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Turri-Zanoni M, Maragliano R, Battaglia P, Giovannardi M, Antognoni P, Lombardi D, Morassi ML, Pasquini E, Tarchini P, Asioli S, Foschini MP, Sessa F, Nicolai P, Castelnuovo P, La Rosa S. The clinicopathological spectrum of olfactory neuroblastoma and sinonasal neuroendocrine neoplasms: Refinements in diagnostic criteria and impact of multimodal treatments on survival. Oral Oncol 2018; 74:21-29. [PMID: 29103747 DOI: 10.1016/j.oraloncology.2017.09.010] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [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: 05/21/2017] [Revised: 08/14/2017] [Accepted: 09/13/2017] [Indexed: 12/23/2022]
Abstract
OBJECTIVES To provide a comprehensive review of the clinical and histopathological features of olfactory neuroblastoma (ONB) and other sinonasal neuroendocrine neoplasms (NENs), in order to refine diagnostic criteria, analyze treatment outcomes, and identify prognostic factors. METHODS Data from an Italian multi-institutional database were analyzed. Patients were treated surgically via a minimally-invasive endoscopic approach followed by adjuvant radiotherapy or radiochemotherapy. Neoadjuvant cisplatin/etoposide chemotherapy was administered in cases of poorly-differentiated tumors. A centralized pathology review was performed in all cases. Patients were prospectively observed for survival. Overall (OS) and Disease-free survival (DFS) estimates were determined from Kaplan-Meier analysis and compared using the log-rank test. Statistically significant variables were entered in a multivariate Cox regression model. RESULTS 98 patients with a median follow-up of 53months were included. Morphology review and the incorporation of cytokeratin 8/18 in the immunohistochemical panel modified the final diagnosis in 8/98 (8.2%) cases. The neoplasms were ultimately classified into four groups with different immunohistochemical profiles and clinical behaviors: ONB in 67 cases (5-year-OS, 91.6%); NEC (poorly-differentiated neuroendocrine carcinoma) in 22 cases (5-year-OS, 42.6%); MiNEN (mixed neuroendocrine/non-neuroendocrine neoplasm) in five cases (5-year-OS, 0%,0/5 cases); and NET (well-differentiated neuroendocrine tumor) in four cases (5-year-OS, 50%, 2/4 cases). Hyams grade and Ki67 index were independent prognostic factors for ONB. Neoadjuvant chemotherapy appeared to be associated with improved OS and DFS for NEC, independent of other clinicopathological variables. CONCLUSIONS Induction chemotherapy improves survival outcomes in patients affected by poorly-differentiated tumors. Recent advances in histopathological diagnosis, including CK8/18 staining, allow to plan the most appropriate range of multimodal treatments.
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Affiliation(s)
- Mario Turri-Zanoni
- Unit of Otorhinolaryngology, Department of Biotechnology and Life Sciences, University of Insubria, Ospedale di Circolo e Fondazione Macchi, Varese, Italy; Head and Neck Surgery & Forensic Dissection Research Center (HNS & FDRc), Department of Biotechnology and Life Sciences, University of Insubria, Varese, Italy.
| | - Roberta Maragliano
- Unit of Pathology, Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Paolo Battaglia
- Unit of Otorhinolaryngology, Department of Biotechnology and Life Sciences, University of Insubria, Ospedale di Circolo e Fondazione Macchi, Varese, Italy; Head and Neck Surgery & Forensic Dissection Research Center (HNS & FDRc), Department of Biotechnology and Life Sciences, University of Insubria, Varese, Italy
| | - Marta Giovannardi
- Unit of Biostatistics, Department of Statistics, Monzino Hospital, Milan, Italy
| | - Paolo Antognoni
- Unit of Radiation Oncology, University of Insubria, Varese, Italy
| | - Davide Lombardi
- Unit of Otorhinolaryngology, Spedali Civili di Brescia, University of Brescia, Italy
| | | | - Ernesto Pasquini
- Ear, Nose and Throat Metropolitan Unit, Azienda Unità Sanitaria Locale di Bologna, Bologna, Italy
| | - Paolo Tarchini
- Ear, Nose and Throat Metropolitan Unit, Azienda Unità Sanitaria Locale di Bologna, Bologna, Italy
| | - Sofia Asioli
- Unit of Pathology, Bellaria Hospital, Department of Biomedical and Neuromotor Sciences, University of Bologna, Italy
| | - Maria Pia Foschini
- Unit of Pathology, Bellaria Hospital, Department of Biomedical and Neuromotor Sciences, University of Bologna, Italy
| | - Fausto Sessa
- Unit of Pathology, Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Piero Nicolai
- Unit of Otorhinolaryngology, Spedali Civili di Brescia, University of Brescia, Italy
| | - Paolo Castelnuovo
- Unit of Otorhinolaryngology, Department of Biotechnology and Life Sciences, University of Insubria, Ospedale di Circolo e Fondazione Macchi, Varese, Italy; Head and Neck Surgery & Forensic Dissection Research Center (HNS & FDRc), Department of Biotechnology and Life Sciences, University of Insubria, Varese, Italy
| | - Stefano La Rosa
- Service of Clinical Pathology, Institute of Pathology, Lausanne University Hospital, Lausanne, Switzerland
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Tarchini P, Farneti P, Bellusci A, Sciarretta V, Donini E, Frezza G, Tosoni A, Brandes A, Pasquini E. PO-134: Retrospective analysis of treatment outcomes of sinonasal malignancies. Our 22-year experience. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)30268-2] [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: 10/19/2022]
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Re M, Tarchini P, Gioacchini FM, Pasquini E. Endonasal endoscopic approach for removal of intraorbital cavernous hemangioma in childhood. Head Neck 2015; 38:E1-6. [PMID: 25214061 DOI: 10.1002/hed.23856] [Citation(s) in RCA: 7] [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] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/09/2014] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Orbital cavernous hemangiomas are the most common primary benign orbital tumors in adults. Although a rudimentary lesion may be present at birth, cavernous hemangiomas do not usually become symptomatic until the third to fifth decade of life and lesions occurring in pediatric age are quite rare. Surgical treatment is indicated in symptomatic cases, and surgical approach is planned according to the localization of the tumor in the orbit. METHODS AND RESULTS We described the first case of pediatric intraorbital extraconal cavernous hemangioma, treated successfully by a pure endoscopic endonasal approach, and demonstrated the minimal invasiveness of this approach, without skin incision and neurovascular retraction. Review of the literature, surgical technique, pitfalls, and differences from previous reports are discussed. CONCLUSION Endoscopic transnasal approaches can now be considered as an alternative option to traditional external approaches in the management of medial and inferior orbital lesions in childhood.
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Affiliation(s)
- Massimo Re
- Department of Otorhinolaryngology, Università Politecnica delle Marche, Ancona, Italy
| | - Paolo Tarchini
- Department of Otorhinolaryngology, Local Health Service, Bologna, Italy
| | - Federico M Gioacchini
- Department of Otorhinolaryngology, Università Politecnica delle Marche, Ancona, Italy
| | - Ernesto Pasquini
- Department of Otorhinolaryngology, Local Health Service, Bologna, Italy
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Staffolani S, Manzella N, Strafella E, Nocchi L, Bracci M, Ciarapica V, Amati M, Rubini C, Re M, Pugnaloni A, Pasquini E, Tarchini P, Valentino M, Tomasetti M, Santarelli L. Wood dust exposure induces cell transformation through EGFR-mediated OGG1 inhibition. Mutagenesis 2015; 30:487-97. [PMID: 25711499 DOI: 10.1093/mutage/gev007] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
A high risk of neoplastic transformation of nasal and paranasal sinuses mucosa is related to the occupational exposure to wood dust. However, the role of occupational exposures in the aetiology of the airway cancers remains largely unknown. Here, an in vitro model was performed to investigate the carcinogenic effect of wood dusts. Human bronchial epithelial cells were incubated with hard and soft wood dusts and the DNA damage and response to DNA damage evaluated. Wood dust exposure induced accumulation of oxidised DNA bases, which was associated with a delay in DNA repair activity. By exposing cells to wood dust at a prolonged time, wood dust-initiated cells were obtained. Initiated-cells were able to form colonies in soft agar, and to induce blood vessel formation. These cells showed extensive autophagy, reduced DNA repair, which was associated with reduced OGG1 expression and oxidised DNA base accumulation. These events were found related to the activation of EGFR/AKT/mTOR pathway, through phosphorylation and subsequent inactivation of tuberin. The persistence in the tissue of wood dusts, their repetitious binding with EGFR may continually trigger the activation switch, leading to chronic down-regulation of genes involved in DNA repair, leading to cell transformation and proliferation.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Massimo Re
- Department of Clinical Sciences, Polytechnic University of Marche, via Tronto, 10A, 60020 Ancona, Italy
| | | | - Ernesto Pasquini
- UOC-ORL Budrio-Metropolitan Hospital Via Benni, 44, Budrio 40054, Bologna, Italy and
| | - Paolo Tarchini
- Department of E.N.T. Polyclinic 'Sant'Orsola Malpighi' Otolaryngology Clinic, University of Bologna Via Pietro Albertoni, 15, 40138, Bologna, Italy
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Bracci M, Mariotti L, Staffolani S, Strafella E, Carlucci C, Pasquini E, Tarchini P, Re M, Santarelli L. [Sinonasal carcinoma and exposure to wood and leather dust: analysis of 36 cases]. G Ital Med Lav Ergon 2012; 34:612-614. [PMID: 23405730] [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: 06/01/2023]
Abstract
In order to define the best strategies of prevention and diagnosis of sinonasal cancer, the aim of our study was the investigation of the etiological and prognostic factors related to 36 cases. The enrolled cases were composed mostly of men working in the footwear industry, with a mean age of 63.7 years and mean exposure of 34.6 years. The period between the start of exposure and the appearance of the neoplasm was of 44.6 years, the time between the onset of symptoms and diagnosis was of 10.8 months. Our results suggest that a diagnosis within 6 months after the onset of symptoms is associated with a lower tumor stage, a better survival and to a lower rate of recurrence. Nasal obstruction (58.3%) and epistaxis (52.7%) are the main initial symptoms. In order to obtain an early diagnosis, in addition to periodic clinical controls, a proper information of workers is required.
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Affiliation(s)
- M Bracci
- Medicina del Lavoro, Dipartimento di Scienze Cliniche e Molecolari, Facoltà di Medicina e Chirurgia, Università Politecnica delle Marche, Ancona, Italy.
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Re M, Magliulo G, Tarchini P, Mallardi V, Rubini C, Santarelli A, Lo Muzio L. p53 and BCL-2 over-expression inversely correlates with histological differentiation in occupational ethmoidal intestinal-type sinonasal adenocarcinoma. Int J Immunopathol Pharmacol 2011; 24:603-9. [PMID: 21978692 DOI: 10.1177/039463201102400306] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Despite their histological resemblance to colorectal adenocarcinoma, there is little information on the molecular events involved in the pathogenesis of intestinal-type sinonasal adenocarcinoma (ITACs). The aim of this paper is to evaluate the possible role of TP53 and Bcl-2 gene defects in ITAC by investigating the immunohistochemical expression of TP53 and Bcl-2 gene products in a group of ethmoidal ITACs associated with occupational exposure. A retrospective study on 15 patients with pathological diagnosis of primary ethmoidal ITAC was conducted. Representative formalin-fixed, paraffin wax-embedded block from each case was selected for immunohistochemical studies using the antibodies against p53 and Bcl-2. Clinical-pathological data were also correlated with the staining results. The results of immunohistochemical examination demonstrated that poorly differentiated cases showed a higher percentage of p53 and Bcl-2 expressing cells in comparison to well-differentiated cases. No correlation was found with other clinico-pathological parameters, including T, stage and relapses. The relationship between up-regulation of p53 and Bcl-2 and poorly differentiated ethmoidal adenocarcinoma suggests a role of these genes, in combination with additional genetic events, in the pathogenesis of ITAC.
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Affiliation(s)
- M Re
- Department of Otorhinolaryngology, Marche Polytechnic University, Ancona, Italy
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Barbieri S, Pirovano C, Scarlato G, Tarchini P, Zappa A, Maranzana M. Long-term effects of 2,3,7,8-tetrachlorodibenzo-p-dioxin on the peripheral nervous system. Clinical and neurophysiological controlled study on subjects with chloracne from the Seveso area. Neuroepidemiology 1988; 7:29-37. [PMID: 2829044 DOI: 10.1159/000110133] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
This work was set up to investigate the possible presence of peripheral nervous system involvement as a long-term effect of the exposure to dioxin in 152 subjects with chloracne from the Seveso area; 123 age- and sex-matched subjects living in nearby towns with similar environmental pollution formed the control group. The accident in Seveso took place in July, 1976, and this study was carried out from October, 1982, to May, 1983. Although a peripheral neuropathy was not found in any of the subjects, a significant increase of the number of individuals presenting at least two bilateral clinical signs (p less than 0.05) or one abnormal electrophysiological parameter (p less than 0.02) was found in the Seveso group. Principal component analysis did not show any subdivision between these two groups. The Fisher approach to discriminant analysis reveals a clear subdivision between the group of the most exposed subjects and randomly selected subgroups of control subjects. In conclusion, clinical and electrophysiological signs of peripheral nervous system involvement occur with a statistically increased frequency in the Seveso population 6 years after the accident, although a peripheral neuropathy was not evident in any of the chloracne patients using the World Health Organization diagnostic criteria.
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Affiliation(s)
- S Barbieri
- Istituto Clinica Neurologica, University of Milan, Italy
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