine, Washington University School of Medicine, St. Louis Children's Hospital, St. Louis, MO 63110, USA
| | - John A Phillips
- Department of Pediatrics, Division of Medical Genetics and Genomic Medicine, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Jean P Pfotenhauer
- Department of Pediatrics, Division of Medical Genetics and Genomic Medicine, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Shalini N Jhangiani
- Human Genome Sequencing Center, Baylor College of Medicine, Houston, TX 77030, USA
| | | | - Wendy K Chung
- Departments of Pediatrics and Medicine, Columbia University, New York, NY 10032, USA
| | - Galen M Schauer
- Department of Pathology, Kaiser Permanente Oakland Medical Center, Oakland, CA 94611, USA
| | - Mark H Lipson
- Department of Genetics, Kaiser Permanente Sacramento Medical Center, Sacramento, CA 95815, USA
| | - Catherine L Mercer
- Wessex Clinical Genetics Service, University Hospital Southampton NHS Foundation Trust, Princess Anne Hospital, Southampton SO16 5YA, UK
| | - Arie van Haeringen
- Department of Clinical Genetics, Leiden University Medical Center, 2333 ZA Leiden, the Netherlands
| | - Qian Liu
- Department of Molecular & Human Genetics, Baylor College of Medicine, Houston, TX 77030, USA
| | - Edwina Popek
- Department of Pathology and Immunology, Baylor College of Medicine, Houston, TX 77030, USA
| | - Zeynep H Coban Akdemir
- Department of Molecular & Human Genetics, Baylor College of Medicine, Houston, TX 77030, USA
| | - James R Lupski
- Department of Molecular & Human Genetics, Baylor College of Medicine, Houston, TX 77030, USA; Texas Children's Hospital, Houston, TX 77030, USA; Human Genome Sequencing Center, Baylor College of Medicine, Houston, TX 77030, USA; Department of Pediatrics, Baylor College of Medicine, Houston, TX 77030, USA
| | - Przemyslaw Szafranski
- Department of Molecular & Human Genetics, Baylor College of Medicine, Houston, TX 77030, USA
| | - Bertrand Isidor
- Service de Génétique Médicale, CHU de Nantes, 44000 Nantes, France; Inserm, CNRS, Univ Nantes, l'institut du thorax, 44000 Nantes, France
| | | | - Paweł Stankiewicz
- Department of Molecular & Human Genetics, Baylor College of Medicine, Houston, TX 77030, USA; Baylor Genetics, Houston, TX 77021, USA; Institute of Mother and Child, 01-211 Warsaw, Poland.
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27
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Orsaria M, Londero AP, Marzinotto S, Di Loreto C, Marchesoni D, Mariuzzi L. Placental type alkaline phosphatase tissue expression in ovarian serous carcinoma. Cancer Biomark 2017; 17:479-486. [PMID: 27802199 DOI: 10.3233/cbm-160665] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVE To analyze the expression profile of placental type alkaline phosphatase (PLAP), cancer antigen 125 (CA125), and human epididymis protein 4 (HE4) in serous ovarian cancer and to correlate their expression with the tumor aggressiveness and progression. METHODS Retrospective study considering a tissue microarray of 82 women affected by ovarian serous cancer. Protein expression was assessed by immunohistochemistry on ovarian serous cancer tissue samples. Immunohistochemical staining was semiquantitatively evaluated as H-score. RESULTS Median H-score values were lower for PLAP, 1 (IQR 0-4) than CA125, 10 (IQR 6-12) or HE4, 8 (IQR 5-12). Even if PLAP was less expressed in the cells of serous ovarian cancer than CA125 or HE4 it was relatively more expressed in the fourth quartile of its H-score distribution among cases with low CA125 or HE4 expression. Furthermore, PLAP and HE4 high expression resulted to be significantly correlated with a better prognosis. CONCLUSIONS PLAP could be an additional marker for early detection of serous ovarian carcinoma, together with the established CA125 and HE4. In addition, PLAP expression is correlated with prognosis, giving, in this way, an additional tool for improving treatment approach.
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Affiliation(s)
- Maria Orsaria
- Department of Medical and Biological Sciences, DSMB, University of Udine, Udine, Italy
| | - Ambrogio P Londero
- Unit of Obstetrics and Gynecology, Hospital of Monfalcone (GO), Italy.,Department of Experimental Clinical and Medical Science, DISM, Clinic of Obstetrics and Gynecology, University of Udine, Udine, Italy
| | - Stefania Marzinotto
- Department of Medical and Biological Sciences, DSMB, University of Udine, Udine, Italy
| | - Carla Di Loreto
- Department of Medical and Biological Sciences, DSMB, University of Udine, Udine, Italy
| | - Diego Marchesoni
- Department of Experimental Clinical and Medical Science, DISM, Clinic of Obstetrics and Gynecology, University of Udine, Udine, Italy
| | - Laura Mariuzzi
- Department of Medical and Biological Sciences, DSMB, University of Udine, Udine, Italy
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28
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Mariuzzi L, Domenis R, Orsaria M, Marzinotto S, Londero AP, Bulfoni M, Candotti V, Zanello A, Ballico M, Mimmi MC, Calcagno A, Marchesoni D, Di Loreto C, Beltrami AP, Cesselli D, Gri G. Functional expression of aryl hydrocarbon receptor on mast cells populating human endometriotic tissues. J Transl Med 2016; 96:959-971. [PMID: 27348627 PMCID: PMC5008463 DOI: 10.1038/labinvest.2016.74] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2015] [Revised: 05/26/2016] [Accepted: 05/27/2016] [Indexed: 12/24/2022] Open
Abstract
Endometriosis is an inflammatory disease characterized by the presence of ectopic endometrial tissue outside the uterus. A diffuse infiltration of mast cells (MCs) is observed throughout endometriotic lesions, but little is known about how these cells contribute to the network of molecules that modulate the growth of ectopic endometrial implants and promote endometriosis-associated inflammation. The aryl hydrocarbon receptor (AhR), a transcription factor known to respond to environmental toxins and endogenous compounds, is present in MCs. In response to AhR activation, MCs produce IL-17 and reactive oxygen species, highlighting the potential impact of AhR ligands on inflammation via MCs. Here, we investigated the possibility that endometrial MCs promote an inflammatory microenvironment by sensing AhR ligands, thus sustaining endometriosis development. Using human endometriotic tissue (ET) samples, we performed the following experiments: (i) examined the cytokine expression profile; (ii) counted AhR-expressing MCs; (iii) verified the phenotype of AhR-expressing MCs to establish whether MCs have a tolerogenic (IL-10-positive) or inflammatory (IL-17-positive) phenotype; (iv) measured the presence of AhR ligands (tryptophan-derived kynurenine) and tryptophan-metabolizing enzymes (indoleamine 2,3-dioxygenase 1 (IDO1)); (v) treated ET organ cultures with an AhR antagonist in vitro to measure changes in the cytokine milieu; and (vi) measured the growth of endometrial stromal cells cultured with AhR-activated MC-conditioned medium. We found that ET tissue was conducive to cytokine production, orchestrating chronic inflammation and a population of AhR-expressing MCs that are both IL-17 and IL-10-positive. ET was rich in IDO1 and the AhR-ligand kynurenine compared with control tissue, possibly promoting MC activation through AhR. ET was susceptible to treatment with an AhR antagonist, and endometrial stromal cell growth was improved in the presence of soluble factors released by MCs on AhR activation. These results suggest a new mechanistic role of MCs in the pathogenesis of endometriosis.
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Affiliation(s)
- Laura Mariuzzi
- Section of Surgical Pathology, Department of Medical and Biological Sciences, University Hospital of Udine, P.le S.Maria della Misericordia 15, 33100 Udine, Italy
| | - Rossana Domenis
- Section of Surgical Pathology, Department of Medical and Biological Sciences, University Hospital of Udine, P.le S.Maria della Misericordia 15, 33100 Udine, Italy
| | - Maria Orsaria
- Section of Surgical Pathology, Department of Medical and Biological Sciences, University Hospital of Udine, P.le S.Maria della Misericordia 15, 33100 Udine, Italy
| | - Stefania Marzinotto
- Section of Surgical Pathology, Department of Medical and Biological Sciences, University Hospital of Udine, P.le S.Maria della Misericordia 15, 33100 Udine, Italy
| | - Ambrogio P Londero
- Clinic of Obstetrics and Gynecology, University Hospital of Udine, P.le S.Maria della Misericordia 15, 33100 Udine, Italy
| | - Michela Bulfoni
- Section of Surgical Pathology, Department of Medical and Biological Sciences, University Hospital of Udine, P.le S.Maria della Misericordia 15, 33100 Udine, Italy
| | - Veronica Candotti
- Section of Surgical Pathology, Department of Medical and Biological Sciences, University Hospital of Udine, P.le S.Maria della Misericordia 15, 33100 Udine, Italy
| | - Andrea Zanello
- Section of Surgical Pathology, Department of Medical and Biological Sciences, University Hospital of Udine, P.le S.Maria della Misericordia 15, 33100 Udine, Italy
| | - Maurizio Ballico
- Section of Applied Physics, Department of Medical and Biological Sciences, University of Udine, P.le Kolbe 4, 33100 Udine, Italy
| | - Maria C Mimmi
- Section of Applied Physics, Department of Medical and Biological Sciences, University of Udine, P.le Kolbe 4, 33100 Udine, Italy
| | - Angelo Calcagno
- Clinic of Obstetrics and Gynecology, University Hospital of Udine, P.le S.Maria della Misericordia 15, 33100 Udine, Italy
| | - Diego Marchesoni
- Clinic of Obstetrics and Gynecology, University Hospital of Udine, P.le S.Maria della Misericordia 15, 33100 Udine, Italy
| | - Carla Di Loreto
- Section of Surgical Pathology, Department of Medical and Biological Sciences, University Hospital of Udine, P.le S.Maria della Misericordia 15, 33100 Udine, Italy
| | - Antonio P Beltrami
- Section of Surgical Pathology, Department of Medical and Biological Sciences, University Hospital of Udine, P.le S.Maria della Misericordia 15, 33100 Udine, Italy
| | - Daniela Cesselli
- Section of Surgical Pathology, Department of Medical and Biological Sciences, University Hospital of Udine, P.le S.Maria della Misericordia 15, 33100 Udine, Italy
| | - Giorgia Gri
- Section of Surgical Pathology, Department of Medical and Biological Sciences, University Hospital of Udine, P.le S.Maria della Misericordia 15, 33100 Udine, Italy
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Londero AP, Orsaria M, Marzinotto S, Grassi T, Fruscalzo A, Calcagno A, Bertozzi S, Nardini N, Stella E, Lellé RJ, Driul L, Tell G, Mariuzzi L. Placental aging and oxidation damage in a tissue micro-array model: an immunohistochemistry study. Histochem Cell Biol 2016; 146:191-204. [PMID: 27106773 DOI: 10.1007/s00418-016-1435-6] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/11/2016] [Indexed: 12/12/2022]
Abstract
To evaluate the expression of markers correlated with cellular senescence and DNA damage (8-hydroxy-2'-deoxy-guanosine (8-OHdG), p53, p21, APE1/Ref-1 (APE1), interleukin (IL-6 and IL-8) in placentas from healthy and pathologic pregnancies. This retrospective study considered a placental tissue micro-array containing 92 controls from different gestational ages and 158 pathological cases including preeclampsia (PE), HELLP syndrome (hemolysis, elevated liver enzymes, low platelet count), small for gestational age (SGA) fetuses, and intrauterine growth restriction (IUGR) occurring at different gestational ages. In this study, we demonstrated a significant influence of gestational age on the expression in the trophoblast of 8-OHdG, p53, p21, APE1, and IL-6. In placentas of cases affected by PE, HELLP, or IUGR, there was an increased expression of 8-OHdG, p53, APE1, and IL-6 compared to controls (only IL-8 was significantly decreased in cases). In both groups of pathology between 22- and 34-week gestation and after 34-week gestation, APE1 levels were higher in the trophoblast of women affected by hypertensive disorders of pregnancy than women carrying an IUGR fetus. The cytoplasmic expression of 8-OHdG was increased in placentas in IUGR cases compared to PE or HELLP pregnancies. In cases after 34-week gestation, p21 was higher in SGA and IUGR than in controls and late PE. Moreover, p53 was increased after 34-week gestation in IUGR pregnancies. Placentas from pathological pregnancies had an altered expression of 8-OHdG, p53, p21, APE1, IL-6, and IL-8. The alterations of intracellular pathways involving these elements may be the cause or the consequence of placental dysfunction, but in any case reflect an impaired placental function, possibly due to increased aging velocity in pathologic cases.
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Affiliation(s)
- Ambrogio P Londero
- Clinic of Obstetrics and Gynecology, Deparment of Experimental Clinical and Medical Science, University of Udine, Piazzale SM della Misericordia, 15, 33100, Udine, Italy. .,Unit of Obstetrics and Gynecology, S. Polo Hospital, 34074, Monfalcone, GO, Italy.
| | - Maria Orsaria
- Department of Medical and Biological Sciences, University of Udine, 33100, Udine, Italy
| | - Stefania Marzinotto
- Department of Medical and Biological Sciences, University of Udine, 33100, Udine, Italy
| | - Tiziana Grassi
- Clinic of Obstetrics and Gynecology, Deparment of Experimental Clinical and Medical Science, University of Udine, Piazzale SM della Misericordia, 15, 33100, Udine, Italy
| | - Arrigo Fruscalzo
- Frauenklinik, St Franziskus Hospital, Münster, Germany.,Clinic of Obstetrics and Gynecology and Institute of Pathology, University Hospital of Münster, Albert-Schweitzer-Campus 1, Gebäude: A1, 48149, Münster, Germany
| | - Angelo Calcagno
- Clinic of Obstetrics and Gynecology, Deparment of Experimental Clinical and Medical Science, University of Udine, Piazzale SM della Misericordia, 15, 33100, Udine, Italy
| | - Serena Bertozzi
- Department of Surgical Oncology, IRCCS CRO, 33081, Aviano, PN, Italy
| | - Nastassia Nardini
- Department of Medical and Biological Sciences, University of Udine, 33100, Udine, Italy
| | - Enrica Stella
- Clinic of Obstetrics and Gynecology, Deparment of Experimental Clinical and Medical Science, University of Udine, Piazzale SM della Misericordia, 15, 33100, Udine, Italy
| | - Ralph J Lellé
- Clinic of Obstetrics and Gynecology and Institute of Pathology, University Hospital of Münster, Albert-Schweitzer-Campus 1, Gebäude: A1, 48149, Münster, Germany
| | - Lorenza Driul
- Clinic of Obstetrics and Gynecology, Deparment of Experimental Clinical and Medical Science, University of Udine, Piazzale SM della Misericordia, 15, 33100, Udine, Italy
| | - Gianluca Tell
- Department of Medical and Biological Sciences, University of Udine, 33100, Udine, Italy
| | - Laura Mariuzzi
- Department of Medical and Biological Sciences, University of Udine, 33100, Udine, Italy
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Maione V, Stinco G, Orsaria M, Chami I, Errichetti E. Yellow plaques in antecubital fossae. J Dtsch Dermatol Ges 2016; 14:535-538. [PMID: 27018987 DOI: 10.1111/ddg.12866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Vincenzo Maione
- Department of Experimental and Clinical Medicine, -Institute of Dermatology, University of Udine, Italy
| | - Giuseppe Stinco
- Department of Experimental and Clinical Medicine, -Institute of Dermatology, University of Udine, Italy
| | | | - Ichrak Chami
- Institute of Dermatology, University of Sfax sud, Hospital Hédi Chaker, Sfax, Tunisia
| | - Enzo Errichetti
- Department of Experimental and Clinical Medicine, -Institute of Dermatology, University of Udine, Italy
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Maione V, Stinco G, Orsaria M, Errichetti E. Interstitial Granulomatous Drug Reaction After Intranasal Desmopressin Administration. Indian J Dermatol 2016; 61:125. [PMID: 26955152 PMCID: PMC4763668 DOI: 10.4103/0019-5154.174175] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Affiliation(s)
- Vincenzo Maione
- Department of Experimental and Clinical Medicine, Institute of Dermatology, Italy. E-mail:
| | - Giuseppe Stinco
- Department of Experimental and Clinical Medicine, Institute of Dermatology, Italy. E-mail:
| | | | - Enzo Errichetti
- Department of Experimental and Clinical Medicine, Institute of Dermatology, Italy. E-mail:
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Fruscalzo A, Orsaria M, Londero AP, Marzinotto S, Nardini N, Driul L, Mariuzzi L. Peculiar Fibronectin immunohistochemical staining in placental tissue of pathological pregnancies associated with insufficient placentation. Z Geburtshilfe Neonatol 2015. [DOI: 10.1055/s-0035-1566683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Orsaria M, Marzinotto S, De Marchi L, Giacomarra V, Boria S, Rubini C, Londero AP, Di Loreto C, Mariuzzi L. HPV-related Oropharyngeal Squamous Cell Carcinoma: p16INK4A Immunohistochemistry or HPV Genotyping? Anticancer Res 2015; 35:4733-4739. [PMID: 26254363] [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] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
BACKGROUND Infection with high-risk human papillomavirus (HPV) is linked to a sub-group of squamous cell oropharyngeal tumors (OPSCC). Our aim was to compare an HPV Polymerase Chain Reaction (PCR) assay and p16(INK4A) expression status by immunohistochemistry (IHC) as a surrogate marker. MATERIALS AND METHODS This was a retrospective study considering patients affected by squamous cell oropharyngeal tumors. All included samples were processed for IHC for p16(INK4A) and tested by PCR for detection of HPV DNA and HPV genotyping. RESULTS A total of 84 patients affected by squamous cell oropharyngeal tumors were included and tested. A significant positive correlation was found between HPV PCR and p16(INK4A) IHC but the agreement was poor (k coefficient of 0.25). In fact, the sensitivity of p16(INK4A) IHC positivity in detecting HPV PCR positivity was low (28.21%, 95% confidence interval=16.54% - 43.78%). CONCLUSION Positivity of p16(INK4A) by IHC had a low sensitivity in detecting HPV DNA and our results suggest the need at least to test p16(INK4A) IHC- negative samples using HPV PCR to increase detection accuracy and provide valuable information for the clinical management of these patients.
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Affiliation(s)
- Maria Orsaria
- Department of Medical and Biological Science, Institute of Anatomic Pathology, University Hospital of Udine, Udine, Italy
| | - Stefania Marzinotto
- Department of Medical and Biological Science, Institute of Anatomic Pathology, University Hospital of Udine, Udine, Italy
| | - Luca De Marchi
- Department of Medical and Biological Science, Institute of Anatomic Pathology, University Hospital of Udine, Udine, Italy
| | - Vittorio Giacomarra
- Division of Otorhinolaryngology, Sant' Antonio Abate Hospital, Tolmezzo, Italy
| | - Silvio Boria
- Division of Otorhinolaryngology, Sant' Antonio Abate Hospital, Tolmezzo, Italy
| | - Corrado Rubini
- Department of Pathologic Anatomy and Histopathology, Marche Polytechnic University, Ancona, Italy
| | | | - Carla Di Loreto
- Department of Medical and Biological Science, Institute of Anatomic Pathology, University Hospital of Udine, Udine, Italy
| | - Laura Mariuzzi
- Department of Medical and Biological Science, Institute of Anatomic Pathology, University Hospital of Udine, Udine, Italy
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Affiliation(s)
- Vincenzo Maione
- Department of Experimental and Clinical Medicine, Institute of Dermatology, University of Udine, Italy
| | - Giuseppe Stinco
- Department of Experimental and Clinical Medicine, Institute of Dermatology, University of Udine, Italy
| | | | - Enzo Errichetti
- Department of Experimental and Clinical Medicine, Institute of Dermatology, University of Udine, Italy
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Grassi T, Calcagno A, Marzinotto S, Londero AP, Orsaria M, Canciani GN, Beltrami CA, Marchesoni D, Mariuzzi L. Mismatch repair system in endometriotic tissue and eutopic endometrium of unaffected women. Int J Clin Exp Pathol 2015; 8:1867-77. [PMID: 25973079 PMCID: PMC4396318] [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] [MESH Headings] [Subscribe] [Scholar Register] [Received: 11/02/2014] [Accepted: 12/22/2014] [Indexed: 06/04/2023]
Abstract
OBJECTIVE To test the immunohistochemical staining pattern of some mismatch repair (MMR) system proteins in endometriotic tissue (ET) and eutopic endometrium. METHODS This was a retrospective study conducted at the Pathology and Obstetrics and Gynecology Departments of the Udine University Hospital. We analyzed 528 samples obtained from 246 patients affected by endometriosis and 71 samples from 71 patients with normal endometrium. A tissue microarray model was used to analyze the immunohistochemical expression of MMR system proteins. RESULTS Significant loss of MMR proteins was found in the stromal component of ETs. We found MSH2 to be expressed at a higher level than any other MMR system proteins in eutopic endometrium and ETs, to be significantly correlated to Ki-67 expression in both stromal and glandular components of ETs, and to be expressed at a significantly higher level in ETs than in eutopic endometrium. When considering the subgroup of endometriosis with high recurrence rate and glandular cytoplasmic staining for aurora A kinase, we found MMR proteins expressed at a significantly higher level in these ETs than in other ETs and eutopic endometrium of unaffected women. CONCLUSIONS We found significant loss of MMR proteins (known to be associated with microsatellite instability) in the stromal component of ETs. The group of ETs with glandular cytoplasmic staining for aurora A kinase had higher MMR protein expression, suggesting an increased activity of this system. Our result suggests a novel role of increased MSH2 expression in cellular proliferation of endometriosis.
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Affiliation(s)
- Tiziana Grassi
- Clinic of Obstetrics and Gynecology, University of Udine33100 Udine, Italy
| | - Angelo Calcagno
- Clinic of Obstetrics and Gynecology, University of Udine33100 Udine, Italy
| | | | - Ambrogio P Londero
- Clinic of Obstetrics and Gynecology, University of Udine33100 Udine, Italy
- Unit of Obstetrics and Gynecology, S. Polo’s Hopital34074 Monfalcone (GO), Italy
| | - Maria Orsaria
- Institute of Pathology, University of Udine33100 Udine, Italy
| | - Gioia N Canciani
- Norwich Medical School, University of East AngliaNorwich, NR4 7TJ, United Kingdom
| | | | - Diego Marchesoni
- Clinic of Obstetrics and Gynecology, University of Udine33100 Udine, Italy
| | - Laura Mariuzzi
- Institute of Pathology, University of Udine33100 Udine, Italy
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Affiliation(s)
- Vincenzo Maione
- Department of Experimental and Clinical Medicine, Institute of Dermatology, University of Udine, Udine, Italy
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Politi M, Robiony M, Avellini C, Orsaria M. Epithelial-myoepithelial carcinoma of the parotid gland: Clinicopathological aspect, diagnosis and surgical consideration. Ann Maxillofac Surg 2014; 4:99-102. [PMID: 24987609 PMCID: PMC4073474 DOI: 10.4103/2231-0746.133085] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
The present paper describes the clinical and pathological features of epithelial-myoepithelial carcinoma (EMC) of the parotid gland. This rare tumor represents <1% of all salivary gland tumors and arises most commonly in the parotid gland, but it has also been described in the submandibular gland, minor salivary glands and palate. EMC is considered to be a low-grade malignant tumor that may commonly recur locally after resection in 23-50% of cases. The complex and varied morphological expression of this neoplasm has attracted numerous investigators, who have presented valuable but often contradictory data. After an in-depth analysis of the clinicopathological aspects of EMC, we speculate that adequate resection with negative soft-tissue margins is the minimum recommended and necessary therapy.
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Affiliation(s)
- Massimo Politi
- Department of Maxillo-Facial Surgery, Institute of Pathology, University of Udine, Udine, Italy
| | - Massimo Robiony
- Department of Maxillo-Facial Surgery, Institute of Pathology, University of Udine, Udine, Italy
| | - Claudio Avellini
- Department of Laboratory Medicine, Institute of Pathology, University of Udine, Udine, Italy
| | - Maria Orsaria
- Department of Laboratory Medicine, Institute of Pathology, University of Udine, Udine, Italy
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Abstract
Acinar dysplasia congenital alveolar dysplasia and alveolar capillary dysplasia with misalignment of pulmonary veins belong to the diffuse developmental disorders (congenital lung dysplasia), very rare fatal disorders of infancy that occur early in lung development. A case of quickly fatal congenital lung dysplasia in a full-term infant is presented and underlines the necessity to suspect this disease in a newborn suffering from severe and refractory respiratory distress.
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Affiliation(s)
- Massimiliano Don
- 1"Sant'Antonio" General Hospital, Pediatric Care Unit, San Daniele del Friuli , Udine , Italy
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Londero AP, Orsaria M, Tell G, Marzinotto S, Capodicasa V, Poletto M, Vascotto C, Sacco C, Mariuzzi L. Expression and prognostic significance of APE1/Ref-1 and NPM1 proteins in high-grade ovarian serous cancer. Am J Clin Pathol 2014; 141:404-14. [PMID: 24515769 DOI: 10.1309/ajcpidkdlsge26cx] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVES To correlate the expression profile of human apurinic endonuclease/redox factor 1 (APE1/Ref-1) with that of nucleolar/nucleoplasmic protein nucleophosmin 1 (NPM1) in association with the aggressiveness and progression of high-grade ovarian serous cancer. METHODS Retrospective study analyzing a tissue microarray of 73 women affected by high-grade ovarian serous cancer. Protein expression was assessed by immunohistochemistry on primary tumor masses and synchronous peritoneal metastases if present. RESULTS APE1/Ref-1 and NPM1 showed a significant correlation in ovarian serous cancer. Patients with a poorer outcome showed a significant overexpression of nuclear NPM1 protein. A Cox proportional hazards multivariate regression model revealed NPM1 expression to be independently significant for overall survival in high-grade ovarian serous cancers after correcting for stage, age, cytoreduction completeness, and platinum resistance. CONCLUSIONS APE1/Ref-1 interacts with NPM1 to control the DNA damage repair system, and it is likely that this interaction plays a defining role in high-grade ovarian serous carcinoma. A high NPM1 immunohistochemical expression was independently correlated with a shorter survival period and thus appears to be an important prognostic factor.
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Affiliation(s)
- Ambrogio P. Londero
- Deparment of Experimental Clinical and Medical Science, Clinic of Obstetrics and Gynecology, University of Udine, Udine, Italy
| | - Maria Orsaria
- Department of Medical and Biological Sciences, University of Udine, Udine, Italy
| | - Gianluca Tell
- Department of Medical and Biological Sciences, University of Udine, Udine, Italy
| | - Stefania Marzinotto
- Department of Medical and Biological Sciences, University of Udine, Udine, Italy
| | - Valentina Capodicasa
- Deparment of Experimental Clinical and Medical Science, Clinic of Obstetrics and Gynecology, University of Udine, Udine, Italy
| | - Mattia Poletto
- Department of Medical and Biological Sciences, University of Udine, Udine, Italy
| | - Carlo Vascotto
- Department of Medical and Biological Sciences, University of Udine, Udine, Italy
| | - Cosimo Sacco
- Clinic of Oncology, University Hospital of Udine, Udine, Italy
| | - Laura Mariuzzi
- Department of Medical and Biological Sciences, University of Udine, Udine, Italy
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Alomari A, Rauch PJ, Orsaria M, Minja FJ, Chiang VL, Vortmeyer AO. Radiologic and histologic consequences of radiosurgery for brain tumors. J Neurooncol 2014; 117:33-42. [PMID: 24442402 DOI: 10.1007/s11060-014-1359-8] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2013] [Accepted: 01/06/2014] [Indexed: 10/25/2022]
Abstract
Progressively enlarging encephalopathic changes are now well-documented effects of gamma knife radiosurgery (GKRS) occurring ~3-30 months after treatment of both benign and malignant brain lesions. These changes can be variably associated with inflammatory demyelination and necrosis and/or recurrent tumor. While radiographic differentiation between encephalopathic changes and recurrent tumor is of high clinical relevance, confident interpretation of post-radiosurgery imaging changes can be challenging or even impossible in some cases. Gadolinium-enhanced MRI of these lesions reveals variable amounts of enhancing and non-enhancing components within these lesions that have not been clearly correlated with structural-pathologic change. The goal of this study is to characterize the histopathological changes associated with enhancing versus non-enhancing regions of GKRS-treated lesions. MRI images of patients with progressive, etiologically ambiguous brain lesions following GKRS were reviewed prior to explorative neurosurgery. Chosen for this study were lesions in which distinct areas of enhancement and non-enhancement of at least 5 mm in size could be identified (n = 16). Distinctly enhancing and non-enhancing areas were separately biopsied and histologically evaluated. Only cases with uniform histological results are presented in this study. Enhancing and non-enhancing areas in post GKRS lesions represent separate pathological changes. Radiographically enhancing areas correlate either with recurrent tumor growth or inflammatory demyelinating changes. Lack of radiographic enhancement correlates with coagulative necrosis if the sample is taken from the center of the lesion, or with reactive astrocytosis if the sample is taken from the periphery. Separate biopsy of enhancing and non-enhancing regions of post-GKRS encephalopathy was able to confirm that the pathologies in these areas are distinct. These findings allow for better-informed correlation of histological and radiological changes and a better understanding of post-treatment tissue pathology.
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Affiliation(s)
- Ahmed Alomari
- Neuropathology Program, Department of Pathology, Yale University School of Medicine, 416A Lauder Hall, 310 Cedar Street, New Haven, CT, 06520, USA
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Orsaria M, Marzinotto S, Mariuzzi L. Large solitary fibrous tumour of the retroperitoneum: a case report and review of the literature. Scott Med J 2013; 58:e26-30. [PMID: 24215055 DOI: 10.1177/0036933013508050] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
INTRODUCTION This report describes an unusual case of a large solitary fibrous tumour (SFT) arising in the retroperitoneum. CASE PRESENTATION A 53-year-old woman presented at the Emergency Department with urinary retention and lumbar pain. The urological examination was negative, whereas a presacral retroperitoneal mass was disclosed on ultrasound. The laboratory studies, including tumour markers, were negative. On laparotomy, it was not possible to remove the mass completely due to the difficulty of dissecting it free of the sacrum. Grossly, the fragment had a yellowish-white surface, with areas of necrosis and haemorrhage. On immunohistochemistry, tumour cells were positive for CD34, CD99 and Bcl-2 and negative for CD45, synaptophysin, chromogranin, S100, neuron-specific enolase, CK AE1-AE3, CK7, Wilms' tumour 1, smooth muscle actin, factor VIII, myogenin, epithelial membrane antigen, thyroid transcription factor-1 and CD117, leading to a diagnosis of SFT. Molecular investigation ruled out synovial sarcoma. CONCLUSION Although SFT usually has a favourable prognosis, close follow-up is recommended due to the limited information on its long-term behaviour.
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Affiliation(s)
- M Orsaria
- Medical Doctor (MD), Department of Pathology, University Hospital of Udine, Italy
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Orsaria M, Khelifa S, Buza N, Kamath A, Hui P. Chromosome 17 polysomy: correlation with histological parameters and HER2NEU gene amplification. J Clin Pathol 2013; 66:1070-5. [DOI: 10.1136/jclinpath-2013-201506] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
AimsHER2NEU gene amplification is present in the majority of invasive breast carcinomas that have HER2 protein overexpression. A subset of breast cancers harbour an increased chromosome 17 (CEP17) copy number (polysomy 17). We investigated the clinicopathologic significance of polysomy 17 in correlation with various histological parameters and HER2NEU gene amplification.MethodsWe collected the surgical specimens of 266 consecutive cases of primary invasive breast carcinomas. HER2NEU gene status and CEP17 copy numbers were assessed by fluorescent in situ hybridisation (FISH). Chromosome 17 polysomy was determined by the presence of ≥3 average CEP17 signals per nucleus.Results63 tumours (23.7%) harboured polysomy 17. Carcinomas with polysomy 17 were associated with adverse histological indicators including high histological grade, high nuclear grade, poor Nottingham Prognostic Index, advanced local tumour extent and progesterone receptor negativity. Polysomy 17 was common to HER2NEU amplified and unamplified tumours, and more frequently observed in HER2NEU unamplified (71.4%) cases.Conclusions In the absence of the gene amplification, HER2 protein overexpression may be explained by other mechanisms including polysomy 17.
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Londero A, Orsaria M, Fruscalzo A, Marzinotto S, Calcagno A, Grassi T, Vascotto C, Driul L, Beltrami CA, Tell G, Marchesoni D, Mariuzzi L. Placental expression of p53 and p21 in pregnancies affected by pre-eclampsia, HELLP, and controls. Geburtshilfe Frauenheilkd 2013. [DOI: 10.1055/s-0033-1347733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Calcagno A, Grassi T, Mariuzzi L, Marzinotto S, Londero AP, Orsaria M, Beltrami CA, Marchesoni D. Expression patterns of Aurora A and B kinases, Ki-67 and the estrogen and progesterone receptors determined using an endometriosis tissue microarray model. Hum Reprod 2011; 26:2731-41. [DOI: 10.1093/humrep/der264] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Avellini C, Orsaria M, Baccarani U, Adani GL, Lorenzin D, Bresadola V, Bresadola F, Beltrami CA. Apurinic apyrimidinic endonuclease/redox effector factor 1 immunoreactivity and grading in hepatocellular carcinoma risk of relapse after liver transplantation. Transplant Proc 2010; 42:1204-8. [PMID: 20534262 DOI: 10.1016/j.transproceed.2010.03.045] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Apurinic apyrimidinic endonuclease (APE1)/redox effector factor 1 (Ref-1), which is a multifunction protein involved in both transcriptional regulation of gene expression during adaptive cellular responses to oxidative stress and in the base excision repair pathway of DNA lesions generated as a consequence of oxidant-induced base damage, contributes to the maintenance of genome stability. APE1/Ref-1 is normally localized in the nucleus; cytoplasmic localization observed in several tumors has been correlated with a poor prognosis. Hepatocellular carcinoma (HCC) grading is an essential tool to predict the risk of relapse and patient prognosis, particularly in patients undergoing liver transplantation (OLT). The aim of this study was to identify the role of APE1/Ref-1 in predicting a posttransplant HCC relapse. We studied 48 patients transplanted for HCC to define grading as well as nuclear and cytoplasmic APE1/Ref-1 expression within neoplastic versus nonneoplastic parenchyma. We defined a cutoff of 60% of cytoplasmic APE1/Ref-1 expression to identify positive cases. At a minimum of 1.5-year follow-up after transplantation, 32 patients are alive and 16 patients are deceased after HCC relapse. Among low-grade HCC (grades 1 and 2), 76% of cases are alive; only 34% showed cytoplasmic APE1/Ref-1 immunoreactivity. Among the high-grade cases (grades 3 and 4), 50% were alive with 64% showing cytoplasmic immunoreactivity. Nuclear reactivity was generally similar either in neoplastic or in cirrhotic livers, irrespective of the grade. These data seemed to support the hypothesis of a predictive role of APE1/Ref-1 for HCC risk of relapse, which together with tumor grade by analysis of a pretransplant needle biopsy should aid decision making for OLT.
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Affiliation(s)
- C Avellini
- Department of Pathology, University Hospital Udine, Udine, Italy
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Avellini C, Baccarani U, Orsaria M, Adani G, Bresadola V, Lorenzin D, Bresadola F, Beltrami C. Evaluation of Prostate Cancer Staging in Organ Donors: Intraoperative Histology on Periglandular Soft Tissues—A Proposal. Transplant Proc 2009; 41:1099-103. [DOI: 10.1016/j.transproceed.2009.03.089] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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