296 research outputs found
Clinical relevance of free peritoneal tumor cells detection in gastric and colorectal cancer: a multiple molecular approach
No full textBackground
Free disseminated peritoneal tumor cells derive from the detachment from primary cancer and may result in peritoneal carcinomatosis. Peritoneal lavage cytology has low sensitivity in detecting free peritoneal tumor cells; reverse-transcriptase polymerase reaction showed higher sensitivity but low specificity. Our study introduces the combination of the RT-PCR, the immunomagnetic enrichment and the immunofluorescence for the detection of peritoneal free tumor cells.
Materials and Methods
Samples of peritoneal lavage were collected from 22 gastric and 45 colorectal cancer patients; samples were also obtained from 6 patients who underwent abdominal surgery for non-malignant diseases. CEA and CK20 mRNA levels were quantified using a real-time qRT-PCR system. Immunomagnetic enrichment followed by immunofluorescence analysis was performed using monoclonal antibody against the pan-epithelial marker EpCAM/CD326 and polyclonal antibodies against the carcinoembryonic antigen.
Results
For gastric carcinoma the positivity rate for cytology, immunofluorescence and qRT-PCR was 14%, 18% and 77% respectively; for colorectal carcinoma the positivity rate for cytology, immunofluorescence and qRT-PCR was 0%, 18% and 44% respectively. All patients except one when positive at immunofluorescence were also positive at qRT-PCR. All samples of peritoneal lavage from the control group resulted negative for cytology, IF and real time qRT-PCR.
Conclusion
The combination of conventional real time qRT-PCR with immunoenrichment and immunofluorescence, which permit morphological assessment and unequivocal identification of the DTCs as well as validation of the molecular analysis, could be an useful and more powerful procedure for the detection of free peritoneal tumor cells.Non
Real-time intraoperative ureteral identification in minimally invasive colorectal surgery: a systematic review
No full textBackground: Although colorectal surgery (CRS) has currently almost entirely standardized surgical procedures, it can still show pitfalls such as the intraoperative ureteral injury. Intraoperative ureteral identification (IUI) could reduce the ureteral injuries rate but evidence is still lacking. We aimed to analyze the utility and the effectiveness of real-time IUI in minimally invasive CRS.Materials and Methods: A systematic review was performed examining available data on randomized and nonrandomized studies evaluating the utility of intraureteral fluorescence dye (IFD) and lighted ureteral stent (LUS) for intraoperative identification of ureters in CRS, in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) standards. Primary endpoint was ureteral injuries rate. Secondary endpoints included acute kidney injury, hematuria, urinary tract infections (UTI), and fluorescence assessment.Results: After literature search, 158 studies have been recorded, 36 studies underwent full-text reviews and 12 studies met inclusion criteria. Overall, out of a total of 822 patients who successfully received IUI, 3 (0.33%) patients experienced ureteral injury. Hematuria was reported in 689 (97.6%) of patients following LUS-guided surgery and in 1 (2%) patient following IFD-guided surgery, although transient in all cases. UTI was reported in 15 (3.3%) LUS-guided resections and in 1 (2%) IFD-guided resections. Acute kidney injury occurred in 23 (2.5%) LUS-guided surgery and 1 (1%) IFD-guided surgery.Conclusions: Real-time ureteral identification techniques could represent a valid solution in complex minimally invasive CRS, safely, with no time consuming and always reproducible by surgeons. Prospective studies will be needed to confirm these findings
Indocyanine green fluorescence in laparoscopic cholecystectomy: an easy procedure to prevent big troubles
No full textNo abstract avaiable
Solid pseudopapillary tumor of the pancreas. A systematic review of clinical, surgical and oncological characteristics of 1384 patients underwent pancreatic surgery
No full textBackground: Pancreatic solid pseudopapillary tumors (SPTs) are rare clinical entity, with low malignancy and still unclear pathogenesis. They account for less than 2% of exocrine pancreatic neoplasms. This study aimed to perform a systematic review of the main clinical, surgical and oncological characteristics of pancreatic SPTs.
Data sources: MEDLINE/PubMed, Web of Science and Scopus databases were systematically searched for the main clinical, surgical and oncological characteristics of pancreatic SPTs up to April 2021, in accordance with the preferred reporting items for systematic reviews and meta-analyses (PRISMA) standards. Primary endpoints were to analyze treatments and oncological outcomes.
Results: A total of 823 studies were recorded, 86 studies underwent full-text reviews and 28 met inclusion criteria. Overall, 1384 patients underwent pancreatic surgery. Mean age was 30 years and 1181 patients (85.3%) were female. The most common clinical presentation was non-specific abdominal pain (52.6% of cases). Mean overall survival was 98.1%. Mean recurrence rate was 2.8%. Mean follow-up was 4.2 years.
Conclusions: Pancreatic SPTs are rare, and predominantly affect young women with unclear pathogenesis. Radical resection is the gold standard of treatment achieving good oncological impact and a favorable prognosis in a yearly life-long follow-up
Solid-pseudopapillary tumor of the pancreas. An extrapancreatic loco-regional site and a review of the literature
No full textBackground: Solid pseudopapillary tumors (SPT) of the pancreas are rare, low malignancy and predominantly affect young women, but it may be locally aggressive. Pancreatic resection is the main treatment for SPTs. However, low malignancy SPT may give insidious extrapancreatic invasions. Case report: A 20-year-old woman was admitted with non-specific abdominal pain and diarrhea. A 9-cm SPT of the pancreas was discovered with extra-pancreatic invasion of the left adrenal gland and the spleen, in close contact with the body-tail of the pancreas, proximal portion of the jejunum, splenic flexure of the colon and the gastric fundus, with no signs of infiltration. For the young patient, a pancreas-preserving tumor excision was performed, with en-bloc resection of the spleen and adrenal gland, lymphadenectomy of the splenic vessels (13 lymph-nodes) and pre-pancreatic lymph node dissection, with no need for distal pancreatectomy. The duration of the surgery was 145 min, with no transfusion. The woman's postoperative course was complicated by a splenic lodge abscess treated via CT-guided percutaneous drainage, and a left pleural effusion treated medically, with a hospital stay of 16 days. Histology confirmed the diagnosis of a 9- cm low-grade SPT of the pancreas. In a close follow-up, the patient was asymptomatic 21 months later, with no tumor recurrence and good health. Conclusions: Low-grade SPT of the pancreas with extra-pancreatic invasion of loco-regional organs can be treated by a pancreas-preserving approach to avoid a pancreatectomy. Moreover, still few cases of extra-pancreatic SPT are reported in the literature and there is an urgent need for more relevant evidence. Key words: Extrapancreatic, Frantz's tumor, Pancreas preserving, Pancreas, Pancreatic neoplasm, Solid pseudopapillary tumor, Solid pancreatic tumor
Apoptosis and microvessel density in gastric cancer: correlation with tumor stage and prognosis.
No full textGastric cancer remains one of the most common human malignancies with a poor prognosis. Apoptosis is known to be a programmed cell death and its inhibition is involved in the unregulated cellular growth that leads to neoplasms. Microvessel density (MVD) has been investigated as a promoting factor for angiogenesis with conflicting results about its relation to survival. The aim of our study was to search a correlation between these factors and some clinicopathological features and prognosis. Identification of apoptotic cells was performed applying the terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick-end labeling technique and recorded as apoptotic index (A.I.), whereas monoclonal antibodies were used for the study of MVD. A significant correlation was found between low and high A.I. and the subgroup of patients in Stages I and II (P < 0.02); 20 per cent of patients with a low A.I. showed an overall survival longer than 5 years versus 44 per cent of patients with an high A.I. (P = 0.041). High MVD was significantly related to the T stage (P = 0.036) and to a poorer 5-year overall survival (P < 0.05). Further studies are required to confirm the role of apoptosis and MVD in the development and progression of gastric cancer
Vascular endothelial growth factor C and microvessel density in gastric carcinoma: Correlation with clinicopathological factors. Our experience and review of the literature
No full textVascular endothelial growth factor (VEGF) has been reported to promote lymphangiogenesis and its overexpression may be related to lymph node metastasis in gastric carcinoma. Microvessel density (MVD) has been investigated as a promoting factor for angiogenesis with conflicting results about its relation to survival. The study aims to investigate the expression of one subtype of VEGF, vascular endothelial growth factor C (VEGF-C), and MVD in gastric carcinoma specimens and their relation with clinicopathological factors. Specimens from 72 patients who underwent gastric resection for gastric carcinoma were analyzed by immunohistochemistry for the VEGF-C study and by monoclonal antibodies for the study of MVD. The VEGF-C and MVD expressions were related to clinicopathological features. High MVD was significantly related to the T stage (p = 0.036); VEGF-C expression was significantly higher in N positive patients (p = 0.047). No relation was found between MVD and VEGF-C expression. An extensive review of the literature was made and data were compared to ours. VEGF-C and MVD resulted to have significant relation with clinicopathological features. Further studies are required to determine whether these factors may be used in clinical practice in order to define the relationship with prognosis and to better characterize the biologic features of gastric carcinoma. Copyright © 2009 Cognizant Comm. Corp
Debating the Presentation, Morphology, Origin, and Prognosis of a Combined Hepatocellular-Cholangiocarcinoma
No full text[No abstract available
High Adhesion of Tumor Cells to Mesothelial Monolayers Derived from Peritoneal Wash of Disseminated Gastrointestinal Cancers
No full textThe role of the mesothelial layer in the peritoneal spreading of cancer cells is only partially clarified. Here we attempted to better define the mesothelial contribution to the tumor cell adhesion using a direct adhesion test applied to human primary cultures of mesothelial cells (HPMCs) derived from the peritoneal washes of patients with gastric and colorectal cancers. Gastric and colon carcinoma cells were seeded on different mesothelial monolayers and quantitative fluorescence analysis was performed to analyze their growth and adhesive properties. The adhesion of the cancer cells was not affected by the origin of the HPMCs when derived from patients with different cancers or with benign disease. In contrast, the high levels of ICAM1 expression and ROS production, which characterize these senescent mesothelial cells, enhanced the tumor cell adhesion. These results suggest that the mesothelial adhesive properties are dependent on the cell senescence, while are not affected by the tumor environment. The use of peritoneal washes as a source to isolate HPMCs provides a practical and reliable tool for the in vitro analysis of the mesothelial conditions affecting the peritoneal carcinomatosis
Free peritoneal tumor cells detection in gastric and colorectal cancer patients
No full textBackground Free peritoneal tumor cells (FPTC) derive from the detachment of primary cancer and may result in peritoneal carcinomatosis. Since peritoneal lavage cytology has low sensitivity in detecting FPTC, our aim was to estimate the clinical relevance of FPTC detected using an approach based on multiple molecular techniques. Materials and Methods Samples of peritoneal lavage were collected from 27 gastric and 48 colorectal cancer patients. FPTC recovery and detection from peritoneal washes was performed by cytological examination and immunomagnetic enrichment for epithelial cells followed by immunofluorescence analysis for epithelial marker EpCAM/CD326 and carcinoembryonic antigen (CEA). CEA and CK20 mRNA levels were quantified using a real-time qRT-PCR system. Results For gastric carcinoma the FPTC positivity rate acquired by cytology, immunofluorescence and qRT-PCR was 14.8%, 14.8%, and 78% and for colorectal carcinoma was 0%, 17%, and 42%, respectively. qRT-PCR positivity was correlated with a poor cancer-specific survival and time-to-recurrence rates in both gastric and colorectal carcinoma. Conclusions Epithelial immunoenrichment and immunofluorescence analysis allows unequivocal identification of the FPTC. The real time qRT-PCR showed higher sensitivity for the detection of CEA and CK20 mRNA levels and confirmed its prognostic value in gastrointestinal cancers. J. Surg. Oncol. 2012; 106:1723. (C) 2012 Wiley Periodicals, Inc
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