36 results on '"Malvi D"'
Search Results
2. RUNX-1 and CD44 as markers of resident stem cell derivation in undifferentiated intimal sarcoma of pulmonary artery
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VASURI, FRANCESCO, FITTIPALDI, SILVIA, PASQUINELLI, GIANANDREA, Resta L, Malvi D, Vasuri F, Resta L, Fittipaldi S, Malvi D, and Pasquinelli G
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undifferentiated intiamal sarcoma ,Adult ,Stem Cells ,Sarcoma ,Pulmonary Artery ,Immunohistochemistry ,ELECTRON MICROSCOPY ,Hyaluronan Receptors ,Microscopy, Electron, Transmission ,Core Binding Factor Alpha 2 Subunit ,Neoplasms, Vascular Tissue ,nestin ,Biomarkers, Tumor ,Humans ,Female ,Tunica Intima ,runx-1 - Abstract
RUNX-1 and CD44 as markers of resident stem cell derivation in undifferentiated intimal sarcoma of pulmonary artery Aims: To report a rare case of undifferentiated intimal sarcoma (UIS) of the pulmonary artery in a 44-year-old woman, and to study it by electron microscopy and a novel immunohistochemical (IHC) panel that recognizes markers of endothelial and haematopoietic stemness, in order to extend current knowledge about the histogenesis of this rare neoplasm. Methods and results: Immunohistochemical reactions for CD31, CD34, a-smooth muscle actin (a-SMA), caldesmon, calponin, actin, desmin, epithelial membrane antigen, WT1, CD117, Ki67, nestin, RUNX-1, platelet-derived growth factor, NG2, CD44, CD90 and CD105 were performed manually or automatically. Neoplastic cells were negative for CD31 and CD34, but positive for calponin, nestin, WT1, CD44, and RUNX-1. Electron microscopy was performed after osmium tetroxide fixation and staining with lead citrate and uranyl acetate. Ultrastructurally, tumour cells had slightly irregular nuclei, cisternae of rough endoplasmic reticulum, and punctate intercellular junctions. Conclusions: We report a case of pulmonary artery UIS expressing previously unreported markers, i.e. RUNX-1, nestin, WT1, and CD44, that are commonly seen in different stages of the vascular differentiation hierarchy. These findings, together with the negativity for mature endothelial and smooth muscle markers, raise the question of whether this neoplasm may derive from a vessel wall-resident stem cell, such as the haemangioblast or an embryonic-like stem cell.
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- 2012
3. Relationship among modality of nodal metastasization and the presence/absence of intestinal metaplasia in the esophagus (BE) and in the stomach (GIM) for a adenocarcinoma of the esophagus and cardia (ADEC)
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Ruffato A, D'Errico A, Aramini B, Lugaresi ML, Malvi D, Aprile MR, Raulli G, Mattioli S., Ruffato A, D'Errico A, Aramini B, Lugaresi ML, Malvi D, Aprile MR, Raulli G, and Mattioli S.
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Metastatization, intestinal metaplasia, Barrett Esophagus, adenocarcinoma, esophagus,cardia ,education ,otorhinolaryngologic diseases ,digestive system diseases - Abstract
Relationship among modality of nodal metastasization and the presence/absence of intestinal metaplasia in the esophagus (BE) and in the stomach (GIM) for a adenocarcinoma of the esophagus and cardia (ADEC).
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- 2012
4. Relationship among modality of nodal metastasization and the presence/absence of intestinal metaplasia in the Esophagus (BE) and in the Stomach (GIM) for an Adenocarcinoma of the Esophagus and Cardia(ADEC)
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Ruffato, Alberto, D'Errico, Antonietta, Aramini, Beatrice, Lugaresi, Marialuisa, Malvi, D, Aprile, Mr, Raulli, G, Mattioli, Sandro, Ruffato A, D’Errico A, Aramini B, Lugaresi M, Malvi D, Aprile MR, Raulli G, and Mattioli S.
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Adenocarcinoma of the esophagu ,Adenocarcinoma of cardia ,Surgery - Abstract
Background: Pathogenesis of ADEC is controversial; we investigated the lymphatic spreading in a group of 194 patients consecutively operated upon for ADEC. Methods: Preoperatively patients underwent the hysthological search for BE in mucosa surrounding ADEC and GIM in the gastric corpus and antrum mucosa. Patients in which BE was documented underwent sub total esophagectomy and gastric pull up (group 1), others underwent esophagectomy at the azygos vein total gastrectomy with Roux Y esophagojejunostomy (group 2). Radical lymphadenectomy was identical in both procedures except for the greater curvature station. Results: Histology confi rmed the preoperative BE grouping which is reported with distribution of pNwithin the presence of BE in table 1. BE- tumors spread to the same abdominal stations with a higher rate of nodal metastases for GIMadenocarcinomas (p 0.001). Groups are not different (p 0,05) for sex, age, mortality, morbidity, R0 resection rate and grading. Median number (IQR) of resected nodes is 29 (15–36.5) in 1 and 30 (20–40) in 2 (p .51). GIM was detected in 4% of group 1 and in 36% of group 2 (p 0.001). 5 year overall survival is 42%; survival tends to be worst for BE- GIM-, better for BE- GIM. Discussion: Thoracic nodal stations were involved in group 1 only, opposite to perigastric and abdominal nodes that were predominantly involved in group 2, with a more aggressive nodal involvement for BE- GIM- tumors. These data suggest the existence of three different types of tumor in ADEC, further investigation is necessary. Disclosure: All authors have declared no confl icts of interest.
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- 2012
5. pN status in adenocarcinoma of the distal esophagus and cardia (ADEC)
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Mattioli S, Ruffato A, D'errico A, Aramini B, Lugaresi ML, Malvi D, Aprile MR., Mattioli S, Ruffato A, D'errico A, Aramini B, Lugaresi ML, Malvi D, and Aprile MR.
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surgical procedures, operative ,pN status, adenocarcinoma, distal esophagus, cardia, ADEC ,otorhinolaryngologic diseases ,neoplasms ,digestive system ,digestive system diseases - Abstract
pN status in adenocarcinoma of the distal esophagus and cardia (ADEC).
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- 2011
6. PN Status in adenocarcinoma of the distal oesophagus and cardia (ADOC)
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RUFFATO, ALBERTO, ARAMINI, BEATRICE, LUGARESI, MARIALUISA, MATTIOLI, SANDRO, D'ERRICO, ANTONIETTA, Malvi D, Guiducci GM, Ruffato A, Aramini B, D’Errico A, Lugaresi ML, Malvi D, Guiducci GM, and Mattioli S
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ADENOCARCINOMA OF THE CARDIA ,SURGERY ,ADENOCARCINOMA OF THE DISTAL OESOPHAGUS - Abstract
Objectives Adenocarcinoma of the distal oesophagus and cardia (ADOC) are grouped among the thoracic tumors according to the TNM 7~ ed., however controversy is pending on the unique or dual pathogenesis (GORD or gastric-like cancerogenesis). We investigated the pathways of Iymphatic spreading in two cohorts of ADOC with or without Barrett's metaplasia. Methods ADOC + Barrett's (group 1) was diagnosed in 54 (subtotal oesophagectomy and oesophagogastrostomy at the neck or chest dome); no Barrett's was detected in 140 ADOC (group 2), (oesophagectomy at the azygos vein + total gastrectomy with Roux oesphagojejunostomy). A11 194 cases, were approached through a right thoracotomy and upper laparotomy. Radical Iymphadenectomy (stations 4L/R-34-7-10-8-9-15-16-17-18-19-20 TNM 7th ed. + pancreatic and pyloric nodes) was identical in both procedures except for the greater curvature stations. Results Histology confirmed the preop. Barrett-non Barrett grouping. Groups I and 2 were not different (p>0,05) for sex, age, mortality, morbidity, R0 resection rate and grading. They were different (p
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- 2011
7. 18[F]FDG small animal PET study of sorafenib efficacy in lymphoma preclinical models
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Ambrosini, V., Quarta, C., Zinzani, P. L., Nanni, C., Milena Fini, Torricelli, P., Giavaresi, G., D Errico-Grigioni, A., Malvi, D., Franchi, R., Fanti, S., Ambrosini V, Quarta C, Zinzani PL, Nanni C, Fini M, Torricelli P, Giavaresi G, D'Errico-Grigioni A, Malvi D, Franchi R, and Fanti S.
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Niacinamide ,Lymphoma ,Pyridines ,Phenylurea Compounds ,Benzenesulfonates ,Drug Evaluation, Preclinical ,Antineoplastic Agents ,Sorafenib ,Prognosis ,Mice ,Treatment Outcome ,Fluorodeoxyglucose F18 ,Cell Line, Tumor ,Positron-Emission Tomography ,Animals ,Humans ,Radiopharmaceuticals - Abstract
Kinase inhibitors have been proposed as novel therapeutic agents in different forms of solid tumours. The Food and Drug Administration (FDA) approved the use of Sorafenib, an oral multikinase inhibitor, for advanced renal carcinoma and unresectable hepatocellular carcinoma. On-going studies are investigating the efficacy of Sorafenib in other solid tumours such as melanoma and non-small cells lung carcinoma and pre-clinical models showed the efficacy of treatment with Sorafenib in murine models of renal cells carcinoma, breast cancer, colon carcinoma and melanoma. To our knowledge, Sorafenib has never been employed in human lymphoma. The aim of the present study was to assess the efficacy of Sorafenib in murine models of human anaplastic large cells lymphoma (ALCL) and Hodgkin lymphoma (HD).Sorafenib cytotoxicity was assessed in vitro and growth inhibition (IC50) was calculated. Cells were assayed for Caspase-3 to measure apoptosis. Human ALCL and HD xenografts in NOD/SCID mice were monitored by small animal positron emission tomography (PET) and computed tomography (CT) over time. Tumour bearing animals were randomly selected to receive treatment with Sorafenib or no treatment. Pathology was available in all cases.Sorafenib efficacy on cells proliferation and apoptosis (IC50: HD=0.0343 mg/L; ALCL=0.319 mg/L) was confirmed in vitro. Caspase-3 production showed a dose-dependent trend reaching significantly higher values for 0.046 mg/L and 0.465 mg/L drug concentrations in both cell lines. In vivo experiments showed a progressive increase of tumour lesions metabolism and dimensions regardless treatment.Sorafenib showed a good cytotoxic effect in vitro especially on human HD cell line, but these findings were not confirmed in vivo. The strong discrepancy between in vitro and in vivo results suggests that further studies are needed to better acknowledge the biodistribution and metabolism of Sorafenib in NOD/SCID mice. Factors influencing drug availability at tumour site or differences in the downstream pathways may be responsible for the scarse effect of treatment.
8. 18F-FDG small animal PET for early detection of human anaplastic large cells lymphoma xenograft in immunocompromised mice
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Ambrosini, V., Quarta, C., Zinzani, P. L., Milena Fini, Giavaresi, G., Torricelli, P., Malvi, D., Nanni, C., Grassetto, G., Rubello, D., and Fanti, S.
9. Prognostic Role of Mismatch Repair Status, Histotype and High-Risk Pathologic Features in Stage II Small Bowel Adenocarcinomas
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Roberto Caronna, Enrico Solcia, Giuseppe Neri, Augusto Orlandi, Michele Martino, Catherine Klersy, Carolina Ciacci, Antonietta D'Errico, Ada Maria Florena, Giovanni Monteleone, Giacomo Caio, Paolo Giuffrida, Gianluca M. Sampietro, Luca Elli, Stefano Ferrero, Maria D'Armiento, G. Solina, Fausto Sessa, Paolo Pedrazzoli, Giuseppe Amodeo, Elena Biletta, Barbara Oreggia, Fabiana Zingone, Deborah Malvi, Claudia Mescoli, Andrea Pietrabissa, Alessandro Vanoli, Camilla Guerini, Giovanni Arpa, Anna D'Odorico, Gabriella Nesi, Massimo Rugge, Fernando Rizzello, Roberto De Giorgio, Federica Grillo, Renato Cannizzaro, Umberto Volta, Livia Biancone, Gilberto Poggioli, Vincenzo Villanacci, Luca Reggiani Bonetti, Maria Cristina Macciomei, Donatella Santini, Sandro Ardizzone, Vincenzo Canzonieri, Rachele Ciccocioppo, Francesco Tonelli, Gino Roberto Corazza, Valeria Barresi, Flavio Caprioli, Roberto Fiocca, Antonio Di Sabatino, Ombretta Luinetti, Giovanni Latella, Paolo Fociani, Marco Paulli, Antonio Calabrò, Antonino Giulio Giannone, Maurizio Vecchi, Renata D'Incà, Aroldo Rizzo, Antonio Ciardi, Marco Vincenzo Lenti, Vanoli A., Grillo F., Guerini C., Neri G., Arpa G., Klersy C., Nesi G., Giuffrida P., Sampietro G., Ardizzone S., Fociani P., Fiocca R., Latella G., Sessa F., D'Errico A., Malvi D., Mescoli C., Rugge M., Ferrero S., Poggioli G., Rizzello F., Macciomei M.C., Santini D., Volta U., De Giorgio R., Caio G., Calabro A., Ciacci C., D'Armiento M., Rizzo A., Solina G., Martino M., Tonelli F., Villanacci V., Cannizzaro R., Canzonieri V., Florena A.M., Biancone L., Monteleone G., Caronna R., Ciardi A., Elli L., Caprioli F., Vecchi M., D'Inca R., Zingone F., D'Odorico A., Lenti M.V., Oreggia B., Reggiani Bonetti L., Giannone A.G., Orlandi A., Barresi V., Ciccocioppo R., Amodeo G., Biletta E., Luinetti O., Pedrazzoli P., Pietrabissa A., Corazza G.R., Solcia E., Paulli M., Di Sabatino A., Vanoli, A., Grillo, F., Guerini, C., Neri, G., Arpa, G., Klersy, C., Nesi, G., Giuffrida, P., Sampietro, G., Ardizzone, S., Fociani, P., Fiocca, R., Latella, G., Sessa, F., D'Errico, A., Malvi, D., Mescoli, C., Rugge, M., Ferrero, S., Poggioli, G., Rizzello, F., Macciomei, M. C., Santini, D., Volta, U., De Giorgio, R., Caio, G., Calabro, A., Ciacci, C., D'Armiento, M., Rizzo, A., Solina, G., Martino, M., Tonelli, F., Villanacci, V., Cannizzaro, R., Canzonieri, V., Florena, A. M., Biancone, L., Monteleone, G., Caronna, R., Ciardi, A., Elli, L., Caprioli, F., Vecchi, M., D'Inca, R., Zingone, F., D'Odorico, A., Lenti, M. V., Oreggia, B., Reggiani Bonetti, L., Giannone, A. G., Orlandi, A., Barresi, V., Ciccocioppo, R., Amodeo, G., Biletta, E., Luinetti, O., Pedrazzoli, P., Pietrabissa, A., Corazza, G. R., Solcia, E., Paulli, M., Di Sabatino, A., Vanoli, Alessandro, Grillo, Federica, Guerini, Camilla, Neri, Giuseppe, Arpa, Giovanni, Klersy, Catherine, Nesi, Gabriella, Giuffrida, Paolo, Sampietro, Gianluca, Ardizzone, Sandro, Fociani, Paolo, Fiocca, Roberto, Latella, Giovanni, Sessa, Fausto, D'Errico, Antonietta, Malvi, Deborah, Mescoli, Claudia, Rugge, Massimo, Ferrero, Stefano, Poggioli, Gilberto, Rizzello, Fernando, Macciomei, Maria C, Santini, Donatella, Volta, Umberto, De Giorgio, Roberto, Caio, Giacomo, Calabrò, Antonio, Ciacci, Carolina, D'Armiento, Maria, Rizzo, Aroldo, Solina, Gaspare, Martino, Michele, Tonelli, Francesco, Villanacci, Vincenzo, Cannizzaro, Renato, Canzonieri, Vincenzo, Florena, Ada Maria, Biancone, Livia, Monteleone, Giovanni, Caronna, Roberto, Ciardi, Antonio, Elli, Luca, Caprioli, Flavio, Vecchi, Maurizio, D'Incà, Renata, Zingone, Fabiana, D'Odorico, Anna, Lenti, Marco Vincenzo, Oreggia, Barbara, Reggiani Bonetti, Luca, Giannone, Antonino Giulio, Orlandi, Augusto, Barresi, Valeria, Ciccocioppo, Rachele, Amodeo, Giuseppe, Biletta, Elena, Luinetti, Ombretta, Pedrazzoli, Paolo, Pietrabissa, Andrea, Corazza, Gino Roberto, Solcia, Enrico, Paulli, Marco, and Di Sabatino, Antonio
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Male ,Oncology ,Colorectal cancer ,DNA Mismatch Repair ,COLORECTAL-CANCER ,Settore MED/12 ,0302 clinical medicine ,PMS2 ,small bowel adenocarcinoma ,Mismatch Repair Endonuclease PMS2 ,0303 health sciences ,Prognosis ,MMR ,MutS Homolog 2 Protein ,CARCINOMAS ,030220 oncology & carcinogenesis ,immunohistochemistry ,Mismatch Repair Status, small bowel adenocarcinoma ,Female ,Microsatellite Instability ,DNA mismatch repair ,MutL Protein Homolog 1 ,Colorectal Neoplasms ,stage II ,medicine.medical_specialty ,high-risk pathologic features ,Humans ,Adenocarcinoma ,mismatch repair status ,NO ,03 medical and health sciences ,small bowel carcinoma ,histotype ,Internal medicine ,Translational Research ,medicine ,030304 developmental biology ,small bowel adenocarcinomas ,business.industry ,Cancer ,Microsatellite instability ,Mismatch Repair Protein ,Adenocarcinoma IBD Cancer ,medicine.disease ,digestive system diseases ,MSH6 ,CONSENSUS ,small bowel carcinoma, MMR, immunohistochemistry ,Mismatch repair, Small bowel Adenocarcinoma ,MSH2 ,Mismatch repair status ,Surgery ,business - Abstract
Background Small bowel adenocarcinoma is a relatively rare cancer, often diagnosed in an advanced stage. In localized and resectable disease, surgery alone or in combination with adjuvant chemotherapy is the mainstay of treatment. In the recently published National Comprehensive Cancer Network Clinical Practice guidelines, criteria for selecting patients with stage II small bowel adenocarcinoma to receive adjuvant chemotherapy are provided, and they are mainly extrapolated from studies on colorectal cancer. Patients and Methods In the present study, we aimed to verify whether mismatch repair deficiency phenotype, high-risk pathologic features (including T4, positive resection margins and a low number of lymph nodes harvested), as well as tumor histologic subtype, were associated with cancer-specific survival in 66 stage II non-ampullary small bowel adenocarcinoma patients, collected through the Small Bowel Cancer Italian Consortium. A central histopathology review was performed. Mismatch repair deficiency was tested by immunohistochemistry for MLH1, MSH2, MSH6 and PMS2, and confirmed by polymerase chain reaction for microsatellite instability. Results We identified mismatch repair deficiency, glandular/medullary histologic subtype, and celiac disease as significant predictors of favorable cancer-specific survival using univariable analysis with retained significance in bivariable models adjusted for pT stage. Among the high-risk features, only T4 showed a significant association with an increased risk of death; however, its prognostic value was not independent of mismatch repair status. Conclusions Mismatch repair protein expression, histologic subtype, association with celiac disease, and, in the mismatch repair proficient subset only, T stage, may help identify patients who may benefit from adjuvant chemotherapy. Graphic Abstract
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- 2021
10. The prognostic impact of histology in esophageal and esophago-gastric junction adenocarcinoma
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Roberto Fiocca, Anna Tomezzoli, Jari Räsänen, Paola Spaggiari, Deborah Malvi, Luca Bottiglieri, Luca Albarello, Elena Bonora, Federica Grillo, Antonietta D'Errico, Luca Mastracci, Uberto Fumagalli Romario, G Raulli, Giovanni de Manzoni, Marialuisa Lugaresi, Ari Ristimäki, Sandro Mattioli, Riccardo Rosati, Kausilia K. Krishnadath, Fiocca, R., Mastracci, L., Lugaresi, M., Grillo, F., D'Errico, A., Malvi, D., Spaggiari, P., Tomezzoli, A., Albarello, L., Ristimaki, A., Bottiglieri, L., Bonora, E., Krishnadath, K. K., Raulli, G. D., Rosati, R., Romario, U. F., De Manzoni, G., Rasanen, J., Mattioli, S., Department of Pathology, HUSLAB, University of Helsinki, Helsinki University Hospital Area, HUS Diagnostic Center, HUS Heart and Lung Center, III kirurgian klinikka, EACSGE Study Group, Fiocca R., Mastracci L., Lugaresi M., Grillo F., D'errico A., Malvi D., Spaggiari P., Tomezzoli A., Albarello L., Ristimaki A., Bottiglieri L., Bonora E., Krishnadath K.K., Raulli G.D., Rosati R., Romario U.F., De Manzoni G., Rasanen J., and Mattioli S.
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Cancer Research ,medicine.medical_specialty ,Multivariate analysis ,Histology ,esophageal adenocarcinoma ,Esophageal adenocarcinoma ,Esophago-gastric junction adenocarcinoma ,Prognosis ,3122 Cancers ,Stage ii ,Lower risk ,Gastroenterology ,THERAPY ,Article ,CLASSIFICATION ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine ,CARDIA ,EPIDEMIOLOGY ,Stage (cooking) ,Esophago gastric junction ,SIGNET-RING CELLS ,RC254-282 ,business.industry ,Poorly differentiated ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,medicine.disease ,CANCER ,3. Good health ,Oncology ,GASTROESOPHAGEAL JUNCTION ,030220 oncology & carcinogenesis ,SURVIVAL ,Adenocarcinoma ,030211 gastroenterology & hepatology ,Human medicine ,business ,GASTRIC-CARCINOMA - Abstract
Stage significantly affects survival of esophageal and esophago-gastric junction adenocarcinomas (EA/EGJAs), however, limited evidence for the prognostic role of histologic subtypes is available. The aim of the study was to describe a morphologic approach to EA/EGJAs and assess its discriminating prognostic power. Histologic slides from 299 neoadjuvant treatment-naïve EA/EGJAs, resected in five European Centers, were retrospectively reviewed. Morphologic features were re-assessed and correlated with survival. In glandular adenocarcinomas (240/299 cases—80%), WHO grade and tumors with a poorly differentiated component ≥6% were the most discriminant factors for survival (both p <, 0.0001), distinguishing glandular well-differentiated from poorly differentiated adenocarcinomas. Two prognostically different histologic groups were identified: the lower risk group, comprising glandular well-differentiated (34.4%) and rare variants, such as mucinous muconodular carcinoma (2.7%) and diffuse desmoplastic carcinoma (1.7%), versus the higher risk group, comprising the glandular poorly differentiated subtype (45.8%), including invasive mucinous carcinoma (5.7%), diffuse anaplastic carcinoma (3%), mixed carcinoma (6.7%) (CSS p <, 0.0001, DFS p = 0.001). Stage (p <, 0.0001), histologic groups (p = 0.001), age >, 72 years (p = 0.008), and vascular invasion (p = 0.015) were prognostically significant in the multivariate analysis. The combined evaluation of stage/histologic group identified 5-year cancer-specific survival ranging from 87.6% (stage II, lower risk) to 14% (stage IVA, higher risk). Detailed characterization of histologic subtypes contributes to EA/EGJA prognostic prediction.
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- 2021
11. PD-L1 in small bowel adenocarcinoma is associated with etiology and tumor-infiltrating lymphocytes, in addition to microsatellite instability
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Giovanni Arpa, Gabriella Nesi, Catherine Klersy, Carolina Ciacci, Antonietta D'Errico, Anna D'Odorico, Marco Paulli, Gino Roberto Corazza, Fausto Sessa, Valeria Barresi, Vittorio Perfetti, Federica Grillo, Vincenzo Canzonieri, Renato Cannizzaro, Roberto Fiocca, Stefano Ferrero, Luca Reggiani Bonetti, Deborah Malvi, Giovanni Latella, Paolo Pedrazzoli, Antonio Calabrò, Roberto De Giorgio, Alessandra Viglio, Fernando Rizzello, Flavio Caprioli, Roberto Caronna, Daniela Furlan, Antonino Giulio Giannone, Marco Silano, Maurizio Vecchi, Michele Martino, Francesco Tonelli, Laura Cantoro, Antonio Di Sabatino, Maria D'Armiento, Enrico Solcia, Paolo Giuffrida, Gianluca M. Sampietro, Ada Maria Florena, Giovanni Monteleone, Livia Biancone, Claudia Mescoli, G. Solina, Andrea Pietrabissa, Umberto Volta, Renata D'Incà, Ombretta Luinetti, Vincenzo Villanacci, Luca Elli, Massimo Rugge, Maria Cristina Macciomei, Paolo Fociani, Marco Astegiano, Rachele Ciccocioppo, Fabiana Zingone, Claudio Papi, Giacomo Caio, G. Sandri, Barbara Oreggia, Alessandro Vanoli, Aroldo Rizzo, Elena Biletta, Augusto Orlandi, Gilberto Poggioli, Antonio Ciardi, Marco Vincenzo Lenti, Paolo Usai, Erica Quaquarini, Donatella Santini, Sandro Ardizzone, Giuffrida, Paolo, Arpa, Giovanni, Grillo, Federica, Klersy, Catherine, Sampietro, Gianluca, Ardizzone, Sandro, Fociani, Paolo, Fiocca, Roberto, Latella, Giovanni, Sessa, Fausto, D'Errico, Antonietta, Malvi, Deborah, Mescoli, Claudia, Rugge, Massimo, Nesi, Gabriella, Ferrero, Stefano, Furlan, Daniela, Poggioli, Gilberto, Rizzello, Fernando, Macciomei, Maria C, Santini, Donatella, Volta, Umberto, De Giorgio, Roberto, Caio, Giacomo, Calabrò, Antonio, Ciacci, Carolina, D'Armiento, Maria, Rizzo, Aroldo, Solina, Gaspare, Martino, Michele, Tonelli, Francesco, Villanacci, Vincenzo, Cannizzaro, Renato, Canzonieri, Vincenzo, Florena, Ada M, Biancone, Livia, Monteleone, Giovanni, Caronna, Roberto, Ciardi, Antonio, Elli, Luca, Caprioli, Flavio, Vecchi, Maurizio, D'Incà, Renata, Zingone, Fabiana, D'Odorico, Anna, Lenti, Marco Vincenzo, Oreggia, Barbara, Reggiani Bonetti, Luca, Astegiano, Marco, Biletta, Elena, Cantoro, Laura, Giannone, Antonino G, Orlandi, Augusto, Papi, Claudio, Perfetti, Vittorio, Quaquarini, Erica, Sandri, Giancarlo, Silano, Marco, Usai, Paolo, Barresi, Valeria, Ciccocioppo, Rachele, Luinetti, Ombretta, Pedrazzoli, Paolo, Pietrabissa, Andrea, Viglio, Alessandra, Paulli, Marco, Corazza, Gino R, Solcia, Enrico, Vanoli, Alessandro, Di Sabatino, Antonio, Giuffrida P., Arpa G., Grillo F., Klersy C., Sampietro G., Ardizzone S., Fociani P., Fiocca R., Latella G., Sessa F., D'Errico A., Malvi D., Mescoli C., Rugge M., Nesi G., Ferrero S., Furlan D., Poggioli G., Rizzello F., Macciomei M.C., Santini D., Volta U., De Giorgio R., Caio G., Calabro A., Ciacci C., D'Armiento M., Rizzo A., Solina G., Martino M., Tonelli F., Villanacci V., Cannizzaro R., Canzonieri V., Florena A.M., Biancone L., Monteleone G., Caronna R., Ciardi A., Elli L., Caprioli F., Vecchi M., D'Inca R., Zingone F., D'Odorico A., Lenti M.V., Oreggia B., Reggiani Bonetti L., Astegiano M., Biletta E., Cantoro L., Giannone A.G., Orlandi A., Papi C., Perfetti V., Quaquarini E., Sandri G., Silano M., Usai P., Barresi V., Ciccocioppo R., Luinetti O., Pedrazzoli P., Pietrabissa A., Viglio A., Paulli M., Corazza G.R., Solcia E., Vanoli A., Di Sabatino A., Giuffrida, P., Arpa, G., Grillo, F., Klersy, C., Sampietro, G., Ardizzone, S., Fociani, P., Fiocca, R., Latella, G., Sessa, F., D'Errico, A., Malvi, D., Mescoli, C., Rugge, M., Nesi, G., Ferrero, S., Furlan, D., Poggioli, G., Rizzello, F., Macciomei, M. C., Santini, D., Volta, U., De Giorgio, R., Caio, G., Calabro, A., Ciacci, C., D'Armiento, M., Rizzo, A., Solina, G., Martino, M., Tonelli, F., Villanacci, V., Cannizzaro, R., Canzonieri, V., Florena, A. M., Biancone, L., Monteleone, G., Caronna, R., Ciardi, A., Elli, L., Caprioli, F., Vecchi, M., D'Inca, R., Zingone, F., D'Odorico, A., Lenti, M. V., Oreggia, B., Reggiani Bonetti, L., Astegiano, M., Biletta, E., Cantoro, L., Giannone, A. G., Orlandi, A., Papi, C., Perfetti, V., Quaquarini, E., Sandri, G., Silano, M., Usai, P., Barresi, V., Ciccocioppo, R., Luinetti, O., Pedrazzoli, P., Pietrabissa, A., Viglio, A., Paulli, M., Corazza, G. R., Solcia, E., Vanoli, A., Di Sabatino, A., and Vincenzo Lenti, Marco
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0301 basic medicine ,Male ,PD-L1 - small bowel adenocarcinoma - tumor-infiltrating lymphocytes - microsatellite instability ,Pathology ,BLOCKADE ,Colorectal cancer ,Lymphocyte ,Small bowel adenocarcinoma ,Gastroenterology ,B7-H1 Antigen ,Settore MED/12 ,0302 clinical medicine ,Crohn Disease ,Intestine, Small ,small bowel adenocarcinoma ,Small bowel adenocarcinomas ,MEDULLARY CARCINOMA ,MORPHOLOGY ,EXPRESSION ,CANCER ,biology ,microsatelliteinstability ,Middle Aged ,medicine.anatomical_structure ,Medullary carcinoma ,tumor infiltrating lymphocytes ,030220 oncology & carcinogenesis ,tumor-infiltrating lymphocytes ,Adenocarcinoma ,Female ,Microsatellite Instability ,PD-L1 ,Adult ,medicine.medical_specialty ,small bowel adenocarcinoma, tumor-infiltrating lymphocytes, microsatelliteinstability ,Settore MED/08 - Anatomia Patologica ,PD-L1, small bowel adenocarcinoma ,NO ,Pathology and Forensic Medicine ,03 medical and health sciences ,Lymphocytes, Tumor-Infiltrating ,Internal medicine ,expression ,Intestinal Neoplasms ,Biomarkers, Tumor ,medicine ,Humans ,PD-L1 in small bowel adenocarcinoma, MSI-H ,Small bowel adenocarcinoma, expression, microsatellite instability, biomarkers ,Aged ,Retrospective Studies ,business.industry ,Tumor-infiltrating lymphocytes ,biomarkers ,Cancer ,Correction ,Microsatellite instability ,medicine.disease ,Celiac Disease ,030104 developmental biology ,biology.protein ,Etiology ,business - Abstract
Small bowel adenocarcinomas (SBAs) are often associated with poor prognosis and have limited therapeutic options. Programmed cell death protein-1 (PD-1)/programmed cell death ligand 1 (PD-L1) pathway blockade is an effective treatment in many microsatellite instability-high (MSI-H) solid tumors. We aimed at investigating PD-L1 and PD-1 expression in non-hereditary, non-ampullary SBAs, associated with celiac disease (CeD), Crohn’s disease (CrD), or sporadic, recruited through the Small Bowel Cancer Italian Consortium. We assessed PD-L1 and PD-1 by immunohistochemistry in a series of 121 surgically resected SBAs, including 34 CeD-SBAs, 49 CrD-SBAs, and 38 sporadic SBAs. PD-L1 and PD-1 expression was correlated with several clinico-pathological features, such as the etiology, microsatellite instability status, and tumor-infiltrating lymphocyte (TIL) density. The prevalence of PD-L1 positivity according to combined positive score (CPS) was 26% in the whole cohort of SBAs, with significantly (p = 0.001) higher percentage (35%) in both CeD-SBAs and CrD-SBAs in comparison with sporadic SBAs (5%). CPS ≥ 1 SBAs were significantly (p = 0.013) more frequent in MSI-H cases (41%) than in non-MSI-H ones (18%); however, 15 CPS ≥ 1 microsatellite stable SBAs were also identified. CPS ≥ 1 SBAs showed higher TIL and PD-1+ immune cell density, more frequently medullary histotype, as well as a better outcome in comparison with CPS < 1 cases. This study demonstrates an increased proportion of PD-L1+ cases in both CeD-SBAs and CrD-SBAs in comparison with sporadic SBAs. In addition, the identification of a subset of PD-L1+ microsatellite stable SBAs supports the need to ascertain additional biomarkers of response to immune checkpoint inhibitors along with MSI-H.
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- 2020
12. Critical diagnostic delay associated with unusual presentation of hepatocellular carcinoma (HCC) with orbital metastases: a case report
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Deborah Malvi, Elisabetta Nobili, Alessandro Federico, Stefano Brocchi, Giovanni Brandi, Barbara Lenzi, Daria Maria Filippini, Filippini D.M., Di Federico A., Lenzi B., Nobili E., Brocchi S., Malvi D., and Brandi G.
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medicine.medical_specialty ,Metastasi ,Treatment-delay ,Metastasis ,Lesion ,03 medical and health sciences ,Therapeutic approach ,0302 clinical medicine ,Biopsy ,medicine ,In patient ,Hepatocellular carcinoma (HCC) ,Advanced and Specialized Nursing ,Orbital metastase ,medicine.diagnostic_test ,business.industry ,Multimodal therapy ,medicine.disease ,Anesthesiology and Pain Medicine ,030220 oncology & carcinogenesis ,Hepatocellular carcinoma ,Misdiagnosi ,030211 gastroenterology & hepatology ,Radiology ,medicine.symptom ,Presentation (obstetrics) ,business - Abstract
Orbital metastases are an extremely rare finding in patients with hepatocarcinoma (HCC), especially as its first presentation. Therefore, the risk of misdiagnosis is high, as well as that of drastic delays of the therapeutic algorithm. Here we report a 71-year-old man presenting with orbital metastases as the initial sign of HCC, whose initial misdiagnosis led to the impossibility to start life-saving cancer treatment. The patient’s history has begun on March 2018 with a growing tumefaction of the right orbit initially treted with antibiotics and corticosteroids without benefit. Subsequently, a facial CT scan showed a voluminous right intra-orbital mass, eroding the orbital roof. Tissue biopsy documented well differentiated malignant epithelial tumor cells. Under the suspect of primitive lachrymal gland tumor, the patient was admitted to the head and neck Unit with surgical intent. However, a subsequent 18F-FDG-PET documented the presence of liver lesions and multiple sites of metastasis. A new biopsy, this time on liver nodules, was carried out and the diagnosis of HCC was finally made. Samples from the first biopsy were then reviewed and judged consistent with HCC metastasis. Unfortunately, the initial misdiagnosis resulted in a six-month delay of the start of a therapeutic approach. During that time, patient’s general conditions got extremely worse, making him unable to afford an antiblastic treatment. The patient died three months after the definitive diagnosis. This case suggests that the presence of intraorbital lesion requires a multimodal approach starting from the initial presentation. Performing a complete staging since tumor’s clinical onset is mandatory, preferably before carrying out a tissue biopsy. Even though HCC represents a rare cause of intraocular metastasis, it needs to be ruled out when an orbital mass is documented, as the short median survival and the frequently poor conditions of HCC patients make a timely diagnosis crucial.
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- 2021
13. Intrahepatocellular crystal storing mimicking a clinical liver disease during monoclonal gammopathy: report of a case and review of the literature
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Mattia Riefolo, Francesco Vasuri, Clara Bertuzzi, Deborah Malvi, Sabrina Valente, Gianandrea Pasquinelli, Elena Sabattini, Antonia D'Errico, Riefolo M., Malvi D., Bertuzzi C., Sabattini E., Valente S., Pasquinelli G., D'Errico A., and Vasuri F.
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Male ,0301 basic medicine ,Pathology ,medicine.medical_specialty ,Crystal-storing histiocytosi ,Paraproteinemias ,Pathology and Forensic Medicine ,Diagnosis, Differential ,Crystal storing histiocytosis ,03 medical and health sciences ,Liver disease ,0302 clinical medicine ,Structural Biology ,transmission electron microscopy ,medicine ,Humans ,Aged ,Inclusion Bodies ,Unusual case ,business.industry ,Liver Diseases ,monoclonal gammopathy ,immunogold labeling ,Immunogold labelling ,medicine.disease ,Lysosomal Storage Diseases ,Histiocytosis ,Monoclonal gammopathy ,030104 developmental biology ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,histopathology ,Immunoglobulin Light Chains ,Histopathology ,Bone marrow ,medicine.symptom ,liver disease ,business - Abstract
We present an unusual case of liver involvement in monoclonal gammopathy with generalized crystal-storing histiocytosis (G-CSH). A bone marrow storage disease was diagnosed in a 79-year-old man with monoclonal gammopathy of uncertain significance (MGUS). The patient presented with pleural effusion, an osteolytic lesion of the humerus, and an increase of aspartate transaminase and cholestatic markers that raised the clinical suspect of liver disease. A second bone marrow biopsy confirmed the diagnosis of MGUS with a histiocytic component suggestive for G-CSH. Liver biopsy showed an unremarkable histology, no significant inflammatory infiltrates, and intrasinusoidal foamy histiocytes. PAS and Masson’s trichrome stains, showed, in the cytoplasm of both histiocytes and hepatocytes, rod-shaped eosinophilic crystals, which were immunoreactive for kappa light chains. Transmission electron microscopy performed on reprocessed histological sections confirmed the presence of crystals in the hepatocyte cytoplasms. Immunogold labeling intensely stained crystals for kappa light chains. To the best of our knowledge, this is the second case in which an intrahepatocellular crystal storage is described during liver involvement in G-CSH. The present case also suggests that an increase in liver serum enzymes may support the clinical diagnosis of liver CSH in a patient with MGUS.
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- 2020
14. The Relationship between Timing of Pretransplant Kidney Biopsy, Graft Loss, and Survival in Kidney Transplantation:An Italian Cohort Study
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Francesco Vasuri, Massimo Del Gaudio, Matteo Ravaioli, Maurizio Sessa, Matteo Serenari, Deborah Malvi, Olga Baraldi, Gaetano La Manna, Giuliana Germinario, Vania Cuna, Irene Capelli, Federica Odaldi, Giorgia Comai, Raffaele Bova, Giacomo Frascaroli, Lorenzo Maroni, Antonietta D'Errico, Valentina Rosa Bertuzzo, Gabriela Sangiorgi, Chiara Zanfi, Odaldi F., Serenari M., Comai G., La Manna G., Bova R., Frascaroli G., Malvi D., Maroni L., Vasuri F., Germinario G., Baraldi O., Capelli I., Cuna V., Sangiorgi G., D'Errico A., Del Gaudio M., Bertuzzo V.R., Zanfi C., Sessa M., and Ravaioli M.
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Graft Rejection ,Male ,medicine.medical_specialty ,Biopsy ,Urology ,Kidney biopsy ,Kidney ,Cold Ischemia Time ,Cohort Studies ,Solid tumors ,Medicine ,Humans ,Kidney clinical ,Kidney transplantation ,Aged ,Outcome ,Aged, 80 and over ,medicine.diagnostic_test ,business.industry ,Graft Survival ,Graft survival ,Middle Aged ,medicine.disease ,Kidney Transplantation ,Confidence interval ,Tissue Donors ,Transplantation ,Survival Rate ,medicine.anatomical_structure ,Italy ,Propensity score matching ,Preoperative Period ,Female ,business ,Cohort study - Abstract
Introduction: Kidney biopsy is performed to assess if an extended criteria graft can be used for transplantation. It may be performed before or after cross-clamping during organ procurement. This study aims to evaluate whether the timing of biopsy may modify cold ischemia times (CIT) and/or graft outcomes. Methods: Kidney transplants performed in our center from January 2007 to December 2017 were analyzed. Grafts with preimplantation kidney biopsy were included. Biopsies were performed during surgical back table (ex situ kidney biopsy [ESKB]) until 2012 and since then before the aortic cross-clamping (in situ kidney biopsy [ISKB]). To overcome biases owing to different distributions, a propensity score model was developed. The study population consists in 322 patients, 115 ESKB, and 207 ISKB. Results: CIT was significantly lower for ISKB (730 min ISKB vs. 840 min ESKB, p value = 0.001). In both crude (OR 0.27; 95% confidence interval, 95% CI 0.12–0.60; p value = 0.002) and adjusted analyses (OR 0.37; 95% CI 0.14–0.94; p value = 0.039), ISKB was associated with a reduced odd of graft loss when compared to ESKB. Discussion/Conclusion: Performing preimplantation kidney biopsy during the recovery, prior to the aortic cross-clamping, may be a strategy to reduce CIT and improve transplant outcomes.
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- 2022
15. Histological Evidence of Diabetic Kidney Disease Precede Clinical Diagnosis
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Deborah Malvi, Gaetano La Manna, Sabrina Valente, Irene Capelli, Gianandrea Pasquinelli, Matteo Ravaioli, Antonietta D'Errico, Francesco Vasuri, Francesca Ambrosi, Alessia Fornoni, Andrea Angeletti, Giorgia Comai, Comai G., Malvi D., Angeletti A., Vasuri F., Valente S., Ambrosi F., Capelli I., Ravaioli M., Pasquinelli G., D'Errico A., Fornoni A., and La Manna G.
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Male ,Albuminuria diabetes mellitu ,medicine.medical_specialty ,Biopsy ,Kidney biopsy ,030232 urology & nephrology ,Urology ,Renal function ,Diabetic nephropathy ,Type 2 diabetes ,030204 cardiovascular system & hematology ,Risk Assessment ,Article ,03 medical and health sciences ,0302 clinical medicine ,Microscopy, Electron, Transmission ,Diabetes mellitus ,Glomerular Basement Membrane ,medicine ,Albuminuria ,Humans ,Diabetic Nephropathies ,Diabetic kidney disease ,Aged ,Retrospective Studies ,Proteinuria ,medicine.diagnostic_test ,urogenital system ,business.industry ,Middle Aged ,medicine.disease ,Diabetes Mellitus, Type 1 ,Diabetes Mellitus, Type 2 ,Nephrology ,Female ,medicine.symptom ,business ,Glomerular Filtration Rate ,Kidney disease - Abstract
Background: In the absence of a histological diagnosis, persistent albuminuria is globally accepted as the main diagnostic criteria for diabetic kidney disease (DKD). Methods: In the present retrospective study, we evaluated data from an Italian cohort of 42 deceased diabetic donors (mainly with type 2 diabetes). Using the kidney biopsies obtained at the time of donation to evaluate single or double allocation based on Karpinski score, we determined the prevalence of histological lesions attributable to diabetes. Results: All 42 donors presented with proteinuria in the normal range and an estimated glomerular filtration rate (eGFR) (chronic kidney disease [CKD]-EPI) >60 mL/min/1.73 m2. A kidney biopsy was available for 36 patients; of these, one was not interpretable and 32 showed histopathological lesions consistent with DKD and encompassing all histological classes. Thus, we found a relatively high proportion of histologically proven DKD that had been clinically undiagnosed, as none of the patient had significant proteinuria and eGFR 2. Conclusions: The data we present here support the need to implement routine kidney biopsies in normoalbuminuric diabetic subjects in the early stages of CKD. Such strategy may help to improve risk stratification in diabetic patients and guide therapeutic decisions during the early stages of the disease.
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- 2019
16. Prognostic relevance and putative histogenetic role of cytokeratin 7 and MUC5AC expression in Crohn’s disease-associated small bowel carcinoma
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Daniela Furlan, Roberto Fiocca, Gianluca M. Sampietro, Alessandro Vanoli, Ombretta Luinetti, Catherine Klersy, Antonietta D'Errico, Valeria Barresi, Roberto Caronna, Carlo Capella, Enrico Solcia, Giovanni Latella, Fausto Sessa, Claudia Mescoli, Gilberto Poggioli, Sandro Ardizzone, Deborah Malvi, Rachele Ciccocioppo, Massimo Rugge, Giovanni Arpa, Antonio Di Sabatino, Federica Grillo, Maria Cristina Macciomei, Gabriella Nesi, Francesco Tonelli, Fernando Rizzello, Antonio Ciardi, Marco Vincenzo Lenti, Marco Paulli, Arpa G., Vanoli A., Grillo F., Fiocca R., Klersy C., Furlan D., Sessa F., Ardizzone S., Sampietro G., Macciomei M.C., Nesi G., Tonelli F., Capella C., Latella G., Ciardi A., Caronna R., Lenti M.V., Ciccocioppo R., Barresi V., Malvi D., D'Errico A., Rizzello F., Poggioli G., Mescoli C., Rugge M., Luinetti O., Paulli M., Di Sabatino A., and Solcia E.
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Pathology ,Gene Expression ,Disease ,Histogenesis ,Mucin 5AC ,Small ,Crohn Disease ,Duodenal Neoplasms ,Intestine, Small ,Stage (cooking) ,Intestinal Mucosa ,Crohn's disease ,Small bowel adenocarcinoma ,General Medicine ,Prognosis ,Phenotype ,Intestine ,Gene Expression Regulation, Neoplastic ,Original Article ,Non-conventional dysplasia ,Survival Analysi ,Human ,Cytokeratin 7 ,MUC5AC ,medicine.medical_specialty ,Prognosi ,Duodenal Neoplasm ,Adenocarcinoma ,Precancerous Condition ,Pathology and Forensic Medicine ,Cytokeratin ,medicine ,Humans ,Molecular Biology ,Neoplastic ,Metaplasia ,business.industry ,Carcinoma ,Keratin-7 ,Precancerous Conditions ,Survival Analysis ,Transcriptome ,Cancer ,Cell Biology ,medicine.disease ,Gene Expression Regulation ,Dysplasia ,business - Abstract
Most Crohn’s disease-associated small bowel carcinomas (CrD-SBCs) are diagnosed in advanced stage and have poor prognosis. To improve diagnosis and therapy, a better knowledge of tumour precancerous lesions, histotypes and prognostic factors is needed. We investigated histologically and immunohistochemically 52 CrD-SBCs and 51 small bowel carcinomas unrelated to inflammatory disease, together with their tumour-associated mucosa, looking for Crohn-selective changes. Histologic patterns and phenotypic markers potentially predictive of CrD-SBC histogenesis and prognosis were analysed. Cytokeratin 7 or MUC5AC-positive metaplastic changes were found in about half of investigated CrD-SBCs, significantly more frequently than in CrD-unrelated SBCs. They correlated with metaplastic changes of their associated mucosa, while being absent in normal ileal mucosa. Histologic patterns suggestive for progression of some cytokeratin 7 and/or MUC5AC-positive metaplastic lesions into cancer of the same phenotype were also observed. Patient survival analyses showed that tumour cytokeratin 7 or MUC5AC expression and non-cohesive histotype were adverse prognostic factors at univariable analysis, while cytokeratin 7 and non-cohesive histotype were also found to predict worse survival in stage- and age-inclusive multivariable analyses. Besides conventional dysplasia, hyperplasia-like non-conventional lesions were observed in CrD-SBC-associated mucosa, with patterns suggestive for a histogenetic link with adjacent cancer. In conclusion the cytokeratin 7 and/or MUC5AC-positive metaplastic foci and the non-conventional growths may have a role in cancer histogenesis, while tumour cytokeratin 7 and non-cohesive histotype may also predict poor patient survival. Present findings are worth being considered in future prospective histogenetic and clinical studies. Supplementary Information The online version contains supplementary material available at 10.1007/s00428-021-03109-2.
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- 2021
17. Donor-Transmitted Cancers in Transplanted Livers: Analysis of Clinical Outcomes
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Ilaria Girolami, Deborah Malvi, Matteo Brunelli, Letizia Lombardini, Amedeo Carraro, Claudia Mescoli, Albino Eccher, Umberto Montin, Stefano Marletta, Desley Neil, Massimo Cardillo, Luca Novelli, Ugo Boggi, Antonietta D'Errico, Eccher A., Girolami I., Marletta S., Brunelli M., Carraro A., Montin U., Boggi U., Mescoli C., Novelli L., Malvi D., Lombardini L., Cardillo M., Neil D., and D'Errico A.
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Oncology ,medicine.medical_specialty ,liver grafts ,medicine.medical_treatment ,cancer transmission ,Transplants ,030230 surgery ,Neuroendocrine tumors ,Liver transplantation ,Malignancy ,donor organ ,liver recipients ,systematic review ,03 medical and health sciences ,0302 clinical medicine ,Neoplasms ,Internal medicine ,medicine ,Humans ,Registries ,Liver transplantation, cancer transmissio ,Transplantation ,Hepatology ,business.industry ,Transmission (medicine) ,Melanoma ,Graft Survival ,Cancer ,medicine.disease ,Tissue Donors ,Liver Transplantation ,Lymphoma ,030211 gastroenterology & hepatology ,Surgery ,business - Abstract
The risk of transmission of malignancy from donor to recipient is low. However, this occurrence has dramatic consequences. Many reports of donor-derived cancers in liver transplant recipients have been published, but they have not been systematically summarized into a lucid and unified analysis. The present study is an attempt to provide clarity to this unusual but clinically important problem. We systematically reviewed all patient reports, patient series, and registries published on cancer transmission events through the end of December 2019. We identified a total of 67 publications with 92 transmission events. The most frequently transmitted cancers were lymphomas (30; 32.6%), melanomas (8; 8.7%), and neuroendocrine tumors (8; 8.7%). Most of the melanomas were metastasizing, whereas most of the lymphomas were localized to the graft. The median time to cancer diagnosis after transplantation was 7months, with 78.1% of diagnoses established in the first year. Melanoma carried the worst prognosis, with no recipients alive at 1year after cancer diagnosis. Lymphoma recipients had a better outcome, with more than 75% surviving at 2years. A metastatic cancer carries a worse prognosis for recipients, and recipients with localized cancer can benefit from the chance to undergo transplantation again. The findings confirm the need to pay attention to donors with a history of melanoma but also suggest the need for a more careful evaluation of groups of donors, such as those dying from cerebral hemorrhage. Finally, recipients of organs from donors with cancer should be carefully followed to detect potential transmission.
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- 2021
18. Recovering histological sections for ultrastructural diagnosis of glomerular diseases through the pop-off technique
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Deborah Malvi, Gaetano La Manna, Valeria Corradetti, Sabrina Valente, Giorgia Comai, Gianandrea Pasquinelli, Valente S., Comai G., Malvi D., Corradetti V., La Manna G., and Pasquinelli G.
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Pathology ,medicine.medical_specialty ,Microscope ,Basement Membrane Thickness ,Biopsy ,030232 urology & nephrology ,Kidney biopsy ,Fluorescent Antibody Technique ,030204 cardiovascular system & hematology ,Immunofluorescence ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,law ,Glomerular Basement Membrane ,medicine ,Electron microscopy ,Humans ,Glomerular disease ,medicine.diagnostic_test ,business.industry ,urogenital system ,Glomerular basement membrane ,Pop-off technique ,Microscopy, Electron ,medicine.anatomical_structure ,Nephrology ,Ultrastructure ,Kidney Diseases ,Renal biopsy ,Electron microscope ,business - Abstract
Introduction: Electron microscopy (EM) represents an indispensable technique for the diagnosis of kidney glomerular diseases. When dedicated tissue is not available, histological and cryostat sections can be reprocessed for EM using the pop-off technique. Here the practical value of this technique is analysed with emphasis on its accuracy in measuring basement membrane thickness and detecting immune deposits. Methods: Ninety-four histological sections of kidney tissues fixed in Serra’s solution, stained with H&E, PAS, and Masson's Trichrome; for EM analysis, the sections were recovered from either treated or untreated microscope slides through the pop-off technique. Some sections were recovered from cryosections allocated for immunofluorescence. Results: The ultrastructural details were sufficiently maintained on tissues fixed with Serra's solution despite being considered disadvantageous for EM. The type of microscope slides and the time of biopsy storage did not affect the quality of section recovery. The histological stains had only moderate effects on the electron-density of the glomerular basement membrane (GBM). The pop-off technique reduced the GBM thickness when compared to the conventional EM processing but preserved the electron density of immune deposits. Conclusions: The application of the pop-off method to renal biopsy is a useful recovery method that produces limited but satisfactory results when there is no suitable material for EM. The ultrastructural morphology was retained even from tissues fixed with Serra's solution, and deposits maintained the expected electron density, however, we observed an overall thickness reduction of the GBM that could have a potential impact on thin membrane disease diagnosis. Graphic abstract: [Figure not available: see fulltext.]
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- 2021
19. Treatment of Advanced Gastro-Entero-Pancreatic Neuro-Endocrine Tumors: A Systematic Review and Network Meta-Analysis of Phase III Randomized Controlled Trials
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Francesco Minni, Giuseppe Lamberti, Cristina Mosconi, Carlo Ingaldi, Lisa Manuzzi, Deborah Malvi, Riccardo Casadei, Davide Campana, Nico Pagano, Laura Alberici, Francesca Rosini, Claudio Ricci, Fabio Monari, Valentina Ambrosini, Ricci C., Lamberti G., Ingaldi C., Mosconi C., Pagano N., Alberici L., Ambrosini V., Manuzzi L., Monari F., Malvi D., Rosini F., Minni F., Campana D., and Casadei R.
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Oncology ,carcinoid ,Cancer Research ,medicine.medical_specialty ,Bevacizumab ,MEDLINE ,Gastro entero pancreatic ,network metanalysis ,Placebo ,lcsh:RC254-282 ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Randomized controlled trial ,law ,Internal medicine ,medicine ,Endocrine system ,030212 general & internal medicine ,Network metanalysi ,Everolimus ,neuroendocrine neoplasms ,business.industry ,Sunitinib ,lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,030220 oncology & carcinogenesis ,Meta-analysis ,Systematic Review ,business ,medicine.drug - Abstract
Simple Summary The most effective and safest approach for the treatment of advanced gastro-entero-pancreatic neuroendocrine neoplasms (GEP–NENs) remains unknown. A systematic review was done to clarify this point. A network meta-analysis was used to overcome the multiarm problem. Our study confirmed that somatostatin analogs (SSAs) alone remain the best choice for well-differentiated GEP–NENs. 177Lu-Dotatate plus SSA is a valid alternative for midgut NENs since it has been shown to be slightly more efficacious but yielding a higher risk for toxicity than SSAs. Abstract Several new therapies have been approved to treat advanced gastro-entero-pancreatic neuroendocrine neoplasms (GEP–NENs) in the last twenty years. In this systematic review and meta-analysis, we searched MEDLINE, ISI Web of Science, and Scopus phase III randomized controlled trials (RCTs) comparing two or more therapies for unresectable GEP–NENs. Network metanalysis was used to overcome the multiarm problem. For each arm, we described the surface under the cumulative ranking (SUCRA) curves. The primary endpoints were progression-free survival and grade 3–4 of toxicity. We included nine studies involving a total of 2362 patients and 5 intervention arms: SSA alone, two IFN-α plus SSA, two Everolimus alone, one Everolimus plus SSA, one Sunitinib alone, one 177Lu-Dotatate plus SSA, and one Bevacizumab plus SSA. 177Lu-Dotatate plus SSA had the highest probability (99.6%) of being associated with the longest PFS. This approach was followed by Sunitinib use (64.5%), IFN-α plus SSA one (53.0%), SSA alone (46.6%), Bevacizumab plus SSA one (45.0%), and Everolimus ± SSA one (33.6%). The placebo administration had the lowest probability of being associated with the longest PFS (7.6%). Placebo or Bevacizumab use had the highest probability of being the safest (73.7% and 76.7%), followed by SSA alone (65.0%), IFN-α plus SSA (52.4%), 177Lu-Dotatate plus SSA (49.4%), and Sunitinib alone (28.8%). The Everolimus-based approach had the lowest probability of being the safest (3.9%). The best approaches were SSA alone or combined with 177Lu-Dotatate.
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- 2021
20. Molecular Characterization of Pancreatic Ductal Adenocarcinoma Using a Next-Generation Sequencing Custom-Designed Multigene Panel
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Deborah Malvi, Francesco Vasuri, Thais Maloberti, Viviana Sanza, Antonio De Leo, Adele Fornelli, Michele Masetti, Claudia Benini, Raffaele Lombardi, Maria Fortuna Offi, Mariacristina Di Marco, Matteo Ravaioli, Sirio Fiorino, Enrico Franceschi, Alba A. Brandes, Elio Jovine, Antonietta D’Errico, Giovanni Tallini, Dario de Biase, Malvi D., Vasuri F., Maloberti T., Sanza V., De Leo A., Fornelli A., Masetti M., Benini C., Lombardi R., Offi M.F., Di Marco M., Ravaioli M., Fiorino S., Franceschi E., Brandes A.A., Jovine E., D'errico A., Tallini G., and de Biase D.
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endocrine system diseases ,pancreatic cancer ,Clinical Biochemistry ,KRAS ,PDAC ,next-generation sequencing ,TP53 ,mutations ,mutation ,digestive system diseases - Abstract
Despite the efforts made in the management of PDAC, the 5-year relative survival rate of pancreatic ductal adenocarcinoma (PDAC) still remains very low (10%). To date, precision oncology is far from being ready to be applied in cases of PDAC, although studies exploring the molecular and genetic alterations have been conducted, and the genomic landscape of PDAC has been characterized. This study aimed to apply a next-generation sequencing (NGS) laboratory-developed multigene panel to PDAC samples to find molecular alterations that could be associated with histopathological features and clinical outcomes. A total of 68 PDACs were characterized by using a laboratory-developed multigene NGS panel. KRAS and TP53 mutations were the more frequent alterations in 75.0% and 44.6% of cases, respectively. In the majority (58.7%) of specimens, more than one mutation was detected, mainly in KRAS and TP53 genes. KRAS mutation was significantly associated with a shorter time in tumor recurrence compared with KRAS wild-type tumors. Intriguingly, KRAS wild-type cases had a better short-term prognosis despite the lymph node status. In conclusion, our work highlights that the combination of KRAS mutation with the age of the patient and the lymph node status may help in predicting the outcome in PDAC patients.
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- 2022
21. Hypothermic Oxygenated New Machine Perfusion System in Liver and Kidney Transplantation of Extended Criteria Donors:First Italian Clinical Trial
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Federica Odaldi, Massimo Del Gaudio, Maurizio Baldassarre, Guido Fallani, Vito Marco Ranieri, Antonietta D'Errico, Deborah Malvi, Lorenzo Maroni, Gianandrea Pasquinelli, Vanessa De Pace, Gaetano La Manna, Matteo Cescon, Paolo Caraceni, Matteo Ravaioli, Giuliana Germinario, Valentina Rosa Bertuzzo, Giorgia Comai, Francesco Vasuri, Antonio Daniele Pinna, Andrea Angeletti, Antonio Siniscalchi, Maria Cristina Morelli, Chiara Donadei, Ravaioli M., De Pace V., Angeletti A., Comai G., Vasuri F., Baldassarre M., Maroni L., Odaldi F., Fallani G., Caraceni P., Germinario G., Donadei C., Malvi D., Del Gaudio M., Bertuzzo V.R., Siniscalchi A., Ranieri V.M., D'Errico A., Pasquinelli G., Morelli M.C., Pinna A.D., Cescon M., and La Manna G.
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medicine.medical_specialty ,medicine.medical_treatment ,Urology ,lcsh:Medicine ,Cold storage ,030230 surgery ,Liver transplantation ,Kidney ,Article ,Kidney transplantation ,03 medical and health sciences ,0302 clinical medicine ,Extended Criteria Donor ,Hypothermic oxygenated machine perfusion ,Medicine ,lcsh:Science ,Machine perfusion ,Kidney diseases ,Multidisciplinary ,integumentary system ,business.industry ,lcsh:R ,Kidney metabolism ,medicine.disease ,Clinical trial design ,Transplantation ,Clinical trial ,nervous system ,lcsh:Q ,030211 gastroenterology & hepatology ,business ,tissues ,Perfusion - Abstract
With the aim to explore innovative tools for organ preservation, especially in marginal organs, we hereby describe a clinical trial of ex-vivo hypothermic oxygenated perfusion (HOPE) in the field of liver (LT) and kidney transplantation (KT) from Extended Criteria Donors (ECD) after brain death. A matched-case analysis of donor and recipient variables was developed: 10 HOPE-ECD livers and kidneys (HOPE-L and HOPE-K) were matched 1:3 with livers and kidneys preserved with static cold storage (SCS-L and SCS-K). HOPE and SCS groups resulted with similar basal characteristics, both for recipients and donors. Cumulative liver and kidney graft dysfunction were 10% (HOPE L-K) vs. 31.7%, in SCS group (p = 0.05). Primary non-function was 3.3% for SCS-L vs. 0% for HOPE-L. No primary non-function was reported in HOPE-K and SCS-K. Median peak aspartate aminotransferase within 7-days post-LT was significantly higher in SCS-L when compared to HOPE-L (637 vs.344 U/L, p = 0.007). Graft survival at 1-year post-transplant was 93.3% for SCS-L vs. 100% of HOPE-L and 90% for SCS-K vs. 100% of HOPE-K. Clinical outcomes support our hypothesis of machine perfusion being a safe and effective system to reduce ischemic preservation injuries in KT and in LT.
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- 2020
22. Pathological features and outcomes of incidental renal cell carcinoma in candidate solid organ donors
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Francesco Vasuri, Antonia D'Errico, Carlo de Cillia, Deborah Malvi, Matteo Ravaioli, Costantino Ricci, Massimo Cardillo, Michelangelo Fiorentino, Francesca Ambrosi, Ambrosi F., Ricci C., Malvi D., De Cillia C., Ravaioli M., Fiorentino M., Cardillo M., Vasuri F., and D'errico A.
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medicine.medical_specialty ,lcsh:Internal medicine ,lcsh:Specialties of internal medicine ,030232 urology & nephrology ,Chromophobe cell ,030204 cardiovascular system & hematology ,urologic and male genital diseases ,Kidney transplantation ,03 medical and health sciences ,0302 clinical medicine ,Renal cell carcinoma ,lcsh:RC581-951 ,medicine ,Stage (cooking) ,lcsh:RC31-1245 ,Risk assessment ,Frozen section procedure ,business.industry ,Papillary Adenoma ,Cancer ,General Medicine ,Cancer transmission ,medicine.disease ,Donor evaluation ,Original Article ,Radiology ,business ,Clear cell - Abstract
Background : We report the findings of a single Italian center in the evaluation of renal lesions in deceased donors from 2001 to 2017. In risk evaluation, we applied the current Italian guidelines, which include donors with small (< 4 cm, stage pT1a) renal carcinomas in the category of non-standard donors with a negligible risk of cancer transmission. Methods : From the revision of our registries, 2,406 donors were considered in the Emilia Romagna region of Italy; organs were accepted from 1,321 individuals for a total of 3,406 organs. Results : The evaluation of donor safety required frozen section analysis for 51 donors, in which a renal suspicious lesion was detected by ultrasound. Thirty-two primary renal tumors were finally diagnosed: 26 identified by frozen sections and 6 in discarded kidneys. The 32 tumors included 13 clear cell renal cell carcinomas (RCCs), 6 papillary RCCs, 6 angiomyolipomas, 5 oncocytomas, 1 chromophobe RCC, and 1 papillary adenoma. No cases of tumor transmission were recorded in follow-up of the recipients. Conclusion : Donors with small RCCs can be accepted to increase the donor pool. Collaboration in a multidisciplinary setting is fundamental to accurately evaluate donor candidate risk assessment and to improve standardized protocols for surgeons and pathologists.
- Published
- 2020
23. Loss of decay-accelerating factor triggers podocyte injury and glomerulosclerosis
- Author
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Jeremy S. Leventhal, Gaetano La Manna, Miguel Fribourg, Andrea Angeletti, Clara Fischman, John Cijiang He, Gianluigi Zaza, Paolo Cravedi, Sofia Andrighetto, Wenzhen Xiao, Enrico Fiaccadori, Kelly Budge, Vivette D. D'Agati, Astgik Petrosyan, Peter S. Heeger, Danica Galešić-Ljubanović, Chiara Donadei, Deborah Malvi, Stefano Da Sacco, Jenny Wong, Joaquin Manrique, Susan Hartzell, Laura Perin, Chiara Cantarelli, Kirk N. Campbell, Joshua M. Thurman, Angeletti A., Cantarelli C., Petrosyan A., Andrighetto S., Budge K., D'Agati V.D., Hartzell S., Malvi D., Donadei C., Thurman J.M., Galesic-Ljubanovic D., He J.C., Xiao W., Campbell K.N., Wong J., Fischman C., Manrique J., Zaza G., Fiaccadori E., La Manna G., Fribourg M., Leventhal J., Da Sacco S., Perin L., Heeger P.S., and Cravedi P.
- Subjects
Male ,0301 basic medicine ,Interleukin-1beta ,Autoimmunity ,Podocyte ,decay-accelerating factor ,podocyte injury ,glomerulosclerosis ,0302 clinical medicine ,Immunology and Allergy ,Complement Activation ,Decay-accelerating factor ,Cell Line, Transformed ,Mice, Knockout ,CD55 Antigens ,biology ,Glomerulosclerosis, Focal Segmental ,Podocytes ,Middle Aged ,Receptors, Complement ,Cell biology ,Complement cascade ,Actin Cytoskeleton ,Proteinuria ,medicine.anatomical_structure ,Organ Specificity ,030220 oncology & carcinogenesis ,Complement C3b ,Female ,Disease Susceptibility ,Decay-accelerating factor (DAF/CD55) ,Signal Transduction ,Immunology ,Down-Regulation ,chemical and pharmacologic phenomena ,Article ,Diabetes Mellitus, Experimental ,Nephrin ,03 medical and health sciences ,Phospholipase D ,medicine ,Animals ,Humans ,Autocrine signalling ,Aged ,Glomerulosclerosis ,medicine.disease ,Actin cytoskeleton ,C3-convertase ,Mice, Inbred C57BL ,030104 developmental biology ,Doxorubicin ,biology.protein ,Glomerulosclerosi ,C3a receptor ,Kidney glomerulosclerosis ,Kidney glomerulosclerosis, decay-accelerating factor, podocyte injury - Abstract
While glomerulosclerosis commonly progresses to kidney failure, its mechanisms are unclear. Using murine models and human samples, the authors show that progressive glomerulosclerosis results from loss of decay-accelerating factor (DAF/CD55) on podocytes, which in turn initiates complement C3aR signaling and downstream IL-1β/IL-1R1–mediated podocyte injury and loss., Kidney glomerulosclerosis commonly progresses to end-stage kidney failure, but pathogenic mechanisms are still poorly understood. Here, we show that podocyte expression of decay-accelerating factor (DAF/CD55), a complement C3 convertase regulator, crucially controls disease in murine models of adriamycin (ADR)-induced focal and segmental glomerulosclerosis (FSGS) and streptozotocin (STZ)-induced diabetic glomerulosclerosis. ADR induces enzymatic cleavage of DAF from podocyte surfaces, leading to complement activation. C3 deficiency or prevention of C3a receptor (C3aR) signaling abrogates disease despite DAF deficiency, confirming complement dependence. Mechanistic studies show that C3a/C3aR ligations on podocytes initiate an autocrine IL-1β/IL-1R1 signaling loop that reduces nephrin expression, causing actin cytoskeleton rearrangement. Uncoupling IL-1β/IL-1R1 signaling prevents disease, providing a causal link. Glomeruli of patients with FSGS lack DAF and stain positive for C3d, and urinary C3a positively correlates with the degree of proteinuria. Together, our data indicate that the development and progression of glomerulosclerosis involve loss of podocyte DAF, triggering local, complement-dependent, IL-1β–induced podocyte injury, potentially identifying new therapeutic targets., Graphical Abstract
- Published
- 2020
24. Adaptive Mechanisms of Renal Bile Acid Transporters in a Rat Model of Carbon Tetrachloride-Induced Liver Cirrhosis
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Chiara Donadei, Andrea Angeletti, Maria Cappuccilli, Massimiliano Conti, Diletta Conte, Fulvia Zappulo, Alessio De Giovanni, Deborah Malvi, Rita Aldini, Aldo Roda, Gaetano La Manna, Donadei C., Angeletti A., Cappuccilli M., Conti M., Conte D., Zappulo F., De Giovanni A., Malvi D., Aldini R., Roda A., and La Manna G.
- Subjects
bile acids ,Urinary tubular injury biomarkers ,choleric nephropathy ,liver cirrhosis ,rat model ,Serum inflammation biomarker ,Bile acid ,General Medicine ,Organic transport protein ,Liver cirrhosi ,acute kidney injury ,organic transport proteins ,serum inflammation biomarkers ,urinary tubular injury biomarkers ,Medicine - Abstract
Background: Acute kidney injury (AKI) is common in advanced liver cirrhosis, a consequence of reduced kidney perfusion due to splanchnic arterial vasodilation and intrarenal vasoconstriction. It clinically manifests as hepatorenal syndrome type 1, type 2, or as acute tubular necrosis. Beyond hemodynamic factors, an additional mechanism may be hypothesized to explain the renal dysfunction during liver cirrhosis. Recent evidence suggest that such mechanisms may be closely related to obstructive jaundice. Methods: Given the not completely elucidated role of bile acids in kidney tissue damage, this study developed a rat model of AKI with liver cirrhosis induction by carbon tetrachloride (CCl4) inhalation for 12 weeks. Histological analyses of renal and liver biopsies were performed at sacrifice. Organic anion tubular transporter distribution and apoptosis in kidney cells were analyzed by immunohistochemistry. Circulating and urinary markers of inflammation and tubular injury were assayed in 21 treated rats over time (1, 2, 4, 8, and 12 weeks of CCl4 administration) and 5 controls. Results: No renal histopathological alterations were found at sacrifice. Comparing treated rats with controls, organic anion transporters were differentially expressed and localized. High serum bile acid values were detected in cirrhotic animals, while caspase-3 staining was negative in both groups. Increased levels of serum inflammatory and urinary tubular injury biomarkers were observed during cirrhosis progression, with a peak after 4 and 8 weeks of treatment. Conclusions: These findings suggest possible adaptive tubular mechanisms for bile acid transporters in response to cirrhosis-induced AKI.
- Published
- 2022
25. Membrane human equilibrative nucleoside transporter 1 is associated with a high proliferation rate and worse survival in resected intrahepatic cholangiocarcinoma patients not receiving adjuvant treatments
- Author
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Marzia Deserti, Francesco Vasuri, Giorgio Frega, Deborah Malvi, S. De Lorenzo, Andrea Palloni, Matteo Cescon, Stefania Curti, Antonietta D'Errico-Grigioni, Maria Abbondanza Pantaleo, Ingrid Garajová, A.D. Pinna, Maria Aurelia Barbera, Luigi Ricciardiello, Simona Tavolari, Giovanni Brandi, Tavolari S, Deserti M, Vasuri F, Curti S, Palloni A, Pinna AD, Cescon M, Frega G, De Lorenzo S, Barbera MA, Garajova I, Ricciardiello L, Malvi D, D'Errico-Grigioni A, Pantaleo MA, and Brandi G
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0301 basic medicine ,Adult ,Male ,Cancer Research ,medicine.medical_specialty ,Time Factors ,Human equilibrative nucleoside transporter 1 ,medicine.medical_treatment ,Nucleoside transporter ,Equilibrative nucleoside transporter 1 ,Gastroenterology ,Risk Assessment ,Cholangiocarcinoma ,Equilibrative Nucleoside Transporter 1 ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,Internal medicine ,Cell Line, Tumor ,medicine ,Biomarkers, Tumor ,Hepatectomy ,Humans ,Clinical significance ,Tissue biomarkers ,Intrahepatic Cholangiocarcinoma ,Aged ,Cell Proliferation ,Intrahepatic cholangiocarcinoma ,Chemotherapy ,biology ,business.industry ,Hazard ratio ,Cell Membrane ,Middle Aged ,Gemcitabine ,Up-Regulation ,Gene Expression Regulation, Neoplastic ,030104 developmental biology ,Treatment Outcome ,Oncology ,Bile Duct Neoplasms ,030220 oncology & carcinogenesis ,biology.protein ,Female ,business ,Adjuvant ,medicine.drug - Abstract
Human equilibrative nucleoside transporter 1 (hENT-1) is a membrane nucleoside transporter mediating the intracellular uptake of nucleosides and their analogues. hENT-1 was recently reported to have a predictive role in intrahepatic cholangiocarcinoma (iCC) patients receiving adjuvant gemcitabine-based chemotherapy, but its biological and clinical significance in iCC remains unsettled. This study investigated the role of hENT-1 in regulating tumour growth and predicting the survival of 40 resected iCC patients not receiving adjuvant treatments. hENT-1 expression was found to be significantly higher in iCC than in the matched non-tumoural liver. Patients harbouring hENT-1 localised on the tumour cell membrane had a worse overall survival than membrane hENT-1-negative patients (median 21.2 months vs 30.3 months, p=0.031), with an adjusted hazard ratio of 2.8 (95% confidence interval 1.01-7.76). Moreover, membrane hENT-1-positive patients had a higher percentage of Ki67-positive cells in tumour tissue than membrane hENT-1-negative patients (median 23% vs 5%, p 
- Published
- 2019
26. Challenging liver lesions in noncirrhotic patients: Report of three cases
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Deborah Malvi, Matteo Ravaioli, Matteo Cescon, Francesco Vasuri, Tania Franceschini, Antonia D'Errico, Lorenzo Maroni, Franceschini T., Malvi D., Maroni L., Ravaioli M., Cescon M., D'Errico A., and Vasuri F.
- Subjects
medicine.medical_specialty ,Pathology ,Angiomyolipoma ,Case Report ,splenosis ,Perivascular Epithelioid Cell ,03 medical and health sciences ,0302 clinical medicine ,Histological diagnosis ,medicine ,lcsh:RC799-869 ,focal nodular hyperplasia ,business.industry ,Liver Angiomyolipoma ,Gastroenterology ,Focal nodular hyperplasia ,Hepatocellular adenoma ,medicine.disease ,angiomyolipoma ,030220 oncology & carcinogenesis ,histopathology ,lcsh:Diseases of the digestive system. Gastroenterology ,030211 gastroenterology & hepatology ,Histopathology ,business ,perivascular epithelioid cell tumor - Abstract
We describe three cases of liver lesions, characterized by a discrepancy between presurgical imaging and histological features, in which the final histological diagnosis was quite different from what the surgeons expected. We present (1) a case of primary liver angiomyolipoma associated with focal nodular hyperplasia, (2) a case of perivascular epithelioid cell tumor, and (3) a case of liver splenosis associated with focal nodular hyperplasia. In all cases, a presurgical diagnosis of hepatocellular adenoma was made. Due to nonspecific clinical and radiological features, these rare liver lesions are often presurgically misdiagnosed, especially in young noncirrhotic patients. The association among different lesions represents one additional diagnostic challenge.
- Published
- 2019
27. Non-Alcoholic Steatohepatitis as a Risk Factor for Intrahepatic Cholangiocarcinoma and Its Prognostic Role
- Author
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Francesco Tovoli, Alessandro Mazzotta, Deborah Malvi, Francesco Vasuri, Matteo Cescon, Julien Edeline, Stefania De Lorenzo, Giovanni Brandi, Antonietta D'Errico, Alessandro Granito, Bruno Turlin, Matteo Renzulli, Heithem Jeddou, Thomas Uguen, Astrid Lièvre, Karim Boudjema, De Lorenzo S., Tovoli F., Mazzotta A., Vasuri F., Edeline J., Malvi D., Boudjema K., Renzulli M., Jeddou H., D'errico A., Turlin B., Cescon M., Uguen T., Granito A., Lievre A., Brandi G., Jonchère, Laurent, University of Bologna/Università di Bologna, Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Pontchaillou [Rennes], Policlinico S. Orsola-malpighi, Alma Mater Studiorum Università di Bologna [Bologna] (UNIBO)-Servizio sanitario regionale Emilia-Romagna, Centre Eugène Marquis (CRLCC), Nutrition, Métabolismes et Cancer (NuMeCan), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Centre de Ressources Biologiques Santé (CRB Santé), Université de Rennes (UR)-CHU Pontchaillou [Rennes]-CRLCC Eugène Marquis (CRLCC), Chemistry, Oncogenesis, Stress and Signaling (COSS), Université de Rennes (UR)-CRLCC Eugène Marquis (CRLCC)-Institut National de la Santé et de la Recherche Médicale (INSERM), University of Bologna, Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-CHU Pontchaillou [Rennes]-CRLCC Eugène Marquis (CRLCC), and Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-CRLCC Eugène Marquis (CRLCC)-Institut National de la Santé et de la Recherche Médicale (INSERM)
- Subjects
Cancer Research ,medicine.medical_specialty ,liver cirrhosis ,Population ,[SDV.CAN]Life Sciences [q-bio]/Cancer ,lcsh:RC254-282 ,digestive system ,Gastroenterology ,Article ,Liver cirrhosi ,03 medical and health sciences ,0302 clinical medicine ,[SDV.CAN] Life Sciences [q-bio]/Cancer ,Internal medicine ,Medicine ,Risk factor ,education ,Intrahepatic cholangiocarcinoma ,Outcome ,education.field_of_study ,business.industry ,Proportional hazards model ,Hazard ratio ,Fatty liver ,nutritional and metabolic diseases ,lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,medicine.disease ,digestive system diseases ,3. Good health ,Oncology ,030220 oncology & carcinogenesis ,Relative risk ,Hepatocellular carcinoma ,030211 gastroenterology & hepatology ,non-alcoholic steatohepatitis ,Steatohepatitis ,business ,Non-alcoholic steatohepatiti ,Non-alcoholic fatty liver disease - Abstract
Non-alcoholic fatty liver disease (NAFLD) and its most aggressive form, non-alcoholic steatohepatitis (NASH), are causing a rise in the prevalence of hepatocellular carcinoma. Data about NAFLD/NASH and intrahepatic cholangiocarcinoma (iCCA) are few and contradictory, coming from population registries that do not correctly distinguish between NAFLD and NASH. We evaluated the prevalence of NAFLD and NASH in peritumoral tissue of resected iCCA (n = 180) and in needle biopsies of matched liver donors. Data of iCCA patients were subsequently analysed to compare NASH-related iCCA (Group A), iCCA arisen in a healthy liver (Group B) or in patients with classical iCCA risk factors (Group C). NASH was found in 22.5% of 129 iCCA patients without known risk factors and in 6.2% of matched controls (risk ratio 3.625, 95% confidence interval 1.723&ndash, 7.626, p <, 0.001), while NAFLD was equally represented in both groups. The overall survival of NASH-related iCCA was inferior to that of patients with healthy liver (38.5 vs. 48.1 months, p = 0.003) and similar to that of patients with known risk factors (31.9 months, p = 0.948), regardless of liver fibrosis. The multivariable Cox regression confirmed NASH as a prognostic factor (hazard ratio 1.773, 95% confidence interval 1.156&ndash, 2.718, p = 0.009). We concluded that NASH (but not NAFLD) is a risk factor for iCCA and might affect its prognosis. Dissecting NASH from NAFLD by histology is necessary to correctly assess the actual role of these conditions. Prevention protocols for NASH patients should also consider the risk for iCCA and not only HCC. Mechanistic studies aimed to find a direct pathogenic link between NASH and iCCA could add further relevant information.
- Published
- 2020
28. Interpathologist concordance in the histological diagnosis of focal prostatic atrophy lesions, acute and chronic prostatitis, PIN, and prostate cancer
- Author
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Massimo Loda, Deborah Malvi, Enrico Bollito, Kristina M. Jordahl, Alessandro Fornari, Maurizio Colecchia, Jennifer R. Rider, Antonietta D'Errico, Barbara Corti, Rodolfo Montironi, Luca Reggiani Bonetti, Mauro Papotti, Michelangelo Fiorentino, Carlo Patriarca, Paolo Degiuli, Francesca Giunchi, Francesco Vasuri, Giunchi, Francesca, Jordahl, Kristina, Bollito, Enrico, Colecchia, Maurizio, Patriarca, Carlo, D'Errico, Antonietta, Vasuri, Francesco, Malvi, Deborah, Fornari, Alessandro, Bonetti, Luca Reggiani, Corti, Barbara, Papotti, Mauro, Degiuli, Paolo, Loda, Massimo, Montironi, Rodolfo, Fiorentino, Michelangelo, Rider, Jennifer R, Giunchi, F, Jordahl, K, Bollito, E, Colecchia, M, Patriarca, C, D'Errico, A, Vasuri, F, Malvi, D, Fornari, A, Bonetti, Lr, Corti, B, Papotti, M, Degiuli, P, Loda, M, Montironi, R, Fiorentino, M, and Rider, Jr.
- Subjects
0301 basic medicine ,Male ,Pathology ,medicine.medical_specialty ,Concordance ,Prostatitis ,Pathology and Forensic Medicine ,Atrophic lesions ,Inflammation ,PAH ,Prostate ,Atrophy ,Chronic Disease ,Humans ,Observer Variation ,Prostatic Intraepithelial Neoplasia ,Prostatic Neoplasms ,2734 ,Molecular Biology ,Cell Biology ,03 medical and health sciences ,Prostate cancer ,0302 clinical medicine ,medicine ,Intraepithelial neoplasia ,Anatomy ,Genitourinary system ,business.industry ,Atrophic lesion ,Cancer ,General Medicine ,medicine.disease ,030104 developmental biology ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,business - Abstract
Epidemiological and biological evidence indicates a causal relationship between the presence of proliferative atrophic lesions and the development of prostatic intraepithelial neoplasia (PIN) and prostate cancer. The presence of inflammatory and atrophic lesions of the prostate is widely underestimated and they are not generally mentioned in pathology reports. We performed a histopathological concordance study among eight genitourinary specialists and seven generalist pathologists, using 116 histological slides of prostate lesions, including proliferative atrophic lesions, PIN, and cancer. The overall agreement between all possible pairs of reviewers was 80% for prostate cancer, 67% for PIN, and 49% for proliferative atrophic lesions. When using as gold standard the assessment of a single genitourinary pathologist, the mean agreement percentage increased to 97% for prostate cancer, 92% for PIN, and 72% for proliferative atrophic lesions.
- Published
- 2017
29. Adenocarcinoma in Crohn’s disease: the pathologist’s experience in a tertiary referral centre of inflammatory bowel disease
- Author
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Elisa Gruppioni, Antonia D’Errico-Grigioni, Benedetta Mattioli, Deborah Malvi, Francesco Vasuri, Walter F. Grigioni, Gilberto Poggioli, Paolo Gionchetti, Michelangelo Fiorentino, Malvi D, Vasuri F, Mattioli B, Gruppioni E, Fiorentino M, Gionchetti P, Grigioni WF, Poggioli G, and D'Errico-Grigioni A
- Subjects
Adult ,Male ,medicine.medical_specialty ,Pathology ,Lymphovascular invasion ,DNA Mutational Analysis ,Rectum ,Adenocarcinoma ,Real-Time Polymerase Chain Reaction ,medicine.disease_cause ,Gastroenterology ,Inflammatory bowel disease ,Pathology and Forensic Medicine ,Tertiary Care Centers ,Crohn Disease ,Internal medicine ,Intestinal Neoplasms ,Humans ,Medicine ,Aged ,Neoplasm Staging ,Crohn's disease ,business.industry ,Keratin 20 ,Middle Aged ,medicine.disease ,Immunohistochemistry ,digestive system diseases ,medicine.anatomical_structure ,Keratin 7 ,Female ,Microsatellite Instability ,KRAS ,Neoplasm Grading ,business ,CROHN’S DISEASE - Abstract
Summary The aim of the present study is to describe the histological and mutational characteristics of a series of both large and small bowel adenocarcinomas in patients with Crohn’s disease from a tertiary referral centre of inflammatory bowel disease. Bowel adenocarcinoma was diagnosed in 11 (1.7%) of 660 consecutive patients submitted to surgery for histologically proven Crohn’s disease in 5 years. The following data were collected: tumour site, stage and grade, intracellular/extra-cellular mucin, lymphovascular invasion, immunohistochem-istry for keratin 7, keratin 20 and CDX-2, mutation analyses of KRAS, B-RAF, PI3K and microsatellite instability. A strong predominance of male gender was observed (10/11). Four (36.4%) adenocarcinomas arose in the small bowel, five (45.4%) in the anus/rectum, and two (18.2%) in anastomosis. Furthermore, all cases of anorectal adenocarcinoma showed >50% of extracellular mucin, with associated KRAS mutations in three of five. No influence in cancer incidence by infliximab therapy was observed. Our series, one of the largest on the topic with immunomorphological and molecular deepening, showed that bowel adenocarcinomas in Crohn’s disease have an aggressive behaviour and a strong predominance of extracellular mucin. In surgical specimens from Crohn’s disease patients, mucinous-looking anal fistulas and ileal areas of adhesion/retraction should always be extensively sampled.
- Published
- 2014
30. 68Ga-DOTANOC PET/CT Allows Somatostatin Receptor Imaging in Idiopathic Pulmonary Fibrosis: Preliminary Results
- Author
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Mario Fabbri, Valentina Ambrosini, Eva Tonveronachi, Deborah Malvi, Stefano Fanti, Cristina Nanni, Maurizio Zompatori, Fiorella De Luca, Luca Fasano, D'Errico Antonia, Vincenzo Allegri, Ambrosini V., Zompatori M., De Luca F., D'Errico A., Allegri V., Nanni C., Malvi D., Tonveronachi E., Fasano L., Fabbri M., and Fanti S.
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Male ,endocrine system ,Pathology ,medicine.medical_specialty ,Biopsy ,Idiopathic pulmonary fibrosis ,In vivo ,Fibrosis ,Organometallic Compounds ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Prospective Studies ,Receptors, Somatostatin ,Honeycombing ,Aged ,PET-CT ,Lung ,Somatostatin receptor ,business.industry ,Middle Aged ,respiratory system ,medicine.disease ,Respiratory Function Tests ,respiratory tract diseases ,PULMONARY FIBROSIS ,PET ,Somatostatin ,medicine.anatomical_structure ,Positron-Emission Tomography ,UIP ,Pulmonary Diffusing Capacity ,Female ,Radiopharmaceuticals ,business ,hormones, hormone substitutes, and hormone antagonists ,LUNG ,Tomography, Emission-Computed ,CT - Abstract
Interstitial lung diseases include different clinical entities with variable prognoses. Idiopathic pulmonary fibrosis (IPF), the most common, presents the most severe outcome (death within 3–5 y), whereas nonspecific interstitial pneumonia (NSIP) shows a more indolent progression. Preclinical evidence of somatostatin receptor (SSTR) expression on fibroblasts in vitro and in lung fibrosis murine models, coupled with the longer survival of mice with fibrotic lungs treated with agents blocking SSTR, supports the hypothesis of imaging fibroblast activity in vivo by visualization of SSTR with 68Ga-DOTANOC PET/CT. The aim of this study was to evaluate 68Ga-DOTANOC PET/CT in patients with IPF and NSIP. Methods: Seven IPF patients and 7 NSIP patients were included in the study. 68Ga-DOTANOC PET/CT and high-resolution CT (HRCT) were performed in all cases by following a standard procedure. PET/CT results were compared with disease sites and extent on HRCT. Results: In IPF, 68Ga-DOTANOC uptake was peripheral, subpleural, and directly correlated with pathologic areas on HRCT (subpleural/reticular fibrosis, honeycombing). NSIP patients showed fainter tracer uptake, whereas corresponding HRCT showed areas of ground-glass opacity and rare fibrotic changes. Only IPF patients showed a linear correlation between maximal SUV and disease extent quantified both automatically (Q) (IPF: P = 0.002, R = 0.93) and using the visual score (Spearman ρ = 0.46, P = 0.0001). Q directly correlated with percentage carbon monoxide diffusing capacity in IPF (P = 0.03, R = 0.79) and NSIP (P = 0.05, R = 0.94), whereas maximal SUV did not present any correlation with percentage carbon monoxide diffusing capacity. Conclusion: Our preliminary data show that 68Ga-DOTANOC PET/CT demonstrates SSTR overexpression in IPF patients; this may prove interesting for the evaluation of novel treatments with somatostatin analogs.
- Published
- 2010
31. Real-time Quantitative Assay for Routine Testing of HCV RNA in Formalin-fixed, Paraffin-embedded Liver Samples
- Author
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Francesco Vasuri, Michelangelo Fiorentino, Deborah Malvi, Gian L. Grazi, Elisa Capizzi, Annalisa Altimari, Maria Giulia Pirini, Elisa Gruppioni, Walter F. Grigioni, Antonia D’Errico-Grigioni, Gruppioni E, Vasuri F, Fiorentino M, Capizzi E, Altimari A, Pirini MG, Grazi GL, Malvi D, Grigioni WF, and D'Errico-Grigioni A.
- Subjects
Pathology ,medicine.medical_specialty ,Tissue Fixation ,HCV RNA ,Hepatitis C virus ,PARAFFIN-EMBEDDED LIVER NEEDLE BIOPSY ,Hepacivirus ,real-time RT-PCR ,Biology ,liver ,medicine.disease_cause ,Gastroenterology ,NO ,Pathology and Forensic Medicine ,Serology ,Immunoenzyme Techniques ,Liver Function Tests ,Cholestasis ,Predictive Value of Tests ,Formaldehyde ,Internal medicine ,medicine ,Humans ,Molecular Biology ,Retrospective Studies ,Hepatitis ,Paraffin Embedding ,real-time RT-PCR, HCV, immunohistochemistry, liver ,medicine.diagnostic_test ,Reverse Transcriptase Polymerase Chain Reaction ,Reproducibility of Results ,virus diseases ,RNA ,Cell Biology ,Hepatitis C ,medicine.disease ,digestive system diseases ,Molecular Diagnostic Techniques ,HCV ,immunohistochemistry ,RNA, Viral ,Liver function ,Liver function tests - Abstract
The assessment of hepatitis C virus (HCV) RNA in liver tissues is clinically relevant in cases where histology, liver function tests, and HCV serology are not sufficient for a definitive diagnosis of HCV-related hepatitis. We analyzed 215 formalin-fixed, paraffin-embedded liver needle biopsies from patients infected with HCV genotypes 1b and 2. HCV RNA extracted from paraffin sections were quantified by means of a TaqMan real-time reverse transcription-polymerase chain reaction method. The quantification of HCV RNA in liver tissue was correlated with the amount of HCV detected by immunohistochemistry (IHC) on paired frozen biopsies, the HCV RNA load in the serum, and the main serum tests of liver function and cholestasis. HCV RNA was detected by real-time reverse transcription-polymerase chain reaction in 169 liver biopsies (78.6%) with a mean value of 13.59+/-37.25 IU/ng. Tissue HCV RNA levels strongly correlated with the IHC results (P
- Published
- 2009
32. Reinfusion of highly purified CD133+ bone marrow-derived stem/progenitor cells in patients with end-stage liver disease: a phase I clinical trial
- Author
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Mauro Bernardi, Lucia Brodosi, Roberto M. Lemoli, Fabio Conti, Francesco Giuseppe Foschi, Andrea Casadei, Benedetta Nicolini, Valeria Giudice, Simonetta Rizzi, Deborah Malvi, Elisa Dan, Mariele Viganò, Lucia Catani, Tiziana Montemurro, Rosaria Giordano, Stefania Lorenzini, Pietro Andreone, Cristina Margini, Daria Sollazzo, Andreone, P, Catani, L, Margini, C, Brodosi, L, Lorenzini, S, Sollazzo, D, Nicolini, B, Giordano, R, Montemurro, T, Rizzi, S, Dan, E, Giudice, V, Viganò, M, Casadei, A, Foschi, F, Malvi, D, Bernardi, M, Conti, F, and Lemoli, RM.
- Subjects
Adult ,Male ,medicine.medical_specialty ,Pathology ,medicine.medical_treatment ,Hematopoietic stem cell transplantation ,Liver transplantation ,Gastroenterology ,End Stage Liver Disease ,Liver disease ,Liver Function Tests ,Antigens, CD ,Internal medicine ,Granulocyte Colony-Stimulating Factor ,Humans ,Medicine ,AC133 Antigen ,Leukapheresis ,Prospective Studies ,Progenitor cell ,Hematopoietic Stem Cell Mobilization ,Aged ,Glycoproteins ,Stem cell therapy ,Cirrhosi ,Hepatology ,business.industry ,Stem Cells ,Hematopoietic Stem Cell Transplantation ,Stem-cell therapy ,Middle Aged ,medicine.disease ,Cirrhosis ,Haematopoietic stem/progenitor cells ,Regenerative medicine ,Italy ,Case-Control Studies ,Female ,Liver function ,Haematopoietic stem/progenitor cell ,Stem cell ,Peptides ,business - Abstract
Background Bone marrow stem/progenitor cells seem to be effective in liver regeneration after tissue injury. Aim To evaluate the feasibility and safety of the mobilization and reinfusion of CD133+ stem/progenitor cells in patients with end-stage liver disease. Methods Autologous CD133+ stem/progenitor cells, mobilized with granulocyte-colony stimulating factor, were collected by leukapheresis and reinfused at increasing doses through the hepatic artery starting from 5 × 104/kg up to 1 × 106/kg. Results 16 subjects with Model for End-stage Liver Disease (MELD) score between 17 and 25 were enrolled, 14 mobilized an adequate number of CD133+ stem/progenitor cells and 12 were reinfused. No severe adverse events related to the procedure were reported. MELD score significantly worsened during mobilization in Child Turcotte Pugh-C patients. A significant improvement of liver function was observed 2 months after reinfusion (MELD 19.5 vs 16; P = 0.045). Overall, 5 patients underwent liver transplantation within 12 months from reinfusion and 2 died because of progressive liver failure. Conclusions CD133+ stem/progenitor cells reinfusion in patients with end-stage liver disease is feasible and safe. A worsening of liver function was observed during mobilization in Child Turcotte Pugh-C patients. The temporary improvement of MELD score after reinfusion suggests that stem cells therapy may be a “bridge to transplant” approach for these patients.
- Published
- 2015
33. Revisiting the role of pathological analysis in transarterial chemoembolization-treated hepatocellular carcinoma after transplantation
- Author
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Giorgio Ercolani, Francesco Vasuri, Walter F. Grigioni, Alexandro Paccapelo, Francesca Rosini, Deborah Malvi, Antonia D’Errico-Grigioni, Michelangelo Fiorentino, Pamela Baldin, Antonio Maria Morselli-Labate, Antonio Daniele Pinna, Rita Golfieri, Vasuri F, Malvi D, Rosini F, Baldin P, Fiorentino M, Paccapelo A, Ercolani G, Pinna AD, Golfieri R, Morselli-Labate AM, Grigioni WF, and D'Errico-Grigioni A
- Subjects
Adult ,Male ,medicine.medical_specialty ,Pathology ,Carcinoma, Hepatocellular ,Time Factors ,medicine.medical_treatment ,Kaplan-Meier Estimate ,Liver transplantation ,Milan criteria ,Risk Assessment ,Risk Factors ,Retrospective Study ,medicine ,Humans ,HEPATOCELLULAR CARCINOMA ,Chemoembolization, Therapeutic ,CHEMOEMBOLIZATION ,Neoadjuvant therapy ,Aged ,Neoplasm Staging ,Proportional Hazards Models ,Retrospective Studies ,Proportional hazards model ,business.industry ,Liver Neoplasms ,Gastroenterology ,Nodule (medicine) ,General Medicine ,Middle Aged ,medicine.disease ,digestive system diseases ,Neoadjuvant Therapy ,Liver Transplantation ,Transplantation ,Treatment Outcome ,Italy ,Chemotherapy, Adjuvant ,Hepatocellular carcinoma ,Multivariate Analysis ,Linear Models ,Female ,Histopathology ,Radiology ,Neoplasm Recurrence, Local ,medicine.symptom ,business - Abstract
AIM: To define the histopathological features predictive of post-transplant hepatocellular carcinoma (HCC) recurrence after transarterial chemoembolization, applicable for recipient risk stratification. METHODS: We retrospectively reviewed the specimens of all suspicious nodules (total 275) from 101 consecutive liver transplant recipients which came to our Pathology Unit over a 6-year period. All nodules were sampled and analyzed, and follow-up data were collected. We finally considered 11 histological variables for each patient: total number of nodules, number of viable nodules, size of the major nodule, size of the major viable nodule, occurrence of microscopic vascular invasion, maximum Edmondson's grade, clear cell/sarcomatous changes, and the residual neoplastic volume. Survival data were computed by means of the Kaplan-Meier procedure and analyzed by means of the Cox proportional hazards model. The multivariate linear regression and a k-means cluster analysis were also used in order to compute the standardized histological score. RESULTS: The total number of nodules, the residual neoplastic volume (the total volume of all evaluated nodules minus the necrotic portion) and the microvascular invasion entered the Cox multivariate hazard model with HCC recurrence as dependent variable. The histological score was therefore computed and a cluster analysis sorted recipients into 3 risk groups, with 3.3%, 18.5% and 53.8% respectively of tumor recurrence rates and 1.6%, 11.1% and 38.5% of tumor-related mortality respectively at the end of follow-up. CONCLUSION: The histological score allows a reliable stratification of HCC recurrence risk, especially in those recipients found out to be beyond the Milan criteria after orthotopic liver transplantation (OLT).
- Published
- 2014
34. Esophagogastric metaplasia relates to nodal metastases in adenocarcinoma of esophagus and cardia
- Author
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Deborah Malvi, Giandomenico Raulli, Ottorino Perrone, Alberto Ruffato, Marialuisa Lugaresi, Luca Frassineti, Antonietta D'Errico, Maria Rosaria Aprile, Massimo Pierluigi Di Simone, Sandro Mattioli, Ruffato A., Mattioli S., Perrone O., Lugaresi M., Di Simone M.P., D'Errico A., Malvi D., Aprile M.R., Raulli G., and Frassineti L.
- Subjects
Male ,Pathology ,Esophageal Neoplasms ,medicine.medical_treatment ,BARRETT’S ESOPHAGUS ,Multimodal Imaging ,Gastroenterology ,Metaplasia ,hemic and lymphatic diseases ,Medicine ,Endoscopy, Digestive System ,Prospective Studies ,Intestinal Mucosa ,ADENOCARCINOMA OF THE CARDIA ,Stomach ,ADENOCARCINOMA OF THE ESOPHAGUS ,Anastomosis, Surgical ,Intestinal metaplasia ,Cardia ,Middle Aged ,Prognosis ,Jejunum ,medicine.anatomical_structure ,Esophagectomy ,Lymphatic Metastasis ,Adenocarcinoma ,Female ,medicine.symptom ,biological phenomena, cell phenomena, and immunity ,Cardiology and Cardiovascular Medicine ,Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,education ,Barrett Esophagus ,Esophagus ,Gastrectomy ,Stomach Neoplasms ,Internal medicine ,Humans ,GASTRO-INTESTINAL METAPLASIA ,neoplasms ,Aged ,business.industry ,medicine.disease ,digestive system diseases ,GASTRIC CANCER ,Positron-Emission Tomography ,Barrett's esophagus ,Surgery ,Lymphadenectomy ,Lymph Nodes ,Tomography, X-Ray Computed ,business - Abstract
BACKGROUND: Immunohistochemical profiles of esophageal and cardia adenocarcinoma differ according to the presence or absence of Barrett's epithelium (BIM) and gastric intestinal metaplasia (GIM) in the fundus and antrum. Different lymphatic spreading has been demonstrated in esophageal adenocarcinoma. We investigated the correlation among the presence or absence of intestinal metaplasia in the esophagus and stomach and lymphatic metastases in patients who underwent radical surgery for esophageal and cardia adenocarcinoma. METHODS: The mucosa surrounding the adenocarcinoma and the gastric mucosa were analyzed. The BIM+ patients underwent subtotal esophagectomy and gastric pull up, and the BIM- patients underwent esophagectomy at the azygos vein, total gastrectomy, and esophagojejunostomy. The radical thoracic (station numbers 2, 3, 4R, 7, 8, and 9) and abdominal (station numbers 15 through 20) lymphadenectomy was identical in both procedures except for the greater curvature. RESULTS: One hundred ninety-four consecutive patients were collected in three major groups: BIM+/GIM-, 52 patients (26.8%); BIM-/GIM-, 90 patients (46.4%); BIM-/GIM+, 50 patients (25.8%). Two patients (1%) were BIM+/GIM+. A total of 6,010 lymph nodes were resected: 1,515 were recovered in BIM+, 1,587 in BIM-/GIM+, and 2,908 in BIM-/GIM- patients. The percentage of patients with pN+ stations 8 and 9 was higher in BIM+ (p = 0.001), and the percentage of patients with pN+ perigastric stations was higher in BIM- (p = 0.001). The BIM-/GIM- patients had a number of abdominal metastatic lymph nodes higher than did the BIM-/GIM+ patients (p = 0.0001). CONCLUSIONS: According to the presence or absence of BIM and GIM in the esophagus and cardia, adenocarcinoma correspond to three different patterns of lymphatic metastasization, which may reflect different biologic and carcinogenetic pathways.
- Published
- 2013
35. Expanding the criteria of organ procurement from donors with prostate cancer: the application of the new Italian guidelines
- Author
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D'ERRICO, ANTONIETTA, FIORENTINO, MICHELANGELO, VASURI, FRANCESCO, CORTI, BARBARA, GRIGIONI, FRANCO, PIRINI, MARIA GIULIA, MALVI, DEBORAH, FABBRIZIO, BENEDETTA, CAPRARA, GIACOMO, Ridolfi L, Pathology Unit for organ safety of the F. Addarii Institute, Bologna, Bagni A, Alvaro N., D'Errico-Grigioni A, Fiorentino M, Vasuri F, Corti B, Ridolfi L, Grigioni WF, Pathology Unit for organ safety of the F. Addarii Institute, Bologna, Bagni A, Pirini MG, Malvi D, Fabbrizio B, Caprara G, and Alvaro N.
- Subjects
Adult ,Male ,medicine.medical_specialty ,Tissue and Organ Procurement ,MEDLINE ,Guidelines as Topic ,Malignancy ,PROSTATE CANCER ,Prostate cancer ,Prostate ,Internal medicine ,medicine ,MARGINAL DONORS ,Immunology and Allergy ,Humans ,Pharmacology (medical) ,Organ donation ,ORGAN DONATION ,Referral and Consultation ,Aged ,Digital Rectal Examination ,Gynecology ,Transplantation ,medicine.diagnostic_test ,business.industry ,Second opinion ,Cancer ,Prostatic Neoplasms ,Rectal examination ,Middle Aged ,Prostate-Specific Antigen ,medicine.disease ,Tissue Donors ,medicine.anatomical_structure ,Italy ,business - Abstract
Prostate cancer (CaP) represents the most prevalent malignancy in men more than 60-year-old, posing a problem in organ procurement from elderly subjects. However, most of the currently diagnosed CaP are low-grade and intraprostatic, with low metastatic risk, and there is recent evidence that most patients are overdiagnosed. The Italian National guidelines about organ acceptance from neoplastic donors changed in March 2005, extending the pool of potential candidates with CaP and introducing the function of a second opinion expert. Between 2001 and February 2005, 40 candidate donors with total PSA>/=10 and/or positive digital rectal examination underwent histopathological analysis of the prostate: 15 (37.5%) donors harboured CaP, and 25 (62%) were judged at 'standard risk'. After the introduction of the new guidelines in 2005, the second opinion expert judged at 'standard risk' 48 of 65 donors, while 17 of 65 needed histopathological analysis. Four (6.2%) donors harboured CaP, and 61 (94%) where judged at 'standard risk', with a significant increase of donated and actually transplanted organs. The application of the new guidelines and the introduction of a second opinion expert allowed a significant extension of the 'standard risk' category also to CaP patients, decreasing the histopathological examinations and expanding the donor pool.
- Published
- 2010
36. Benign metastasizing leiomyoma of the lung: PET findings
- Author
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Mario Fabbri, Valerio Di Scioscio, Deborah Malvi, Paola Feraco, L Miglio, Angela Maria Grazia Pacilli, Francesco Toni, Luca Fasano, Maurizio Zompatori, Di Scioscio V, Feraco P, Miglio L, Toni F, Malvi D, Pacilli AM, Fasano L, Fabbri M, and Zompatori M.
- Subjects
Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Lung Neoplasms ,medicine.medical_treatment ,Contrast Media ,BENIGN METASTASIZING LEIOMYOMA ,Asymptomatic ,Fluorodeoxyglucose F18 ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,neoplasms ,LEIOMYOMA ,Lung ,Uterine leiomyoma ,Hysterectomy ,medicine.diagnostic_test ,Thoracic computed tomography ,business.industry ,Biopsy, Needle ,POSITRON EMISSION TOMOGRAPHY (PET)-CT WITH 18F-FLUORODEOXYGLUCOSE ,Middle Aged ,medicine.disease ,female genital diseases and pregnancy complications ,medicine.anatomical_structure ,Leiomyoma ,Uterine Neoplasms ,Female ,Radiology ,Radiopharmaceuticals ,medicine.symptom ,COMPUTED TOMOGRAPHY ,Tomography, X-Ray Computed ,Chest radiograph ,business ,Benign metastasizing leiomyoma ,Tomography, Emission-Computed - Abstract
We report the case of pulmonary benign metastasizing leiomyoma in an asymptomatic 64-year-old woman who underwent hysterectomy for a uterine leiomyoma 26 years earlier. Routine chest radiograph revealed bilateral diffuse nodular opacities within the pulmonary lobes. Thoracic computed tomography (CT) scan showed peripheral lung nodules that do not display contrast enhancement. Positron emission tomography (PET)-CT with 18F-fluorodeoxyglucose (18F-FDG PET-CT) demonstrated no significant metabolic activity of the nodules. The lesions were diagnosed as benign metastasizing leiomyoma by histopathologic examination. To our best knowledge, this is the first case studied combining CT and FDG PET-CT technique.
- Published
- 2009
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