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Rocco G, Pennazza G, Tan KS, Vanstraelen S, Santonico M, Corba RJ, Park BJ, Sihag S, Bott MJ, Crucitti P, Isbell JM, Ginsberg MS, Weiss H, Incalzi RA, Finamore P, Longo F, Zompanti A, Grasso S, Solomon SB, Vincent A, McKnight A, Cirelli M, Voli C, Kelly S, Merone M, Molena D, Gray K, Huang J, Rusch VW, Bains MS, Downey RJ, Adusumilli PS, Jones DR. A real-world assessment of stage I lung cancer through electronic nose technology. J Thorac Oncol 2024:S1556-0864(24)00211-9. [PMID: 38762120 DOI: 10.1016/j.jtho.2024.05.006] [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: 03/07/2024] [Revised: 04/03/2024] [Accepted: 05/02/2024] [Indexed: 05/20/2024]
Abstract
INTRODUCTION Electronic nose (E-nose) technology has demonstrated excellent sensitivity and specificity in the setting of lung cancer screening. However, the performance of E-nose specifically for early-stage tumors remains unclear. Therefore, the aim of our study was to assess the diagnostic performance of E-nose technology in clinical stage I lung cancer. METHODS This Phase-IIc trial (NCT04734145) included patients diagnosed with a single ≥50% solid stage I nodule. Exhalates were prospectively collected from January 2020 to August 2023. Blinded bioengineers analyzed the exhalates, using E-nose technology to determine the probability of malignancy. Patients were stratified into 3 risk groups (low-risk, <0.2; moderate-risk, ≥0.2 to 0.7; high-risk, ≥0.7). The primary outcome was the diagnostic performance of E-nose versus histopathology (accuracy and F1 score). The secondary outcome was the clinical performance of the E-nose versus clinicoradiological prediction models. RESULTS Based on the predefined cut-off (<0.20), E-nose agreed with histopathological results in 86% of cases, achieving an F1 score of 92.5%, based on 86 true positives, 2 false negatives, and 12 false positives (n=100). Compared with Swensen and Brock models, E-nose would refer fewer patients with malignant nodules to observation (Low-risk: 2 vs. 9 and 11; respectively; p=0.028 and p=0.011) and more patients with malignant nodules to treatment without biopsy (High-risk: 27 vs. 19 and 6; respectively; p=0.057 and p<0.001). CONCLUSIONS In the setting of clinical stage I lung cancer, E-nose has good agreement with histopathology. Accordingly, E-nose technology can be used in addition to imaging or as part of a "multiomics" platform.
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Affiliation(s)
- Gaetano Rocco
- Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Druckenmiller Center for Lung Cancer Research, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
| | - Giorgio Pennazza
- Department of Engineering, Unit of Electronics for Sensor Systems, Università Campus Bio-Medico di Roma, Rome, Italy
| | - Kay See Tan
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Stijn Vanstraelen
- Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Marco Santonico
- Department of Science and Technology for Sustainable Development and One Health, Unit of Electronics for Sensor Systems, Università Campus Bio-Medico di Roma, Rome, Italy
| | - Robert J Corba
- Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Bernard J Park
- Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Smita Sihag
- Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Matthew J Bott
- Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Pierfilippo Crucitti
- Department of Thoracic Surgery, Università Campus Bio-Medico di Roma, Rome, Italy
| | - James M Isbell
- Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Michelle S Ginsberg
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Hallie Weiss
- Department of Anesthesiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Raffaele Antonelli Incalzi
- Department of Geriatrics, Research Unit of Internal Medicine, Università Campus Bio-Medico di Roma, Rome, Italy
| | - Panaiotis Finamore
- Department of Thoracic Surgery, Università Campus Bio-Medico di Roma, Rome, Italy
| | - Filippo Longo
- Department of Thoracic Surgery, Università Campus Bio-Medico di Roma, Rome, Italy
| | - Alessandro Zompanti
- Department of Engineering, Unit of Electronics for Sensor Systems, Università Campus Bio-Medico di Roma, Rome, Italy
| | - Simone Grasso
- Department of Science and Technology for Sustainable Development and One Health, Unit of Electronics for Sensor Systems, Università Campus Bio-Medico di Roma, Rome, Italy
| | - Stephen B Solomon
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Alain Vincent
- Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Alexa McKnight
- Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Michael Cirelli
- Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Carmela Voli
- Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Susan Kelly
- Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Mario Merone
- Department of Engineering, Unit of Computational Systems and Bioinformatics, Università Campus Bio-Medico di Roma, Rome, Italy
| | - Daniela Molena
- Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Katherine Gray
- Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - James Huang
- Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Valerie W Rusch
- Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Manjit S Bains
- Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Robert J Downey
- Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Prasad S Adusumilli
- Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - David R Jones
- Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Druckenmiller Center for Lung Cancer Research, Memorial Sloan Kettering Cancer Center, New York, NY, USA
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Takada K, Takamori S, Brunetti L, Crucitti P, Cortellini A. Impact of Neoadjuvant Immune Checkpoint Inhibitors on Surgery and Perioperative Complications in Patients With Non-small-cell Lung Cancer: A Systematic Review. Clin Lung Cancer 2023; 24:581-590.e5. [PMID: 37741717 DOI: 10.1016/j.cllc.2023.08.017] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 08/11/2023] [Accepted: 08/31/2023] [Indexed: 09/25/2023]
Abstract
Several clinical trials are currently underway to evaluate immune checkpoint inhibitors (ICIs) as neoadjuvant treatment for patients with early-stage non-small-cell lung cancer (NSCLC), and their use in clinical practice is expected to increase in the future. Therefore, a proper assessment of surgical outcomes and perioperative complications after neoadjuvant ICIs is essential to establish recommendations and guidelines. We performed a systematic literature review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines (PRISMA), searching the PubMed and Scopus databases from the January 1, 2017, to the July 27, 2023, to identify potentially relevant published trials of neoadjuvant ICIs in patients with reseactable NSCLC with available information on surgical outcomes and perioperative complications. A total of 18 studies were included in the review. The rates of surgery cancellation ranged from 0% to 45.8%. Importantly, adverse events (AEs) were the least reported underlying cause, while disease progression caused from 0% to 75% of cancellations. Surgery delays ranged from 0% to 31.3% with AEs as the most frequently reported underlying cause. However, 6 out of 13 trials (46.2%) reported no surgery delays. Conversion rates from minimally invasive to open chest surgery were available for 7 trials and ranged from 0% to 53.8%. Thirty-day mortality rates ranged from 0% to 5.4%, with 11 out of 16 trials reporting 0%. A few reports described perioperative complications in detail. Considering the limited evidence available, we can preliminarily confirm that preoperative ICIs are safe and well tolerated even from the surgical perspective. Additional details on intraoperative findings from prospective controlled trials are needed to establish and disseminate guidelines and recommendations for thoracic surgeons.
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Affiliation(s)
- Kazuki Takada
- Department of Surgery, Saiseikai Fukuoka General Hospital, Fukuoka, Japan
| | - Shinkichi Takamori
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Leonardo Brunetti
- Medical Oncology Department, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
| | - Pierfilippo Crucitti
- Thoracic Surgery Department, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo 200, 00128, Rome, Italy
| | - Alessio Cortellini
- Medical Oncology Department, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy; Department of Surgery and Cancer, Hammersmith Hospital Campus, Imperial College London, London, UK.
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Bellantuono L, Tommasi R, Pantaleo E, Verri M, Amoroso N, Crucitti P, Di Gioacchino M, Longo F, Monaco A, Naciu AM, Palermo A, Taffon C, Tangaro S, Crescenzi A, Sodo A, Bellotti R. An eXplainable Artificial Intelligence analysis of Raman spectra for thyroid cancer diagnosis. Sci Rep 2023; 13:16590. [PMID: 37789191 PMCID: PMC10547772 DOI: 10.1038/s41598-023-43856-7] [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] [Received: 06/30/2023] [Accepted: 09/29/2023] [Indexed: 10/05/2023] Open
Abstract
Raman spectroscopy shows great potential as a diagnostic tool for thyroid cancer due to its ability to detect biochemical changes during cancer development. This technique is particularly valuable because it is non-invasive and label/dye-free. Compared to molecular tests, Raman spectroscopy analyses can more effectively discriminate malignant features, thus reducing unnecessary surgeries. However, one major hurdle to using Raman spectroscopy as a diagnostic tool is the identification of significant patterns and peaks. In this study, we propose a Machine Learning procedure to discriminate healthy/benign versus malignant nodules that produces interpretable results. We collect Raman spectra obtained from histological samples, select a set of peaks with a data-driven and label independent approach and train the algorithms with the relative prominence of the peaks in the selected set. The performance of the considered models, quantified by area under the Receiver Operating Characteristic curve, exceeds 0.9. To enhance the interpretability of the results, we employ eXplainable Artificial Intelligence and compute the contribution of each feature to the prediction of each sample.
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Affiliation(s)
- Loredana Bellantuono
- Dipartimento di Biomedicina Traslazionale e Neuroscienze (DiBraiN), Università degli Studi di Bari Aldo Moro, 70124, Bari, Italy
- Istituto Nazionale di Fisica Nucleare, Sezione di Bari, 70125, Bari, Italy
| | - Raffaele Tommasi
- Dipartimento di Biomedicina Traslazionale e Neuroscienze (DiBraiN), Università degli Studi di Bari Aldo Moro, 70124, Bari, Italy
| | - Ester Pantaleo
- Istituto Nazionale di Fisica Nucleare, Sezione di Bari, 70125, Bari, Italy
- Dipartimento Interateneo di Fisica, Università degli Studi di Bari Aldo Moro, 70125, Bari, Italy
| | - Martina Verri
- Unit of Endocrine Organs and Neuromuscolar Pathology, Fondazione Policlinico Universitario Campus Bio-Medico, 00128, Rome, Italy
- Dipartimento di Scienze, Università degli Studi Roma Tre, 00146, Roma, Italy
| | - Nicola Amoroso
- Istituto Nazionale di Fisica Nucleare, Sezione di Bari, 70125, Bari, Italy
- Dipartimento di Farmacia-Scienze del Farmaco, Università degli Studi di Bari Aldo Moro, 70125, Bari, Italy
| | - Pierfilippo Crucitti
- Unit of Thoracic Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, 00128, Rome, Italy
| | | | - Filippo Longo
- Unit of Thoracic Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, 00128, Rome, Italy
| | - Alfonso Monaco
- Istituto Nazionale di Fisica Nucleare, Sezione di Bari, 70125, Bari, Italy
- Dipartimento Interateneo di Fisica, Università degli Studi di Bari Aldo Moro, 70125, Bari, Italy
| | - Anda Mihaela Naciu
- Unit of Metabolic Bone and Thyroid Diseases, Fondazione Policlinico Universitario Campus Bio-Medico, 00128, Rome, Italy
| | - Andrea Palermo
- Unit of Metabolic Bone and Thyroid Diseases, Fondazione Policlinico Universitario Campus Bio-Medico, 00128, Rome, Italy
| | - Chiara Taffon
- Unit of Endocrine Organs and Neuromuscolar Pathology, Fondazione Policlinico Universitario Campus Bio-Medico, 00128, Rome, Italy
| | - Sabina Tangaro
- Istituto Nazionale di Fisica Nucleare, Sezione di Bari, 70125, Bari, Italy
- Dipartimento di Scienze del Suolo, della Pianta e degli Alimenti, Università degli Studi di Bari Aldo Moro, 70125, Bari, Italy
| | - Anna Crescenzi
- Unit of Endocrine Organs and Neuromuscolar Pathology, Fondazione Policlinico Universitario Campus Bio-Medico, 00128, Rome, Italy
| | - Armida Sodo
- Dipartimento di Scienze, Università degli Studi Roma Tre, 00146, Roma, Italy
| | - Roberto Bellotti
- Istituto Nazionale di Fisica Nucleare, Sezione di Bari, 70125, Bari, Italy
- Dipartimento Interateneo di Fisica, Università degli Studi di Bari Aldo Moro, 70125, Bari, Italy
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Marziali V, Frasca L, Ambrogi V, Patirelis A, Longo F, Crucitti P. Prognostic significance of uncertain resection for metastasis in the highest mediastinal lymph node after surgery for clinical N0 non-small cell lung cancer. Front Surg 2023; 10:1115696. [PMID: 37396297 PMCID: PMC10308307 DOI: 10.3389/fsurg.2023.1115696] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Accepted: 06/01/2023] [Indexed: 07/04/2023] Open
Abstract
Background The International Association for the Study of Lung Cancer defined types of surgical resection and considered the positivity of the highest mediastinal lymph node resected a parameter of "uncertain resection" (R-u). We investigated the metastases in the highest mediastinal lymph node, defined as the lowest numerically numbered station among those resected. We aimed to evaluate the prognostic value of R-u compared with R0. Materials and methods We selected 550 patients with non-small cell lung cancer at clinical Stage I, IIA, IIB (T3N0M0), or IIIA (T4N0M0) undergoing lobectomy and systematic lymphadenectomy between 2015 and 2020. The R-u group included patients with positive highest mediastinal resected lymph node. Results In the groups of patients with mediastinal lymph node metastasis, we defined 31 as R-u (45.6%, 31/68). The incidence of metastases in the highest lymph node was related to the pN2 subgroups (p < 0.001) and the type of lymphadenectomy performed (p < 0.001). The survival analysis compared R0 and R-u: 3-year disease-free survival was 69.0% and 20.0%, respectively, and 3-year overall survival was 78.0% and 40.0%, respectively. The recurrence rate was 29.7% in R0 and 71.0% in R-u (p-value < 0.001), and the mortality rate was 18.9% and 51.6%, respectively (p-value < 0.001). R-u variable showed a tendency to be a significant prognostic factor for disease-free survival and overall survival (hazard ratio: 4.6 and 4.5, respectively, p-value < 0.001). Conclusions The presence of metastasis in the highest mediastinal lymph node removed seems to be an independent prognostic factor for mortality and recurrence. The finding of these metastases represents the margin of cancer dissemination at the time of surgery, so it could imply metastasis into the N3 node or distant metastasis.
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Affiliation(s)
| | - Luca Frasca
- Department of Thoracic Surgery, University Campus Bio-Medico, Rome, Italy
- Microbiology, Immunology, Infectious Diseases, and Transplants (MIMIT), University Tor Vergata, Rome, Italy
| | - Vincenzo Ambrogi
- Department of Thoracic Surgery, University Tor Vergata, Rome, Italy
| | | | - Filippo Longo
- Department of Thoracic Surgery, University Campus Bio-Medico, Rome, Italy
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Nibid L, Sabarese G, Righi D, Rossi SM, Merlini G, Crucitti P, Vincenzi B, Tonini G, Perrone G. Feasibility of Comprehensive Genomic Profiling (CGP) in Real-Life Clinical Practice. Diagnostics (Basel) 2023; 13:diagnostics13040782. [PMID: 36832270 PMCID: PMC9955416 DOI: 10.3390/diagnostics13040782] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 02/14/2023] [Accepted: 02/16/2023] [Indexed: 02/22/2023] Open
Abstract
In advanced or metastatic settings, Comprehensive Genomic Profiling (CGP) allows the evaluation of thousands of gene alterations with the goal of offering new opportunities for personalized treatment in solid tumors. This study evaluated the CGP Success Rate in a real-life cohort of 184 patients enrolled in a prospective clinical trial. CGP data were compared with the routine molecular testing strategy adopted in-house. Sample age, tumor area, and the percentage of tumor nuclei were recorded for CGP analysis. We found that 150/184 (81.5%) samples resulted in satisfying CGP reports. The CGP Success Rate was higher in samples from surgical specimens (96.7%) and in specimens that had been stored (sample age) for less than six months (89.4%). Among the inconclusive CGP reports, 7/34 (20.6%) were optimal samples, according to CGP sample requirements. Moreover, with the in-house molecular testing approach, we could obtain clinically relevant molecular data in 25/34 (73.5%) samples that had inconclusive CGP reports. In conclusion, despite the fact that CGP offers specific therapeutical options in selected patients, our data suggest that the standard molecular testing strategy should not be replaced in routine molecular profiling.
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Affiliation(s)
- Lorenzo Nibid
- Research Unit of Anatomical Pathology, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21-00128 Roma, Italy
- Correspondence: (L.N.); (G.P.)
| | - Giovanna Sabarese
- Research Unit of Anatomical Pathology, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21-00128 Roma, Italy
- Anatomical Pathology Operative Research Unit, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200-00128 Roma, Italy
| | - Daniela Righi
- Anatomical Pathology Operative Research Unit, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200-00128 Roma, Italy
| | - Silvia Maria Rossi
- Research Unit of Anatomical Pathology, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21-00128 Roma, Italy
| | - Giorgia Merlini
- Research Unit of Anatomical Pathology, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21-00128 Roma, Italy
| | - Pierfilippo Crucitti
- Research Unit of General Surgery, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21-00128 Roma, Italy
- Thoracic Surgery Operative Research Unit, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200-00128 Roma, Italy
| | - Bruno Vincenzi
- Research Unit of Oncology, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21-00128 Roma, Italy
- Medical Oncology Operative Research Unit, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200-00128 Roma, Italy
| | - Giuseppe Tonini
- Research Unit of Oncology, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21-00128 Roma, Italy
- Medical Oncology Operative Research Unit, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200-00128 Roma, Italy
| | - Giuseppe Perrone
- Research Unit of Anatomical Pathology, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21-00128 Roma, Italy
- Anatomical Pathology Operative Research Unit, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200-00128 Roma, Italy
- Correspondence: (L.N.); (G.P.)
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Marziali V, Frasca L, Ambrogi V, Patirelis A, Longo F, Crucitti P. Non-Lobe Specific Metastases in Occult N2 after Lobectomy for Clinical N0 Non-Small Cell Lung Cancer. Int J Cancer Med 2023; 6:58-68. [PMID: 36790951 PMCID: PMC9924359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
OBJECTIVES Non-small cell lung cancer can spread into lobe specific stations and non-lobe-specific mediastinal lymph nodes. We evaluated frequency and features of non-lobe specific nodal metastases, focusing especially on the prognostic value of only non-lobe specific N2-metastases after lobectomy. METHODS We performed a retrospective review of 550 patients with non-small cell lung cancer with clinical N0, undergoing lobectomy and systematic or lobe specific node dissection. We evaluated disease free and overall survival rates using Kaplan-Meier method and significance was tested by log-rank test. RESULT Occult N2 disease was detected in 68 patients (8.1%), 26 of them (38.2%) had metastases in non-lobe specific stations. Comparing patients with lobe and non-lobe specific lymph node metastases, 3-years DFS rate was 44.4% vs. 20.0% (p-value = 0.009), while 3-years OS rate was 87.3% vs. 26.7% (p-value <0.001). Among patients with non-lobe specific metastases 16 of them (61.5%) had only non-lobe specific metastases, the remaining 10 patients (38.5%) had metastatic lymph node at the same time in non-lobe specific station but also in lobe-specific stations. Comparing post-operative survival between patients with only non-lobe specific metastases and synchronous lobe and non-lobe specific metastases, 3-years DFS rate was 12.5% vs. 41.3% respectively (p-value = 0.03), and 3-years OS rate was 12.5% vs 76.7% (p-value = 0.002). CONCLUSION In patients with occult N2 disease, the finding of a metastatic lymph node in a non-lobe specific station relates with significant lower survival rate. The subset of patients who presented only non-lobe specific node metastases showed a significant lower survival rate compared to the remaining occult N2.
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Affiliation(s)
| | - Luca Frasca
- Department of Thoracic Surgery, University Campus Bio-Medico, Rome, Italy,PhD course in Microbiology, Immunology, Infectious Diseases, and Transplants (MIMIT), University Tor Vergata, Rome, Italy
| | - Vincenzo Ambrogi
- Department of Thoracic Surgery, University Tor Vergata, Rome, Italy
| | | | - Filippo Longo
- Department of Thoracic Surgery, University Campus Bio-Medico, Rome, Italy
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Palermo A, Sodo A, Naciu AM, Di Gioacchino M, Paolucci A, di Masi A, Maggi D, Crucitti P, Longo F, Perrella E, Taffon C, Verri M, Ricci MA, Crescenzi A. Clinical Use of Raman Spectroscopy Improves Diagnostic Accuracy for Indeterminate Thyroid Nodules. J Clin Endocrinol Metab 2022; 107:3309-3319. [PMID: 36103268 DOI: 10.1210/clinem/dgac537] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Indexed: 02/13/2023]
Abstract
BACKGROUND AND OBJECTIVE Molecular analysis of thyroid fine-needle aspiration (FNA) specimens is believed to improve the management of indeterminate nodules. Raman spectroscopy (RS) can differentiate benign and malignant thyroid lesions in surgically removed tissues, generating distinctive structural profiles. Herein, the diagnostic performance of RS was tested on FNA biopsies of thyroid gland. DESIGN Prospective, blinded, and single-center study. METHODS We enrolled 123 patients with indeterminate or more ominous cytologic diagnoses (TIR3A-low-risk indeterminate lesion, TIR3B-high-risk indeterminate lesion, TIR4-suspicious of malignancy, TIR5-malignant). All subjects were surgical candidates (defined by international guidelines) and submitted to FNA procedures for RS analysis. We compared RS data, cytologic findings, and final histologic assessments (as reference standard) using various statistical techniques. RESULTS The distribution of our study population was as follows: TIR3A:37, TIR3B:32, TIR4:16, and TIR5:38. In 30.9% of patients, histologic diagnoses were benign. For predicting thyroid malignancy in FNA samples, the overall specificity of RS was 86.8%, with 86.5% specificity in indeterminate cytologic categories. In patients with high-risk ultrasound categories, the specificity of RS increased to 87.5% for TIR3A, reaching 100% for TIR3B. Benign histologic diagnoses accounted for 72.9% of patients classified as TIR3A and 31.3% of those classified as TIR3B. Based on positive RS testing, unnecessary surgery was reduced to 7.4% overall (TIR3A-33.3%, TIR3B-6.7%). CONCLUSIONS This premier use of RS for thyroid cytology confirms its role as a valuable diagnostic tool and a valid alternative to molecular studies, capable of improving the management of indeterminate nodules and reducing unnecessary surgery.
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Affiliation(s)
- Andrea Palermo
- Unit of Metabolic Bone and Thyroid Disorders, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200 - 00128 Roma, Italy
- Unit of Endocrinology and Diabetes, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21 - 00128 Roma, Italy
| | - Armida Sodo
- Dipartimento di Scienze, Università Roma Tre, Rome, Italy
| | - Anda Mihaela Naciu
- Unit of Metabolic Bone and Thyroid Disorders, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200 - 00128 Roma, Italy
| | | | | | | | - Daria Maggi
- Unit of Endocrinology and Diabetes, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
| | - Pierfilippo Crucitti
- Unit of Thoracic Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
| | - Filippo Longo
- Unit of Thoracic Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
| | - Eleonora Perrella
- Unit of Pathology, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
| | - Chiara Taffon
- Unit of Pathology, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
| | - Martina Verri
- Unit of Pathology, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
| | | | - Anna Crescenzi
- Unit of Pathology, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
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Palermo A, Sodo A, Naciu AM, Gioacchino MD, Paolucci A, Masi AD, Maggi D, Crucitti P, Longo F, Perrella E, Taffon C, Verri M, Ricci MA, Crescenzi A. PSAT379 Performance of a Raman Fingerprint in Thyroid Nodules with Indeterminate Cytology: A Prospective Blinded Monocentric Study. J Endocr Soc 2022. [PMCID: PMC9628681 DOI: 10.1210/jendso/bvac150.1748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Background Molecular analysis of thyroid fine-needle aspiration biopsy (FNA) was proposed to improve indeterminate nodules management. However, sensibility and specificity as well as the cost of molecular diagnostics require to be improved to increase their cost-effectiveness for medical practice setting. Raman spectroscopy (RS) demonstrated ability in separating benign from malignant thyroid lesions in surgically removed tissues, based on specific RS profile. This study aimed to investigate the diagnostic performance of RS on cytological samples obtained by thyroid FNA. Methods In this prospective, blinded monocentric study, we enrolled 123 patients with indeterminate or worse cytological diagnosis, candidate to surgery according to international guidelines, and submitted to RS analysis of FNA samples. Cytology specimens were evaluated in agreement to Italian Reporting System for Thyroid Cytology1 as follows: TIR1 (non-diagnostic), TIR1C (non-diagnostic-cystic), TIR 2 non-malignant/benign, TIR3A (low-risk indeterminate lesion), TIR3B (high-risk indeterminate lesion), TIR 4 (suspicious of malignancy), or TIR 5 (malignant). As previously published2, the two diagnostic subcategories referred to indeterminate nodules with low (TIR3A) and high risk (TIR3B) of malignancy, may be respectively compared to the class III and Class IV of The Bethesda System for Reporting Thyroid Cytopathology. We compared RS, cytology and final histology, as reference standard, using various statistical approaches. Findings: Our study population included 37 TIR3A, 32 TIR3B, 16 TIR4 and 38 TIR5; the 30.9% of patients had benign histological diagnosis after surgery. In particular, 72.9% of patients classified TIR3A and 31.3% TIR3B had benign histological diagnosis. RS analysis of FNA samples had overall specificity of 86.8% in predicting thyroid malignancy. In indeterminate cytological categories, RS specificity was 86.5%. In patients with TI-RADS score four or five, the specificity of RS increased to 87.5% for TIR3A and reached 100% in TIR3B.; if considering RS positive test, unnecessary surgery was reduced to 7.4% in the whole sample, 33.3% in TIR3A, and 6.7% in TIR 3B. Interpretation: We demonstrated for the first time that RS represents a valuable tool for thyroid cytology and a valid alternative to molecular analyses, able to improve management and reduce unnecessary surgery in indeterminate nodules. Funding: This study was supported by Ministero della Salute, through TIRAMA project (RF-2018-12366568). 1 J Endocrinol Invest. 2014;37(6): 593-599. doi: 10.1007/s40618-014-0062-0 2Cytopathology. 2021;32(6): 714-717. Presentation: Saturday, June 11, 2022 1:00 p.m. - 3:00 p.m.
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Nibid L, Frasca L, Sabarese G, Righi D, Taccogna S, Crucitti P, Graziano P, Perrone G. DOG-1 positive primary acinic cell carcinoma of the lung and investigation of molecular status. Pathologica 2022; 114:385-390. [PMID: 36305026 PMCID: PMC9614299 DOI: 10.32074/1591-951x-786] [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: 06/20/2022] [Accepted: 09/26/2022] [Indexed: 11/16/2022] Open
Abstract
Primary acinic cell carcinoma (ACC) of the lung is an extremely rare neoplasm that more often arises near to a right bronchus. It is characterized by two populations of clear and dark eosinophilic cells, arranged in a glandular acinar pattern. Mitosis are rare and tumor cells show small and eccentric nuclei. Positive stain for PAS, PAS-D, cytokeratin, A1AT and A1ACT is reported, while TTF1, p40, synaptophysin, SMA, and S100 are substantially negative. DOG-1 positive stain was observed in ACC of the salivary glands and its negativity was proposed to distinguish between primary and metastatic ACC of the lung. Here, we report the 30th case of primary ACC of the lung, describing the immunohistochemical positivity for DOG-1 and the molecular status of the neoplasm for the first time.
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Affiliation(s)
- Lorenzo Nibid
- Pathology Unit, Campus Bio-Medico University Hospital Foundation, Rome, Italy,Correspondence Lorenzo Nibid Campus Bio-Medico University Hospital Foundation, via Álvaro del Portillo, 192-00128 Roma (RM) E-mail:
| | - Luca Frasca
- Thoracic Surgery Unit, Campus Bio-Medico University Hospital Foundation, Rome, Italy
| | - Giovanna Sabarese
- Pathology Unit, Campus Bio-Medico University Hospital Foundation, Rome, Italy
| | - Daniela Righi
- Pathology Unit, Campus Bio-Medico University Hospital Foundation, Rome, Italy
| | - Silvia Taccogna
- Pathology Unit, Regina Apostolorum Hospital, Albano Laziale (RM), Italy
| | - Pierfilippo Crucitti
- Thoracic Surgery Unit, Campus Bio-Medico University Hospital Foundation, Rome, Italy
| | - Paolo Graziano
- Pathology Unit, IRCCS Ospedale Casa Sollievo della Sofferenza, San Giovanni Rotondo, Foggia, Italy
| | - Giuseppe Perrone
- Pathology Unit, Campus Bio-Medico University Hospital Foundation, Rome, Italy
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10
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Cardillo G, Nosotti M, Scarci M, Torre M, Alloisio M, Benvenuti MR, Bertani A, Cagini L, Casablanca G, Cavallesco G, Cherchi R, Crucitti P, Curcio C, Denegri A, Droghetti A, Guggino G, Imperatori A, Infante MV, Lucchi M, Macrì P, Marulli G, Melloni G, Paci M, Paladini P, Pariscenti GL, Potenza E, Rea F, Refai M, Rena O, Ricciardi S, Rusca M, Sollitto F, Taurchini M, Terzi A, Voltolini L, Crisci R. Air leak and intraoperative bleeding in thoracic surgery: a Delphi consensus among the members of Italian society of thoracic surgery. J Thorac Dis 2022; 14:3842-3853. [PMID: 36389328 PMCID: PMC9641338 DOI: 10.21037/jtd-22-619] [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: 05/18/2022] [Accepted: 09/09/2022] [Indexed: 01/25/2023]
Abstract
Background Persistent air leak and the management of intraoperative blood loss are common threats in thoracic surgical practice. The availability of new procedures, technology and materials is constantly evolving topical hemostats and surgical sealants must be added to this toolkit. Topical hemostats and surgical sealants differ according to their chemical nature and physical characteristics, to their origin and mechanism of action, regulatory/registration and vigilance paths. A Delphi consensus was set to highlight the different points of view on the use of topical haemostatic products and sealants among the members of Italian Society of thoracic surgery. Methods The board was formed by a group of five Italian experts; in the first phase after a careful review of the scientific literature and two rounds, the board finally generated 16 consensus statements for testing across a wider audience. During the second phase, the statements were collated into a questionnaire, which was electronically sent to a panel of 46 Italian surgeons, experts in the field. Results Out of 46 Italian surgeons, 33 (72%) panel members responded to the Delphi questionnaire. All the items reached a positive consensus, with elevated levels of agreement, as demonstrated by the presence of a 100% consensus for nine items. For the remaining 7 statements the minimum level of consent was 88% (29 participants approved the statement and 4 disagreed) and the maximum was 97% (32 participants approved the statement and 1 was in disagreement). Conclusions The present Delphi analysis shows that air leak and intraoperative bleeding are clinical problems well known among thoracic surgeons. Nevertheless, the aim of the scientific societies and of the group of experts is to execute the education activities in the surgery community. This Delphi survey suggest the need of wider and updated scientific information about technical and registration characteristics of most recent technologic solutions, such as the of topical hemostats and surgical sealants to provide healthcare and administrative staff with the opportunity to work and interact through a common and shared language and eventually to guarantee minimal requirements of assistance.
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Affiliation(s)
- Giuseppe Cardillo
- Department of Thoracic Surgery, Azienda Ospedaliera San Camillo Forlanini, Rome, Italy
- Unicamillus - Saint Camillus International University of Health Sciences, Rome, Italy
| | - Mario Nosotti
- University of Milan, Foundation IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Marco Scarci
- Imperial College Healthcare NHS Trust, London, UK
| | - Massimo Torre
- Department of Thoracic Surgery, ASST GOM Niguarda, Milan, Italy
| | - Marco Alloisio
- Division of Thoracic Surgery, IRCCS Humanitas Research Hospital, Rozzano, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
| | | | - Alessandro Bertani
- Thoracic Surgery and Lung Transplant Division, IRCCS ISMETT – UPMC, Palermo, Italy
| | - Lucio Cagini
- Department of Thoracic Surgery, University of Perugia, Perugia, Italy
- Thoracic Surgery Department, Ospedale del Mare, Naples, Italy
| | | | - Giorgio Cavallesco
- Department of Surgery 1 Thoracic, Hospital Unit University of Ferrara, Ferrara, Italy
| | - Roberto Cherchi
- Department of Thoracic Surgery, U.O.C A.R.N.A.S. -Brotzu, Cagliari, Italy
| | - Pierfilippo Crucitti
- Department of Thoracic Surgery, Fondazione Policlinico Campus Bio-Medico of Rome, Rome, Italy
| | - Carlo Curcio
- UOC Thoracic Surgery, AORN dei Colli. Monaldi Hospital, Naples, Italy
| | - Andrea Denegri
- Department of Thoracic Surgery, UOC Azienda Ospedaliera SS Annunziata Cosenza, Cosenza, Italy
| | | | - Gianluca Guggino
- Department of Thoracic Surgery, UOC Azienda Ospedaliera Rilievo Nazionale “A. Cardarelli”, Naples, Italy
| | - Andrea Imperatori
- Center for Thoracic Surgery, Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | | | - Marco Lucchi
- Division of Thoracic Surgery, University of Pisa, Pisa, Italy
| | - Paolo Macrì
- Department of Thoracic Surgery, Humanitas Istituto Clinico Catanese, Misterbianco, Italy
| | - Giuseppe Marulli
- Thoracic Surgery Unit, Department of Emergency and Organ Transplantation, University Hospital of Bari, Bari, Italy
| | - Giulio Melloni
- Department of Thoracic Surgery, S.Croce e Carle General Hospital, Cuneo, Italy
| | - Massimiliano Paci
- Department of Thoracic Surgery, Azienda Unità Sanitaria Locale–IRCCS, Reggio Emilia, Italy
| | - Piero Paladini
- Department of Thoracic Surgery, University of Siena, Siena, Italy
| | - Gian Luca Pariscenti
- Department of Thoracic Surgery, IRCCS San Martino Polyclinic Hospital, Genoa, Italy
| | - Enrico Potenza
- Department of Thoracic Surgery, U.O.C. A.O.R.N.A.S. Garibaldi Nesima, Catania, Italy
| | - Federico Rea
- Unit of Thoracic Surgery and Lung Transplantation, Department of Cardio-Thoracic and Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | - Majed Refai
- Department of Thoracic Surgery, AOU Ospedali Riuniti, Ancona, Italy
| | - Ottavio Rena
- Thoracic Surgery Unit, University Hospital “Maggiore della Carità”, Novara, Italy
| | - Sara Ricciardi
- Unit of Thoracic Surgery, San Camillo Forlanini Hospital, Rome, Italy
- PhD Program, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | | | | | - Marco Taurchini
- Department of Thoracic Surgery, UOC Policlinico SS Annunziata Asl Taranto, Taranto, Italy
| | - Alberto Terzi
- IRCCS Sacro Cuore-Don Calabria, Hospital Negrar di Valpolicella, Valpolicella, Italy
| | - Luca Voltolini
- Thoracic Surgery Unit, University Hospital Careggi, Florence, Italy
| | - Roberto Crisci
- Department of Thoracic Surgery, MeSVA Department University of L’Aquila, L’Aquila, Italy
- Division of Thoracic Surgery, “Mazzini” Hospital, Teramo, Italy
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11
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di Masi A, Sessa RL, Cerrato Y, Pastore G, Guantario B, Ambra R, Di Gioacchino M, Sodo A, Verri M, Crucitti P, Longo F, Naciu AM, Palermo A, Taffon C, Acconcia F, Bianchi F, Ascenzi P, Ricci MA, Crescenzi A. Unraveling the Effects of Carotenoids Accumulation in Human Papillary Thyroid Carcinoma. Antioxidants (Basel) 2022; 11:antiox11081463. [PMID: 36009182 PMCID: PMC9405418 DOI: 10.3390/antiox11081463] [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: 06/18/2022] [Revised: 07/12/2022] [Accepted: 07/20/2022] [Indexed: 02/01/2023] Open
Abstract
Among the thyroid cancers, papillary thyroid cancer (PTC) accounts for 90% of the cases. In addition to the necessity to identify new targets for PTC treatment, early diagnosis and management are highly demanded. Previous data indicated that the multivariate statistical analysis of the Raman spectra allows the discrimination of healthy tissues from PTC ones; this is characterized by bands typical of carotenoids. Here, we dissected the molecular effects of carotenoid accumulation in PTC patients by analyzing whether they were required to provide increased retinoic acid (RA) synthesis and signaling and/or to sustain antioxidant functions. HPLC analysis revealed the lack of a significant difference in the overall content of carotenoids. For this reason, we wondered whether the carotenoid accumulation in PTC patients could be related to vitamin A derivative retinoic acid (RA) biosynthesis and, consequently, the RA-related pathway activation. The transcriptomic analysis performed using a dedicated PCR array revealed a significant downregulation of RA-related pathways in PTCs, suggesting that the carotenoid accumulation in PTC could be related to a lower metabolic conversion into RA compared to that of healthy tissues. In addition, the gene expression profile of 474 PTC cases previously published in the framework of the Cancer Genome Atlas (TGCA) project was examined by hierarchical clustering and heatmap analyses. This metanalysis study indicated that the RA-related pathways resulted in being significantly downregulated in PTCs and being associated with the follicular variant of PTC (FV-PTC). To assess whether the possible fate of the carotenoids accumulated in PTCs is associated with the oxidative stress response, the expression of enzymes involved in ROS scavenging was checked. An increased oxidative stress status and a reduced antioxidant defense response were observed in PTCs compared to matched healthy thyroids; this was possibly associated with the prooxidant effects of high levels of carotenoids. Finally, the DepMap datasets were used to profile the levels of 225 metabolites in 12 thyroid cancer cell lines. The results obtained suggested that the high carotenoid content in PTCs correlates with tryptophan metabolism. This pilot provided novel possible markers and possible therapeutic targets for PTC diagnosis and therapy. For the future, a larger study including a higher number of PTC patients will be necessary to further validate the molecular data reported here.
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Affiliation(s)
- Alessandra di Masi
- Department of Sciences, Roma Tre University, 00146 Rome, Italy; (R.L.S.); (Y.C.); (M.D.G.); (A.S.); (F.A.); (P.A.); (M.A.R.)
- Correspondence: ; Tel.: +39-06-57336363
| | - Rosario Luigi Sessa
- Department of Sciences, Roma Tre University, 00146 Rome, Italy; (R.L.S.); (Y.C.); (M.D.G.); (A.S.); (F.A.); (P.A.); (M.A.R.)
| | - Ylenia Cerrato
- Department of Sciences, Roma Tre University, 00146 Rome, Italy; (R.L.S.); (Y.C.); (M.D.G.); (A.S.); (F.A.); (P.A.); (M.A.R.)
| | - Gianni Pastore
- CREA (Council for Agricultural Research and Economics), Research Centre for Food and Nutrition, 00178 Rome, Italy; (G.P.); (B.G.); (R.A.)
| | - Barbara Guantario
- CREA (Council for Agricultural Research and Economics), Research Centre for Food and Nutrition, 00178 Rome, Italy; (G.P.); (B.G.); (R.A.)
| | - Roberto Ambra
- CREA (Council for Agricultural Research and Economics), Research Centre for Food and Nutrition, 00178 Rome, Italy; (G.P.); (B.G.); (R.A.)
| | - Michael Di Gioacchino
- Department of Sciences, Roma Tre University, 00146 Rome, Italy; (R.L.S.); (Y.C.); (M.D.G.); (A.S.); (F.A.); (P.A.); (M.A.R.)
| | - Armida Sodo
- Department of Sciences, Roma Tre University, 00146 Rome, Italy; (R.L.S.); (Y.C.); (M.D.G.); (A.S.); (F.A.); (P.A.); (M.A.R.)
| | - Martina Verri
- Pathology Unit, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy; (M.V.); (C.T.); (A.C.)
| | - Pierfilippo Crucitti
- Unit of Thoracic Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy; (P.C.); (F.L.)
| | - Filippo Longo
- Unit of Thoracic Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy; (P.C.); (F.L.)
| | - Anda Mihaela Naciu
- Unit of Metabolic Bone and Thyroid Disorders, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy; (A.M.N.); (A.P.)
| | - Andrea Palermo
- Unit of Metabolic Bone and Thyroid Disorders, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy; (A.M.N.); (A.P.)
| | - Chiara Taffon
- Pathology Unit, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy; (M.V.); (C.T.); (A.C.)
| | - Filippo Acconcia
- Department of Sciences, Roma Tre University, 00146 Rome, Italy; (R.L.S.); (Y.C.); (M.D.G.); (A.S.); (F.A.); (P.A.); (M.A.R.)
| | - Fabrizio Bianchi
- Cancer Biomarkers Unit, Fondazione IRCCS Casa Sollievo della Sofferenza, 71013 San Giovanni Rotondo, FG, Italy;
| | - Paolo Ascenzi
- Department of Sciences, Roma Tre University, 00146 Rome, Italy; (R.L.S.); (Y.C.); (M.D.G.); (A.S.); (F.A.); (P.A.); (M.A.R.)
| | - Maria Antonietta Ricci
- Department of Sciences, Roma Tre University, 00146 Rome, Italy; (R.L.S.); (Y.C.); (M.D.G.); (A.S.); (F.A.); (P.A.); (M.A.R.)
| | - Anna Crescenzi
- Pathology Unit, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy; (M.V.); (C.T.); (A.C.)
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12
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Finamore P, Tanese L, Longo F, De Stefano D, Pedone C, Angelici L, Agabiti N, Cascini S, Davoli M, Zobel BB, Incalzi RA, Crucitti P. The additional value of lung cancer screening program in identifying unrecognized diseases. BMC Pulm Med 2022; 22:48. [PMID: 35101007 PMCID: PMC8802423 DOI: 10.1186/s12890-022-01826-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 12/18/2021] [Indexed: 11/17/2022] Open
Abstract
Background A systematic examination of low-dose CT (LDCT) scan, beside lung nodules, may disclose the presence of undiagnosed diseases, improving the efficacy and the cost/efficacy of these programs. The study was aimed at evaluating the association between LDCT scan findings and non-oncologic and oncologic diseases. Methods The LDCT scan of participants to the “Un Respiro per la vita”® lung cancer screening program were checked and abnormal findings, beside lung nodules, recorded. First admission to the acute care because of cardiovascular (CD), respiratory (RD) and oncological diseases (OD) in the following three years were retrieved. The association of LDCT scan abnormal findings with CD, RD and OD was assessed through univariable and multivariable logistic regression models. Results Mean age of 746 participants was 62 years (SD:5), 62% were male. 11 (1.5%) received a diagnosis of lung cancer. 16.1% participants were admitted to the acute care in the following three years: 8.6% for CD, 4.3% for RD and 5.2% for OD. Valve calcification (OR 2.02, p:0.02) and mucus plugs (OR 3.37, p:0.04) were positively associated with CD, while sub-pleural fibrosis had a protective role (OR 0.47, p:0.01). Lung nodules > 8 mm (OR 5.54, p: < 0.01), tracheal deviation (OR 6.04, p:0.01) and mucus plugs (OR 4.00, p:0.04) were positively associated with OD admissions. Centrilobular emphysema OR for RD admissions was 1.97 (p:0.06). Conclusions The observed association between selected LDCT findings and ensuing CD, RD and OD suggests that the information potential of LCDT goes beyond the screening of lung cancer. Supplementary Information The online version contains supplementary material available at 10.1186/s12890-022-01826-1.
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Affiliation(s)
- Panaiotis Finamore
- Unit of Geriatrics, Department of Medicine and Surgery, Campus Bio-Medico University and Teaching Hospital, Rome, Italy
| | - Luigi Tanese
- Unit of Imaging Center, Department of Medicine and Surgery, Campus Bio-Medico University and Teaching Hospital, Rome, Italy
| | - Filippo Longo
- Unit of Thoracic Surgery, Department of Medicine and Surgery, Campus Bio-Medico University and Teaching Hospital, Rome, Italy.
| | - Domenico De Stefano
- Unit of Imaging Center, Department of Medicine and Surgery, Campus Bio-Medico University and Teaching Hospital, Rome, Italy
| | - Claudio Pedone
- Unit of Geriatrics, Department of Medicine and Surgery, Campus Bio-Medico University and Teaching Hospital, Rome, Italy
| | - Laura Angelici
- Dipartimento di Epidemiologia del Servizio Sanitario Regionale, Regione Lazio, ASL Roma 1, Rome, Italy
| | - Nera Agabiti
- Dipartimento di Epidemiologia del Servizio Sanitario Regionale, Regione Lazio, ASL Roma 1, Rome, Italy
| | - Silvia Cascini
- Dipartimento di Epidemiologia del Servizio Sanitario Regionale, Regione Lazio, ASL Roma 1, Rome, Italy
| | - Marina Davoli
- Dipartimento di Epidemiologia del Servizio Sanitario Regionale, Regione Lazio, ASL Roma 1, Rome, Italy
| | - Bruno Beomonte Zobel
- Unit of Imaging Center, Department of Medicine and Surgery, Campus Bio-Medico University and Teaching Hospital, Rome, Italy
| | - Raffaele Antonelli Incalzi
- Unit of Geriatrics, Department of Medicine and Surgery, Campus Bio-Medico University and Teaching Hospital, Rome, Italy
| | - Pierfilippo Crucitti
- Unit of Thoracic Surgery, Department of Medicine and Surgery, Campus Bio-Medico University and Teaching Hospital, Rome, Italy
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13
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Frasca L, Tacchi G, Longo F, Marziali V, De Peppo V, Moscardelli A, Crucitti P. Uniportal video-assisted thoracic surgery approach for simultaneous lung cancer and thymic carcinoma: Case report and literature review. Thorac Cancer 2021; 13:489-493. [PMID: 34935296 PMCID: PMC8807336 DOI: 10.1111/1759-7714.14258] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 11/03/2021] [Revised: 11/13/2021] [Accepted: 11/15/2021] [Indexed: 01/15/2023] Open
Abstract
Thymic carcinoma is an epithelial tumor derived from thymic epithelial cells. Thymic tumors may be associated with other simultaneous and/or metachronous extra‐thymic tumors (e.g., lung cancer). Here, we report a case of simultaneous surgical management of lung and mediastinal neoplasm together with a review of the literature. During radiological follow‐up for prostate and colorectal cancer, an 82‐year‐old man was diagnosed with lung cancer with simultaneous mediastinal suspected neoplasm. Both were surgically removed with a single intervention performed via a uniportal video‐assisted thoracic surgery (uni‐VATS) approach. The literature emphasizes how extra‐thymic cancer can be diagnosed before, concurrently and consecutively with thymic neoplasia. The surgical treatment of such simultaneous cancer is challenging. We succeeded in the excision of both neoplasia with a mini‐invasive surgical technique. This report highlights the feasibility of uniportal VATS in a patient with very unusual clinical and oncological history.
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Affiliation(s)
- Luca Frasca
- Thoracic Surgery Department, Policlinico Campus Bio-medico, Rome, Italy
| | - Giovanni Tacchi
- Thoracic Surgery Department, Policlinico Campus Bio-medico, Rome, Italy
| | - Filippo Longo
- Thoracic Surgery Department, Policlinico Campus Bio-medico, Rome, Italy
| | | | - Valerio De Peppo
- Thoracic Surgery Department, Policlinico Campus Bio-medico, Rome, Italy
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14
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Qiu B, Cai K, Chen C, Chen J, Chen KN, Chen QX, Cheng C, Dai TY, Fan J, Fan Z, Hu J, Hu WD, Huang YC, Jiang GN, Jiang J, Jiang T, Jiao WJ, Li HC, Li Q, Liao YD, Liu HX, Liu JF, Liu L, Liu Y, Long H, Luo QQ, Ma HT, Mao NQ, Pan XJ, Tan F, Tan LJ, Tian H, Wang D, Wang WX, Wei L, Wu N, Wu QC, Xiang J, Xu SD, Yang L, Zhang H, Zhang L, Zhang P, Zhang Y, Zhang Z, Zhu K, Zhu Y, Um SW, Oh IJ, Tomita Y, Watanabe S, Nakada T, Seki N, Hida T, Sasada S, Uchino J, Sugimura H, Dermime S, Cappuzzo F, Rizzo S, Cho WCS, Crucitti P, Longo F, Lee KY, De Ruysscher D, Vanneste BGL, Furqan M, Sieren JC, Yendamuri S, Merrell KW, Molina JR, Metro G, Califano R, Bongiolatti S, Provencio M, Hofman P, Gao S, He J. Expert consensus on perioperative immunotherapy for local advanced non-small cell lung cancer. Transl Lung Cancer Res 2021; 10:3713-3736. [PMID: 34733623 PMCID: PMC8512472 DOI: 10.21037/tlcr-21-634] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 09/18/2021] [Indexed: 02/05/2023]
Affiliation(s)
- Bin Qiu
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Kaican Cai
- Department of Thoracic Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Chun Chen
- Department of Thoracic Surgery, Fujian Medical University Union Hospital, Fuzhou, China
| | - Jun Chen
- Tianjin Key Laboratory of Lung Cancer Metastasis and Tumor Microenvironment, Lung Cancer Institute, Tianjin Medical University General Hospital, Tianjin, China
| | - Ke-Neng Chen
- Department of Thoracic Surgery, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital & Institute, Beijing, China
| | - Qi-Xun Chen
- Department of Thoracic Surgery, Cancer Hospital of University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Hangzhou, China.,Institute of Cancer and Basic Medicine (IBMC), Chinese Academy of Science, Hangzhou, China
| | - Chao Cheng
- Department of Thoracic Surgery, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Tian-Yang Dai
- Department of Thoracic Surgery, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Junqiang Fan
- Department of Thoracic Surgery, Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China
| | - Zhaohui Fan
- Department of Thoracic Surgery, Jiangsu Cancer Hospital (Nanjing Medical University Affiliated Cancer Hospital) and Jiangsu Institute of Cancer Research, Nanjing, China
| | - Jian Hu
- Department of Thoracic Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Wei-Dong Hu
- Department of Thoracic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Yun-Chao Huang
- Department of Thoracic Surgery, Yunnan Cancer Hospital, Kunming, China
| | - Ge-Ning Jiang
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
| | - Jie Jiang
- Department of Thoracic Surgery, The First Affiliated Hospital of Xiamen University, Xiamen, China
| | - Tao Jiang
- Department of Thoracic Surgery, Tangdu Hospital, Fourth Military Medical University, Xi'an, China
| | - Wen-Jie Jiao
- Department of Thoracic Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - He-Cheng Li
- Department of Thoracic Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qiang Li
- Department of Thoracic Surgery, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Yong-De Liao
- Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Hong-Xu Liu
- Department of Thoracic Surgery, Cancer Hospital of China Medical University, Liaoning Cancer Hospital & Institute, Shenyang, China
| | - Jun-Feng Liu
- Department of Thoracic Surgery, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Lunxu Liu
- Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Yang Liu
- Department of Thoracic Surgery, Chinese PLA General Hospital, Beijing, China
| | - Hao Long
- Department of Thoracic Surgery, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Qing-Quan Luo
- Shanghai Lung Cancer Center, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Hai-Tao Ma
- Department of Thoracic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Nai-Quan Mao
- Department of Thoracic Surgery, Tumor Hospital Affiliated to Guangxi Medical University, Nanning, China
| | - Xiao-Jie Pan
- Department of Thoracic Surgery, Fujian Provincial Hospital, Fuzhou, China
| | - Fengwei Tan
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Li-Jie Tan
- Department of Thoracic Surgery, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Hui Tian
- Department of Thoracic Surgery, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Dong Wang
- Department of Cardiothoracic Surgery, Affiliated Taikang Xianlin Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China
| | - Wen-Xiang Wang
- Department of Thoracic Surgery II, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University/Hunan Cancer Hospital, Changsha, China
| | - Li Wei
- Henan Provincial People's Hospital, Zhengzhou, China
| | - Nan Wu
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Thoracic Surgery II, Peking University Cancer Hospital & Institute, Beijing, China
| | - Qing-Chen Wu
- Department of Cardiothoracic Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jiaqing Xiang
- Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China
| | - Shi-Dong Xu
- Department of Thoracic Surgery, Harbin Medical University Cancer Hospital, Harbin, China
| | - Lin Yang
- Department of Thoracic Surgery, Shenzhen People's Hospital, 2nd Clinical Medical College of Jinan University, Shenzhen, China
| | - Hao Zhang
- Department of Thoracic Cardiovascular Surgery, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Lanjun Zhang
- Department of Thoracic Surgery, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangdong Esophageal Cancer Institute, Guangzhou, China
| | - Peng Zhang
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
| | - Yi Zhang
- Department of Thoracic Surgery, Xuanwu Hospital of Capital Medical University, Beijing, China
| | - Zhenfa Zhang
- Department of Lung Cancer, Tianjin Medical University Cancer Institute & Hospital, Tianjin, China
| | - Kunshou Zhu
- Department of Thoracic Surgery, Fujian Cancer Hospital and Fujian Medical University Cancer Hospital, Fuzhou, Fujian, China
| | - Yuming Zhu
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Sang-Won Um
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - In-Jae Oh
- Department of Internal Medicine, Chonnam National University Medical School and Hwasun Hospital, Jeonnam, Korea
| | - Yusuke Tomita
- Department of Respiratory Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Satoshi Watanabe
- Department of Respiratory Medicine and Infectious Diseases, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Takeo Nakada
- Department of Thoracic Surgery, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Nobuhiko Seki
- Division of Medical Oncology, Department of Internal Medicine, Teikyo University School of Medicine, Tokyo, Japan
| | - Toyoaki Hida
- Lung Cancer Center, Central Japan International Medical Center, Gifu, Japan
| | - Shinji Sasada
- Department of Respiratory Medicine, Tokyo Saiseikai Central Hospital, Tokyo, Japan
| | - Junji Uchino
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Haruhiko Sugimura
- Department of Tumor Pathology, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
| | - Said Dermime
- Department of Medical Oncology and Translational Research Institute, National Center for Cancer Care and Research, Hamad Medical Corporation, Doha, Qatar
| | - Federico Cappuzzo
- Division of Medical Oncology 2, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Stefania Rizzo
- Imaging Institute of the Southern Switzerland (IIMSI), Ente Ospedaliero Cantonale (EOC), Università della Svizzera Italiana, Lugano, Switzerland
| | | | | | - Filippo Longo
- Department of Thoracic Surgery, University Campus Bio-Medico, Rome, Italy
| | - Kye Young Lee
- Precision Medicine Lung Cancer Center, Konkuk University Medical Center, Seoul, Korea
| | - Dirk De Ruysscher
- Department of Radiation Oncology, MAASTRO Clinic, GROW School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Ben G L Vanneste
- Department of Radiation Oncology, MAASTRO Clinic, GROW School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Muhammad Furqan
- Division of Hematology, Oncology and Blood and Marrow Transplantation, Department of Internal Medicine, University of Iowa, Iowa City, IA, USA
| | - Jessica C Sieren
- Department of Radiology and Biomedical Engineering, University of Iowa, Iowa City, IA, USA
| | - Sai Yendamuri
- Department of Thoracic Surgery, Roswell Park Cancer Institute, Buffalo, NY, USA
| | | | - Julian R Molina
- Division of Medical Oncology, Mayo Clinic, Rochester, MN, USA
| | - Giulio Metro
- Medical Oncology, Santa Maria della Misericordia Hospital, Azienda Ospedaliera di Perugia, Perugia, Italy
| | - Raffaele Califano
- Department of Medical Oncology, The Christie NHS Foundation Trust and Division of Cancer Sciences, The University of Manchester, Manchester, UK
| | | | - Mariano Provencio
- Medical Oncology Department, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain
| | - Paul Hofman
- Laboratory of Clinical and Experimental Pathology, FHU OncoAge, Pasteur Hospital, BB-0033-00025, CHU Nice, Université Côte d'Azur, Nice, France
| | - Shugeng Gao
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jie He
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Giordano FM, Ippolito E, Quattrocchi CC, Greco C, Mallio CA, Santo B, D’Alessio P, Crucitti P, Fiore M, Zobel BB, D’Angelillo RM, Ramella S. Radiation-Induced Pneumonitis in the Era of the COVID-19 Pandemic: Artificial Intelligence for Differential Diagnosis. Cancers (Basel) 2021; 13:cancers13081960. [PMID: 33921652 PMCID: PMC8074058 DOI: 10.3390/cancers13081960] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 03/02/2021] [Revised: 04/12/2021] [Accepted: 04/12/2021] [Indexed: 12/25/2022] Open
Abstract
(1) Aim: To test the performance of a deep learning algorithm in discriminating radiation therapy-related pneumonitis (RP) from COVID-19 pneumonia. (2) Methods: In this retrospective study, we enrolled three groups of subjects: pneumonia-free (control group), COVID-19 pneumonia and RP patients. CT images were analyzed by mean of an artificial intelligence (AI) algorithm based on a novel deep convolutional neural network structure. The cut-off value of risk probability of COVID-19 was 30%; values higher than 30% were classified as COVID-19 High Risk, and values below 30% as COVID-19 Low Risk. The statistical analysis included the Mann-Whitney U test (significance threshold at p < 0.05) and receiver operating characteristic (ROC) curve, with fitting performed using the maximum likelihood fit of a binormal model. (3) Results: Most patients presenting RP (66.7%) were classified by the algorithm as COVID-19 Low Risk. The algorithm showed high sensitivity but low specificity in the detection of RP against COVID-19 pneumonia (sensitivity = 97.0%, specificity = 2%, area under the curve (AUC = 0.72). The specificity increased when an estimated COVID-19 risk probability cut-off of 30% was applied (sensitivity 76%, specificity 63%, AUC = 0.84). (4) Conclusions: The deep learning algorithm was able to discriminate RP from COVID-19 pneumonia, classifying most RP cases as COVID-19 Low Risk.
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Affiliation(s)
- Francesco Maria Giordano
- Departmental Faculty of Medicine and Surgery, Diagnostic Imaging and Interventional Radiology, Università Campus Bio-Medico di Roma, 00128 Rome, Italy; (F.M.G.); (C.A.M.); (P.D.); (B.B.Z.)
| | - Edy Ippolito
- Departmental Faculty of Medicine and Surgery, Radiation Oncology, Università Campus Bio-Medico di Roma, 00128 Rome, Italy; (E.I.); (C.G.); (B.S.); (M.F.); (S.R.)
| | - Carlo Cosimo Quattrocchi
- Departmental Faculty of Medicine and Surgery, Diagnostic Imaging and Interventional Radiology, Università Campus Bio-Medico di Roma, 00128 Rome, Italy; (F.M.G.); (C.A.M.); (P.D.); (B.B.Z.)
- Correspondence: ; Tel.: +39-06225411708
| | - Carlo Greco
- Departmental Faculty of Medicine and Surgery, Radiation Oncology, Università Campus Bio-Medico di Roma, 00128 Rome, Italy; (E.I.); (C.G.); (B.S.); (M.F.); (S.R.)
| | - Carlo Augusto Mallio
- Departmental Faculty of Medicine and Surgery, Diagnostic Imaging and Interventional Radiology, Università Campus Bio-Medico di Roma, 00128 Rome, Italy; (F.M.G.); (C.A.M.); (P.D.); (B.B.Z.)
| | - Bianca Santo
- Departmental Faculty of Medicine and Surgery, Radiation Oncology, Università Campus Bio-Medico di Roma, 00128 Rome, Italy; (E.I.); (C.G.); (B.S.); (M.F.); (S.R.)
| | - Pasquale D’Alessio
- Departmental Faculty of Medicine and Surgery, Diagnostic Imaging and Interventional Radiology, Università Campus Bio-Medico di Roma, 00128 Rome, Italy; (F.M.G.); (C.A.M.); (P.D.); (B.B.Z.)
| | - Pierfilippo Crucitti
- Departmental Faculty of Medicine and Surgery, Thoracic Surgery, Università Campus Bio-Medico di Roma, 00128 Rome, Italy;
| | - Michele Fiore
- Departmental Faculty of Medicine and Surgery, Radiation Oncology, Università Campus Bio-Medico di Roma, 00128 Rome, Italy; (E.I.); (C.G.); (B.S.); (M.F.); (S.R.)
| | - Bruno Beomonte Zobel
- Departmental Faculty of Medicine and Surgery, Diagnostic Imaging and Interventional Radiology, Università Campus Bio-Medico di Roma, 00128 Rome, Italy; (F.M.G.); (C.A.M.); (P.D.); (B.B.Z.)
| | - Rolando Maria D’Angelillo
- Departmental Faculty of Medicine and Surgery, Radiation Oncology, Università degli Studi Tor Vergata, 00133 Rome, Italy;
| | - Sara Ramella
- Departmental Faculty of Medicine and Surgery, Radiation Oncology, Università Campus Bio-Medico di Roma, 00128 Rome, Italy; (E.I.); (C.G.); (B.S.); (M.F.); (S.R.)
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Naciu AM, Verri M, Crescenzi A, Taffon C, Longo F, Frasca L, Tabacco G, Monte L, Palermo A, Crucitti P, Cesareo R. Hobnail variant of papillary thyroid carcinoma showing goiter-like presentation and rapid growth. Endocrinol Diabetes Metab Case Rep 2021; 2021:EDM200184. [PMID: 33522492 PMCID: PMC7849458 DOI: 10.1530/edm-20-0184] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 12/20/2020] [Accepted: 01/07/2021] [Indexed: 12/04/2022] Open
Abstract
SUMMARY We present the case of a 47-year-old Caucasian previously healthy woman with a voluminous thyroid nodule occupying almost the entire anterior neck region. The lesion had progressively increased in size during the previous 3 months and the patient presented intermittent symptoms of dysphagia and odynophagia with a slight change in voice. Fine needle aspiration showed papillary carcinoma. Based on imaging and cytological findings, the patient underwent total thyroidectomy. The surgical sample revealed a totally enlarged thyroid gland (weight: 208 g) with the presence of a poly-lobulated lesion centrally located and involving the isthmus and both lobes. Hobnail features were present in more than 30% of the neoplastic cells in agreement with the criteria for this subtype. Psammoma bodies and focal necrosis were also present. The extra-thyroidal extension included strap muscles and peri-esophageal glands. Immunohistochemistry using VE1 antibody for detecting BRAF-V600E mutation resulted positive. The final diagnosis was papillary thyroid carcinoma (PTC) hobnail variant (HVPTC)-pT4a. The HVPTC is a rare entity and, in most cases, appears like a unifocal lesion with a maximum tumor size of 8 cm reported so far. To our knowledge, this represents the largest tumor ever described (14 cm), showing rapid growth and with multinodular goiter-like aspect. LEARNING POINTS HVPTC is an aggressive variant of PTC, usually associated with radioactive iodine refractoriness, and a higher mortality rate compared to classic PTC. However, there is a marked individual variability in this association. HVPTC usually appears as small unifocal lesion but a multinodular goiter presentation may occur. The present case highlights that despite of the histology, our patient achieved a high ablation success rate after radioactive iodine therapy.
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Affiliation(s)
- Anda Mihaela Naciu
- Unit of Endocrinology and Diabetes, Campus Bio-Medico Univerity of Rome, Rome, Italy
| | - Martina Verri
- Unit of Pathology, Campus Bio-Medico Univerity of Rome, Rome, Italy
| | - Anna Crescenzi
- Unit of Pathology, Campus Bio-Medico Univerity of Rome, Rome, Italy
| | - Chiara Taffon
- Unit of Pathology, Campus Bio-Medico Univerity of Rome, Rome, Italy
| | - Filippo Longo
- Unit of Neck and Chest Surgery, Campus Bio-Medico Univerity of Rome, Rome, Italy
| | - Luca Frasca
- Unit of Neck and Chest Surgery, Campus Bio-Medico Univerity of Rome, Rome, Italy
| | - Gaia Tabacco
- Unit of Endocrinology and Diabetes, Campus Bio-Medico Univerity of Rome, Rome, Italy
| | - Lavinia Monte
- Unit of Endocrinology and Diabetes, Campus Bio-Medico Univerity of Rome, Rome, Italy
| | - Andrea Palermo
- Unit of Endocrinology and Diabetes, Campus Bio-Medico Univerity of Rome, Rome, Italy
| | - Pierfilippo Crucitti
- Unit of Neck and Chest Surgery, Campus Bio-Medico Univerity of Rome, Rome, Italy
| | - Roberto Cesareo
- Unit of Metabolic Diseases, ‘S.M. Goretti’ Hospital, Latina, Italy
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Faiella E, Messina L, Castiello G, Bernetti C, Pacella G, Altomare C, Andresciani F, Sarli M, Longo F, Crucitti P, Beomonte Zobel B, Grasso RF. Augmented reality 3D navigation system for percutaneous CT-guided pulmonary ground-glass opacity biopsies: a comparison with the standard CT-guided technique. J Thorac Dis 2021; 14:247-256. [PMID: 35280488 PMCID: PMC8902131 DOI: 10.21037/jtd-21-1285] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [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: 08/06/2021] [Accepted: 12/15/2021] [Indexed: 11/17/2022]
Abstract
Background Augmented reality navigation system for percutaneous computed tomography (CT)-guided pulmonary biopsies has recently been introduced. There are no studies in literature about its use for ground glass lesions biopsies. The aim of this study is to evaluate the effectiveness of an augmented reality infrared navigation system performance on CT-guided percutaneous lung ground glass opacity (GGO) biopsy compared to a standard CT-guided technique. Methods A total of 80 patients with lung GGO who underwent to a percutaneous CT-guided lung biopsy with an augmented reality infrared navigation system were retrospectively enrolled in the study. Comparison was performed with a group of 80 patients who underwent to lung biopsy with the standard CT-guided technique. Evaluation of maximum lesion diameter (MLD), distance between lesion and pleural surface (DPS), distance travelled by the needle (DTP), procedural time, validity of histological sample, procedural complications and the radiation dose to the patient’s chest were recorded for each patient of both groups. In addition, each group was divided into two subgroups based on lesion size, according to a cut-off of 1.5 cm (<1.5 cm; ≥1.5 cm). Results Augmented reality navigation system showed a significant reduction in procedural time, radiation dose administrated to patients and complications rate compared to a standard CT-guided technique. Technical success was achieved in the 100% of cases in both groups, but the diagnostical success was higher in the group where patients underwent to lung biopsies with the use of navigation system. We also found that using an augmented reality navigation system increases the diagnostical success rate for lesion <1.5 cm. MLD, DPS and DTP did not differ significantly between the two groups of patients. Conclusions The use of an augmented reality navigation system for percutaneous CT-guided pulmonary GGO biopsies has demonstrated a lower incidence of post-procedural complications, a significantly reduction of the radiation dose administered to patients and a higher diagnostical success rate.
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Affiliation(s)
- Eliodoro Faiella
- Diagnostic and Interventional Radiology, Departmental Falculty of Medicine and Surgery, Università Campus Bio-medico di Roma, Rome, Italy
| | - Laura Messina
- Diagnostic and Interventional Radiology, Departmental Falculty of Medicine and Surgery, Università Campus Bio-medico di Roma, Rome, Italy
| | - Gennaro Castiello
- Diagnostic and Interventional Radiology, Departmental Falculty of Medicine and Surgery, Università Campus Bio-medico di Roma, Rome, Italy
| | - Caterina Bernetti
- Diagnostic and Interventional Radiology, Departmental Falculty of Medicine and Surgery, Università Campus Bio-medico di Roma, Rome, Italy
| | - Giuseppina Pacella
- Diagnostic and Interventional Radiology, Departmental Falculty of Medicine and Surgery, Università Campus Bio-medico di Roma, Rome, Italy
| | - Carlo Altomare
- Diagnostic and Interventional Radiology, Departmental Falculty of Medicine and Surgery, Università Campus Bio-medico di Roma, Rome, Italy
| | - Flavio Andresciani
- Diagnostic and Interventional Radiology, Departmental Falculty of Medicine and Surgery, Università Campus Bio-medico di Roma, Rome, Italy
| | - Marina Sarli
- Diagnostic and Interventional Radiology, Departmental Falculty of Medicine and Surgery, Università Campus Bio-medico di Roma, Rome, Italy
| | - Filippo Longo
- Department of Thoracic Surgery, Departmental Falculty of Medicine and Surgery, Università Campus Bio-medico di Roma, Rome, Italy
| | - Pierfilippo Crucitti
- Department of Thoracic Surgery, Departmental Falculty of Medicine and Surgery, Università Campus Bio-medico di Roma, Rome, Italy
| | - Bruno Beomonte Zobel
- Diagnostic and Interventional Radiology, Departmental Falculty of Medicine and Surgery, Università Campus Bio-medico di Roma, Rome, Italy
| | - Rosario Francesco Grasso
- Diagnostic and Interventional Radiology, Departmental Falculty of Medicine and Surgery, Università Campus Bio-medico di Roma, Rome, Italy
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18
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Sodo A, Verri M, Palermo A, Naciu AM, Sponziello M, Durante C, Di Gioacchino M, Paolucci A, di Masi A, Longo F, Crucitti P, Taffon C, Ricci MA, Crescenzi A. Raman Spectroscopy Discloses Altered Molecular Profile in Thyroid Adenomas. Diagnostics (Basel) 2020; 11:diagnostics11010043. [PMID: 33383892 PMCID: PMC7823803 DOI: 10.3390/diagnostics11010043] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 12/09/2020] [Revised: 12/22/2020] [Accepted: 12/23/2020] [Indexed: 12/13/2022] Open
Abstract
Follicular patterned nodules are sometimes complex to be classified due to ambiguous nuclear features and/or questionable capsular or vascular invasion. In this setting, there is a poor inter-observer concordance even among expert pathologists. Raman spectroscopy was recently used to separate benign and malignant thyroid nodules based on their molecular fingerprint; anyway, some histologically proved follicular adenomas were clustered as having a characteristic profile of malignant lesions. In this study, we analyzed five follicular thyroid adenomas with a malignant spectroscopic profile compared to five follicular adenomas with a benign Raman spectrum in order to assess possible molecular differences between the two groups. Morphological, immunohistochemical, and molecular analyses evidenced expression of malignancy-associated proteins in four out of five malignant clustered adenomas. The remaining malignant clustered adenoma showed a TSHR mutation previously associated with autonomously functioning follicular carcinomas. In conclusion, thyroid follicular adenomas are a group of morphologically benign neoplasms that may have altered the mutational or expression profile; cases of adenomas with altered immunophenotype are recognized as showing a profile associated with malignancy by Raman spectroscopy. This correlation warrants a more extensive evaluation and suggests a potential predictive value of spectroscopic assessment in recognizing characteristics associated with tumor progression in follicular thyroid neoplasms.
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Affiliation(s)
- Armida Sodo
- Department of Sciences, University Roma Tre, 00146 Rome, Italy; (A.S.); (M.D.G.); (A.P.); (A.d.M.); (M.A.R.)
| | - Martina Verri
- Pathology Unit, Campus Bio-Medico University Hospital, 00128 Rome, Italy; (M.V.); (C.T.)
| | - Andrea Palermo
- Unit of Endocrinology and Diabetes, Campus Bio-Medico University, 00128 Rome, Italy; (A.P.); (A.M.N.)
| | - Anda Mihaela Naciu
- Unit of Endocrinology and Diabetes, Campus Bio-Medico University, 00128 Rome, Italy; (A.P.); (A.M.N.)
| | - Marialuisa Sponziello
- Department of Translational and Precision Medicine, Sapienza University of Rome, 00185 Rome, Italy; (M.S.); (C.D.)
| | - Cosimo Durante
- Department of Translational and Precision Medicine, Sapienza University of Rome, 00185 Rome, Italy; (M.S.); (C.D.)
| | - Michael Di Gioacchino
- Department of Sciences, University Roma Tre, 00146 Rome, Italy; (A.S.); (M.D.G.); (A.P.); (A.d.M.); (M.A.R.)
| | - Alessio Paolucci
- Department of Sciences, University Roma Tre, 00146 Rome, Italy; (A.S.); (M.D.G.); (A.P.); (A.d.M.); (M.A.R.)
| | - Alessandra di Masi
- Department of Sciences, University Roma Tre, 00146 Rome, Italy; (A.S.); (M.D.G.); (A.P.); (A.d.M.); (M.A.R.)
| | - Filippo Longo
- Unit of Thoracic Surgery, Campus Bio-Medico University Hospital, 00128 Rome, Italy; (F.L.); (P.C.)
| | - Pierfilippo Crucitti
- Unit of Thoracic Surgery, Campus Bio-Medico University Hospital, 00128 Rome, Italy; (F.L.); (P.C.)
| | - Chiara Taffon
- Pathology Unit, Campus Bio-Medico University Hospital, 00128 Rome, Italy; (M.V.); (C.T.)
| | - Maria Antonietta Ricci
- Department of Sciences, University Roma Tre, 00146 Rome, Italy; (A.S.); (M.D.G.); (A.P.); (A.d.M.); (M.A.R.)
| | - Anna Crescenzi
- Pathology Unit, Campus Bio-Medico University Hospital, 00128 Rome, Italy; (M.V.); (C.T.)
- Correspondence: ; Tel.: +39-06-225411106
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19
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Longo F, Piliego C, Martuscelli M, Tomaselli E, Crucitti P, Longo F, Agrò FE. Rhomboid intercostal and subserratus plane block for intubated uniportal video-assisted thoracoscopic surgery lobectomy. J Clin Anesth 2020; 65:109881. [DOI: 10.1016/j.jclinane.2020.109881] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 05/17/2020] [Indexed: 11/26/2022]
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20
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Marziali V, Geropoulos G, Frasca L, Longo F, Patrini D, Panagiotopoulos N, Crucitti P. Focus on the pulmonary involvement and genetic patterns in Birt-Hogg-Dubè syndrome: Literature review. Respir Med 2020; 168:105995. [PMID: 32469710 DOI: 10.1016/j.rmed.2020.105995] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 04/20/2020] [Accepted: 04/24/2020] [Indexed: 10/24/2022]
Abstract
INTRODUCTION Brit-Hogg-Dubé syndrome (BHD) is a rare disorder that is estimated to affects about 600 families in the World. The disease-causing mutations is on FLCN gene which codes for folliculin. This protein has a role in different organs as skin, kidney and lung, thanks to the interaction with type I and II cadherins, RhoA activity and the regulation of AMPK, mTORC1 pathways and cell adhesion. The aim of our study is to focus on the manifestation of the syndrome, especially the pulmonary involvement, then on genetical analysis and on the available treatments. MATERIAL AND METHODS We collected 15 previous studies where we found medical history information, clinical manifestations, radiological and histological diagnosis and genetical analysis. RESULTS The prevalence of pneumothorax in patients with BHD syndrome was about 65%, but the lung involvement with multiple small cysts, localized especially in the lower part, was 85%. The prevalence of renal involvement in BHD patients ranged from 6.5% to 34%, while skin lesions ranged from 11% to 50%. More than 150 FLCN germline has been described, though the mutation in exon 11 is the most frequently detected, especially among Caucasian population. CONCLUSIONS BHD syndrome is rare and usually the first manifestations appear in early age. In patients with these clinical and radiological characteristics we suggest taking a careful medical history, though the diagnosis of BHD syndrome should be confirmed with the analysis of FLCN gene.
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Affiliation(s)
- Valentina Marziali
- Department of Thoracic Surgery, University Campus Bio-Medico, Via Alvaro Del Portillo 21, Rome, 00128, Italy.
| | - Georgios Geropoulos
- Department of Thoracic Surgery, University College London Hospitals, NHS Foundation Trust, 16-18 Westmoreland Street, London, W1G 8PH, UK.
| | - Luca Frasca
- Department of Thoracic Surgery, University Campus Bio-Medico, Via Alvaro Del Portillo 21, Rome, 00128, Italy.
| | - Filippo Longo
- Department of Thoracic Surgery, University Campus Bio-Medico, Via Alvaro Del Portillo 21, Rome, 00128, Italy.
| | - Davide Patrini
- Department of Thoracic Surgery, University College London Hospitals, NHS Foundation Trust, 16-18 Westmoreland Street, London, W1G 8PH, UK.
| | - Nikolaos Panagiotopoulos
- Department of Thoracic Surgery, University College London Hospitals, NHS Foundation Trust, 16-18 Westmoreland Street, London, W1G 8PH, UK.
| | - Pierfilippo Crucitti
- Department of Thoracic Surgery, University Campus Bio-Medico, Via Alvaro Del Portillo 21, Rome, 00128, Italy.
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Frasca L, Longo F, Tacchi G, Stilo F, Zito A, Brunetti B, Depalma M, Crucitti P. Importance of muldisciplinary management of giant mediastinal sarcoma: A case report with phrenic nerve reconstruction. Thorac Cancer 2020; 11:1734-1737. [PMID: 32329211 PMCID: PMC7262890 DOI: 10.1111/1759-7714.13452] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 04/04/2020] [Accepted: 04/05/2020] [Indexed: 01/12/2023] Open
Affiliation(s)
- Luca Frasca
- Department of Thoracic Surgery, Campus Bio-Medico University of Rome, Rome, Italy
| | - Filippo Longo
- Department of Thoracic Surgery, Campus Bio-Medico University of Rome, Rome, Italy
| | - Giovanni Tacchi
- Department of Thoracic Surgery, Campus Bio-Medico University of Rome, Rome, Italy
| | - Francesco Stilo
- Department of Vascular Surgery, Campus Bio-Medico University of Rome, Rome, Italy
| | - Anna Zito
- Department of Geriatrics, Campus Bio-Medico University of Rome, Rome, Italy
| | - Beniamino Brunetti
- Department of Reconstructive and Aesthetic Surgery, Campus Bio-Medico University of Rome, Rome, Italy
| | - Massimiliano Depalma
- Department of Thoracic Surgery, Campus Bio-Medico University of Rome, Rome, Italy
| | - Pierfilippo Crucitti
- Department of Thoracic Surgery, Campus Bio-Medico University of Rome, Rome, Italy
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22
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di Masi A, Leboffe L, Sodo A, Tabacco G, Cesareo R, Sbroscia M, Giovannoni I, Taffon C, Crucitti P, Longo F, Manfrini S, Ricci MA, Ascenzi P, Crescenzi A, Palermo A. Metabolic profile of human parathyroid adenoma. Endocrine 2020; 67:699-707. [PMID: 31786773 DOI: 10.1007/s12020-019-02146-x] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Accepted: 11/18/2019] [Indexed: 10/25/2022]
Abstract
PURPOSE Recently, it has been demonstrated that Raman spectroscopy is able to differentiate between healthy parathyroid tissues and parathyroid adenoma based on the basis of a specific molecular fingerprint. However, to our knowledge, no previous studies have been performed to evaluate the metabolic profile of parathyroid adenoma. Therefore, we designed a proof of concept study aimed to investigate the glucose/fatty acid metabolisms, in addition to the mitochondrial changes, in solitary parathyroid adenoma and in healthy parathyroid glands. METHODS Nine females with primary hyperparathyroidism due to a solitary parathyroid adenoma and formal surgical indication for parathyroidectomy have been enrolled. At the time of surgery, the removed specimens were immediately submitted unfixed and a tissue slice of about 0.5 cm in diameter was obtained from the nodular lesion. The expression of selected metabolic enzymes and proteins has been evaluated by western blot analysis, using human parathyroid whole tissue lysates as control. RESULTS Data obtained highlighted an increase, compared with the healthy group, of: (i) the glucose uptake by the GLUT-1 receptor and its phosphorylation by hexokinase II (HXKII); (ii) the expression of 3-phosphoglycerate dehydrogenase (3-PGDH) and glucose-6-phosphate dehydrogenase (G6PD); (iii) lipids biosynthesis; and (iv) cytochrome c expression. CONCLUSIONS Our findings highlight for the first time the parathyroid adenoma metabolic hallmarks that could represent potential molecular targets usable for the development of new pharmacological treatments, allowing to reduce surgical parathyroidectomy.
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Affiliation(s)
| | - Loris Leboffe
- Department of Sciences, Roma Tre University, I-00146, Roma, Italy
| | - Armida Sodo
- Department of Sciences, Roma Tre University, I-00146, Roma, Italy
| | - Gaia Tabacco
- Unit of Endocrinology and Diabetes, Campus Bio-Medico University, Roma, Italy
| | - Roberto Cesareo
- Unit of Metabolic Diseases, Department of Internal Medicine, Santa Maria Goretti Hospital, Latina, Italy
| | - Marco Sbroscia
- Department of Sciences, Roma Tre University, I-00146, Roma, Italy
| | | | - Chiara Taffon
- Pathology Unit, Campus Bio-Medico University Hospital, Roma, Italy
| | | | - Filippo Longo
- Unit of Neck and Chest Surgery, Campus Bio-Medico University, Roma, Italy
| | - Silvia Manfrini
- Unit of Endocrinology and Diabetes, Campus Bio-Medico University, Roma, Italy
| | | | - Paolo Ascenzi
- Department of Sciences, Roma Tre University, I-00146, Roma, Italy
| | - Anna Crescenzi
- Pathology Unit, Campus Bio-Medico University Hospital, Roma, Italy
| | - Andrea Palermo
- Unit of Endocrinology and Diabetes, Campus Bio-Medico University, Roma, Italy
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Bertolaccini L, Batirel H, Brunelli A, Gonzalez-Rivas D, Ismail M, Ucar AM, Ng CSH, Scarci M, Sihoe ADL, Ugalde PA, Akar FA, Bedetti B, Nadal SB, Brandolini J, Crucitti P, Enyedi A, Fernando HC, Furak J, Gallego-Poveda J, Galvez-Munos C, Hanke I, Hernandez-Arenas LA, Janik M, Juhos P, Libretti L, Lucciarini P, Macrì P, Margaritora S, Mahoozi HR, Nachira D, Pardolesi A, Pischik V, Sagan D, Schreurs H, Sekhniaidze D, Socci L, Tosi D, Turna A, Vannucci F, Zielinski M, Rocco G. Corrigendum to 'Uniportal video-assisted thoracic surgery lobectomy: a consensus report from the Uniportal VATS Interest Group (UVIG) of the European Society of Thoracic Surgeons (ESTS)' [Eur J Cardiothorac Surg 2019;56:224-9]. Eur J Cardiothorac Surg 2019; 56:628-629. [PMID: 31436834 DOI: 10.1093/ejcts/ezz229] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Luca Bertolaccini
- Department of Thoracic Surgery, Maggiore Teaching Hospital, Bologna, Italy
| | - Hasan Batirel
- Department of Thoracic Surgery, Marmara University Hospital, Istanbul, Turkey
| | | | - Diego Gonzalez-Rivas
- Minimally Invasive Thoracic Surgery Unit (UCTMI), Department of Thoracic Surgery, Coruna University Hospital, Coruna, Spain
| | - Mahmoud Ismail
- Department of Thoracic Surgery, Klinikum Ernst von Bergmann, Potsdam, Germany
| | | | - Calvin S H Ng
- Department of Surgery, The Chinese University of Hong Kong, Hong Kong, China
| | - Marco Scarci
- Department of Thoracic Surgery, San Gerardo Hospital, Monza, Italy
| | - Alan D L Sihoe
- Department of Surgery, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China.,Department of Thoracic Surgery, Tongji University Shanghai Pulmonary Hospital, Shanghai, China
| | - Paula A Ugalde
- Department of Thoracic Surgery, Institut Universitaire de Cardiologie et de Pneumologie de Québec (Hôpital Laval), Quebec, Canada
| | - Firas Abu Akar
- Department of Cardiothoracic Surgery, Makassed Charitable Society Hospital, East Jerusalem, Israel.,Department of Cardiothoracic Surgery, Shaare Zedek Medical Center (SZMC), Jerusalem, Israel
| | | | | | - Jury Brandolini
- Department of Thoracic Surgery, Maggiore Teaching Hospital, Bologna, Italy
| | | | - Attila Enyedi
- Division of Thoracic Surgery, University of Debrecen, Debrecen, Hungary
| | - Hiran C Fernando
- Department of Surgery, Fairfax Medical Campus, Falls Church, VA, USA
| | - Jozsef Furak
- Department of Surgery, University of Szeged, Szeged, Hungary
| | | | - Carlos Galvez-Munos
- Department of Thoracic Surgery, General University Hospital, Alicante, Spain
| | - Ivo Hanke
- Department of Thoracic Surgery, University Hospital Hradec Kralove, Hradec, Kralov, Czech Republic
| | - Luis A Hernandez-Arenas
- Department of Thoracic Surgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Miroslav Janik
- Department of Thoracic Surgery, Slovak Medical University, University Hospital Bratislava, Bratislava, Slovakia
| | - Peter Juhos
- Department of Thoracic Surgery, Slovak Medical University, University Hospital Bratislava, Bratislava, Slovakia
| | - Lidia Libretti
- Department of Thoracic Surgery, San Gerardo Hospital, Monza, Italy
| | - Paolo Lucciarini
- Department of Visceral, Transplant and Thoracic Surgery, Medical University Innsbruck, Innsbruck, Austria
| | - Paolo Macrì
- Thoracic Surgery Unit, Istituto Clinico Humanitas CCO - Catania, Catania, Italy
| | - Stefano Margaritora
- Department of General Thoracic Surgery, Fondazione Policlinico Universitario "A. Gemelli", Rome, Italy
| | - Hamid Reza Mahoozi
- Department of Thoracic Surgery, Evangelisches Krankenhaus Herne, Herne, Germany
| | - Dania Nachira
- Department of General Thoracic Surgery, Fondazione Policlinico Universitario "A. Gemelli", Rome, Italy
| | | | - Vadim Pischik
- Faculty of Medicine, St-Petersburg State University, Saint-Petersburg, Russia
| | - Dariusz Sagan
- Department of Thoracic Surgery, Medical University of Lublin, Lublin, Poland
| | | | | | - Laura Socci
- Thoracic Surgery Units, Sheffield Teaching Hospital, Sheffield, UK
| | - Davide Tosi
- Division of Thoracic and Transplant Surgery, Fondazione Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Akif Turna
- Department of Thoracic Surgery, Cerrahpasa Medical School, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Fernando Vannucci
- Department of Thoracic Surgery, Hospital Federal do Andarai, Rio de Janeiro, Brazil
| | - Marcin Zielinski
- Department of Thoracic Surgery, Pulmonary Hospital, Zakopane, Poland
| | - Gaetano Rocco
- Department of Surgery, Thoracic Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
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Frasca L, Carannante F, Longo F, Marziali V, Crucitti P. Sarcopenia in non-small cell lung cancer patients underwent pulmonary surgery: clinical outcome and cost effectiveness. J Hosp Manag Health Policy 2019; 3:25-25. [DOI: 10.21037/jhmhp.2019.08.04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/16/2023]
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Carannante F, Frasca L, Depalma M, Longo F, Crucitti P. Ectopic thoracic thyroid removed by uniportal VATS approach. A case report. Int J Surg Case Rep 2019; 61:111-114. [PMID: 31357100 PMCID: PMC6664090 DOI: 10.1016/j.ijscr.2019.07.027] [Citation(s) in RCA: 4] [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: 04/21/2019] [Revised: 07/11/2019] [Accepted: 07/14/2019] [Indexed: 12/13/2022] Open
Abstract
VATS technique is minimally invasive and, moreover, it is characterized by a shorter recovery period, a minor blood loss and a shorter hospital stay. We speak of “Ectopic thyroid gland” when a piece of thyroid tissue is placed at a certain distance from the second to fourth tracheal cartilages. This case report aims at describing the successful extraction of a massive piece of ectopic thyroid from a young woman’s body, thanks to uniportal VATS.
Introduction We speak of “Ectopic thyroid gland” when a piece of thyroid tissue is placed at a certain distance from the second to fourth tracheal cartilages. Presentation of case This case report focuses on a case of a hyperplastic cystic nodule of ectopic thyroid in a 30-year-old woman treated with uniportal video-assisted thoracic surgery (VATS). The patient, was admitted to Emergency Unit for abdominal pain and vomit, underwent a CT which highlighted a mass of significant dimension on the right side of the mediastinum, in contact with close structures. The lesion has been removed with an innovative mini-invasive technique, which is characterized, differently from traditional surgical approaches, by reduced loss of blood and time of hospitalization and, in addiction to that, an aesthetic small-dimensioned scar. Discussion VATS technique is minimally invasive and, moreover, it is characterized by a shorter recovery period, a minor blood loss and a shorter hospital stay. VATS has been advocated since 2010 for pulmonary resections, but today it is also performed for mediastinal intervention and a series of reports have demonstrated that it is feasible and safe. Conclusion The report aims at pointing out the possibility of undergoing this kind of surgery not only in case of pulmonary mass (on which the previous literature has focused) but also when mediastinum lesions occur, as in our case.
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Affiliation(s)
- F Carannante
- Department of Thoracic Surgery, Università Campus Bio-Medico, Via Alvaro del Portillo 21, 00128 Rome, Italy.
| | - L Frasca
- Department of Thoracic Surgery, Università Campus Bio-Medico, Via Alvaro del Portillo 21, 00128 Rome, Italy
| | - M Depalma
- Department of Thoracic Surgery, Università Campus Bio-Medico, Via Alvaro del Portillo 21, 00128 Rome, Italy
| | - F Longo
- Department of Thoracic Surgery, Università Campus Bio-Medico, Via Alvaro del Portillo 21, 00128 Rome, Italy
| | - P Crucitti
- Department of Thoracic Surgery, Università Campus Bio-Medico, Via Alvaro del Portillo 21, 00128 Rome, Italy
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Bertolaccini L, Batirel H, Brunelli A, Gonzalez-Rivas D, Ismail M, Ucar AM, Ng CSH, Scarci M, Sihoe ADL, Ugalde PA, Abu Akar F, Bedetti B, Nadal SB, Brandolini J, Crucitti P, Enyedi A, Fernando HC, Furak J, Gallego-Poveda J, Galvez-Munos C, Hanke I, Hernandez-Arenas LA, Janik M, Juhos P, Libretti L, Lucciarini P, Macrì P, Margaritora S, Mahoozi HR, Nachira D, Pardolesi A, Pischik V, Sagan D, Schreurs H, Sekhniaidze D, Socci L, Tosi D, Turna A, Vannucci F, Zielinski M, Rocco G. Uniportal video-assisted thoracic surgery lobectomy: a consensus report from the Uniportal VATS Interest Group (UVIG) of the European Society of Thoracic Surgeons (ESTS). Eur J Cardiothorac Surg 2019; 56:224-229. [DOI: 10.1093/ejcts/ezz133] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Revised: 03/07/2019] [Accepted: 03/20/2019] [Indexed: 01/05/2023] Open
Abstract
Abstract
OBJECTIVES
Our goal was to report the results of the first consensus paper among international experts in uniportal video-assisted thoracoscopic surgery (UniVATS) lobectomy obtained through a Delphi process, the objective of which was to define and standardize the main procedural steps, optimize its indications and perioperative management and identify elements to assist in future training.
METHODS
The 40 members of the working group were convened and organized on a voluntary basis by the Uniportal VATS Interest Group (UVIG) of the European Society of Thoracic Surgeons (ESTS). An e-consensus finding exercise using the Delphi method was applied to require 75% agreement for reaching consensus on each question. Repeated iterations of anonymous voting continued for 3 rounds.
RESULTS
Overall, 31 international experts from 18 countries completed all 3 rounds of questionnaires. Although a technical quorum was not achieved, most of the responders agreed that the maximum size of a UniVATS incision should be ≤4 cm. Agreement was reached on many points outlining the currently accepted definition of a UniVATS lobectomy, its indications and contraindications, perioperative clinical management and recommendations for training and future research directions.
CONCLUSIONS
The UVIG Consensus Report stated that UniVATS offers a valid alternative to standard VATS techniques. Only longer follow-up and randomized controlled studies will predict whether UniVATS represents a valid alternative approach to multiport VATS for major lung resections or whether it should be performed only in selected cases and by selected centres. The next step for the ESTS UVIG is the establishment of a UniVATS section inside the ESTS databases.
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Affiliation(s)
- Luca Bertolaccini
- Department of Thoracic Surgery, Maggiore Teaching Hospital, Bologna, Italy
| | - Hasan Batirel
- Department of Thoracic Surgery, Marmara University Hospital, Istanbul, Turkey
| | | | - Diego Gonzalez-Rivas
- Minimally Invasive Thoracic Surgery Unit (UCTMI), Department of Thoracic Surgery, Coruña University Hospital, Coruña, Spain
| | - Mahmoud Ismail
- Department of Thoracic Surgery, Klinikum Ernst von Bergmann, Potsdam, Germany
| | | | - Calvin S H Ng
- Department of Surgery, The Chinese University of Hong Kong, Hong Kong, China
| | - Marco Scarci
- Department of Thoracic Surgery, San Gerardo Hospital, Monza, Italy
| | - Alan D L Sihoe
- Department of Surgery, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
- Department of Thoracic Surgery, Tongji University Shanghai Pulmonary Hospital, Shanghai, China
| | - Paula A Ugalde
- Department of Thoracic Surgery, Institut Universitaire de Cardiologie et de Pneumologie de Québec (Hôpital Laval), Quebec, Canada
| | - Firas Abu Akar
- Department of Cardiothoracic Surgery, Makassed Charitable Society Hospital, East Jerusalem, Israel
- Department of Cardiothoracic Surgery, Shaare Zedek Medical Center (SZMC), Jerusalem, Israel
| | | | | | - Jury Brandolini
- Department of Thoracic Surgery, Maggiore Teaching Hospital, Bologna, Italy
| | | | - Attila Enyedi
- Division of Thoracic Surgery, University of Debrecen, Debrecen, Hungary
| | - Hiran C Fernando
- Department of Surgery, Fairfax Medical Campus, Falls Church, VA, USA
| | - Jozsef Furak
- Department of Surgery, University of Szeged, Szeged, Hungary
| | | | - Carlos Galvez-Munos
- Department of Thoracic Surgery, General University Hospital, Alicante, Spain
| | - Ivo Hanke
- Department of Thoracic Surgery, University Hospital Hradec Kralove, Hradec, Kralov, Czech Republic
| | - Luis A Hernandez-Arenas
- Department of Thoracic Surgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Miroslav Janik
- Department of Thoracic Surgery, Slovak Medical University, University Hospital Bratislava, Bratislava, Slovakia
| | - Peter Juhos
- Department of Thoracic Surgery, Slovak Medical University, University Hospital Bratislava, Bratislava, Slovakia
| | - Lidia Libretti
- Department of Thoracic Surgery, San Gerardo Hospital, Monza, Italy
| | - Paolo Lucciarini
- Department of Visceral, Transplant and Thoracic Surgery, Medical University Innsbruck, Innsbruck, Austria
| | - Paolo Macrì
- Thoracic Surgery Unit, Istituto Clinico Humanitas CCO – Catania, Catania, Italy
| | - Stefano Margaritora
- Department of General Thoracic Surgery, Fondazione Policlinico Universitario “A. Gemelli”, Rome, Italy
| | - Hamid Reza Mahoozi
- Department of Thoracic Surgery, Evangelisches Krankenhaus Herne, Herne, Germany
| | - Dania Nachira
- Department of General Thoracic Surgery, Fondazione Policlinico Universitario “A. Gemelli”, Rome, Italy
| | | | - Vadim Pischik
- Faculty of Medicine, St-Petersburg State University, Saint-Petersburg, Russia
| | - Dariusz Sagan
- Department of Thoracic Surgery, Medical University of Lublin, Lublin, Poland
| | | | | | - Laura Socci
- Thoracic Surgery Units, Sheffield Teaching Hospital, Sheffield, UK
| | - Davide Tosi
- Department of Thoracic Surgery, Cerrahpasa Medical School, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Akif Turna
- Division of Thoracic and Transplant Surgery, Fondazione Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Fernando Vannucci
- Department of Thoracic Surgery, Hospital Federal do Andaraí, Rio de Janeiro, Brazil
| | - Marcin Zielinski
- Department of Thoracic Surgery, Pulmonary Hospital, Zakopane, Poland
| | - Gaetano Rocco
- Department of Surgery, Thoracic Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
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Pezzuto A, Stellato M, Catania G, Mazzara C, Tonini S, Caricato M, Crucitti P, Tonini G. Short-term benefit of smoking cessation along with glycopirronium on lung function and respiratory symptoms in mild COPD patients: a retrospective study. J Breath Res 2018; 12:046007. [PMID: 29967309 DOI: 10.1088/1752-7163/aad0a8] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [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]
Abstract
INTRODUCTION Tobacco smoke is the leading cause of chronic obstructive pulmonary disease (COPD). Smoking cessation can change the natural history of COPD, as we know from the GOLD guidelines. Little is known about the short-term clinical and functional effects of smoking cessation treatment combined with anti-muscarinic bronchodilators. OBJECTIVE To determine whether quitting smoking, obtained by smoking cessation treatment combined with the use of a new long-acting muscarinic antagonist bronchodilator (LAMA), can improve lung function tests and respiratory symptoms more than the use of LAMA alone. METHODS We evaluated, in a retrospective analysis, the functional and clinical data, collected in one year, of 120 patients who were current smokers affected by mild COPD and who quit smoking using smoking cessation treatment combined with glycopirronium. We compared them with a group of 80 patients with mild COPD undergoing the same treatment but who did not quit smoking. All patients underwent functional and clinical tests at baseline and at a third-month check. MEASUREMENTS AND MAIN RESULTS The two groups were homogeneous in terms of demographic data without significant differences. All patients used varenicline for smoking cessation. They all performed the following tests: a spirometry with detection of resistances, the 6 min walking test, haemogasanalysis, the exhaled CO test, the COPD assessment test (CAT) and finally the modified Medical Research Council test (mMRC). A significant improvement in the functional tests at the third-month check was found in both groups-quitters and non-quitters. However, a notable increase in the examined parameters was registered in the group of patients who quit smoking, in particular, we observed a significant increase at the third-month check of the parameter forced expiratory volume in 1 s (FEV1) of more than 200 ml with p < 0.001. A comparison between quitters and non-quitters revealed a major benefit derived from smoking cessation in terms of functional changes and symptom relief. In particular, not only FEV1 but also forced expiratory flow at 25%-75% of vital capacity (FEF 25-75) (p < 0.01) and CAT (p < 0.001) were found to be significantly improved in patients who quit than in patients who did not at the check time point. CONCLUSIONS Smoking cessation treatment obtained by varenicline was confirmed as a crucial therapeutic option, especially when combined with bronchodilator in mild COPD. Patients who quit smoking could already benefit from both treatments in the short term, improving lung function and respiratory symptoms and therefore improving their quality of life.
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Affiliation(s)
- Aldo Pezzuto
- Cardiovascular-pulmonary Department, Sant' Andrea Hospital-Sapienza University, Via di Grottarossa, 1035/39 , I-00189; Rome, Italy
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Palermo A, Fosca M, Tabacco G, Marini F, Graziani V, Santarsia MC, Longo F, Lauria A, Cesareo R, Giovannoni I, Taffon C, Rocchia M, Manfrini S, Crucitti P, Pozzilli P, Crescenzi A, Rau JV. Raman Spectroscopy Applied to Parathyroid Tissues: A New Diagnostic Tool to Discriminate Normal Tissue from Adenoma. Anal Chem 2017; 90:847-854. [PMID: 29227640 DOI: 10.1021/acs.analchem.7b03617] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Primary hyperparathyroidism is an endocrine disorder characterized by autonomous production of parathyroid hormone. Patients with the symptomatic disease should be referred for parathyroidectomy. However, the distinction between the pathological condition and the benign one is very challenging in the surgical setting; therefore, accurate recognition is important to ensure success during minimally invasive surgery. At present, all intraoperative techniques significantly increase surgical time and, consequently, cost. In this proof-of-concept study, Raman microscopy was used to differentiate between healthy parathyroid tissue and parathyroid adenoma from 18 patients. The data showed different spectroscopic features for the two main tissue types of healthy and adenoma. Moreover, the parathyroid adenoma subtypes (chief cells and oxyphil cells) were characterized by their own Raman spectra. The partial least-squares discriminant analysis (PLS-DA) model built to discriminate healthy from adenomatous parathyroid tissue was able to correctly classify all samples in the calibration and validation data sets, providing 100% prediction accuracy. The PLS-DA model built to discriminate chief cell adenoma from oxyphil cell adenoma allowed us to correctly classify >99% of the spectra during calibration and cross-validation and to correctly predict 100% of oxyphil and 99.8% of chief cells in the external validation data set. The results clearly demonstrate the great potential of Raman spectroscopy. The final goal would be development of a Raman portable fiber probe device for intraoperative optical biopsy, both to improve the surgical success rate and reduce surgical cost.
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Affiliation(s)
- Andrea Palermo
- Unit of Endocrinology and Diabetes, Campus Bio-Medico University , via Álvaro del Portillo 200, 00128 Roma, Italy
| | - Marco Fosca
- Istituto di Struttura della Materia, Consiglio Nazionale delle Ricerche (ISM-CNR) , via del Fosso del Cavaliere 100, 00133 Roma, Italy
| | - Gaia Tabacco
- Unit of Endocrinology and Diabetes, Campus Bio-Medico University , via Álvaro del Portillo 200, 00128 Roma, Italy
| | - Federico Marini
- Dipartimento di Chimica, Università"La Sapienza" , Piazzale Aldo Moro 5, 00185 Roma, Italy
| | - Valerio Graziani
- Istituto di Struttura della Materia, Consiglio Nazionale delle Ricerche (ISM-CNR) , via del Fosso del Cavaliere 100, 00133 Roma, Italy
| | - Maria Carla Santarsia
- Unit of Endocrinology and Diabetes, Campus Bio-Medico University , via Álvaro del Portillo 200, 00128 Roma, Italy
| | - Filippo Longo
- Unit of Neck and Chest Surgery, Campus Bio-Medico University , via Álvaro del Portillo 200, 00128 Roma, Italy
| | - Angelo Lauria
- Unit of Endocrinology and Diabetes, Campus Bio-Medico University , via Álvaro del Portillo 200, 00128 Roma, Italy
| | - Roberto Cesareo
- Malattie della Tiroide ed Osteometaboliche, Hospital Santa Maria Goretti , Via Canova, 04100 Latina, Italy
| | - Isabella Giovannoni
- Unit of Pathology, Campus Bio-Medico University , via Álvaro del Portillo 200, 00128 Roma, Italy
| | - Chiara Taffon
- Unit of Pathology, Campus Bio-Medico University , via Álvaro del Portillo 200, 00128 Roma, Italy
| | | | - Silvia Manfrini
- Unit of Endocrinology and Diabetes, Campus Bio-Medico University , via Álvaro del Portillo 200, 00128 Roma, Italy
| | - Pierfilippo Crucitti
- Unit of Neck and Chest Surgery, Campus Bio-Medico University , via Álvaro del Portillo 200, 00128 Roma, Italy
| | - Paolo Pozzilli
- Unit of Endocrinology and Diabetes, Campus Bio-Medico University , via Álvaro del Portillo 200, 00128 Roma, Italy
| | - Anna Crescenzi
- Unit of Pathology, Campus Bio-Medico University , via Álvaro del Portillo 200, 00128 Roma, Italy
| | - Julietta V Rau
- Istituto di Struttura della Materia, Consiglio Nazionale delle Ricerche (ISM-CNR) , via del Fosso del Cavaliere 100, 00133 Roma, Italy
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29
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Longo F, Crucitti P, Quintarelli F, Rocco R, Mangiameli G, Rocco G. Bipolar sealing devices in video-assisted thoracic surgery. J Vis Surg 2017; 3:13. [PMID: 29078576 DOI: 10.21037/jovs.2017.01.07] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [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: 11/30/2016] [Accepted: 12/13/2016] [Indexed: 11/06/2022]
Abstract
Intraoperative bleeding is one of the main severe complications in complete video-assisted thoracic surgery (c-VATS) and post-operative air-leaks prevention still represents an important challenge. Usually, hemostasis is often difficult and unsafe when the VATS approach is performed and the potential role of bipolar sealing devices is still undefined, as proven by limited experiences reported in the literature. By introducing endostaplers in VATS surgery, it was possible to perform safe thoracoscopic resections of lung. On the other hand, several diathermy techniques have been proposed to reduce intraoperative blood loss in surgery. In particular, standard bipolar technology has proven to effect coagulation in small vessels. The aim of this study is to compare bipolar electro thermal devices to endostapler in VATS lung resections concerning intraoperative bleeding and post-operative air leaks.
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Affiliation(s)
- Filippo Longo
- Section of Thoracic Surgery, Department of Vascular Surgery, Campus Bio-Medico University of Rome, Rome, Italy
| | - Pierfilippo Crucitti
- Section of Thoracic Surgery, Department of Vascular Surgery, Campus Bio-Medico University of Rome, Rome, Italy
| | - Fabio Quintarelli
- Section of Thoracic Surgery, Department of Vascular Surgery, Campus Bio-Medico University of Rome, Rome, Italy
| | - Raffaele Rocco
- Section of Thoracic Surgery, Department of Vascular Surgery, Campus Bio-Medico University of Rome, Rome, Italy
| | - Giuseppe Mangiameli
- Section of Thoracic Surgery, Department of Vascular Surgery, Campus Bio-Medico University of Rome, Rome, Italy
| | - Gaetano Rocco
- Division of Thoracic Surgery, Department of Thoracic Surgery and Oncology, Istituto Nazionale Tumori, IRCCS, Fondazione Pascale, Napoli, Italy
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Mangiameli G, Longo F, Grasso RF, Iacopino A, Rocco R, Quintarelli F, Crucitti P. Focus on lung cancer screening program at Campus Bio-Medico of Rome: update on over 3250 patients. MINERVA CHIR 2017. [PMID: 28635245 DOI: 10.23736/s0026-4733.17.07336-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Giuseppe Mangiameli
- Section of Thoracic Surgery, Department of Vascular Surgery, Campus Bio-Medico University, Rome, Italy -
| | - Filippo Longo
- Section of Thoracic Surgery, Department of Vascular Surgery, Campus Bio-Medico University, Rome, Italy
| | - Rosario F Grasso
- Department of Radiology, Campus Bio-Medico University, Rome, Italy
| | - Antonino Iacopino
- Section of Thoracic Surgery, Department of Vascular Surgery, Campus Bio-Medico University, Rome, Italy
| | - Raffaele Rocco
- Section of Thoracic Surgery, Department of Vascular Surgery, Campus Bio-Medico University, Rome, Italy
| | - Fabio Quintarelli
- Section of Thoracic Surgery, Department of Vascular Surgery, Campus Bio-Medico University, Rome, Italy
| | - Pierfilippo Crucitti
- Section of Thoracic Surgery, Department of Vascular Surgery, Campus Bio-Medico University, Rome, Italy
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Longo F, Rocco R, Crucitti P, Gonzales-Rivas D, Rocco G. Non intubated VATS: where do we stand? Video-assist Thorac Surg 2017. [DOI: 10.21037/vats.2017.03.05] [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: 11/06/2022]
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Crucitti P, Mangiameli G, Petitti T, Condoluci A, Rocco R, Gallo IF, Longo F, Rocco G. Does prophylactic ligation of the thoracic duct reduce chylothorax rates in patients undergoing oesophagectomy? A systematic review and meta-analysis. Eur J Cardiothorac Surg 2016; 50:1019-1024. [DOI: 10.1093/ejcts/ezw125] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/30/2023] Open
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Palermo A, Mangiameli G, Tabacco G, Longo F, Pedone C, Briganti SI, Maggi D, Vescini F, Naciu A, Lauria Pantano A, Napoli N, Angeletti S, Pozzilli P, Crucitti P, Manfrini S. PTH(1-34) for the Primary Prevention of Postthyroidectomy Hypocalcemia: The THYPOS Trial. J Clin Endocrinol Metab 2016; 101:4039-4045. [PMID: 27525532 DOI: 10.1210/jc.2016-2530] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Abstract
CONTEXT There are no studies evaluating teriparatide for prevention of post-thyroidectomy hypocalcemia. OBJECTIVE Our objective was to evaluate whether teriparatide can prevent postsurgical hypocalcemia and shorten the hospitalization in subjects at high risk of hypocalcemia following thyroid surgery. DESIGN This was a prospective phase II randomized open-label trial. SETTING This trial was set on a surgical ward. PATIENTS Twenty-six subjects (six males, 20 females) with intact PTH lower than10 pg/ml 4 hours after thyroidectomy were included. INTERVENTION Subjects were randomized (1:1) to receive SC administration of 20 mcg of teriparatide every 12 hours until the discharge (treatment group) or to follow standard clinical care (control group). MAIN OUTCOME MEASURE Adjusted serum calcium, duration of hospitalization, and calcium/calcitriol supplementation were measured. RESULTS Overall, the incidence of hypocalcemia was 3/13 in treatment group and 11/13 in the control group (P = .006). Treated patients had a lower risk of hypocalcemia than controls (relative risk, 0.26 [95% confidence interval, 0.09-0.723)]). The median duration of hospitalization was 3 days (interquartile range, 1) in control subjects and 2 days (interquartile range, 0) in treated subjects (P = .012). One month after discharge, 10/13 subjects in the treatment group had stopped calcium carbonate supplements, while only 5/13 in the control group had discontinued calcium. The ANOVA for repeated measures showed a significant difference in calcium supplements between groups at 1-month visit (P = .04) as well as a significant difference between discharge and 1-month visit in the treatment group (P for interaction time group = .04) Conclusions: Teriparatide may prevent postsurgical hypocalcemia, shorten the duration of hospitalization, and reduce the need for calcium and vitamin D supplementation after discharge in high risk subjects after thyroid surgery.
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Affiliation(s)
- Andrea Palermo
- Department of Endocrinology and Diabetes (A.P., G.T., S.I.B., D.M., A.N., A.L.P., N.N., P.P., S.M.), University Campus Bio-Medico, Rome, Italy; Department of Neck and Chest Surgery (G.M., F.L., P.C.), University Campus Bio-Medico, Rome, Italy; Department of Geriatric Medicine (C.P.), University Campus Bio-Medico, Rome, Italy; Department of Endocrinology and Diabetes (F.V.), Santa Maria della Misericordia Hospital, Udine, Italy; Department of Laboratory Medicine (S.A.), University Campus Bio-Medico, Rome, Italy
| | - Giuseppe Mangiameli
- Department of Endocrinology and Diabetes (A.P., G.T., S.I.B., D.M., A.N., A.L.P., N.N., P.P., S.M.), University Campus Bio-Medico, Rome, Italy; Department of Neck and Chest Surgery (G.M., F.L., P.C.), University Campus Bio-Medico, Rome, Italy; Department of Geriatric Medicine (C.P.), University Campus Bio-Medico, Rome, Italy; Department of Endocrinology and Diabetes (F.V.), Santa Maria della Misericordia Hospital, Udine, Italy; Department of Laboratory Medicine (S.A.), University Campus Bio-Medico, Rome, Italy
| | - Gaia Tabacco
- Department of Endocrinology and Diabetes (A.P., G.T., S.I.B., D.M., A.N., A.L.P., N.N., P.P., S.M.), University Campus Bio-Medico, Rome, Italy; Department of Neck and Chest Surgery (G.M., F.L., P.C.), University Campus Bio-Medico, Rome, Italy; Department of Geriatric Medicine (C.P.), University Campus Bio-Medico, Rome, Italy; Department of Endocrinology and Diabetes (F.V.), Santa Maria della Misericordia Hospital, Udine, Italy; Department of Laboratory Medicine (S.A.), University Campus Bio-Medico, Rome, Italy
| | - Filippo Longo
- Department of Endocrinology and Diabetes (A.P., G.T., S.I.B., D.M., A.N., A.L.P., N.N., P.P., S.M.), University Campus Bio-Medico, Rome, Italy; Department of Neck and Chest Surgery (G.M., F.L., P.C.), University Campus Bio-Medico, Rome, Italy; Department of Geriatric Medicine (C.P.), University Campus Bio-Medico, Rome, Italy; Department of Endocrinology and Diabetes (F.V.), Santa Maria della Misericordia Hospital, Udine, Italy; Department of Laboratory Medicine (S.A.), University Campus Bio-Medico, Rome, Italy
| | - Claudio Pedone
- Department of Endocrinology and Diabetes (A.P., G.T., S.I.B., D.M., A.N., A.L.P., N.N., P.P., S.M.), University Campus Bio-Medico, Rome, Italy; Department of Neck and Chest Surgery (G.M., F.L., P.C.), University Campus Bio-Medico, Rome, Italy; Department of Geriatric Medicine (C.P.), University Campus Bio-Medico, Rome, Italy; Department of Endocrinology and Diabetes (F.V.), Santa Maria della Misericordia Hospital, Udine, Italy; Department of Laboratory Medicine (S.A.), University Campus Bio-Medico, Rome, Italy
| | - Silvia Irina Briganti
- Department of Endocrinology and Diabetes (A.P., G.T., S.I.B., D.M., A.N., A.L.P., N.N., P.P., S.M.), University Campus Bio-Medico, Rome, Italy; Department of Neck and Chest Surgery (G.M., F.L., P.C.), University Campus Bio-Medico, Rome, Italy; Department of Geriatric Medicine (C.P.), University Campus Bio-Medico, Rome, Italy; Department of Endocrinology and Diabetes (F.V.), Santa Maria della Misericordia Hospital, Udine, Italy; Department of Laboratory Medicine (S.A.), University Campus Bio-Medico, Rome, Italy
| | - Daria Maggi
- Department of Endocrinology and Diabetes (A.P., G.T., S.I.B., D.M., A.N., A.L.P., N.N., P.P., S.M.), University Campus Bio-Medico, Rome, Italy; Department of Neck and Chest Surgery (G.M., F.L., P.C.), University Campus Bio-Medico, Rome, Italy; Department of Geriatric Medicine (C.P.), University Campus Bio-Medico, Rome, Italy; Department of Endocrinology and Diabetes (F.V.), Santa Maria della Misericordia Hospital, Udine, Italy; Department of Laboratory Medicine (S.A.), University Campus Bio-Medico, Rome, Italy
| | - Fabio Vescini
- Department of Endocrinology and Diabetes (A.P., G.T., S.I.B., D.M., A.N., A.L.P., N.N., P.P., S.M.), University Campus Bio-Medico, Rome, Italy; Department of Neck and Chest Surgery (G.M., F.L., P.C.), University Campus Bio-Medico, Rome, Italy; Department of Geriatric Medicine (C.P.), University Campus Bio-Medico, Rome, Italy; Department of Endocrinology and Diabetes (F.V.), Santa Maria della Misericordia Hospital, Udine, Italy; Department of Laboratory Medicine (S.A.), University Campus Bio-Medico, Rome, Italy
| | - Anda Naciu
- Department of Endocrinology and Diabetes (A.P., G.T., S.I.B., D.M., A.N., A.L.P., N.N., P.P., S.M.), University Campus Bio-Medico, Rome, Italy; Department of Neck and Chest Surgery (G.M., F.L., P.C.), University Campus Bio-Medico, Rome, Italy; Department of Geriatric Medicine (C.P.), University Campus Bio-Medico, Rome, Italy; Department of Endocrinology and Diabetes (F.V.), Santa Maria della Misericordia Hospital, Udine, Italy; Department of Laboratory Medicine (S.A.), University Campus Bio-Medico, Rome, Italy
| | - Angelo Lauria Pantano
- Department of Endocrinology and Diabetes (A.P., G.T., S.I.B., D.M., A.N., A.L.P., N.N., P.P., S.M.), University Campus Bio-Medico, Rome, Italy; Department of Neck and Chest Surgery (G.M., F.L., P.C.), University Campus Bio-Medico, Rome, Italy; Department of Geriatric Medicine (C.P.), University Campus Bio-Medico, Rome, Italy; Department of Endocrinology and Diabetes (F.V.), Santa Maria della Misericordia Hospital, Udine, Italy; Department of Laboratory Medicine (S.A.), University Campus Bio-Medico, Rome, Italy
| | - Nicola Napoli
- Department of Endocrinology and Diabetes (A.P., G.T., S.I.B., D.M., A.N., A.L.P., N.N., P.P., S.M.), University Campus Bio-Medico, Rome, Italy; Department of Neck and Chest Surgery (G.M., F.L., P.C.), University Campus Bio-Medico, Rome, Italy; Department of Geriatric Medicine (C.P.), University Campus Bio-Medico, Rome, Italy; Department of Endocrinology and Diabetes (F.V.), Santa Maria della Misericordia Hospital, Udine, Italy; Department of Laboratory Medicine (S.A.), University Campus Bio-Medico, Rome, Italy
| | - Silvia Angeletti
- Department of Endocrinology and Diabetes (A.P., G.T., S.I.B., D.M., A.N., A.L.P., N.N., P.P., S.M.), University Campus Bio-Medico, Rome, Italy; Department of Neck and Chest Surgery (G.M., F.L., P.C.), University Campus Bio-Medico, Rome, Italy; Department of Geriatric Medicine (C.P.), University Campus Bio-Medico, Rome, Italy; Department of Endocrinology and Diabetes (F.V.), Santa Maria della Misericordia Hospital, Udine, Italy; Department of Laboratory Medicine (S.A.), University Campus Bio-Medico, Rome, Italy
| | - Paolo Pozzilli
- Department of Endocrinology and Diabetes (A.P., G.T., S.I.B., D.M., A.N., A.L.P., N.N., P.P., S.M.), University Campus Bio-Medico, Rome, Italy; Department of Neck and Chest Surgery (G.M., F.L., P.C.), University Campus Bio-Medico, Rome, Italy; Department of Geriatric Medicine (C.P.), University Campus Bio-Medico, Rome, Italy; Department of Endocrinology and Diabetes (F.V.), Santa Maria della Misericordia Hospital, Udine, Italy; Department of Laboratory Medicine (S.A.), University Campus Bio-Medico, Rome, Italy
| | - Pierfilippo Crucitti
- Department of Endocrinology and Diabetes (A.P., G.T., S.I.B., D.M., A.N., A.L.P., N.N., P.P., S.M.), University Campus Bio-Medico, Rome, Italy; Department of Neck and Chest Surgery (G.M., F.L., P.C.), University Campus Bio-Medico, Rome, Italy; Department of Geriatric Medicine (C.P.), University Campus Bio-Medico, Rome, Italy; Department of Endocrinology and Diabetes (F.V.), Santa Maria della Misericordia Hospital, Udine, Italy; Department of Laboratory Medicine (S.A.), University Campus Bio-Medico, Rome, Italy
| | - Silvia Manfrini
- Department of Endocrinology and Diabetes (A.P., G.T., S.I.B., D.M., A.N., A.L.P., N.N., P.P., S.M.), University Campus Bio-Medico, Rome, Italy; Department of Neck and Chest Surgery (G.M., F.L., P.C.), University Campus Bio-Medico, Rome, Italy; Department of Geriatric Medicine (C.P.), University Campus Bio-Medico, Rome, Italy; Department of Endocrinology and Diabetes (F.V.), Santa Maria della Misericordia Hospital, Udine, Italy; Department of Laboratory Medicine (S.A.), University Campus Bio-Medico, Rome, Italy
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Mangiameli G, Crucitti P, Rocco G. Microsized lung adenocarcinoma vs. small-sized lung adenocarcinoma: clinical characteristics, advantages and surgical implications. J Thorac Dis 2016; 8:E1003-E1005. [PMID: 27747046 DOI: 10.21037/jtd.2016.08.04] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Giuseppe Mangiameli
- Section of Thoracic Surgery, Department of Vascular Surgery, Campus Bio-Medico University of Rome, Via Alvaro Del Portillo, 200 - Rome, Italy
| | - Pierfilippo Crucitti
- Section of Thoracic Surgery, Department of Vascular Surgery, Campus Bio-Medico University of Rome, Via Alvaro Del Portillo, 200 - Rome, Italy
| | - Gaetano Rocco
- Department of Thoracic Surgery and Oncology, Division of Thoracic Surgery, Istituto Nazionale Tumori, IRCCS, Fondazione Pascale-Napoli, Italy
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Rau JV, Graziani V, Fosca M, Taffon C, Rocchia M, Crucitti P, Pozzilli P, Onetti Muda A, Caricato M, Crescenzi A. RAMAN spectroscopy imaging improves the diagnosis of papillary thyroid carcinoma. Sci Rep 2016; 6:35117. [PMID: 27725756 PMCID: PMC5057130 DOI: 10.1038/srep35117] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [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: 06/20/2016] [Accepted: 09/19/2016] [Indexed: 12/12/2022] Open
Abstract
Recent investigations strongly suggest that Raman spectroscopy (RS) can be used as a clinical tool in cancer diagnosis to improve diagnostic accuracy. In this study, we evaluated the efficiency of Raman imaging microscopy to discriminate between healthy and neoplastic thyroid tissue, by analyzing main variants of Papillary Thyroid Carcinoma (PTC), the most common type of thyroid cancer. We performed Raman imaging of large tissue areas (from 100 × 100 μm2 up to 1 × 1 mm2), collecting 38 maps containing about 9000 Raman spectra. Multivariate statistical methods, including Linear Discriminant Analysis (LDA), were applied to translate Raman spectra differences between healthy and PTC tissues into diagnostically useful information for a reliable tissue classification. Our study is the first demonstration of specific biochemical features of the PTC profile, characterized by significant presence of carotenoids with respect to the healthy tissue. Moreover, this is the first evidence of Raman spectra differentiation between classical and follicular variant of PTC, discriminated by LDA with high efficiency. The combined histological and Raman microscopy analyses allow clear-cut integration of morphological and biochemical observations, with dramatic improvement of efficiency and reliability in the differential diagnosis of neoplastic thyroid nodules, paving the way to integrative findings for tumorigenesis and novel therapeutic strategies.
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Affiliation(s)
- Julietta V Rau
- Istituto di Struttura della Materia (ISM-CNR), via del Fosso del Cavaliere 100, 00133 Roma, Italy
| | - Valerio Graziani
- Istituto di Struttura della Materia (ISM-CNR), via del Fosso del Cavaliere 100, 00133 Roma, Italy
| | - Marco Fosca
- Istituto di Struttura della Materia (ISM-CNR), via del Fosso del Cavaliere 100, 00133 Roma, Italy
| | - Chiara Taffon
- Policlinico Universitario Campus Bio-medico, via Álvaro del Portillo 200, 00128 Roma, Italy
| | | | - Pierfilippo Crucitti
- Policlinico Universitario Campus Bio-medico, via Álvaro del Portillo 200, 00128 Roma, Italy
| | - Paolo Pozzilli
- Policlinico Universitario Campus Bio-medico, via Álvaro del Portillo 200, 00128 Roma, Italy
| | - Andrea Onetti Muda
- Policlinico Universitario Campus Bio-medico, via Álvaro del Portillo 200, 00128 Roma, Italy
| | - Marco Caricato
- Policlinico Universitario Campus Bio-medico, via Álvaro del Portillo 200, 00128 Roma, Italy
| | - Anna Crescenzi
- Policlinico Universitario Campus Bio-medico, via Álvaro del Portillo 200, 00128 Roma, Italy
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Amato M, Perrone G, Righi D, Pellegrini C, Rabitti C, Di Matteo F, Crucitti P, Caputo D, Coppola R, Tonini G, Santini D, Onetti Muda A. HER2 Status in Gastric Cancer: Comparison between Primary and Distant Metastatic Disease. Pathol Oncol Res 2016; 23:55-61. [PMID: 27363700 DOI: 10.1007/s12253-016-0082-5] [Citation(s) in RCA: 8] [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: 01/04/2016] [Accepted: 06/14/2016] [Indexed: 01/21/2023]
Abstract
HER2 (human epidermal growth factor receptor-2) assessment in histological samples of gastric cancer is essential to determine which patients might benefit from trastuzumab therapy. HER2 is often evaluated in primary tumor even if trastuzumab therapy is used to treat metastatic disease. However, the exact relationship in terms of HER2 status between primary and metastatic tumors has not been fully clarified. We aimed to evaluate the HER2 status concordance between primary gastric cancer and corresponding distant metastasis. HER2 status was evaluated by IHC (immunohistochemistry) and/or FISH ( fluorescence in situ hybridization) in 41 patients in primary gastric cancer and in paired metastasis. HER2 was assessed according scoring criteria applied in clinical approach. HER2 positivity was found in 14,6 % primary tumors and in 24,4%corresponding metastasis. HER2 concordance rate between primary and metastasis was 80,5 % (K-value = 0,388). Eight/41 (19,5 %)cases resulted discordant: 6 patients with metastatic HER2 positive lesions were found HER2 negative in primary cancers while 2 patient HER2 positive in primary lesion showed a negative conversion in metastasis. Our results showed a good concordance in terms of HER2 status between primary and metastatic lesions, as well as in biopsy and surgical removed specimens. However, the higher rate of HER2 positive status found in metastatic lesions underlined the importance of HER2 assessment in all samples obtained from different sites of gastric cancer disease.
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Affiliation(s)
- Michelina Amato
- Department of Pathology, Campus Bio-Medico University of Rome, Via Alvaro del Portillo, 200, Rome, Italy
| | - Giuseppe Perrone
- Department of Pathology, Campus Bio-Medico University of Rome, Via Alvaro del Portillo, 200, Rome, Italy.
| | - Daniela Righi
- Department of Pathology, Campus Bio-Medico University of Rome, Via Alvaro del Portillo, 200, Rome, Italy
| | - Claudio Pellegrini
- Department of Pathology, Campus Bio-Medico University of Rome, Via Alvaro del Portillo, 200, Rome, Italy
| | - Carla Rabitti
- Department of Pathology, Campus Bio-Medico University of Rome, Via Alvaro del Portillo, 200, Rome, Italy
| | - Francesco Di Matteo
- Endoscopic Unit, Campus Bio-Medico University of Rome, Via Alvaro del Portillo, 200, Rome, Italy
| | - Pierfilippo Crucitti
- Department of Surgery, Campus Bio-Medico University of Rome, Via Alvaro del Portillo, 200, Rome, Italy
| | - Damiano Caputo
- Department of Surgery, Campus Bio-Medico University of Rome, Via Alvaro del Portillo, 200, Rome, Italy
| | - Roberto Coppola
- Department of Surgery, Campus Bio-Medico University of Rome, Via Alvaro del Portillo, 200, Rome, Italy
| | - Giuseppe Tonini
- Oncology Unit, Campus Bio-Medico University of Rome, Via Alvaro del Portillo, 200, Rome, Italy
| | - Daniele Santini
- Oncology Unit, Campus Bio-Medico University of Rome, Via Alvaro del Portillo, 200, Rome, Italy
| | - Andrea Onetti Muda
- Department of Pathology, Campus Bio-Medico University of Rome, Via Alvaro del Portillo, 200, Rome, Italy
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Pezzuto A, Stumbo L, Russano M, Crucitti P, Scarlata S, Caricato M, Tonini G. "Impact of Smoking Cessation Treatment" on Lung Function and Response Rate in EGFR Mutated Patients: A Short-Term Cohort Study. Recent Pat Anticancer Drug Discov 2016; 10:342-51. [PMID: 26246248 DOI: 10.2174/1574892810666150806111014] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2015] [Revised: 07/28/2015] [Accepted: 08/04/2015] [Indexed: 11/22/2022]
Abstract
BACKGROUND Erlotinib is a validated drug "for the treatment of patients affected by advanced unresectable non small cell lung cancer (NSCLC) with EGFR mutations". We want to focus on potential functional benefits deriving from a combined therapy containing TKI (erlotinib) and a nicotinic partial agonist (varenicicline) in smokers. METHODS we analyzed the records of patients affected by NSCLC treated undergoing "first line therapy with Erlotinib" and smoking cessation (with varenicicline). Response to therapy was evaluated by CT scan. Data concerning clinical history, smoking habit, nicotine dependence were collected after three months from the beginning of the recruitment. Pulmonary function tests including spirometry with pletismographic technique and exhaled carbon monoxide (CO) were performed with recording of resistances, flows, volumes. A group of ten current smokers affected by NSCLC with EGFR activating mutation and concurrent mild COPD undergoing anti-EGFR treatment without smoking cessation was used to compare clinical and functional data. A control group of NSCLC wild type with mild COPD undergoing smoking cessation was assessed for functional data. RESULTS Twenty-five patients were enrolled. All of them reported partial response at CT re-evaluation. All functional indexes and parameters were improved after combined treatment a significant increase of FEV1 level and a decrease of exhaled CO. In particular, a mean increase of FEV1 from 1.93 (SD 0.48) to 2.03(SD 0.46) liters was recorded. A notable reduction of sRAW (specific resistances) was also observed. The improvement of some parameters such as CO, heart rate (HR), sRAW and FEV1 resulted statistically significant. A better response to therapy was found "in the study group compared to the second group of mutated NSCLC patients". In this second group, we also observed an improvement of functional obstructive parameters although it was less remarkable than study group. Only sRAW and FEF 25/75 were significantly increased. The group of NSCLC wild type undergoing only smoking cessation showed a lower increase of FEV1 by about 50 ml compared to the first group. CONCLUSION The combination of anti-EGFR treatment and concurrent therapy for smoking cessation seems to be more effective than erlotinib alone in improving lung function and clinical response in advanced NSCLC patients with EGFR-mutations. It is conceivable that erlotinib may potentiate the action of varenicline. We have also outlined some relevant patents concerning varenicline and EGFR-TKI.
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Affiliation(s)
| | | | - Marco Russano
- Department of Medical Oncology, Campus Bio-Medico University of Rome, Via Alvaro del Portillo 200, 00128 Rome, Italy.
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Crucitti P, Gallo IF, Santoro G, Mangiameli G. Lung cancer screening with low dose CT: experience at Campus Bio-Medico of Rome on 1500 patients. MINERVA CHIR 2015; 70:393-399. [PMID: 25700151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
AIM The main purpose of our project was to evaluate the prevalence of lung cancer in high risk, asymptomatic individuals in addition to quantifying the rate of surgically resectable tumors, and evaluating the role of lung cancer with low dose computed tomography (LDCT) as a tool for lung cancer screening. METHODS Between June 2011 and March 2014, 1500 volunteers at high risk for lung cancer were enrolled in our study and underwent LDCT in our institution. The subsequent diagnostic and therapeutic steps were planned in relation to the results emerging from LDCT. To evaluate speed and type of growth, solid nodules ≤4 mm were reassessed with annual LDCT, those >4-6 mm or >6-8 mm were reassessed with LDCT in 6 or 3 months while nodules suspicious for malignancy were investigated with PET-CT or biopsy according to NCCN guidelines. RESULTS Non-calcified nodules were detected in 525 subjects (35% of population): among these 42% had a diameter ≤4 mm, 43% had a diameter >5 mm but <10 mm, 3% appeared as "ground glass" lesions, and 63 (12% of detected nodules) had malignant characteristics (irregular margins, retraction of the surrounding parenchyma, diameter >10 mm). Among the 63 patients who underwent PET-CT or biopsy, 25 cases resulted positive for lung cancer (1.7% of population). These patients underwent surgical treatment with histological detection of tumors in stages IA, IB or IIB. CONCLUSION Our study confirmed the emerging data on the use of LDCT as a screening tool for lung neoplasm in individuals at risk. Due to the LDCT low rate of specificity complementary biomarkers are required to properly define patients at risk and to reduce the number of further radiological examinations.
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Affiliation(s)
- P Crucitti
- Division of Thoracic Surgery, Department of General Surgery, Campus Bio‑Medico, University of Rome, Rome, Italy -
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Rocco R, Incalzi RA, Pennazza G, Santonico M, Pedone C, Bartoli IR, Vernile C, Mangiameli G, La Rocca A, De Luca G, Rocco G, Crucitti P. BIONOTE e-nose technology may reduce false positives in lung cancer screening programmes†. Eur J Cardiothorac Surg 2015; 49:1112-7; discussion 1117. [PMID: 26385981 DOI: 10.1093/ejcts/ezv328] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [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: 06/05/2015] [Accepted: 08/18/2015] [Indexed: 01/21/2023] Open
Abstract
OBJECTIVES Breath composition may be suggestive of different conditions. E-nose technology has been used to profile volatile organic compounds (VOCs) pattern in the breath of patients compared with that of healthy individuals. BIOsensor-based multisensorial system for mimicking NOse, Tongue and Eyes (BIONOTE) technology differs from Cyranose® based on a set of separate transduction features. On the basis of our previously published experience, we investigated the discriminating ability of BIONOTE in a high-risk population enrolled in a lung cancer screening programme. METHODS One hundred individuals were selected for BIONOTE based on the attribution to the high-risk category (i.e. age, smoking status, chronic obstructive pulmonary disease status) of the University Campus Bio-Medico lung screening programme. We used a measure chain consisting of (i) a device named Pneumopipe (EU patent: EP2641537 (A1):2013-09-25) able to catch exhaled breath by an individual normally breathing into it and collect the exhalate onto an adsorbing cartridge; (ii) an apparatus for thermal desorption of the cartridge into the sensors chamber and (iii) a gas sensor array which is part of a sensorial platform named BIONOTE for the VOCs mixture analysis. Partial least square (PLS) has been used to build up the model, with Leave-One-Out cross-validation criterion. Each breath fingerprint analysis costs €10. RESULTS The overall sensitivity and specificity were 86 and 95%, respectively, delineating a substantial difference between patients and healthy individuals. CONCLUSIONS Our preliminary data show that BIONOTE technology may be used to reduce false-positive rates resulting from lung cancer screening with low-dose computed tomography in a cost-effective fashion. The model will be tested on a larger number of patients to confirm the reliability of these results.
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Affiliation(s)
- Raffaele Rocco
- Section of Thoracic Surgery, Università Campus Bio-Medico, Rome, Italy
| | | | - Giorgio Pennazza
- Center for Integrated Research, Unit of Electronics for Sensor Systems, Università Campus Bio-Medico, Rome, Italy
| | - Marco Santonico
- Center for Integrated Research, Unit of Electronics for Sensor Systems, Università Campus Bio-Medico, Rome, Italy
| | - Claudio Pedone
- Division of Geriatry, Università Campus Bio-Medico, Rome, Italy
| | | | - Chiara Vernile
- Center for Integrated Research, Unit of Electronics for Sensor Systems, Università Campus Bio-Medico, Rome, Italy
| | | | - Antonello La Rocca
- Division of Thoracic Surgery, Department of Thoracic Surgery and Oncology, Istituto Nazionale Tumori, Fondazione Pascale, IRCCS, Naples, Italy
| | - Giuseppe De Luca
- Division of Thoracic Surgery, Department of Thoracic Surgery and Oncology, Istituto Nazionale Tumori, Fondazione Pascale, IRCCS, Naples, Italy
| | - Gaetano Rocco
- Division of Thoracic Surgery, Department of Thoracic Surgery and Oncology, Istituto Nazionale Tumori, Fondazione Pascale, IRCCS, Naples, Italy
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Rocco R, Antonelli Incalzi R, Pennazza G, Santonico M, Pedone C, Vernile C, Mangiameli G, La Rocca A, De Luca G, Rocco G, Crucitti P. F-041BIONOTE E-NOSE TECHNOLOGY MAY REDUCE FALSE POSITIVES IN LUNG CANCER SCREENING PROGRAMMES. Interact Cardiovasc Thorac Surg 2015. [DOI: 10.1093/icvts/ivv204.41] [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: 11/14/2022] Open
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Pantano F, Santoni M, Procopio G, Rizzo M, Iacovelli R, Porta C, Conti A, Lugini A, Milella M, Galli L, Ortega C, Guida FM, Silletta M, Schinzari G, Verzoni E, Modica D, Crucitti P, Rauco A, Felici A, Ballatore V, Cascinu S, Tonini G, Carteni G, Russo A, Santini D. The changes of lipid metabolism in advanced renal cell carcinoma patients treated with everolimus: a new pharmacodynamic marker? PLoS One 2015; 10:e0120427. [PMID: 25885920 PMCID: PMC4401714 DOI: 10.1371/journal.pone.0120427] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2014] [Accepted: 01/22/2015] [Indexed: 12/30/2022] Open
Abstract
Background Everolimus is a mammalian target of rapamycin (mTOR) inhibitor approved for the treatment of metastatic renal cell carcinoma (mRCC). We aimed to assess the association between the baseline values and treatmentrelated modifications of total serum cholesterol (C), triglycerides (T), body mass index (BMI), fasting blood glucose level (FBG) and blood pressure (BP) levels and the outcome of patients treated with everolimus for mRCC. Methods 177 patients were included in this retrospective analysis. Time to progression (TTP), clinical benefit (CB) and overall survival (OS) were evaluated. Results Basal BMI was significantly higher in patients who experienced a CB (p=0,0145). C,T and C+T raises were significantly associated with baseline BMI (p=0.0412, 0.0283 and 0.0001). Median TTP was significantly longer in patients with T raise compared to patients without T (10 vs 6, p=0.030), C (8 vs 5, p=0.042) and C+T raise (10.9 vs 5.0, p=0.003). At the multivariate analysis, only C+T increase was associated with improved TTP (p=0.005). T raise (21.0 vs 14.0, p=0.002) and C+T increase (21.0 vs 14.0, p=0.006) were correlated with improved OS but were not significant at multivariate analysis. Conclusion C+T raise is an early predictor for everolimus efficacy for patients with mRCC.
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Affiliation(s)
- Francesco Pantano
- Department of Medical Oncology, Campus Bio-Medico University of Rome, Via Alvaro del Portillo 200, 00128 Rome, Italy
| | - Matteo Santoni
- Department of Medical Oncology, AOU Ospedali Riuniti, Università Politecnica delle Marche, Piazza Roma, 22,60121 Ancona, Italy
| | - Giuseppe Procopio
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Giacomo Venezian, 1, 20133 Milan, Italy
| | - Mimma Rizzo
- Department of Medical Oncology, Cardarelli Hospital, Via A. Cardarelli 9, 80131, Naples, Italy
| | - Roberto Iacovelli
- Department of Oncology, Oncology Unit B, Sapienza University of Rome, Piazzale Aldo Moro, 5, 00185 Rome, Italy
| | - Camillo Porta
- Department of Medical Oncology, I.R.C.C.S. San Matteo University Hospital Foundation, Viale Camillo Golgi, 19, 27100 Pavia, Italy
| | - Alessandro Conti
- Department of Clinical and Specialist Sciences, Urology, Università Politecnica delle Marche, Piazza Roma, 22, 60121, Ancona, Italy
| | - Antonio Lugini
- Department of Medical Oncology, San Camillo De Lellis Hospital, Via John Fitzgerald Kennedy, 17, 02100 Rieti, Italy
| | - Michele Milella
- Department of Medical Oncology, Medical Oncology A, Regina Elena National Cancer Institute, Via Elio Chianesi, 53, 00128 Rome, Italy
| | - Luca Galli
- Department of Medical Oncology, Azienda Ospedaliera Universitaria Pisana, Via Roma, 67, 56126 Pisa, Italy
| | - Cinzia Ortega
- Department of Medical Oncology, Institute for Cancer Research & Treatment (IRCC), Strada Provinciale, 142, 10060 Candiolo, Torino, Italy
| | - Francesco Maria Guida
- Department of Medical Oncology, Campus Bio-Medico University of Rome, Via Alvaro del Portillo 200, 00128 Rome, Italy
| | - Marianna Silletta
- Department of Medical Oncology, Campus Bio-Medico University of Rome, Via Alvaro del Portillo 200, 00128 Rome, Italy
| | - Giovanni Schinzari
- Department of Medical Oncology, Università Cattolica del Sacro Cuore, Largo Agostino Gemelli, 8, 00168 Rome, Italy
| | - Elena Verzoni
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Giacomo Venezian, 1, 20133 Milan, Italy
| | - Daniela Modica
- Department of Oncology, Oncology Unit B, Sapienza University of Rome, Piazzale Aldo Moro, 5, 00185 Rome, Italy
| | - Pierfilippo Crucitti
- Department of Surgery, Campus Bio-Medico University of Rome, Via Alvaro del Portillo 200, 00128 Rome, Italy
| | - Annamaria Rauco
- Department of Medical Oncology, San Camillo De Lellis Hospital, Via John Fitzgerald Kennedy, 17, 02100 Rieti, Italy
| | - Alessandra Felici
- Department of Medical Oncology, Medical Oncology A, Regina Elena National Cancer Institute, Via Elio Chianesi, 53, 00128 Rome, Italy
| | - Valentina Ballatore
- Department of Medical Oncology, Institute for Cancer Research & Treatment (IRCC), Strada Provinciale, 142, 10060 Candiolo, Torino, Italy
| | - Stefano Cascinu
- Department of Medical Oncology, AOU Ospedali Riuniti, Università Politecnica delle Marche, Piazza Roma, 22,60121 Ancona, Italy
| | - Giuseppe Tonini
- Department of Medical Oncology, Campus Bio-Medico University of Rome, Via Alvaro del Portillo 200, 00128 Rome, Italy
| | - Giacomo Carteni
- Department of Medical Oncology, Cardarelli Hospital, Via A. Cardarelli 9, 80131, Naples, Italy
| | - Antonio Russo
- Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy
| | - Daniele Santini
- Department of Medical Oncology, Campus Bio-Medico University of Rome, Via Alvaro del Portillo 200, 00128 Rome, Italy
- * E-mail:
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Perrone G, Amato M, Callea M, Rabitti C, Righi D, Crucitti P, Coppola R, Onetti Muda A. HER2 amplification status in gastric and gastro-oesophageal junction cancer in routine clinical practice: which sample should be used? Histopathology 2012; 61:134-5. [PMID: 22551459 DOI: 10.1111/j.1365-2559.2012.04251.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Vincenzi B, Santini D, Schiavon G, Frezza AM, Silletta M, Crucitti P, Casali P, Tos APD, Rossi S, Rizzo S, Badalamenti G, Tomasino RM, Russo A, Butrynski JE, Tonini G. PML expression in soft tissue sarcoma: Prognostic and predictive value in alkylating agents/antracycline-based first line therapy. J Cell Physiol 2012; 227:1657-62. [DOI: 10.1002/jcp.22889] [Citation(s) in RCA: 3] [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: 01/12/2023]
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Vincenzi B, Santini D, Perrone G, Graziano F, Loupakis F, Schiavon G, Frezza AM, Ruzzo AM, Rizzo S, Crucitti P, Galluzzo S, Zoccoli A, Rabitti C, Muda AO, Russo A, Falcone A, Tonini G. PML as a potential predictive factor of oxaliplatin/fluoropyrimidine-based first line chemotherapy efficacy in colorectal cancer patients. J Cell Physiol 2011; 227:927-33. [DOI: 10.1002/jcp.22801] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Pandolfi M, Rea R, Martino M, Crucitti P, Di Matteo FM, Costamagna G, Gabbrielli A. Pneumoperitoneum caused by gastroscopy in a jaundiced patient treated endoscopically after initial percutaneous approach. Endoscopy 2009; 41 Suppl 2:E16. [PMID: 19221980 DOI: 10.1055/s-0028-1103445] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Affiliation(s)
- M Pandolfi
- Digestive Diseases Department, Campus Bio-Medico University, Rome, Italy.
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Zardi EM, Di Matteo F, Santini D, Uwechie V, Crucitti P, Carassiti M, Picardi A, Perrella E, Caricato M, Tonini G, Coppola R, Afeltra A. Pancreatitis after percutaneous ethanol injection into HCC: a minireview of the literature. J Exp Clin Cancer Res 2008; 27:28. [PMID: 18702805 PMCID: PMC2531081 DOI: 10.1186/1756-9966-27-28] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/22/2008] [Accepted: 08/14/2008] [Indexed: 12/18/2022]
Abstract
Deaths after percutaneous ethanol injection (PEI) into hepatocellular carcinoma (HCC) may occur within a few hours to a few days following the procedure because of hemoperitoneum and haemorrhage from oesophageal varices or hepatic insufficiency. Pancreatitis has been recently reported as a rare lethal complication of intra-arterial PEI, another modality for treating HCCs. In this minireview, we analyze the literature concerning the development of acute pancreatitis after PEI. Pathogenesis of pancreatitis from opioids and ethanol is also addressed. Treatment with opioids to reduce the patient's abdominal pain after PEI in combination with the PEI itself may lead to direct toxic effects, thus favouring the development of pancreatitis.
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Affiliation(s)
- Enrico M Zardi
- Department of Clinical Medicine, Campus Bio-Medico University, Rome, Italy.
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Grasso RF, Quattrocchi CC, Crucitti P, Carboni G, Coppola R, Zobel BB. Superficial Temporal Artery Pseudoaneurysm: A Conservative Approach in a Critically Ill Patient. Cardiovasc Intervent Radiol 2006; 30:286-8. [PMID: 16988876 DOI: 10.1007/s00270-005-0307-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
A 71-year-old man affected by cardio- and cerebrovascular disease experienced an accidental fall and trauma to the fronto-temporal area of the head. A few weeks later a growing mass appeared on his scalp. A diagnosis of superficial temporal artery pseudoaneurysm was made following CT and color Doppler ultrasound. His clinical condition favoured a conservative approach by ultrasound-guided compression and subsequent surgical resection. A conservative approach should be considered the treatment of choice in critically ill patients affected by superficial temporal artery pseudoaneurysm.
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Affiliation(s)
- Rosario Francesco Grasso
- Department of Radiology, Interdisciplinary Center for Biomedical Research, University Campus Bio-Medico of Rome, via Longoni, 47, 00155 Rome, Italy.
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Montesano M, Crucitti P, Pandolfi M, Zanca A, Gabbrielli A, Coppola R. Sems (self expanding metal stents) in a patient with esophagogastric cancer and esophagorespiratory fistula (ERF). Rays 2006; 31:21-4. [PMID: 16999371] [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: 05/12/2023]
Abstract
Esophagorespiratory fistulas, especially in the upper third of the esophagus, are a complication of malignant esophageal tumors, whose management is difficult and prognosis is poor. Treatment is palliative and involves restoration of the ability to ingest food and prevention of aspiration by insertion of esophageal or tracheobronchial stents. In selected patients the insertion of a single stent may be insufficient for pallation therefore the placement of parallel stents may be indicated in patients with symptoms caused by malignant esophagorespiratory fistula. A case of esophagorespiratory fistula managed with insertion of parallel stents is presented.
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Affiliation(s)
- Marilena Montesano
- Dipartimento delle Malattie dell'Apparato Digerente Università Campus Bio-Medico, Roma, Italy.
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Zanca A, Crucitti P, Pandolfi M, Montesano M, Gabbrielli A, Coppola R. Sems (self expanding metal stents) in palliation of esophageal cancer dysphagia. Rays 2006; 31:67-71. [PMID: 16999379] [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: 05/12/2023]
Abstract
Symptomatic inoperable esophageal carcinoma represents a major clinical problem. With no treatment, swallowing deteriorates with a dramatic worsening of quality of life. At present, self-expanding metal stents (SEMS) are the most effective non surgical palliation in inoperable esophageal cancer. The different types of available SEMS, techniques, results and complications are discussed.
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Affiliation(s)
- Annie Zanca
- Dipartimento di Malattie dell'Apparato Digerente Università, Campus Bio-Medico, Roma, Italy.
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Valeri S, Caricato M, Ripetti V, Crucitti P, Ausania F, Garberini A, Giarratano G, Gullotta G, Coppola R. [Signet-ring cell carcinoma of the Vater's ampulla: report of a clinical case]. Suppl Tumori 2005; 4:S61. [PMID: 16437905] [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: 05/06/2023]
Abstract
We report the case of a sixty-six year-old man admitted at our hospital with a suspected malignant tumor of the ampulla of Vater. The patient underwent a Pylorus-preserving pancreatico-duodenectomy. Histology showed a signet-ring cell carcinoma of the ampulla of Vater. This case is the 13th report in the literature of a signet-ring cell carcinoma of the ampulla of Vater.
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Affiliation(s)
- S Valeri
- Area di Chirurgia Generale, Università, Campus Bio-Medico, Roma
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