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Caratterizzazione di cellule staminali tumorali ottenute da linee cellulari di carcinoma della laringe e di carcinoma della vescica
No full textCaratterizzazione di cellule staminali tumorali ottenute da linee cellulari di carcinoma della laringe e di carcinoma della vescica
Secondo la teoria delle cellule staminali tumorali, lo sviluppo del tumore sarebbe sostenuto dalla presenza di una distinta sottopopolazione di cellule tumorali, denominate cancer stem cells (CSCs), dotate della capacità di autorigenerarsi e di una spiccata resistenza agli agenti chemioterapici.
Nel presente studio, è stato messo a punto un protocollo di crescita volto all’arricchimento in CSCs, mediante formazione di sfere, delle linee cellulari Hep-2 (carcinoma della laringe), T24 (carcinoma della vescica), MG63 (osteosarcoma), CaCo-2 (carcinoma del colon-retto) e A549 (carcinoma polmonare). Successivamente è stata effettuata un caratterizzazione molecolare e fenotipica delle popolazioni arricchite in CSCs, mediante rispettivamente l’analisi di espressione di markers di staminalità e la valutazione in vivo del potenziale tumorigenico. Inoltre, a carico delle CSCs e delle cellule di controllo, sono stati analizzati i livelli dell’enzima nicotinamide N-metiltrasferasi (NNMT).
L’analisi immunocitochimica e mediante Real-Time PCR hanno evidenziato elevati livelli di espressione dei markers di staminalità nelle popolazioni cellulari arricchite in CSCs rispetto ai controlli. In seguito all’inoculo in topi atimici delle cellule relative alla linea Hep-2, la popolazione arricchita in CSCs dava luogo a masse tumorali di dimensioni maggiori rispetto a quelle originatesi dalle cellule di controllo, evidenza che suggerisce la spiccata capacità da parte delle CSCs di indurre la formazione in vivo di tumori. Le analisi condotte a carico dell’NNMT mostrano un’overespressione dell’enzima nelle popolazioni arricchite in CSCs rispetto ai controlli.
In considerazione dell’importante ruolo svolto dalle CSCs nello sviluppo di recidive e nella diffusione metastatica, i risultati riportati in questo lavoro potrebbero contribuire allo sviluppo di nuove strategie terapeutiche per il trattamento del cancro e suggeriscono il significativo coinvolgimento dell’NNMT nel metabolismo della cellula neoplastica.
Dottorando:
Dott. Rachela Giuliante
Tutor:
Prof. Monica Emanuelli
Coordinatore:
Prof. Fiorenzo Cont
La poesia non è un colletto inamidato
No full textintroduzione alla prima raccolta completa delle poesie in lingua e in dialetto del poeta Guido Giuliante
Intraoperative liver ultrasound still affects surgical strategy for patients with colorectal metastases in the modern era
No full textIntraoperative liver ultrasound still affects surgical strategy for patients with colorectal metastases in the modern era.
Ferrero A1, Langella S, Giuliante F, Viganò L, Vellone M, Zimmitti G, Ardito F, Nuzzo G, Capussotti L.
Author information1Department of Surgery, Ospedale Mauriziano "Umberto I", Largo Turati 62, 10128, Turin, Italy, [email protected].
Abstract
BACKGROUND: The present study was designed to evaluate the role of intraoperative ultrasound (IOUS) in intrahepatic staging and the impact on surgical strategy for patients with colorectal liver metastases (CRLM).
METHODS: The study included 515 patients who had undergone liver resection for CRLM at two tertiary care referral centers. Data from a prospectively collected database were retrospectively analysed. Early intrahepatic recurrence was assessed at 3 and 6 months after resection and was considered as residual disease undetected by IOUS. Performance of imaging modalities was compared by analysis of studies on individual patients.
RESULTS: A total of 1,370 liver metastases were detected preoperatively with a median of 3 imaging modalities. MRI and PET were performed in 51 and 42 % of the patients, respectively. Median number of days between last imaging and surgery was 18. Contrast-enhanced IOUS was performed in 136 patients (26.4 %). Intraoperatively, 293 new nodules were found in 132 patients: on histology 280 were CRLM (17.6 %). Surgical strategy was changed in 140 patients (27.2 %). On multivariate analysis synchronous and bilobar metastases ≥ 3 in number, BMI ≥ 30, and time between last imaging and surgery longer than 18 days resulted in predictive factors indicating new nodules detected by IOUS. Early intrahepatic recurrences were 3.7 and 7.9 % at 3 and 6 months. Performance of CT, MRI, FDG-PET, and intraoperative staging was compared: sensitivity was 63.6, 68.8, 53.6, and 92 % and specificity was 91, 92.3, 95.8, and 97.8 %, respectively
CONCLUSIONS: The use of IOUS continues to be mandatory for correct staging of patients with CRLM undergoing liver resection
Open technique during laparoscopic operations (Reply to Letter)
No full textNo abstract - The publication replies to issues raised by other surgeons regarding the use of the open technique in laparoscopic operations
Correction to: Diffusion, outcomes and implementation of minimally invasive liver surgery: a snapshot from the I Go MILS (Italian Group of Minimally Invasive Liver Surgery) Registry
Get PDFA technical error led to incorrect rendering of the author group in this article. The correct authorship is as follows: Luca Aldrighetti, Francesca Ratti, Umberto Cillo, Alessandro Ferrero, Giuseppe Maria Ettorre, Alfredo Guglielmi, Felice Giuliante, Fulvio Calise on behalf of the Italian Group of Minimally Invasive Liver Surgery (I GO MILS) The collaborators are: Raffaele Dalla Valle, AOU Parma, Parma; Vincenzo Mazzaferro, Istituto Nazionale Tumori, Milano; Elio Jovine, Ospedale Maggiore, Bologna; Luciano Gregorio De Carlis, Ospedale Niguarda Ca’ Granda, Milano; Ugo Boggi, AOU Pisana, Pisa; Salvatore Gruttadauria, ISMETT, Palermo; Fabrizio Di Benedetto, AOU Policlinico di Modena, Modena; Paolo Reggiani, Ospedale Maggiore Policlinico, Milano; Stefano Berti, Ospedale Civile S.Andrea, La Spezia; Graziano Ceccarelli, Ospedale San Donato, Arezzo; Leonardo Vincenti, AOU Consorziale Policlinico, Bari; Giulio Belli, Ospedale SM Loreto Nuovo, Napoli; Guido Torzilli, Istituto Clinico Humanitas, Rozzano; Fausto Zamboni, Ospedale Brotzu, Cagliari; Andrea Coratti, AOU Careggi, Firenze; Pietro Mezzatesta, Casa di Cura La Maddalena, Palermo; Roberto Santambrogio, AO San Paolo, Milano; Giuseppe Navarra, AOU Policlinico G. Martino, Messina; Antonio Giuliani, AO R.N. Cardarelli, Napoli; Antonio Daniele Pinna, Policlinico Sant’Orsola Malpighi, Bologna; Amilcare Parisi, AO Santa Maria di Terni, Terni; Michele Colledan, AO Papa Giovanni XXIII, Bergamo; Abdallah Slim, AO Desio e Vimercate, Vimercate; Adelmo Antonucci, Policlinico di Monza, Monza; Gian Luca Grazi, Istituto Nazionale Tumori Regina Elena, Roma; Antonio Frena, Ospedale Centrale, Bolzano; Giovanni Sgroi, AO Treviglio-Caravaggio, Treviglio; Alberto Brolese, Ospedale S.Chiara, Trento; Luca Morelli, AOU Pisana, Pisa; Antonio Floridi, AO Ospedale Maggiore, Crema; Alberto Patriti, Ospedale San Matteo degli Infermi, Spoleto; Luigi Veneroni, Ospedale Infermi AUSL Romagna, Rimini; Giorgio Ercolani, Ospedale Morgagni Pierantoni, Forlì; Luigi Boni, AOU Fondazione Macchi, Varese; Pietro Maida, Ospedale Villa Betania, Napoli; Guido Griseri, Ospedale San Paolo, Savona; Andrea Percivale, Ospedale Santa Corona, Pietraligure; Marco Filauro, AO Galliera, Genova; Silvio Guerriero, Ospedale San Martino, Belluno; Giuseppe Tisone, Policlinico Tor Vergata, Roma; Raffaele Romito, AOU Maggiore della Carità, Novara; Umberto Tedeschi, AOU Integrata Verona, Verona; Giuseppe Zimmitti, Fondazione Poliambulanza, Brescia
ALPPS Versus Conventional Two-stage Hepatectomy in Patients With Advanced Colorectal Liver Metastases
No full textN
ASO Author Reflections: The Liver-First Approach: A New Standard for Patients with Multiple Bilobar Colorectal Metastases?
Get PDFThe best surgical strategy for patients with colorectal cancer and synchronous liver metastases is a matter of endless debate. Technical and oncological issues must be considered but have often been confounded. In 2006, Mentha et al.1 proposed an innovative and convincing oncosurgical approach, whereby they reversed the strategy, focusing attention on the prognostically most relevant target, i.e. the liver. Even if appealing, the liver-first approach struggled to find its role and failed to demonstrate a benefit, except for the inclusion of chemoradiotherapy in the treatment schedule of patients with locally advanced rectal tumors. The proposers themselves reported non-inferiority (and not superiority) of the reverse strategy in comparison with the standard primary-first approach.2 A recent network meta-analysis ranked the liver-first approach as the best treatment option for its relative efficacy based on 5-year overall survival outcomes,3 but the evidence is too weak to impact current clinical practice
Minimally invasive liver surgery in a hepato-biliary unit: learning curve and indications
No full textOperative indications and type of resection represent a crucial issue of minimally invasive liver surgery (MILS), and they should not be modified by the increased experience of laparoscopic liver surgeons. The aim of this study was to define the indications for MILS and the learning curve in a high-volume hepatobiliary surgery Unit. Between 2009 and 2014, 993 liver resections were performed in our unit, and MILS was performed in 81 of these (8.2 %). The proportion of MILS significantly increased over the study period of time and was significantly higher during the last 2 years than during the first 2 years (10.8 vs. 6.4 %; p = 0.042). Rate of liver resections for benign disease between the first 2 years and the last 2 years of the study period was not significantly different (14.7 vs. 10.5 %; p = 0.098). Rate of MILS for malignant disease significantly increased from the first 2 years to the last 2 years: 3.2 vs. 7.5 % (p < 0.001). Indication for left lateral sectionectomy in the whole series was rare. It was performed in 37 cases as the only liver surgical procedure, on 993 liver resections (3.7 %). In 25 (67.6 %) of these, a minimally invasive approach was used. Rate of left lateral sectionectomies between the first 2 years and the last 2 years of the study period was not significantly different: 4.5 vs. 3.8 % (p = 0.645). This study shows that the proportion of MILS significantly increased over the study period of time in our high-volume hepatobiliary surgery Unit without changing surgical indications for benign disease and type of resections
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