1,721,029 research outputs found
Software per il calcolo del Nottingham Prognostic Index (NPI)
No full textSviluppo, beta test, e pubblicazione di un software scritto in Visual Basic per il calcolo del Nottingham Prognostic Index, potente e validato indice multifattoriale in grado di stratificare le pazienti affette da carcinoma mammario in un gruppo a basso, ad intermedio e ad alto rischio
Integrazione del Nottingham Prognostic Index con i fenotipi biologici per una migliore definizione prognostica delle pazienti affette da carcinoma della mammella.
No full textLa storia clinica dei carcinomi mammari infiltranti è determinata da fattori morfologici e biologici. Il pT, il pN ed il G hanno dimostrato avere un ruolo molto importante nella valutazione prognostica. Il Nottingham Prognostic Index (NPI) integra in un unico dato sintetico queste informazioni fornendo al clinico un potente strumento per stratificare la prognosi in tre classi di rischio. Gli studi su l'espressione genica hanno permesso di identificare tre profili biologici (basale, HER-2+/ER- e luminale) ad andamento prognostico differente. Un'analisi combinata [1] dei dati presentati da Nielsen [2] e Livasy [3] ha permesso di individuare con ottima approssimazione questi fenotipi biologici basandosi sull'espressione di un pannel di marcatori (ER, PR, HER-2) oggi indispensabili nella routine diagnostica del carcinoma della mammella.
METODI
Lo studio è stato condotto su 702 pazienti (pz) affette da carcinoma mammario infiltrante incidente negli anni 1989-1993 diagnosticato presso la Sezione di Anatomia, Istologia e Citologia Patologica del Dipartimento di Medicina Sperimentale e Diagnostica dell'Università di Ferrara di cui era disponibile la caratterizzazione clinico-patologica (età < 70 anni: 557 pz; 527 duttali, 109 lobulari, 66 speciali; pT: < 2 cm: 450 pz). Sono stati raccolti i dati di follow up (media: 93 mesi, mediana: 101 mesi; range: 8-158 mesi), allestiti 31 tissue micro arrays (TMA) su cui è stata effettuata la valutazione del G e dei parametri biologici (ER, PR, HER2) la cui integrazione ha permesso di identificare 118 casi con fenotipo basale o HER-2+ ([ER-/PR-/HER-2-] o [HER-2+]) e 549 casi a fenotipo luminale (ER+ e/o PR+).
RISULTATI
Il 40,9% dei pz aveva un NPI 5.4 (alto rischio), il 44,1% dei pz aveva una prognosi intermedia (3.4 70aa, con andamento clinico non statisticamente differente da quello del gruppo a basso NPI.
CONCLUSIONI
L'integrazione dei parametri morfologici con i profili biologici identificati dalla biologia molecolare può permettere una migliore stratificazione prognostica delle pazienti affette da carcinoma mammario infiltrante. Nella nostra casistica questa integrazione ha permesso di ricategorizzare la prognosi del 37% delle pazienti a NPI intermedio
Acute cholecystitis as a presentation of metastatic breast carcinoma of the gallbladder: A case report
No full textTHE AUTHORS PRESENT A CASE OF ACUTE CHOLECYSTITIS AS A PRESENTATION OF METASTATIC BREAST CARCINOMA OF THE GALLBLADDE
Wells' Syndrome associated with COVID-19 vaccination
No full textThis case is unique for its uncommon clinical presentations and the possible causal relationship with COVID-19 vaccine (Moderna Biontech®)
Diagnosi citologica molecolare integrata (reflex test) nella patologia neoplastica dell'urotelio.
No full textQuantitative detection of molecular markers ProEx C (minichromosome maintenance protein 2 and topoisomerase IIa) and MIB-1 in liquid-based cervical squamous cell cytology
No full textBACKGROUND: In this study, the authors conducted a comparative quantitative evaluation of the proliferation markers ProEx C (an aberrant S-phase induction marker, human papillomavirus E6-E7 correlated) and MIB-1 in squamous intraepithelial lesions (SIL) to identify a biomolecular profile informative for the diagnosis of high-grade SIL/cervical intraepithelial neoplasia 3 or greater that was complementary to the morphologic Papanicolaou (Pap) test ("biomolecular Pap test"). METHODS: After the cytologic diagnosis, reflex immunocytochemistry was carried out on 76 unstained SurePath cell samples (20 routine samples that were negative for intraepithelial lesion or malignancy and 56 positive samples that were selected with matching histology). Both a morphometric analysis with a software imaging analysis system and a quantitative analysis of atypical squamous clusters were performed. RESULTS: The quantitative evaluation revealed an excellent, direct correlation between the 2 markers, although ProEx C was more selective and more informative for the progression of low- and moderate-grade lesions, because it only revealed cells in aberrant S-phase cell cycle. The quantitative morphometric analysis revealed the increased presence of atypical, positive clusters and the percentage of positive cells within, both paralleling the severity of the lesions. The threshold of a 3% ProEx C-positive nuclear area was useful for splitting lesions into groups with a low risk or high risk of progression. CONCLUSIONS: Both ProEx C and MIB-1 were valid proliferation markers in cytologic preparations, and nuclear positivity was quantified successfully by using computer-assisted analysis. The analysis of atypical clusters may be a valuable tool in the diagnosis of SIL. The presence of atypical clusters and their positivity for proliferation markers are good first-glance indicators of lesion grade
The impact of the introduction of irinotecan and oxaliplatin on the outcome of patients with advanced colorectal cancer
No full textThe effectiveness of oxaliplatin and irinotecan in advanced colorectal cancer therapy has been shown by many randomized clinical trials. We developed a retrospective study on patients treated in the clinical practice. The main inclusion criteria were: diagnosis of unresectable colorectal adenocarcinoma and having undergone chemotherapy. Univariate and multivariate analyses were performed to identify the prognostic factors of survival. The study included 286 consecutive patients. Three factors were associated with worse survival: high CA19-9 levels (p=0.003), schedules without new regimens (p=0.031) and weight loss (p=0.070). The use of new regimens was associated with a significant improvement in median survival (15 to 10 months, p<0.001). Although the new regimens improved survival in clinical practice, the median gain is smaller than that reported in randomized trials. The palliative intent of these therapies should not be forgotten in order to improve quality of life rather than absolute survival
Quantitative analysis of molecular markers MCM2, TOPO2A and KI-67 (Mib1) in squamous intraepithelial neoplasia in liquid-based cytology
No full textShiitake dermatitis: toxic or allergic reaction?
No full textA case of linear dermatitis after oral assumption of mushrooms has been described
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