231 results on '"Repaci, Andrea"'
Search Results
52. Prevalence of Hyperandrogenic States in Late Adolescent and Young Women: Epidemiological Survey on Italian High-School Students
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Gambineri, Alessandra, Fanelli, Flaminia, Prontera, Olga, Repaci, Andrea, Di Dalmazi, Guido, Zanotti, Laura, Pagotto, Uberto, Flacco, Maria Elena, Guidi, Jenny, Fava, Giovanni Andrea, Manzoli, Lamberto, and Pasquali, Renato
- Published
- 2013
53. Combined Aldosterone and Cortisol Secretion by Adrenal Incidentaloma
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Vicennati, Valentina, Repaci, Andrea, di Dalmazi, Guido, Rinaldi, Eleonora, Golfieri, Rita, Giampalma, Emanuela, Minni, Francesco, Marrano, Nicola, Santini, Donatella, and Pasquali, Renato
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- 2012
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54. Impact of age, body weight and metabolic risk factors on steroid reference intervals in men
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Mezzullo, Marco, primary, Di Dalmazi, Guido, additional, Fazzini, Alessia, additional, Baccini, Margherita, additional, Repaci, Andrea, additional, Gambineri, Alessandra, additional, Vicennati, Valentina, additional, Pelusi, Carla, additional, Pagotto, Uberto, additional, and Fanelli, Flaminia, additional
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- 2020
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55. Prevalence and incidence of atrial fibrillation in a large cohort of adrenal incidentalomas: A long-term retrospective study
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Di, Dalmazi Guido, primary, Vicennati, Valentina, additional, Pizzi, Carmine, additional, Mosconi, Cristina, additional, Tucci, Lorenzo, additional, Balacchi, Caterina, additional, Cosentino, Eugenio, additional, Paolisso, Pasquale, additional, Fanelli, Flaminia, additional, Gambineri, Alessandra, additional, Pelusi, Carla, additional, Repaci, Andrea, additional, Garelli, Silvia, additional, Galiè, Nazzareno, additional, Borghi, Claudio, additional, Golfieri, Rita, additional, and Pagotto, Uberto, additional
- Published
- 2020
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56. Prediction algorithm for persistent primary hyperparathyroidism after parathyroidectomy
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Repaci, Andrea, primary, Vicennati, Valentina, additional, Salituro, Nicola, additional, Vandi, Giulia, additional, Zavatta, Guido, additional, Altieri, Paola, additional, Di, Dalmazi Guido, additional, Gambineri, Alessandra, additional, Pelusi, Carla, additional, Burgio, Luca, additional, Piccin, Ottavio, additional, Cavicchi, Ottavio, additional, and Pagotto, Uberto, additional
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- 2020
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57. Prevalence and Incidence of Atrial Fibrillation in a Large Cohort of Adrenal Incidentalomas: A Long-Term Study
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Di Dalmazi, Guido, primary, Vicennati, Valentina, additional, Pizzi, Carmine, additional, Mosconi, Cristina, additional, Tucci, Lorenzo, additional, Balacchi, Caterina, additional, Cosentino, Eugenio Roberto, additional, Paolisso, Pasquale, additional, Fanelli, Flaminia, additional, Gambineri, Alessandra, additional, Pelusi, Carla, additional, Repaci, Andrea, additional, Garelli, Silvia, additional, Galiè, Nazzareno, additional, Borghi, Claudio, additional, Golfieri, Rita, additional, and Pagotto, Uberto, additional
- Published
- 2020
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58. Female and male serum reference intervals for challenging sex and precursor steroids by liquid chromatography - tandem mass spectrometry
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Mezzullo, Marco, primary, Pelusi, Carla, additional, Fazzini, Alessia, additional, Repaci, Andrea, additional, Di Dalmazi, Guido, additional, Gambineri, Alessandra, additional, Pagotto, Uberto, additional, and Fanelli, Flaminia, additional
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- 2020
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59. In memoriam: Renato Pasquali (1946–2019)
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Gambineri, Alessandra, primary, Vicennati, Valentina, additional, Di Dalmazi, Guido, additional, Pelusi, Carla, additional, Altieri, Paola, additional, Fanelli, Flaminia, additional, Repaci, Andrea, additional, Garelli, Silvia, additional, Ribichini, Danilo, additional, and Pagotto, Uberto, additional
- Published
- 2020
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60. Does the Site of Origin of the Microcarcinoma with Respect to the Thyroid Surface Matter? A Multicenter Pathologic and Clinical Study for Risk Stratification
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Tallini, Giovanni, primary, De Leo, Antonio, additional, Repaci, Andrea, additional, de Biase, Dario, additional, Bacchi Reggiani, Maria Letizia, additional, Di Nanni, Doriana, additional, Ambrosi, Francesca, additional, Di Gioia, Cira, additional, Grani, Giorgio, additional, Rhoden, Kerry Jane, additional, Solaroli, Erica, additional, Monari, Fabio, additional, Filetti, Sebastiano, additional, and Durante, Cosimo, additional
- Published
- 2020
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61. Denosumab in post-liver transplantation osteoporosis: preliminary data on the effects on bone mineral density and turnover markers
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Zavatta, Guido, primary, Vandi, Giulia, additional, Di, Dalmazi Guido, additional, Repaci, Andrea, additional, Ravaioli, Matteo, additional, Cescon, Matteo, additional, Morelli, Maria Cristina, additional, Pagotto, Uberto, additional, and Altieri, Paola, additional
- Published
- 2019
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62. Evaluation of bone metabolism in women on aromatase-inhibitors before and after antiresorptive treatment
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Vandi, Giulia, primary, Zavatta, Guido, additional, Repaci, Andrea, additional, Di, Dalmazi Guido, additional, Altieri, Paola, additional, and Pagotto, Uberto, additional
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- 2019
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63. Calcium to Phosphorus (Ca/P) ratio as an accurate index for the diagnosis of primary hyperparathyroidism (PHPT) and hypoparathyroidism (HypoPT)
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Vincentis, Sara De, primary, Repaci, Andrea, additional, Altieri, Paola, additional, Kara, Elda, additional, Vescini, Fabio, additional, Amadori, Pierluigi, additional, Balestrieri, Antonio, additional, Rochira, Vincenzo, additional, and Madeo, Bruno, additional
- Published
- 2019
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64. BRAF V600E Status and Stimulated Thyroglobulin at Ablation Time Increase Prognostic Value of American Thyroid Association Classification Systems for Persistent Disease in Differentiated Thyroid Carcinoma
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Repaci, Andrea, primary, Vicennati, Valentina, additional, Paccapelo, Alexandro, additional, Cavicchi, Ottavio, additional, Salituro, Nicola, additional, Monari, Fabio, additional, de Biase, Dario, additional, Tallini, Giovanni, additional, Altimari, Annalisa, additional, Gruppioni, Elisa, additional, Fiorentino, Michelangelo, additional, and Pagotto, Uberto, additional
- Published
- 2019
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65. Clinical presentation and management of primary hyperparathyroidism in Italy
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Federica Saponaro, Cetani, Filomena, Repaci, Andrea, Camozzi, Valentina, Minisola, Salvatore, Scillitani, Alfredo, Chiodini, Iacopo, Romanelli, Francesco, Madeo, Bruno, Gianotti, Laura, Faggiano, Antongiulio, Cianferotti, Luisella, Corbetta, Sabrina, Feo, Maria Laura, Palermo, Andrea, Pozzilli, Paolo, and Marcocci, Claudio
- Published
- 2017
66. Clinical manifestation of Hypoparathyroidism in a monocentric cohort: our experience
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Repaci, Andrea, primary, Altieri, Paola, additional, Dianori, Francesco, additional, Salituro, Nicola, additional, Vandi, Giulia, additional, and Pagotto, Uberto, additional
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- 2018
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67. Mutant MYO1F alters the mitochondrial network and induces tumor proliferation in thyroid cancer
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Diquigiovanni, Chiara, primary, Bergamini, Christian, additional, Evangelisti, Cecilia, additional, Isidori, Federica, additional, Vettori, Andrea, additional, Tiso, Natascia, additional, Argenton, Francesco, additional, Costanzini, Anna, additional, Iommarini, Luisa, additional, Anbunathan, Hima, additional, Pagotto, Uberto, additional, Repaci, Andrea, additional, Babbi, Giulia, additional, Casadio, Rita, additional, Lenaz, Giorgio, additional, Rhoden, Kerry J., additional, Porcelli, Anna Maria, additional, Fato, Romana, additional, Bowcock, Anne, additional, Seri, Marco, additional, Romeo, Giovanni, additional, and Bonora, Elena, additional
- Published
- 2018
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68. Large deletion at the CDC73 gene locus and search for predictive markers of the presence of a CDC73 genetic lesion
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Muscarella, Lucia Anna, primary, Turchetti, Daniela, additional, Fontana, Andrea, additional, Baorda, Filomena, additional, Palumbo, Orazio, additional, la Torre, Annamaria, additional, de Martino, Danilo, additional, Franco, Renato, additional, Losito, Nunzia Simona, additional, Repaci, Andrea, additional, Pagotto, Uberto, additional, Cinque, Luigia, additional, Copetti, Massimiliano, additional, Chiofalo, Maria Grazia, additional, Pezzullo, Luciano, additional, Graziano, Paolo, additional, Scillitani, Alfredo, additional, and Guarnieri, Vito, additional
- Published
- 2018
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69. Molecular pathology of thyroid tumours of follicular cells: a review of genetic alterations and their clinicopathological relevance
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Acquaviva, Giorgia, primary, Visani, Michela, additional, Repaci, Andrea, additional, Rhoden, Kerry J, additional, de Biase, Dario, additional, Pession, Annalisa, additional, and Giovanni, Tallini, additional
- Published
- 2017
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70. BRAFV600E status and Stimulated Thyroglobulin at ablation time increase prognostic value of American Thyroid Association (ATA) classification systems for persistent disease in Differentiated Thyroid Carcinoma (DTC)
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Repaci, Andrea, primary, Vicennati, Valentina, additional, Paccapelo, Alexandro, additional, Salituro, Nicola, additional, Cavicchi, Ottavio, additional, Monari, Fabio, additional, Tallini, Giovanni, additional, Gruppioni, Elisa, additional, Altimari, Annalisa, additional, Fiorentino, Michelangelo, additional, and Pagotto, Uberto, additional
- Published
- 2017
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71. 18F-FDG Pet-Guided External Beam Radiotherapy in Iodine-Refractory Differentiated Thyroid Cancer: A Pilot Study
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Farina, Eleonora, primary, Monari, Fabio, additional, Castellucci, Paolo, additional, Romani, Fabrizio, additional, Repaci, Andrea, additional, Farina, Arianna, additional, Rambaldi, Giuseppe Zanirato, additional, Frezza, Giovanni, additional, Mazzarotto, Renzo, additional, Cammelli, Silvia, additional, Tagliaferri, Luca, additional, Autorino, Rosa, additional, Deodato, Francesco, additional, Macchia, Gabriella, additional, Cilla, Savino, additional, Valentini, Vincenzo, additional, Fanti, Stefano, additional, and Morganti, Alessio G., additional
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- 2017
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72. Tablet and oral liquid L-thyroxine formulation in the treatment of naïve hypothyroid patients with Helicobacter pylori infection
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Ribichini, Danilo, primary, Fiorini, Giulia, additional, Repaci, Andrea, additional, Castelli, Valentina, additional, Gatta, Luigi, additional, Vaira, Dino, additional, and Pasquali, Renato, additional
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- 2016
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73. The Steroid Profile of Adrenal Incidentalomas: Subtyping Subjects With High Cardiovascular Risk.
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Di Dalmazi, Guido, Fanelli, Flaminia, Zavatta, Guido, Ricci Bitti, Silvia, Mezzullo, Marco, Repaci, Andrea, Pelusi, Carla, Gambineri, Alessandra, Altieri, Paola, Mosconi, Cristina, Balacchi, Caterina, Golfieri, Rita, Cosentino, Eugenio Roberto, Borghi, Claudio, Vicennati, Valentina, Pasquali, Renato, and Pagotto, Uberto
- Abstract
Steroid profiling by mass spectrometry has shown implications for diagnosis and subtyping of adrenal tumors.
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- 2019
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74. Unusual Thyroid Carcinoma Metastases: a Case Series and Literature Review
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Farina, Eleonora, primary, Monari, Fabio, additional, Tallini, Giovanni, additional, Repaci, Andrea, additional, Mazzarotto, Renzo, additional, Giunchi, Francesca, additional, Panzacchi, Riccardo, additional, Cammelli, Silvia, additional, Padula, Gilbert D. A., additional, Deodato, Francesco, additional, Pasquali, Renato, additional, Fanti, Stefano, additional, Fiorentino, Michelangelo, additional, and Morganti, Alessio G., additional
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- 2015
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75. Complete pathological response after chemo-radiation in anaplastic thyroid cancer: A report of two cases
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Zanirato Rambaldi, Giuseppe, primary, Monari, Fabio, additional, Fiorentino, Michelangelo, additional, Cammelli, Silvia, additional, Repaci, Andrea, additional, Cremonini, Nadia, additional, Cavicchi, Ottavio, additional, Caliceti, Umberto, additional, Farina, Eleonora, additional, Deodato, Francesco, additional, Di Fabio, Francesca, additional, Presutti, Livio, additional, Fanti, Stefano, additional, Frezza, Giovanni P., additional, and Morganti, Alessio G., additional
- Published
- 2015
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76. Salivary cortisol response to psychological stress in late adolescent and young women: impact of menstrual irregularity, hirsutism, and hyperandrogenaemia
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Mezzullo, Marco, primary, Gambineri, Alessandra, additional, Fanelli, Flaminia, additional, Repaci, Andrea, additional, Prontera, Olga, additional, Di, Dalmazi Guido, additional, Pagotto, Uberto, additional, and Pasquali, Renato, additional
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- 2015
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77. 18F-FDG Pet-Guided External Beam Radiotherapy in Iodine-Refractory Differentiated Thyroid Cancer: A Pilot Study.
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Farina, Eleonora, Monari, Fabio, Castellucci, Paolo, Romani, Fabrizio, Repaci, Andrea, Farina, Arianna, Rambaldi, Giuseppe Zanirato, Frezza, Giovanni, Mazzarotto, Renzo, Cammelli, Silvia, Tagliaferri, Luca, Autorino, Rosa, Deodato, Francesco, Macchia, Gabriella, Cilla, Savino, Valentini, Vincenzo, Fanti, Stefano, and Morganti, Alessio G.
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CANCER relapse ,CLINICAL trials ,COMPUTED tomography ,CONFIDENCE intervals ,DEOXY sugars ,GLOBULINS ,LUNG tumors ,METASTASIS ,RADIONUCLIDE imaging ,RADIOPHARMACEUTICALS ,RADIOTHERAPY ,SURVIVAL analysis (Biometry) ,THYROID gland tumors ,THYROIDECTOMY ,TIME ,POSITRON emission tomography ,PILOT projects ,TREATMENT effectiveness ,PROGNOSIS - Abstract
Introduction. To evaluate the clinical response rate after a postoperative
18 F-FDG PET/CT guided external beam radiotherapy (EBRT) in Iodine-refractory differentiated thyroid cancer. Material and Methods. Patients with thyroid cancer locally recurrent after total thyroidectomy plus metabolic radiotherapy and treated with radical EBRT were included. Inclusion criteria were detectable thyroglobulin (Tg), negative postmetabolic radiotherapy whole body scintigraphy, and no surgical indications. The pretreatment18 F-FDG PET/CT resulted positive in all cases (loggia, lymph nodes, and lung). EBRT was delivered with IMRT-SIB technique. A18 F-FDG PET/CT revaluation and Tg dosage were performed 3 months after the treatment. Results. Sixteen consecutive patients were included in this analysis (median follow-up: 6–44 months). Post-EBRT18 F-FDG PET/CT showed CR in 43.7%, PR in 31.2%, SD in 25.0% patients, and PD due to lung metastases in 12.5%. Overall response rate was 75.0% (CI 95%: 41.4–93.3%). Tg levels decreased in 75.0% with a median Δ of 68.0%. Two-year PFS and OS rates were 80.0% and 93.0%, respectively. Acute G3 toxicity occurred in 18.7% and late G2 toxicity in 12.5%. Conclusions.18 F-FDG PET/CT was useful in target definition for radiotherapy planning, identifying positive areas not detected with131 I scintigraphy. IMRT based EBRT was feasible and our results encourage future prospective studies. This clinical trial is registered with ID:NCT03191643 . [ABSTRACT FROM AUTHOR]- Published
- 2017
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78. Clinical Significance of BRAF Mutation in Thyroid Papillary Cancer
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Fernandez, Ignacio J., primary, Piccin, Ottavio, additional, Sciascia, Silvia, additional, Cavicchi, Ottavio, additional, Repaci, Andrea, additional, Vicennati, Valentina, additional, and Fiorentino, Michelangelo, additional
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- 2013
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79. Clinical Significance of BRAF Mutation in Papillary Cancer
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Fernandez, Ignacio J., primary, Piccin, Ottavio, additional, Sciascia, Silvia, additional, Cavicchi, Ottavio, additional, Repaci, Andrea, additional, Vicennati, Valentina, additional, and Fiorentino, Michelangelo, additional
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- 2012
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80. Combined Aldosterone and Cortisol Secretion by Adrenal Incidentaloma
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Vicennati, Valentina, primary, Repaci, Andrea, additional, di Dalmazi, Guido, additional, Rinaldi, Eleonora, additional, Golfieri, Rita, additional, Giampalma, Emanuela, additional, Minni, Francesco, additional, Marrano, Nicola, additional, Santini, Donatella, additional, and Pasquali, Renato, additional
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- 2011
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81. Ghrelin and reproductive disorders
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Repaci, Andrea, primary, Gambineri, Alessandra, additional, Pagotto, Uberto, additional, and Pasquali, Renato, additional
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- 2011
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82. The role of low-grade inflammation in the polycystic ovary syndrome
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Repaci, Andrea, primary, Gambineri, Alessandra, additional, and Pasquali, Renato, additional
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- 2011
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83. Complete pathological response after chemo-radiation in anaplastic thyroid cancer: A report of two cases.
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Zanirato Rambaldi, Giuseppe, Monari, Fabio, Fiorentino, Michelangelo, Cammelli, Silvia, Repaci, Andrea, Cremonini, Nadia, Cavicchi, Ottavio, Caliceti, Umberto, Farina, Eleonora, Deodato, Francesco, Di Fabio, Francesca, Presutti, Livio, Fanti, Stefano, Frezza, Giovanni P., and Morganti, Alessio G.
- Abstract
The article presents two cases of patients with unresectable anaplastic thyroid carcinoma (ATC) in which the combination of radiation therapy (RT) and chemotherapy (CHT) resulted in surgical resection with pathological complete response of the disease. It includes the 68-year-old female patient noted the appearance of a hard mass in the right supraclavicular region.
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- 2016
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84. Proposal of a molecular testing algorithm for differentiated thyroid cancer (DTC)
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Nannini, Margherita, Repaci, Andrea, Leo, Antonio, Vicennati, Valentina, Gruppioni, Elisa, Altimari, Annalisa, Solaroli, Erica, Rizzini, Elisa Lodi, Monari, Fabio, Savastio, Gabriella, Lovato, Luigi, Giovanni Tallini, Pantaleo, Maria A., and Biase, Dario
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Cancer Research ,Oncology - Abstract
e18090 Background: In the growing era of precision medicine and tumor-agnostic therapies, the molecular testing of DTC is becoming mandatory to optimize diagnostic and therapeutical strategies. Even if the most frequent oncogenic events, occurring in a mutually exclusive manner, are BRAF V600E, followed by RAS, gene fusions mainly occurring in RET, NTRK1-3, and ALK genes have been also found. In this scenario, the definition of a molecular testing algorithm to be implemented for clinical practice is needed, in order to optimize resources and time for better clinical patient management. Methods: Gene mutations and gene fusions were evaluated on DNA and RNA extracted from cytologic or histologic samples. Mutations were tested using a lab-developed multi-gene panel able to analyze the hot-spot regions of 28 genes (total of 343 amplicons, 21.77 kb); gene fusions were tested using the Oncomine Focus assay panel. Results: Molecular characterization was performed on a total of 63 DTC (50 papillary thyroid carcinoma - PTC, 8 – follicular thyroid carcinoma - FTC, 5 – hurthle cell carcinoma - HCC) by the treating clinician for diagnostic, prognostic or clinical reasons. In 27 cases (42.8%) at least one DNA mutation was detected, 17 cases (26.9%) were positive for gene fusion rearrangement, in only 2 cases (3.1%) both DNA mutations and gene rearrangements were found and in the remaining 17 (26.9%) cases no DNA mutations or rearrangements were detected. Among mutated-subgroup, BRAF V600E mutation was the most common (14 of 63 cases – 22.2%), followed by RAS mut (9 cases – 14.2%: 4 NRAS, 3 HRAS, and 3 KRAS), both as single event in 7 and 4 cases respectively. Substitutions in TERT promoter region was found in 16 cases (25.3%), of which 14 as secondary event. Other mutations in TP53 (4 cases –6.3 %, of which 2 as single event), PIK3CA (1 case – 1.5%), AKT1(1 case – 1.5%), and RNF43 (1 case – 1.5%) were detected. Among riarranged subgroup, RET fusions and NTRK1-3 was found in 8 cases respectively (12.6%), while ALK fusion was found 1 case (1.5%). The concomitant mutational and fusion events found in 2 cases were the following: 1) HRAS and PAX8/PPARG; 2) PIK3CA/TP53/TERT and RET/CCDC6. Conclusions: As expected, BRAF and RAS mutations represent the most common genetic events in DTC and occur in a mutual exclusive manner. However, in about 30% of patients, mostly of young age, with papillary histology and lymph nodal involvement, a clinically actionable gene rearrangement has been found. Thus, we propose a two-step molecular testing algorithm with a first-level test to identify the most common mutations and a second-level test, including less common mutations and gene rearrangements, if the genes analyzed with the first level test are wild-type. The second-level test may be performed up-front in cases where there are clinicopathologic features suggestive of fusion gene TC gene or in clinically aggressive unconventional cases for which molecular therapy is being considered.
85. Expanding the Spectrum of BRAF Non-V600E Mutations in Thyroid Nodules: Evidence-Based Data from a Tertiary Referral Centre
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Antonio De Leo, Daniela Serban, Thais Maloberti, Viviana Sanza, Sara Coluccelli, Annalisa Altimari, Elisa Gruppioni, Federico Chiarucci, Angelo Gianluca Corradini, Andrea Repaci, Alessandra Colapinto, Margherita Nannini, Maria A. Pantaleo, Dario de Biase, Giovanni Tallini, De Leo, Antonio, Serban, Daniela, Maloberti, Thai, Sanza, Viviana, Coluccelli, Sara, Altimari, Annalisa, Gruppioni, Elisa, Chiarucci, Federico, Corradini, Angelo Gianluca, Repaci, Andrea, Colapinto, Alessandra, Nannini, Margherita, Pantaleo, Maria A, de Biase, Dario, and Tallini, Giovanni
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Organic Chemistry ,thyroid tumors ,General Medicine ,Catalysis ,BRAF ,Computer Science Applications ,Inorganic Chemistry ,next-generation sequencing ,noncanonical mutation ,Physical and Theoretical Chemistry ,mutation ,Molecular Biology ,Spectroscopy - Abstract
The BRAF p.V600E mutation represents the most specific marker for papillary thyroid carcinoma and is potentially related to aggressive behavior and persistent disease. BRAF alterations other than the p.V600E are less common in thyroid carcinoma and represent an alternative mechanism of BRAF activation with unclear clinical significance. The study aims to describe the frequency and clinicopathologic characteristics of BRAF non-V600E mutations in a large cohort (1654 samples) of thyroid lesions characterized by next-generation sequencing. BRAF mutations have been found in 20.3% (337/1654) of thyroid nodules, including classic (p.V600E) mutation in 19.2% (317/1654) of samples and non-V600E variants in 1.1% of cases (19/1654). BRAF non-V600E alterations include 5 cases harboring p.K601E, 2 harboring p.V600K substitutions, 2 with a p.K601G variant, and 10 cases with other BRAF non-V600E alterations. BRAF non-V600E mutations have been reported in one case of follicular adenoma, three cases of conventional papillary thyroid carcinoma, eight cases of follicular variant of papillary carcinomas, one case of columnar cell variant papillary thyroid carcinoma, one case of oncocytic follicular carcinoma, and two bone metastasis of follicular thyroid carcinoma. We confirm that BRAF non-V600E mutations are uncommon and typically found in indolent follicular-patterned tumors. Indeed, we show that BRAF non-V600E mutations can be found in tumors with metastatic potential. However, in both aggressive cases, the BRAF mutations were concomitant with other molecular alterations, such as TERT promoter mutation.
- Published
- 2023
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86. A Data-Driven Approach to Refine Predictions of Differentiated Thyroid Cancer Outcomes: A Prospective Multicenter Study
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Giorgio Grani, Michele Gentili, Federico Siciliano, Domenico Albano, Valentina Zilioli, Silvia Morelli, Efisio Puxeddu, Maria Chiara Zatelli, Irene Gagliardi, Alessandro Piovesan, Alice Nervo, Umberto Crocetti, Michela Massa, Maria Teresa Samà, Chiara Mele, Maurilio Deandrea, Laura Fugazzola, Barbara Puligheddu, Alessandro Antonelli, Ruth Rossetto, Annamaria D’Amore, Graziano Ceresini, Roberto Castello, Erica Solaroli, Marco Centanni, Salvatore Monti, Flavia Magri, Rocco Bruno, Clotilde Sparano, Luciano Pezzullo, Anna Crescenzi, Caterina Mian, Dario Tumino, Andrea Repaci, Maria Grazia Castagna, Vincenzo Triggiani, Tommaso Porcelli, Domenico Meringolo, Laura Locati, Giovanna Spiazzi, Giulia Di Dalmazi, Aris Anagnostopoulos, Stefano Leonardi, Sebastiano Filetti, Cosimo Durante, Grani, Giorgio, Gentili, Michele, Siciliano, Federico, Albano, Domenico, Zilioli, Valentina, Morelli, Silvia, Puxeddu, Efisio, Chiara Zatelli, Maria, Gagliardi, Irene, Piovesan, Alessandro, Nervo, Alice, Crocetti, Umberto, Massa, Michela, Teresa Samà, Maria, Mele, Chiara, Deandrea, Maurilio, Fugazzola, Laura, Puligheddu, Barbara, Antonelli, Alessandro, Rossetto, Ruth, D’Amore, Annamaria, Ceresini, Graziano, Castello, Roberto, Solaroli, Erica, Centanni, Marco, Monti, Salvatore, Magri, Flavia, Bruno, Rocco, Sparano, Clotilde, Pezzullo, Luciano, Crescenzi, Anna, Mian, Caterina, Tumino, Dario, Repaci, Andrea, Grazia Castagna, Maria, Triggiani, Vincenzo, Porcelli, Tommaso, Meringolo, Domenico, Locati, Laura, Spiazzi, Giovanna, Di Dalmazi, Giulia, Anagnostopoulos, Ari, Leonardi, Stefano, Filetti, Sebastiano, and Durante, Cosimo
- Subjects
Endocrinology ,Endocrinology, Diabetes and Metabolism ,Biochemistry (medical) ,Clinical Biochemistry ,differentiated thyroid cancer ,risk stratification ,evidence-based guidelines ,Biochemistry ,clinical practice - Abstract
ContextThe risk stratification of patients with differentiated thyroid cancer (DTC) is crucial in clinical decision making. The most widely accepted method to assess risk of recurrent/persistent disease is described in the 2015 American Thyroid Association (ATA) guidelines. However, recent research has focused on the inclusion of novel features or questioned the relevance of currently included features.ObjectiveTo develop a comprehensive data-driven model to predict persistent/recurrent disease that can capture all available features and determine the weight of predictors.MethodsIn a prospective cohort study, using the Italian Thyroid Cancer Observatory (ITCO) database (NCT04031339), we selected consecutive cases with DTC and at least early follow-up data (n = 4773; median follow-up 26 months; interquartile range, 12-46 months) at 40 Italian clinical centers. A decision tree was built to assign a risk index to each patient. The model allowed us to investigate the impact of different variables in risk prediction.ResultsBy ATA risk estimation, 2492 patients (52.2%) were classified as low, 1873 (39.2%) as intermediate, and 408 as high risk. The decision tree model outperformed the ATA risk stratification system: the sensitivity of high-risk classification for structural disease increased from 37% to 49%, and the negative predictive value for low-risk patients increased by 3%. Feature importance was estimated. Several variables not included in the ATA system significantly impacted the prediction of disease persistence/recurrence: age, body mass index, tumor size, sex, family history of thyroid cancer, surgical approach, presurgical cytology, and circumstances of the diagnosis.ConclusionCurrent risk stratification systems may be complemented by the inclusion of other variables in order to improve the prediction of treatment response. A complete dataset allows for more precise patient clustering.
- Published
- 2023
87. International Medullary Thyroid Carcinoma Grading System: A Validated Grading System for Medullary Thyroid Carcinoma
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Ian Ganly, Fedaa Najdawi, Angela Chou, Antonio De Leo, Justine A. Barletta, Philip M. Spanheimer, Abir Al Ghuzlan, Alex Papachristos, Dana M. Hartl, Mohammed Alghamdi, Aradhya Nigam, Bayan Alzumaili, Christina Kanaan, Anthony J. Gill, James A. Fagin, Bin Xu, Eric Baudin, Erica Solaroli, Brian R. Untch, Sara Ahmadi, Andrea Repaci, Mohamed-Amine Bani, Anthony Glover, Ronald Ghossein, Giovanni Tallini, Talia L Fuchs, Pierre Khneisser, Xu, Bin, Fuchs, Talia L, Ahmadi, Sara, Alghamdi, Mohammed, Alzumaili, Bayan, Bani, Mohamed-Amine, Baudin, Eric, Chou, Angela, De Leo, Antonio, Fagin, James A, Ganly, Ian, Glover, Anthony, Hartl, Dana, Kanaan, Christina, Khneisser, Pierre, Najdawi, Fedaa, Nigam, Aradhya, Papachristos, Alex, Repaci, Andrea, Spanheimer, Philip M, Solaroli, Erica, Untch, Brian R, Barletta, Justine A, Tallini, Giovanni, Al Ghuzlan, Abir, Gill, Anthony J, and Ghossein, Ronald A
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Adult ,Male ,Cancer Research ,Pathology ,medicine.medical_specialty ,Consensus ,Proliferation index ,Medullary cavity ,Adolescent ,Biopsy ,Risk Assessment ,Thyroid carcinoma ,Necrosis ,Young Adult ,Predictive Value of Tests ,Risk Factors ,Mitotic Index ,Medicine ,Humans ,Thyroid Neoplasms ,Grading (education) ,Child ,Aged ,Cell Proliferation ,Retrospective Studies ,Aged, 80 and over ,business.industry ,Reproducibility of Results ,Middle Aged ,United States ,Carcinoma, Neuroendocrine ,Europe ,Ki-67 Antigen ,Oncology ,Child, Preschool ,medullary thyroid carcinoma, grading, prognosis, survival, ki67, proliferation index, tumor necrosis, neuroendocrine tumor, thyroid carcinoma ,Female ,Neoplasm Grading ,New South Wales ,business - Abstract
PURPOSE Medullary thyroid carcinoma (MTC) is an aggressive neuroendocrine tumor (NET) arising from the calcitonin-producing C cells. Unlike other NETs, there is no widely accepted pathologic grading scheme. In 2020, two groups separately developed slightly different schemes (the Memorial Sloan Kettering Cancer Center and Sydney grade) on the basis of proliferative activity (mitotic index and/or Ki67 proliferative index) and tumor necrosis. Building on this work, we sought to unify and validate an internationally accepted grading scheme for MTC. PATIENTS AND METHODS Tumor tissue from 327 patients with MTC from five centers across the United States, Europe, and Australia were reviewed for mitotic activity, Ki67 proliferative index, and necrosis using uniform criteria and blinded to other clinicopathologic features. After reviewing different cutoffs, a two-tiered consensus grading system was developed. High-grade MTCs were defined as tumors with at least one of the following features: mitotic index ≥ 5 per 2 mm2, Ki67 proliferative index ≥ 5%, or tumor necrosis. RESULTS Eighty-one (24.8%) MTCs were high-grade using this scheme. In multivariate analysis, these patients demonstrated decreased overall (hazard ratio [HR] = 11.490; 95% CI, 3.118 to 32.333; P < .001), disease-specific (HR = 8.491; 95% CI, 1.461 to 49.327; P = .017), distant metastasis-free (HR = 2.489; 95% CI, 1.178 to 5.261; P = .017), and locoregional recurrence-free (HR = 2.114; 95% CI, 1.065 to 4.193; P = .032) survivals. This prognostic power was maintained in subgroup analyses of cohorts from each of the five centers. CONCLUSION This simple two-tiered international grading system is a powerful predictor of adverse outcomes in MTC. As it is based solely on morphologic assessment in conjunction with Ki67 immunohistochemistry, it brings the grading of MTCs in line with other NETs and can be readily applied in routine practice. We therefore recommend grading of MTCs on the basis of mitotic count, Ki67 proliferative index, and tumor necrosis.
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- 2021
88. Pathogenic Mitochondrial DNA Mutation Load Inversely Correlates with Malignant Features in Familial Oncocytic Parathyroid Tumors Associated with Hyperparathyroidism-Jaw Tumor Syndrome
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Nunzio Salfi, Daniela Turchetti, Ivana Kurelac, Lorena Marchio, Monica De Luise, Andrea Repaci, Uberto Pagotto, Greta Tedesco, Maria Lucia Tardio, Camelia Alexandra Coadă, Anna Maria Porcelli, Giuseppe Gasparre, Luisa Iommarini, De Luise, Monica, Iommarini, Luisa, Marchio, Lorena, Tedesco, Greta, Coadă, Camelia Alexandra, Repaci, Andrea, Turchetti, Daniela, Tardio, Maria Lucia, Salfi, Nunzio, Pagotto, Uberto, Kurelac, Ivana, Porcelli, Anna Maria, and Gasparre, Giuseppe
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Adenoma ,Mitochondrial DNA ,QH301-705.5 ,Somatic cell ,Respiratory chain ,Fibroma ,Biology ,medicine.disease_cause ,respiratory complexe ,DNA, Mitochondrial ,Germline ,Article ,familial oncocytic tumors ,respiratory complexes ,medicine ,Carcinoma ,Humans ,Biology (General) ,mitochondrial DNA mutations ,parathyroid cancer ,Mutation ,Base Sequence ,Hyperparathyroidism ,Cancer ,General Medicine ,medicine.disease ,Jaw Neoplasms ,Hyperparathyroidism-Jaw Tumor Syndrome ,familial oncocytic tumor ,Parathyroid Neoplasms ,Phenotype ,mitochondrial DNA mutation ,Cancer research ,Ribosomes ,hyperparathyroidism-jaw tumor syndrome - Abstract
While somatic disruptive mitochondrial DNA (mtDNA) mutations that severely affect the respiratory chain are counter-selected in most human neoplasms, they are the genetic hallmark of indolent oncocytomas, where they appear to contribute to reduce tumorigenic potential. A correlation between mtDNA mutation type and load, and the clinical outcome of a tumor, corroborated by functional studies, is currently lacking. Recurrent familial oncocytomas are extremely rare entities, and they offer the chance to investigate the determinants of oncocytic transformation and the role of both germline and somatic mtDNA mutations in cancer. We here report the first family with Hyperparathyroidism-Jaw Tumor (HPT-JT) syndrome showing the inherited predisposition of four individuals to develop parathyroid oncocytic tumors. MtDNA sequencing revealed a rare ribosomal RNA mutation in the germline of all HPT-JT affected individuals whose pathogenicity was functionally evaluated via cybridization technique, and which was counter-selected in the most aggressive infiltrating carcinoma, but positively selected in adenomas. In all tumors different somatic mutations accumulated on this genetic background, with an inverse clear-cut correlation between the load of pathogenic mtDNA mutations and the indolent behavior of neoplasms, highlighting the importance of the former both as modifiers of cancer fate and as prognostic markers.
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- 2021
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89. Minimal Extrathyroidal Extension in Predicting 1-Year Outcomes: A Longitudinal Multicenter Study of Low-to-Intermediate-Risk Papillary Thyroid Carcinoma (ITCO#4)
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Barbara Puligheddu, Loredana Pagano, Sebastiano Filetti, Giovanni Tallini, Giovanna Spiazzi, Andrea Repaci, Valentina Zilioli, Giorgio Grani, Silvia Morelli, Umberto Ferraro Petrillo, Dario Tumino, Luciano Pezzullo, Alberto Ragni, Efisio Puxeddu, Marco Alfò, Marco Centanni, Laura Fugazzola, R. Rossetto, Maria Grazia Castagna, Raffaele Giubbini, Clotilde Sparano, Anna Crescenzi, Raffaella Forleo, Massimo Torlontano, Celestino Pio Lombardi, Maurilio Deandrea, Alessandro Piovesan, Cosimo Durante, Fabio Monzani, Alessandro Antonelli, Rocco Bruno, Salvatore Monti, Maria Chiara Zatelli, Irene Gagliardi, Graziano Ceresini, Forleo, Raffaella, Grani, Giorgio, Alfò, Marco, Zilioli, Valentina, Giubbini, Raffaele, Zatelli, Maria Chiara, Gagliardi, Irene, Piovesan, Alessandro, Ragni, Alberto, Morelli, Silvia, Puxeddu, Efisio, Pagano, Loredana, Deandrea, Maurilio, Ceresini, Graziano, Torlontano, Massimo, Puligheddu, Barbara, Antonelli, Alessandro, Centanni, Marco, Fugazzola, Laura, Spiazzi, Giovanna, Monti, Salvatore, Rossetto, Ruth, Monzani, Fabio, Tallini, Giovanni, Crescenzi, Anna, Sparano, Clotilde, Bruno, Rocco, Repaci, Andrea, Tumino, Dario, Pezzullo, Luciano, Lombardi, Celestino Pio, Ferraro Petrillo, Umberto, Filetti, Sebastiano, Durante, Cosimo, and Castagna, Maria Grazia
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extrathyroidal extension ,Oncology ,Adult ,Male ,medicine.medical_specialty ,endocrine system diseases ,Endocrinology, Diabetes and Metabolism ,MEDLINE ,Papillary thyroid carcinoma ,Radioactive iodine remnant ablation ,Thyroid carcinoma ,Iodine Radioisotopes ,Endocrinology ,Internal medicine ,medicine ,Humans ,Longitudinal Studies ,Prospective Studies ,Thyroid Neoplasms ,Risk factor ,aggressive histology ,Tumor size ,business.industry ,micropapillary thyroid cancer ,Middle Aged ,PTC ,Multicenter study ,Thyroid Cancer, Papillary ,aggressive histology, micropapillary thyroid cancer, minimal extrathyroidal extension, PTC, tumor diameter ,Thyroidectomy ,Female ,tumor diameter ,minimal extrathyroidal extension ,business ,Intermediate risk - Abstract
Background: The role of minimal extrathyroidal extension (mETE) as a risk factor for persistent papillary thyroid carcinoma (PTC) is still debated. The aim of this study was to assess the clinical impact of mETE as a predictor of worse initial treatment response in PTC patients and to verify the impact of radioiodine therapy after surgery in patients with mETE. Methods: We reviewed all records in the Italian Thyroid Cancer Observatory (ITCO) database and selected 2237 consecutive patients with PTC who satisfied the inclusion criteria (PTC with no lymph node metastases and at least 1 year of follow-up). For each case, we considered initial surgery, histological variant of PTC, tumor diameter, recurrence risk class according to the American Thyroid Association (ATA) risk stratification system, use of radioiodine therapy, and initial therapy response, as suggested by ATA guidelines. Results: At 1-year follow-up, 1831 patients (81.8%) had an excellent response, 296 (13.2%) had an indeterminate response, 55 (2.5%) had a biochemical incomplete response, and 55 (2.5%) had a structural incomplete response. Statistical analysis suggested that mETE (odds ratio [OR] 1.16, p=0.65), tumor size >2 cm (OR 1.45, p=0.34), aggressive PTC histology (OR 0.55, p=0.15), and age at diagnosis (OR 0.90, p=0.32) were not significant risk factors for a worse initial therapy response. When evaluating the combination of mETE, tumor size, and aggressive PTC histology, the presence of mETE with a >2 cm tumor was significantly associated with a worse outcome (OR 5.27, 95% CI, p=0.014). The role of radioiodine ablation in patients with mETE was also evaluated. When considering radioiodine treatment, propensity score-based matching was performed, and no significant differences were found between treated and non-treated patients (p=0.24). Conclusions: This study failed to show the prognostic value of mETE in predicting initial therapy response in a large cohort of PTC patients without lymph node metastases. The study suggests that the combination of tumor diameter and mETE can be used as a reliable prognostic factor for persistence and could be easily applied in clinical practice to manage PTC patients with low-to-intermediate risk of recurrent/persistent disease.
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- 2021
90. Real-World Performance of the American Thyroid Association Risk Estimates in Predicting 1-Year Differentiated Thyroid Cancer Outcomes: A Prospective Multicenter Study of 2000 Patients
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Laura Fugazzola, Cecilia Francese, Silvia Morelli, Andrea Repaci, Luisa Petrone, Marco Alfò, Fabio Orlandi, Carolina Adele Maniglia, Emanuela Arvat, Teresa Montesano, Caterina Mian, Giorgio Grani, Maria Chiara Zatelli, R. Rossetto, Maria Grazia Castagna, Massimo Torlontano, Dario Tumino, Fabio Monari, Maria Giulia Santaguida, Erica Solaroli, Domenico Salvatore, Graziano Ceresini, Cesare Piazza, Roberto Castello, Raffaele Giubbini, Loredana Pagano, Domenico Meringolo, Sebastiano Filetti, Salvatore Monti, Giovanna Spiazzi, Vincenzo Triggiani, Flavia Magri, Anna Crescenzi, Giovanni Tallini, Rocco Bruno, Luciano Pezzullo, Cosimo Durante, Celestino Pio Lombardi, Fabio Monzani, Alessandro Antonelli, Maurilio Deandrea, Umberto Ferraro Petrillo, Roberta Elisa Rossi, Grani, Giorgio, Zatelli, Maria Chiara, Alfò, Marco, Montesano, Teresa, Torlontano, Massimo, Morelli, Silvia, Deandrea, Maurilio, Antonelli, Alessandro, Francese, Cecilia, Ceresini, Graziano, Orlandi, Fabio, Maniglia, Carolina Adele, Bruno, Rocco, Monti, Salvatore, Santaguida, Maria Giulia, Repaci, Andrea, Tallini, Giovanni, Fugazzola, Laura, Monzani, Fabio, Giubbini, Raffaele, Rossetto, Ruth, Mian, Caterina, Crescenzi, Anna, Tumino, Dario, Pagano, Loredana, Pezzullo, Luciano, Lombardi, Celestino Pio, Arvat, Emanuela, Petrone, Luisa, Castagna, Maria Grazia, Spiazzi, Giovanna, Salvatore, Domenico, Meringolo, Domenico, Solaroli, Erica, Monari, Fabio, Magri, Flavia, Triggiani, Vincenzo, Castello, Roberto, Piazza, Cesare, Rossi, Roberta, Ferraro Petrillo, Umberto, Filetti, Sebastiano, and Durante, Cosimo
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Male ,Time Factors ,Databases, Factual ,Settore MED/18 - CHIRURGIA GENERALE ,Endocrinology, Diabetes and Metabolism ,differentiated thyroid cancer ,evidence-based guidelines ,clinical practice ,risk stratification ,medicine.disease_cause ,Iodine Radioisotopes ,0302 clinical medicine ,Endocrinology ,Risk Factors ,thyroid cancer ,Prospective Studies ,LS4_3 ,Prospective cohort study ,Thyroid cancer ,Thyroid ,Cell Differentiation ,evidence-based guideline ,Middle Aged ,Treatment Outcome ,medicine.anatomical_structure ,Italy ,030220 oncology & carcinogenesis ,Cohort ,Thyroidectomy ,Female ,evidence based guidelines ,Adult ,medicine.medical_specialty ,030209 endocrinology & metabolism ,Risk Assessment ,Decision Support Techniques ,NO ,03 medical and health sciences ,Predictive Value of Tests ,Internal medicine ,medicine ,Humans ,Thyroid Neoplasms ,Pathological ,Thyroid neoplasm ,Settore MED/06 - ONCOLOGIA MEDICA ,business.industry ,Odds ratio ,medicine.disease ,Confidence interval ,Lymph Node Excision ,Neoplasm Recurrence, Local ,Radiopharmaceuticals ,business - Abstract
Background: One of the most widely used risk stratification systems for estimating individual patients' risk of persistent or recurrent differentiated thyroid cancer (DTC) is the American Thyroid Association (ATA) guidelines. The 2015 ATA version, which has increased the number of patients considered at low or intermediate risk, has been validated in several retrospective, single-center studies. The aims of this study were to evaluate the real-world performance of the 2015 ATA risk stratification system in predicting the response to treatment 12 months after the initial treatment and to determine the extent to which this performance is affected by the treatment center in which it is used. Methods: A prospective cohort of DTC patients collected by the Italian Thyroid Cancer Observatory web-based database was analyzed. We reviewed all records present in the database and selected consecutive cases that satisfied inclusion criteria: (i) histological diagnosis of DTC, with the exclusion of noninvasive follicular thyroid neoplasm with papillary-like nuclear features; (ii) complete data of the initial treatment and pathological features; and (iii) results of 1-year follow-up visit (6-18 months after the initial treatment), including all data needed to classify the estimated response to treatment. Results: The final cohort was composed of 2071 patients from 40 centers. The ATA risk of persistent/recurrent disease was classified as low in 1109 patients (53.6%), intermediate in 796 (38.4%), and high in 166 (8.0%). Structural incomplete responses were documented in only 86 (4.2%) patients: 1.5% in the low-risk, 5.7% in the intermediate-risk, and 14.5% in the high-risk group. The baseline ATA risk class proved to be a significant predictor of structural persistent disease, both for intermediate-risk (odds ratio [OR] 4.67; 95% confidence interval [CI] 2.59-8.43) and high-risk groups (OR 16.48; CI 7.87-34.5). Individual center did not significantly influence the prediction of the 1-year disease status. Conclusions: The ATA risk stratification system is a reliable predictor of short-term outcomes in patients with DTC in real-world clinical settings characterized by center heterogeneity in terms of size, location, level of care, local management strategies, and resource availability.
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- 2021
91. Gene expression profile in metastatic and non-metastatic parathyroid carcinoma
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Liborio Torregrossa, Filomena Cetani, Maria Grazia Chiofalo, Giovanni Tallini, Claudio Marcocci, Elena Pardi, Vincenzo Condello, Lucia Anna Muscarella, Andrea Repaci, Maria Denaro, Francesco Boi, Paolo Piaggi, Anello Marcello Poma, Fulvio Basolo, Paolo Graziano, Simona Borsari, Gabriele Materazzi, Condello, Vincenzo, Cetani, Filomena, Denaro, Maria, Torregrossa, Liborio, Pardi, Elena, Piaggi, Paolo, Borsari, Simona, Poma, Anello Marcello, Muscarella, Lucia Anna, Graziano, Paolo, Grazia Chiofalo, Maria, Repaci, Andrea, Tallini, Giovanni, Boi, Francesco, Materazzi, Gabriele, Basolo, Fulvio, and Marcocci, Claudio
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0301 basic medicine ,Cancer Research ,Angiogenesis ,Endocrinology, Diabetes and Metabolism ,EMT process ,Biology ,Parathyroid carcinoma, Gene expression profile, metastasis ,Metastasis ,03 medical and health sciences ,HOTAIR ,0302 clinical medicine ,Endocrinology ,medicine ,Humans ,primary hyperparathyroidism ,Gene ,ECM ,Neovascularization, Pathologic ,medicine.disease ,Hepatic stellate cell activation ,030104 developmental biology ,Parathyroid Neoplasms ,Oncology ,Parathyroid carcinoma ,Tumor progression ,030220 oncology & carcinogenesis ,Cancer research ,Transcriptome ,Primary hyperparathyroidism - Abstract
Parathyroid carcinoma (PC) is one of the rarest and aggressive malignancies of the endocrine system. In some instances, the histological diagnosis remains uncertain unless there is evidence of gross local invasion or secondary spread. The identification of molecular markers could improve the diagnostic accuracy of these lesions. The expression of 740 genes involved in the tumor progression processes was assessed in 8 parathyroid adenomas (PAs), 17 non-metastatic and 10 metastatic PCs using NanoString technology. Clustering analysis and Ingenuity Pathway Analysis (IPA) were interrogated to compare the gene expression profiles among the three analyzed groups and to evaluate the potential role of differentially expressed genes, respectively. The 103 differentially expressed genes between metastatic PCs and PAs are able to discriminate perfectly the two groups from a molecular point of view. The molecular signatures identified in non-metastatic PCs vs PAs and in metastatic PCs vs non-metastatic PCs comparisons, although with some exceptions, seem to be histotype-specific IPA reveals that hepatic fibrosis/hepatic stellate cell activation and GP6 signaling pathway are involved in malignant behavior of parathyroid tumors, whereas the activation of the HOTAIR regulatory pathway are involved in the metastatization process. Our investigation identified differentially expressed genes in non-metastatic PCs mainly encoding ECM proteins and in metastatic PCs driving endothelial-to-mesenchymal transition or encoding mediators of angiogenesis. The identified genes might be promising molecular markers potentially useful in the clinical practice for the early diagnosis and prognosis of PC.
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- 2020
92. In memoriam: Renato Pasquali (1946–2019)
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Uberto Pagotto, Andrea Repaci, Flaminia Fanelli, Carla Pelusi, Alessandra Gambineri, Valentina Vicennati, Paola Altieri, Danilo Ribichini, Silvia Garelli, Guido Di Dalmazi, Gambineri, Alessandra, Vicennati, Valentina, Di Dalmazi, Guido, Pelusi, Carla, Altieri, Paola, Fanelli, Flaminia, Repaci, Andrea, Garelli, Silvia, Ribichini, Danilo, and Pagotto, Uberto
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medicine.medical_specialty ,Endocrinology ,Endocrinology, Diabetes and Metabolism ,Internal medicine ,Philosophy ,medicine ,NA ,General Medicine ,Humanities - Abstract
NA
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- 2020
93. BRAF V600E Status and Stimulated Thyroglobulin at Ablation Time Increase Prognostic Value of American Thyroid Association Classification Systems for Persistent Disease in Differentiated Thyroid Carcinoma
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Michelangelo Fiorentino, Alexandro Paccapelo, Annalisa Altimari, Giovanni Tallini, Uberto Pagotto, Fabio Monari, Andrea Repaci, Dario de Biase, Elisa Gruppioni, Nicola Salituro, Valentina Vicennati, Ottavio Cavicchi, Repaci, Andrea, Vicennati, Valentina, Paccapelo, Alexandro, Cavicchi, Ottavio, Salituro, Nicola, Monari, Fabio, de Biase, Dario, Tallini, Giovanni, Altimari, Annalisa, Gruppioni, Elisa, Fiorentino, Michelangelo, and Pagotto, Uberto
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medicine.medical_specialty ,Article Subject ,endocrine system diseases ,Endocrinology, Diabetes and Metabolism ,medicine.medical_treatment ,030209 endocrinology & metabolism ,Gastroenterology ,lcsh:Diseases of the endocrine glands. Clinical endocrinology ,Thyroid carcinoma ,03 medical and health sciences ,0302 clinical medicine ,Endocrinology ,Text mining ,Internal medicine ,medicine ,Thyroid cancer ,Thyroid Carcinoma, Cancer prognosis, BRAF V600E, Thyroglobulin measurement, Thyroid ablation ,lcsh:RC648-665 ,Receiver operating characteristic ,Endocrine and Autonomic Systems ,business.industry ,Thyroid ,medicine.disease ,Ablation ,Persistent Disease ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Thyroglobulin ,business ,Research Article - Abstract
Background. Stimulated thyroglobulin levels measured at the time of remnant ablation (A-hTg) and BRAFV600E mutation had shown prognostic value in predicting persistent disease in differentiated thyroid cancer (DTC). The aim of this study was to evaluate the prognostic role of A-hTg combined with the BRAFV600E status in association with the revised American Thyroid Association (ATA) risk stratification. Material and Methods. 620 patients treated for a DTC were included in this study with a median follow-up duration of 6.1 years. All patients underwent total thyroidectomy followed by radioiodine ablation. Patients with positive anti-thyroglobulin antibodies were excluded. The predictive value of A-hTg was calculated by receiver operating characteristic curve (ROC curve) analysis. The Cox proportional hazard regression model, including the BRAF status, A-hTg, and ATA classification system, was assessed to evaluate the existing persistent disease risk. Results. Taken together, the BRAF status and A-hTg levels improve the ATA risk classification in all categories. In particular, in the low-risk ATA classification, only the combination of BRAFV600E+A-hTg>8.9ng/ml was associated with persistent disease (P=0.001, HR 60.2, CI 95% 5.28-687). In the intermediate-risk ATA classification, BRAFWT+A-hTg>8.9ng/ml was associated with persistent disease (P=0.029, HR 2.71, CI 95% 1.106-6.670) and BRAFV600E+A-hTg>8.9ng/ml was also associated with persistent disease (P<0.001, HR 5.001, CI 95% 2.318-10.790). In the high-risk ATA classification, both BRAFV600E+A-hTg<8.9ng/ml and BRAFV600E+A-hTg>8.9 ng/ml were associated with persistent disease (P=0.042, HR 5.963, CI 95% 1.069-33.255 and P=0.002, HR 11.564, CI 95% 2.543-52.576, respectively). Conclusions. The BRAF status and stimulated thyroglobulin levels at ablation time improve the ATA risk stratification of differentiated thyroid cancer; therefore, even A-hTg could be included in risk classification factors.
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- 2019
94. Defining Hyperandrogenism in Women With Polycystic Ovary Syndrome: A Challenging Perspective
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Danilo Ribichini, Andrea Repaci, Renato Pasquali, Alessandra Gambineri, Antonio Maria Morselli Labate, Flaminia Fanelli, Marco Mezzullo, Alessia Fazzini, Laura Zanotti, Pasquali, Renato, Zanotti, Laura, Fanelli, Flaminia, Mezzullo, Marco, Fazzini, Alessia, MORSELLI LABATE, ANTONIO MARIA, Repaci, Andrea, Ribichini, Danilo, and Gambineri, Alessandra
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Adult ,Blood Glucose ,0301 basic medicine ,Hirsutism ,medicine.medical_specialty ,Adolescent ,Endocrinology, Diabetes and Metabolism ,Clinical Biochemistry ,030209 endocrinology & metabolism ,Biochemistry ,Young Adult ,03 medical and health sciences ,Follicle-stimulating hormone ,0302 clinical medicine ,Endocrinology ,Sex hormone-binding globulin ,Sex Hormone-Binding Globulin ,Internal medicine ,Humans ,Insulin ,Medicine ,Testosterone ,Androstenedione ,hirsutism ,biology ,business.industry ,Free androgen index ,Biochemistry (medical) ,Hyperandrogenism ,Luteinizing Hormone ,medicine.disease ,Lipids ,Polycystic ovary ,Cross-Sectional Studies ,Phenotype ,030104 developmental biology ,biology.protein ,Female ,Follicle Stimulating Hormone ,business ,Luteinizing hormone ,Polycystic Ovary Syndrome - Abstract
Objective: This study was designed to assess the steroid profiling by liquid chromatography coupled with tandem mass spectrometry in PCOS women with different phenotypes. Design: Cross-sectional study. Setting: University hospital of Bologna, Italy. Patients and Methods: A total of 156 PCOS women and 141 controls comparable for age were investigated. All underwent a steroid profiling by liquid chromatography coupled with tandem mass spectrometry. Metabolic parameters were also investigated and hirsutism was measured by the modified Ferriman-Gallwey (mF-G) score. Results: Three distinct phenotypes were initially defined according to the combination of hirsutism (mF-G ≥ 8) and/or high testosterone (T) (HA), oligo-amenorrhea (OA), and polycystic ovarian morphology (PCOm); OA + PCOm (n = 43), HA + OA (n = 65), and HA + OA + PCOm (n = 45). T, androstenedione (A), and free androgen index (FAI) levels progressively increased in the 3 PCOS phenotypes with respect to the controls, with the highest values in the HA + OA + PCOm phenotype. The various combinations of hirsutism, high T, high A, and high FAI made it possible to categorize the 3 original phenotypes into 8 hyperandrogenic subgroups, characterized by divergent additional steroid profile and metabolic pattern. A total of 90% of patients with PCOS thus proved hyperandrogenic. Interestingly, half the PCOS women originally classified as having the OA-PCOm phenotype were categorized in a hyperandrogenic subgroup. No significant correlation was found between T, A, and the mF-G score. In contrast, significant correlation was found between A and both T and FAI. Conclusions: This study provides evidence that, by including a steroid profile in the definition of hyperandrogenemia, the majority of women with PCOS are hyperandrogenic, although a clinical and biochemical heterogeneity exists. In addition, these data demonstrate that hirsutism and high androgen levels cannot be used indifferently to define hyperandrogenism.
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- 2016
95. Profiling plasma N-Acylethanolamine levels and their ratios as a biomarker of obesity and dysmetabolism
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Alessandra Gambineri, Marco Mezzullo, Guido Di Dalmazi, Daniela Ibarra Gasparini, Uberto Pagotto, Andrea Repaci, Antonio Maria Morselli-Labate, Marianna Mastroroberto, Ilaria Belluomo, Flaminia Fanelli, Valentina Vicennati, Renato Pasquali, Fanelli, Flaminia, Mezzullo, Marco, Repaci, Andrea, Belluomo, Ilaria, Ibarra Gasparini, Daniela, Di Dalmazi, Guido, Mastroroberto, Marianna, Vicennati, Valentina, Gambineri, Alessandra, Morselli-Labate, Antonio Maria, Pasquali, Renato, and Pagotto, Uberto
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0301 basic medicine ,Male ,N-oleoylethanolamide ,BMI, body mass index ,Overweight ,chemistry.chemical_compound ,0302 clinical medicine ,Medicine ,2. Zero hunger ,Aged, 80 and over ,PEA, N-palmitoylethanolamide ,OB, obese ,Middle Aged ,EC, endocannabinoid ,3. Good health ,Menopause ,N-palmitoylethanolamide ,HOMA-IR, homeostatic model assessment of insulin resistance ,Cholesterol ,Ethanolamines ,lipids (amino acids, peptides, and proteins) ,Female ,Original Article ,medicine.symptom ,Waist Circumference ,NAE, N-acylethanolamine ,Adult ,2AG, 2-arachidonoylglycerol ,medicine.medical_specialty ,lcsh:Internal medicine ,Waist ,Endocannabinoid system ,DBP, diastolic blood pressure ,030209 endocrinology & metabolism ,OW, overweight ,AEA, N-arachidonoylethanolamide ,Dysmetabolism ,OEA, N-oleoylethanolamide ,03 medical and health sciences ,Insulin resistance ,Lipid oxidation ,Internal medicine ,Humans ,Obesity ,lcsh:RC31-1245 ,Molecular Biology ,Triglycerides ,Aged ,Int., interaction ,Triglyceride ,NW, normal weight ,business.industry ,SBP, systolic blood pressure ,Cell Biology ,Anandamide ,medicine.disease ,HDL, high density lipoprotein ,030104 developmental biology ,Endocrinology ,chemistry ,business ,SD, standard deviation ,Body mass index ,Biomarkers ,ECS, endocannabinoid system - Abstract
Objective N-acylethanolamines play different roles in energy balance; anandamide (AEA) stimulates energy intake and storage, N-palmitoylethanolamide (PEA) counters inflammation, and N-oleoylethanolamide (OEA) mediates anorectic signals and lipid oxidation. Inconsistencies in the association of plasma N-acylethanolamines with human obesity and cardiometabolic risk have emerged among previous studies, possibly caused by heterogeneous cohorts and designs, and by unstandardized N-acylethanolamine measurements. We aimed to characterize changes in the plasma profile, including N-acylethanolamine levels and ratios associated with obesity, menopause in women, and ageing in men, and to define the significance of such a profile as a biomarker for metabolic imbalance. Methods Adult, drug-free women (n = 103 premenopausal and n = 81 menopausal) and men (n = 144) were stratified according to the body mass index (BMI) into normal weight (NW; BMI: 18.5–24.9 kg/m2), overweight (OW; BMI: 25.0–29.9 kg/m2), and obese (OB; BMI ≥30.0 kg/m2). Anthropometric and metabolic parameters were determined. Validated blood processing and analytical procedures for N-acylethanolamine measurements were used. We investigated the effect of BMI and menopause in women, and BMI and age in men, as well as the BMI-independent influence of metabolic parameters on the N-acylethanolamine profile. Results BMI and waist circumference directly associated with AEA in women and men, and with PEA in premenopausal women and in men, while BMI directly associated with OEA in premenopausal women and in men. BMI, in both genders, and waist circumference, in women only, inversely associated with PEA/AEA and OEA/AEA. Menopause increased N-acylethanolamine levels, whereas ageing resulted in increasing OEA relative abundance in men. AEA and OEA abundances in premenopausal, and PEA and OEA abundances in lean menopausal women, were directly associated with hypertension. Conversely, PEA and OEA abundances lowered with hypertension in elderly men. Insulin resistance was associated with changes in N-acylethanolamine ratios specific for premenopausal (reduced PEA/AEA and OEA/AEA), menopausal (reduced OEA/AEA) women and men (reduced OEA/AEA and OEA/PEA). PEA and OEA levels increased with total cholesterol, and OEA abundance specifically increased with HDL-cholesterol. Elevated triglyceride levels were associated with increased N-acylethanolamine levels only in menopausal women. Conclusions Obesity-related N-acylethanolamine hypertone is characterized by imbalanced N-acylethanolamine ratios. The profile given by a combination of N-acylethanolamine absolute levels and ratios enables imbalances to be identified in relationship with different metabolic parameters, with specific relevance according to gender, menopause and age, representing a useful means for monitoring metabolic health. Finally, N-acylethanolamine system appears a promising target for intervention strategies., Highlights • Obesity is featured by plasma N-acylethanolamine excess and imbalanced ratios. • AEA excess is a biomarker of abdominal fat irrespectively of sex and menopause/age. • PEA and OEA protect from hypertension in gender and menopause/age specific fashion. • AEA excess in women and OEA deficiency in men are biomarkers of insulin resistance. • High AEA in men and low OEA in men and menopausal women reflect low HDL-cholesterol.
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- 2018
96. Mutant MYO1F alters the mitochondrial network and induces tumor proliferation in thyroid cancer
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Andrea Repaci, Anne M. Bowcock, Natascia Tiso, Romana Fato, Elena Bonora, Kerry J. Rhoden, Christian Bergamini, Uberto Pagotto, Francesco Argenton, Cecilia Evangelisti, Anna Maria Porcelli, Andrea Vettori, Chiara Diquigiovanni, Rita Casadio, Giulia Babbi, Marco Seri, Giorgio Lenaz, Federica Isidori, Hima Anbunathan, Anna Costanzini, Giovanni Romeo, Luisa Iommarini, Diquigiovanni, Chiara, Bergamini, Christian, Evangelisti, Cecilia, Isidori, Federica, Vettori, Andrea, Tiso, Natascia, Argenton, Francesco, Costanzini, Anna, Iommarini, Luisa, Anbunathan, Hima, Pagotto, Uberto, Repaci, Andrea, Babbi, Giulia, Casadio, Rita, Lenaz, Giorgio, Rhoden, Kerry J., Porcelli, Anna Maria, Fato, Romana, Bowcock, Anne, Seri, Marco, Romeo, Giovanni, and Bonora, Elena
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0301 basic medicine ,Male ,Cancer Research ,Embryo, Nonmammalian ,Protein Conformation ,Papillary ,Mutant ,MYO1F ,Non-Medullary Thyroid Carcinoma ,TCO locus ,mitochondrial network ,whole exome sequencing ,Apoptosis ,Thyroid Cancer ,Exon ,0302 clinical medicine ,80 and over ,Child ,Zebrafish ,Thyroid cancer ,Exome sequencing ,Cells, Cultured ,Aged, 80 and over ,Cultured ,Nonmammalian ,Thyroid ,Middle Aged ,non-medullary thyroid carcinoma ,Adolescent ,Adult ,Aged ,Animals ,Chromosomes, Human, Pair 19 ,Female ,Genetic Predisposition to Disease ,Genotype ,Humans ,Mitochondria ,Myosin Type I ,Oxygen Consumption ,Pedigree ,Thyroid Cancer, Papillary ,Thyroid Neoplasms ,Young Adult ,Cell Proliferation ,Mutation ,medicine.anatomical_structure ,Oncology ,Embryo ,030220 oncology & carcinogenesis ,Human ,Cells ,TCO locu ,Locus (genetics) ,Biology ,Chromosomes ,03 medical and health sciences ,medicine ,Mitochondrial network ,Pair 19 ,Non-medullary thyroid carcinoma ,Whole exome sequencing ,biology.organism_classification ,medicine.disease ,Molecular biology ,Exon skipping ,030104 developmental biology - Abstract
Familial aggregation is a significant risk factor for the development of thyroid cancer and familial non-medullary thyroid cancer (FNMTC) accounts for 5-7% of all NMTC. Whole exome sequencing analysis in the family affected by FNMTC with oncocytic features where our group previously identified a predisposing locus on chromosome 19p13.2, revealed a novel heterozygous mutation (c.400G > A, NM_012335; p.Gly134Ser) in exon 5 of MYO1F, mapping to the linkage locus. In the thyroid FRTL-5 cell model stably expressing the mutant MYO1F p.Gly134Ser protein, we observed an altered mitochondrial network, with increased mitochondrial mass and a significant increase in both intracellular and extracellular reactive oxygen species, compared to cells expressing the wild-type (wt) protein or carrying the empty vector. The mutation conferred a significant advantage in colony formation, invasion and anchorage-independent growth. These data were corroborated by in vivo studies in zebrafish, since we demonstrated that the mutant MYO1F p.Gly134Ser, when overexpressed, can induce proliferation in whole vertebrate embryos, compared to the wt one. MYO1F screening in additional 192 FNMTC families identified another variant in exon 7, which leads to exon skipping, and is predicted to alter the ATP-binding domain in MYO1F. Our study identified for the first time a role for MYO1F in NMTC.
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- 2018
97. Large deletion at the CDC73 gene locus and search for predictive markers of the presence of a CDC73 genetic lesion
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Andrea Repaci, Massimiliano Copetti, Renato Franco, Alfredo Scillitani, Uberto Pagotto, Nunzia Simona Losito, Luigia Cinque, Danilo de Martino, Orazio Palumbo, Annamaria la Torre, Lucia Anna Muscarella, Andrea Fontana, Filomena Baorda, Vito Guarnieri, Maria Grazia Chiofalo, Paolo Graziano, Luciano Pezzullo, Daniela Turchetti, Muscarella, Lucia Anna, Turchetti, Daniela, Fontana, Andrea, Baorda, Filomena, Palumbo, Orazio, la Torre, Annamaria, de Martino, Danilo, Franco, Renato, Losito, Nunzia Simona, Repaci, Andrea, Pagotto, Uberto, Cinque, Luigia, Copetti, Massimiliano, Chiofalo, Maria Grazia, Pezzullo, Luciano, Graziano, Paolo, Scillitani, Alfredo, and Guarnieri, Vito
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0301 basic medicine ,Gynecology ,medicine.medical_specialty ,Muscarella ,business.industry ,030209 endocrinology & metabolism ,Locus (genetics) ,Gene mutation ,CDC73 ,03 medical and health sciences ,Large genomic deletion ,030104 developmental biology ,0302 clinical medicine ,Innovative Therapies ,Oncology ,HPT-JT ,Medicine ,In patient ,Parathyroid surgery ,business ,Snp array analysis ,Early onset ,Research Paper - Abstract
// Lucia Anna Muscarella 1, * , Daniela Turchetti 2, * , Andrea Fontana 3, * , Filomena Baorda 4 , Orazio Palumbo 4 , Annamaria la Torre 1, 5 , Danilo de Martino 6 , Renato Franco 7 , Nunzia Simona Losito 7 , Andrea Repaci 8 , Uberto Pagotto 8 , Luigia Cinque 4 , Massimiliano Copetti 3 , Maria Grazia Chiofalo 9 , Luciano Pezzullo 9 , Paolo Graziano 10 , Alfredo Scillitani 11 and Vito Guarnieri 4 1 Laboratory of Oncology, IRCCS Casa Sollievo della Sofferenza Hospital, San Giovanni Rotondo 71013, Italy 2 Medical Genetics, Sant’Orsola Malpighi Hospital, University of Bologna, Bologna 40138, Italy 3 Unit of Biostatistics, IRCCS Casa Sollievo della Sofferenza Hospital, San Giovanni Rotondo 71013, Italy 4 Medical Genetics, IRCCS Casa Sollievo della Sofferenza Hospital, San Giovanni Rotondo 71013, Italy 5 ISBReMIT, Institute for Stem-cell Biology, Regenerative Medicine and Innovative Therapies, IRCCS Casa Sollievo della Sofferenza Hospital, San Giovanni Rotondo 71013, Italy 6 Thoracic Surgery, IRCCS Casa Sollievo della Sofferenza Hospital, San Giovanni Rotondo 71013, Italy 7 Pathology , Istituto Nazionale Tumori, Fondazione “G. Pascale”, Napoli 80131, Italy 8 Endocrinology, Sant’Orsola Malpighi Hospital, University of Bologna, Bologna 40138, Italy 9 Thyroid and Parathyroid Surgery Unit, Istituto Nazionale Tumori, Fondazione “G. Pascale”, Napoli 80131, Italy 10 Pathology, IRCCS Casa Sollievo della Sofferenza Hospital, San Giovanni Rotondo 71013, Italy 11 Endocrinology, IRCCS Casa Sollievo della Sofferenza Hospital, San Giovanni Rotondo 71013, Italy * These authors contributed equally to this work Correspondence to: Vito Guarnieri, email: v.guarnieri@operapadrepio.it Keywords: CDC73; large genomic deletion; HPT-JT; early onset Received: November 11, 2017 Accepted: March 20, 2018 Published: April 17, 2018 ABSTRACT The Hyperparathyroidism with Jaw-Tumours syndrome is caused by mutations of the CDC73 gene: it has been suggested that early onset of the disease and high Ca 2+ levels may predict the presence of a CDC73 mutation. We searched for large deletions at the CDC73 locus in patients with: HPT-JT (nr 2), atypical adenoma (nr 7) or sporadic parathyroid carcinoma (nr 11) with a specific MLPA and qRT-PCR assays applied on DNA extracted from whole blood. A Medline search in database for all the papers reporting a CDC73 gene mutation, clinical/histological diagnosis, age at onset, Ca 2+ , PTH levels for familial/sporadic cases was conducted with the aim to possibly identify biochemical/clinical markers predictive, in first diagnosis, of the presence of a CDC73 gene mutation. A novel genomic deletion of the first 10 exons of the CDC73 gene was found in a 3-generation HPT-JT family, confirmed by SNP array analysis. A classification tree built on the published data, showed the highest probability of having a CDC73 mutation in subjects with age at the onset 13.96 mg/dL are predictive for the presence of a CDC73 genetic lesion.
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- 2018
98. Molecular pathology of thyroid tumours of follicular cells: a review of genetic alterations and their clinicopathological relevance
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Andrea Repaci, Kerry J. Rhoden, Tallini Giovanni, Annalisa Pession, Michela Visani, Giorgia Acquaviva, Dario de Biase, Acquaviva, Giorgia, Visani, Michela, Repaci, Andrea, Rhoden, Kerry J., de Biase, Dario, Pession, Annalisa, and Giovanni, Tallini
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0301 basic medicine ,endocrine system ,Histology ,Adenoma ,endocrine system diseases ,medicine.disease_cause ,Malignancy ,Pathology and Forensic Medicine ,poorly differentiated thyroid carcinoma ,Thyroid carcinoma ,03 medical and health sciences ,follicular thyroid carcinoma ,0302 clinical medicine ,Poorly Differentiated Thyroid Carcinoma ,molecular pathology ,Follicular phase ,Adenocarcinoma, Follicular ,medicine ,thyroid cancer ,Humans ,Thyroid Neoplasms ,Thyroid cancer ,Thyroid neoplasm ,business.industry ,Molecular pathology ,anaplastic thyroid carcinoma ,General Medicine ,thyroid marker ,medicine.disease ,030104 developmental biology ,Thyroid Epithelial Cells ,030220 oncology & carcinogenesis ,Cancer research ,papillary thyroid carcinoma ,thyroid tumour ,business - Abstract
Thyroid cancer is the most common endocrine malignancy. Knowledge of the molecular pathology of thyroid tumours originating from follicular cells has greatly advanced in the past several years. Common molecular alterations, such as BRAF p.V600E, RAS point mutations, and fusion oncogenes (RET-PTC being the prototypical example), have been, respectively, associated with conventional papillary carcinoma, follicular-patterned tumours (follicular adenoma, follicular carcinoma, and the follicular variant of papillary carcinoma/non-invasive follicular thyroid neoplasm with papillary-like nuclear features), and with papillary carcinomas from young patients and arising after exposure to ionising radiation, respectively. The remarkable correlation between genotype and phenotype shows how specific, mutually exclusive molecular changes can promote tumour development and initiate a multistep tumorigenic process that is characterised by aberrant activation of mitogen-activated protein kinase and phosphoinositide 3-kinase-PTEN-AKT signalling. Molecular alterations are becoming useful biomarkers for diagnosis and risk stratification, and as potential treatment targets for aggressive forms of thyroid carcinoma. What follows is a review of the principal genetic alterations of thyroid tumours originating from follicular cells and of their clinicopathological relevance.
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- 2017
99. 18F-FDG Pet-Guided External Beam Radiotherapy in Iodine-Refractory Differentiated Thyroid Cancer: A Pilot Study
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Alessio G. Morganti, Paolo Castellucci, Renzo Mazzarotto, Fabio Monari, Giovanni Frezza, E. Farina, Arianna Farina, F. Romani, Giuseppe Zanirato Rambaldi, Luca Tagliaferri, Francesco Deodato, Savino Cilla, Vincenzo Valentini, Andrea Repaci, Rosa Autorino, Stefano Fanti, Silvia Cammelli, Gabriella Macchia, Farina, Eleonora, Monari, Fabio, Castellucci, Paolo, Romani, Fabrizio, Repaci, Andrea, Farina, Arianna, Giuseppe Zanirato, Rambaldi, Frezza, Giovanni, Mazzarotto, Renzo, Cammelli, Silvia, Tagliaferri, Luca, Autorino, Rosa, Deodato, Francesco, Macchia, Gabriella, Cilla, Savino, Valentini, Vincenzo, Fanti, Stefano, and Morganti, Alessio G.
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Article Subject ,Endocrinology, Diabetes and Metabolism ,medicine.medical_treatment ,18F-FDG PET/CT external beam radiotherapy Iodine-refractory differentiated thyroid cancer ,Scintigraphy ,lcsh:Diseases of the endocrine glands. Clinical endocrinology ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Refractory ,thyroid cancer ,Medicine ,External beam radiotherapy ,EBRT ,Prospective cohort study ,Thyroid cancer ,Settore MED/36 - DIAGNOSTICA PER IMMAGINI E RADIOTERAPIA ,lcsh:RC648-665 ,medicine.diagnostic_test ,business.industry ,18F-FDG PET/CT ,medicine.disease ,Clinical trial ,Radiation therapy ,030220 oncology & carcinogenesis ,18F-FDG PET/CT, thyroid cancer, EBRT ,Clinical Study ,Thyroglobulin ,business ,Nuclear medicine - Abstract
Introduction. To evaluate the clinical response rate after a postoperative 18F-FDG PET/CT guided external beam radiotherapy (EBRT) in Iodine-refractory differentiated thyroid cancer. Material and Methods. Patients with thyroid cancer locally recurrent after total thyroidectomy plus metabolic radiotherapy and treated with radical EBRT were included. Inclusion criteria were detectable thyroglobulin (Tg), negative postmetabolic radiotherapy whole body scintigraphy, and no surgical indications. The pretreatment 18F-FDG PET/CT resulted positive in all cases (loggia, lymph nodes, and lung). EBRT was delivered with IMRT-SIB technique. A 18F-FDG PET/CT revaluation and Tg dosage were performed 3 months after the treatment. Results. Sixteen consecutive patients were included in this analysis (median follow-up: 6–44 months). Post-EBRT 18F-FDG PET/CT showed CR in 43.7%, PR in 31.2%, SD in 25.0% patients, and PD due to lung metastases in 12.5%. Overall response rate was 75.0% (CI 95%: 41.4–93.3%). Tg levels decreased in 75.0% with a median Δ of 68.0%. Two-year PFS and OS rates were 80.0% and 93.0%, respectively. Acute G3 toxicity occurred in 18.7% and late G2 toxicity in 12.5%. Conclusions. 18F-FDG PET/CT was useful in target definition for radiotherapy planning, identifying positive areas not detected with 131I scintigraphy. IMRT based EBRT was feasible and our results encourage future prospective studies. This clinical trial is registered with ID: NCT03191643.
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- 2017
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100. Tablet and oral liquid L-thyroxine formulation in the treatment of naive hypothyroid patients with Helicobacter pylori infection
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Giulia Fiorini, Valentina Castelli, Andrea Repaci, Danilo Ribichini, Dino Vaira, Renato Pasquali, Luigi Gatta, Ribichini, Danilo, Fiorini, Giulia, Repaci, Andrea, Castelli, Valentina, Gatta, Luigi, Vaira, Dino, and Pasquali, Renato
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Male ,Endocrinology, Diabetes and Metabolism ,Thyroid Gland ,Thyrotropin ,Gastroenterology ,Group A ,Severity of Illness Index ,Group B ,0302 clinical medicine ,Endocrinology ,biology ,Middle Aged ,Anti-Bacterial Agents ,030220 oncology & carcinogenesis ,Gastritis ,Drug Therapy, Combination ,Female ,medicine.symptom ,Tablets ,Adult ,medicine.medical_specialty ,endocrine system ,Autoimmune Gastritis ,Hormone Replacement Therapy ,030209 endocrinology & metabolism ,Helicobacter Infections ,03 medical and health sciences ,Young Adult ,Pharmacotherapy ,Hypothyroidism ,Pituitary Gland, Anterior ,Internal medicine ,Diabetes mellitus ,medicine ,Humans ,Dyspepsia ,Dispepsia ,Helicobacter pylori ,business.industry ,biology.organism_classification ,medicine.disease ,Anti-Ulcer Agents ,L-thyroxine ,Thyroxine ,Intestinal Absorption ,business ,Hormone - Abstract
To compare the clinical efficacy of tablet and oral liquid L-thyroxine (LT4) formulation in naïve hypothyroid subjects with Helicobacter pylori infection. Forty-seven adult naïve hypothyroid subjects with dyspeptic symptoms were investigated with upper endoscopy and divided into: 28 patients with Helicobacter pylori infection (Group A); 15 patients without gastric alterations (group B); 4 patients with autoimmune gastritis were excluded from the study. Subjects were randomly treated with a same dose of LT4 tablet (TAB) or oral liquid formulation (SOL), for 9 months on group A and 6 months on group B. Helicobacter pylori infection was eradicated after 3 months of LT4 treatment. On group A, after 3 months (before Helicobacter pylori eradication), subjects treated with SOL showed a greater thyroid-stimulating hormone reduction (ÎTSH3â0: TAB = â4.1 ± 4.6 mU/L; SOL = â7.7 ± 2.5 mU/L; p = 0.029) and a greater homogeneity in the thyroid-stimulating hormone values (TSH3mo: TAB = 5.7 ± 4.9 mU/L; SOL = 4.1 ± 2.0 mU/L; p = 0.025), compared to LT4 tablet. At 9 months (after 6 months of Helicobacter pylori eradication) mean thyroid-stimulating hormone values were lower in subjects treated with LT4 tablet (TSH9mo: TAB = 1.8 ± 1.2 mU/L; SOL = 3.2 ± 1.7 mU/L; p = 0.006). On group B no difference were observed, at each time point, in the mean thyroid-stimulating hormone values and thyroid-stimulating hormone variations between two LT4 formulations. LT4 liquid formulation may produce a better clinical response compared to the tablet formulation in hypothyroid subjects with Helicobacter pylori infection.
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- 2017
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