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Relevant incidental findings at abdominal multi-detector contrast-enhanced computed tomography:A collateral screening?

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World Journal of Radiology 2015年第10期7卷 350-356页

作者： Luca Maria Sconfienza giovanni Mauri Claudia Muzzupappa Alessandro Poloni Michele Bandirali Anastassia Esseridou Stefania Tritella Francesco Secchi giovanni di leo Francesco Sardanelli Servizio di Radiologia IRCCS Policlinico San Donato dipartimento di Scienze Biomediche per la Salute Università degli Studi di Milano Scuola di Specia-lizzazione in Radiodiagnostica Università degli Studi di Milano

AIM: To investigate the prevalence of relevant incidental findings(RIFs) detected during routine abdominal contrast-enhanced computed tomography(Ce CT).METHODS: We retrospectively evaluated the reports of a consecutive series of abdominal Ce CT studies performed between January and May 2013. For each report, patients' age and sex, admission as inpatient or outpatient, clinical suspicion as indicated by the requesting physician, availability of a previous abdominal examination, and name of the reporting radiologist were recorded. Based on the clinical suspicion, the presence and features of any RIFs(if needing additional workup) was ***: One thousand forty abdominal Ce CT were performed in 949 patients(528 males, mean age 66 ±14 years). No significant difference was found between inpatients and outpatients age and sex distribution(P > 0.472). RIFs were found in 195/1040(18.8%) Ce CT [inpatients = 108/470(23.0%); outpatients = 87/570(15.2%); P = 0.002]. RIFs were found in 30/440(6.8%) Ce CT with a previous exam and in 165/600(27.5%) without a previous exam(P diologists' distribution between inpatients or outpatients was significantly different(P diagnosis should be taken into account.

关键词： Contrast-enhanced computed tomography Abdomen Inci

Reporting rotator cuff tears on magnetic resonance arthrography using the Snyder's arthroscopic classification

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World Journal of Radiology 2017年第3期9卷 126-133页

作者： Alberto Aliprandi Carmelo Messina Paolo Arrigoni Michele Bandirali giovanni di leo Stefano Longo Sandro Magnani Chiara Mattiuz Filippo Randelli Silvana Sdao Francesco Sardanelli Luca Maria Sconfienza Pietro Randelli Servizio di Radiologia IRCCS Policlinico San Donato Scuola di Specializzazione in Radiodiagnostica Università degli Studi di Milano Unità Operativa di Ortopedia e Traumatologia Ⅱ IRCCS Policlinico San Donato dipartimento di Scienze Biomediche per la Salute Università degli Studi di Milano Unità Operativa di Ortopedia e Traumatologia V IRCCS Policlinico San Donato Unità Operativa di Radiologia/diag-nostica per Immagini con Servizio di Radiologia Interventistica IRCCS Istituto Ortopedico Galeazzi Unità Operativa Complessa I Divisione Istituto Ortopedico Gaetano Pini

AIM To determine diagnostic performance of magnetic resonance arthrography(MRA) in evaluating rotator cuff tears(RCTs) using Snyder's classification for *** One hundred and twenty-six patients(64 males, 62 females; median age 55 years) underwent shoulder MRA and arthroscopy, which represented our reference standard. Surgical arthroscopic reports were reviewed and the reported Snyder's classification was recorded. MRA examinations were evaluated by two independent radiologists(14 and 5 years' experience) using Snyder's classification system, blinded to arthroscopy. Agreement between arthroscopy and MRA on partial-and fullthickness tears was calculated, first regardless of their extent. Then, analysis took into account also the extent of the tear. Interobserver agreement was also calculated the quadratically-weighted Cohen kappa *** On arthroscopy, 71/126 patients(56%) had a fullthickness RCT. The remaining 55/126 patients(44%) had a partial-thickness RCT. Regardless of tear extent, out of 71 patients with arthroscopically-confirmed fullthickness RCTs, 66(93%) were correctly scored by both readers. All 55 patients with arthroscopic diagnosis of partial-thickness RCT were correctly assigned as having a partial-thickness RCT at MRA by both readers. Interobserver reproducibility analysis showed total agreement between the two readers in distinguishing partial-thickness from full-thickness RCTs, regardless of tear extent(k = 1.000). With regard to tear extent, in patients in whom a complete tear was correctly diagnosed, correct tear extent was detected in 61/66 cases(92%); in the remaining 5/66 cases(8%), tear extent was underestimated. Agreement was k = 0.955. Interobserver agreement was total(k = 1.000).CONCLUSION MRA shows high diagnostic accuracy and reproducibility in evaluating RCTs using the Snyder's classification for reporting. Snyder's classification may be adopted for routine reporting of MRA.

关键词： Arthroscopy Magnetic resonance imaging Shoulder Arthrography Supraspinatus tendon Rotator cuff tear

Occurrence and patterns of nutritional traits and polycyclic aromatic hydrocarbons(PAHs)in sea cucumber(Holothuria poli)tissues:benefits and risk for human health

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Food Quality and Safety 2022年第2期6卷 287-309页

作者： Francesca Biandolino Isabella Parlapiano Lucia Spada Antonella di leo Maria Calo giovanni Fanelli Ermelinda Prato Santina Giandomenico CNR-IRSA National Research CouncilWater Research Institute--Via Roma 3TarantoItaly

Objectives:The paper evaluates the benefit and risk for human health associated with consumption of sea cucumber Holothuria poli(*** from Italian coasts(Central Mediterranean Sea).Materials and Methods:Body wall(BW),internal tunic(ITu),muscle bands(MBs),alimentary canal(AC),gonad(Gd),and respiratory tree(RT)of *** were analyzed for proximate ***,amino acids(AAs),fatty acids(FAs)and polycyclic aromatic hydrocar bons(PAHs)were determined with high-performance liquid chromatography coupled with ultraviolet-visible spectroscopy(UPLC UV/Vis),gas chromatography-flame ionization detector(GC-FID)and gas chromatography mass spectrometry(GC-MS),***:differences in the contents of total amino acids(TAAs)occurred based on tissue and sex,with AC and MB of female and Gd of male showing higher contents(range 47.8-60.2 g/kg we weight(ww)).Glycine and glutamic acid were the most *** fatty acid(PUFA)was the major class of FAs and arachidonic acid and eicosapentenoic acid(EPA)were the predominant PUFA.n-3 PUFA showed higher content in Gd,AC,and RT,indicating higher quality.A favorable n-3/n-6 in the range of 1.04-1.67 was *** showed values ranging from 23 to 207μg/kg ww with the highest levels in Gd and AC tissues and the lower in ***[alpyrene,the most toxic compound,was detected in all tissues,of both sexes,at levels of 1.5-18μg/kg ***:All tissues of ***,although with differences among them,are valuable food and can contribute for a healthy *** cancer risk(CR)values for Gd and AC tissues were above the considerable CR threshold of one in 10000 established by the United States Environmental Protection Agency(USEPA)for high ingestion rate of this seafood.

关键词： Holothuria poli,nutitional quality polycyclic aromatic hydrocarbons risk assessment estimated weekly intake cancer risk

diagnosis, treatment, and current concepts in the endoscopic management of gastroenteropancreatic neuroendocrine neoplasms

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World Journal of Gastroenterology 2022年第34期28卷 4943-4958页

作者： Giuseppe Iabichino Milena di leo Monica Arena giovanni Giuseppe Rubis Passoni Elisabetta Morandi Francesca Turpini Paolo Viaggi Carmelo Luigiano Luca De Luca digestive Endoscopy Unit ASST Santi Paolo e CarloMilano 20144Italy Gastroenterology Section Grande Ospedale Metropolitano“Bianchi-Melacrino-Morelli”Reggio Calabria 89124Italy

Gastroenteropancreatic neuroendocrine neoplasms(GEP-NENs)are rare tumors derived from the neuroendocrine cell system,which that have increased in incidence and prevalence in recent *** improvements in radiological and metabolic imaging,endoscopy still plays a pivotal role in the number of *** detection,characterization,and staging are essential in management and treatment *** and lower gastrointestinal(GI)endoscopy is essential for correct localization of the primary tumor site of GI *** ultrasonography(EUS)has an important role in the imaging and tissue acquisition of pancreatic NENs and locoregional staging of GI neuroendocrine *** staging and histological diagnosis have important prognostic *** operating techniques allow the removal of small GI NENs in the early stage of mucosal or submucosal invasion of the intestinal *** EUS-guided techniques may help the surgeon locate small and deep tumors,thus avoiding formal pancreatic resections in favor of parenchymal-sparing ***,locoregional ablative treatments have been proposed in recent studies with promising results in selected patients.

关键词： Neuroendocrine neoplasms Gastrointestinal endoscopy Endoscopic resection Endoscopic ultrasound Ablative technique Tissue acquisition

Gastric cancer: Current status of lymph node dissection

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World Journal of Gastroenterology 2016年第10期22卷 2875-2893页

作者： Maurizio Degiuli giovanni De Manzoni Alberto di leo Domenico D'Ugo Erica Galasso Daniele Marrelli Roberto Petrioli Karol Polom Franco Roviello Francesco Santullo Mario Morino Department of Surgery University of TurinCitta della Salute e della Scienza Department of Surgery University of VeronaOspedale Borgo Trento division of Surgery Ospedale di Arco Department of Surgery University "Cattolica del Sacro Cuore""A.Gemelli" University Hospital Department of Surgery University of Siena Department of Oncology University of Siena Department of Surgery Wielkopolskie Centrum Onkologii

D2 procedure has been accepted in Far East as the standard treatment for both early(EGC) and advanced gastric cancer(AGC) for many decades. Recently EGC has been successfully treated with endoscopy by endoscopic mucosal resection or endoscopic submucosal dissection, when restricted or extended Gotoda's criteria can be applied and D1+ surgery is offered only to patients not fitted for less invasive treatment. Furthermore, two randomised controlled trials(RCTs) have been demonstrating the non inferiority of minimally invasive technique as compared to standard open surgery for the treatment of early cases and recently the feasibility of adequate D1+ dissection has been demonstrated also for the robot assisted technique. In case of AGC the debate on the extent of nodal dissection has been open for many decades. While D2 gastrectomy was performed as the standard procedure in eastern countries, mostly based on observational and retrospective studies, in the west the Medical Research Council(MRC), Dutch and Italian RCTs have been conducted to show a survival benefit of D2 over D1 with evidence based medicine. Unfortunately both the MRC and the Dutch trials failed to show a survival benefit after the D2 procedure, mostly due to the significant increase of postoperative morbidity and mortality, which was referred to splenopancreatectomy. Only 15 years after the conclusion of its accrual, the Dutch trial could report a significant decrease of recur-rence after D2 procedure. Recently the long term survival analysis of the Italian RCT could demonstrate a benefit for patients with positive nodes treated with D2 gastrectomy without splenopancreatectomy. As nowadays also in western countries D2 procedure can be done safely with pancreas preserving technique and without preventive splenectomy, it has been suggested in several national guidelines as the recommended procedure for patients with AGC.

关键词： Gastric cancer Lymph node dissection Lymphadenectomy D2 gastrectomy D1 gastrectomy D1 plus gastrectomy Robot assisted lymphadenectomy Laparoscopic lymphadenectomy

New fecal test for non-invasive Helicobacter pylori detection:A diagnostic accuracy study

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World Journal of Gastroenterology 2018年第27期24卷 3021-3029页

作者： Andrea Iannone Floriana Giorgio Francesco Russo Giuseppe Riezzo Bruna Girardi Maria Pricci Suetonia C Palmer Michele Barone Mariabeatrice Principi giovanni FM Strippoli Alfredo di leo Enzo Ierardi Section of Gastroenterology Department of Emergency and Organ TransplantationUniversity of BariBari 70124Italy Department of Emergency and Organ Transplantation University of BariBari 70124Italy THD SpA Correggio(Reggio Emilia)42015Italy National Institute of Gastroenterology “S De Bellis”Research HospitalCastellanaGrotte(Bari)70013Italy Department of Medicine University of Otago ChristchurchChristchurch 8011New Zealand diaverum Academy Lund 22229Sweden diaverum Medical Scientific Office Lund 22229Sweden Sydney School of Public Health University of SydneySydney NSW-2000Australia Section of Nephrology Department of Emergency and Organ TransplantationUniversity of BariBari 70124Italy

AIM To assess the diagnostic accuracy of a new fecal test for detecting Helicobacter pylori(H. pylori), using ^(13)Curea breath test as the reference standard, and explore bacterial antibiotic resistance. METHODS We conducted a prospective two-center diagnostic test accuracy study. We enrolled consecutive people≥ 18 years without previous diagnosis of H. pylori infection, referred for dyspepsia between February and October 2017. At enrollment, all participants underwent 13 C-urea breath test. Participants aged over 50 years were scheduled to undergo upper endoscopy with histology. Participants collected stool samples 1-3 d after enrollment for a new fecal investigation(THD fecal test). The detection of bacterial 23 S rRNA subunit gene indicated H. pylori infection. We also used the index diagnostic test to examine mutations conferring resistance to clarithromycin and levofloxacin. Independent investigators analyzed index test and reference test standard results blinded to the other test findings. We estimated sensitivity, specificity, positive(PPV) and negative(NPV) predictive value, diagnostic accuracy, positive and negative likelihood ratio(LR), together with 95% confidence intervals(CI).RESULTS We enrolled 294 consecutive participants(age: Median 37.0 years, IQR: 29.0-46.0 years; men: 39.8%). Ninetyfive(32.3%) participants had a positive ^(13)C-urea breath test. Twenty-three(7.8%) participants underwent upper endoscopy with histology, with a full concordance between ^(13)C-urea breath test and histology in detecting H. pylori infection. Four(1.4%) out of the 294 participants withdrew from the study after the enrollment visit and did not undergo THD fecal testing. In the 290 participants who completed the study, the THD fecal test sensitivity was 90.2%(CI: 84.2%-96.3%), specificity 98.5%(CI:96.8%-100%), PPV 96.5%(CI: 92.6%-100%), NPV 95.6%(CI: 92.8%-98.4%), accuracy 95.9%(CI: 93.6%-98.2%), positive LR 59.5(CI: 19.3-183.4), negative LR 0.10(CI: 0.05-0.18). Out of 8

关键词： Helicobacter pylori Fecal test Feces Stools 23S rRNA Molecular analysis Antibiotic resistance diagnostic accuracy

Molecular alterations in pancreatic tumors

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World Journal of Gastroenterology 2021年第21期27卷 2710-2726页

作者： Michela Visani Giorgia Acquaviva Antonio De leo Viviana Sanza Lidia Merlo Thais Maloberti Alba ABrandes Enrico Franceschi Monica di Battista Michele Masetti Elio Jovine Sirio Fiorino Annalisa Pession giovanni Tallini Dario de Biase Department of Experimental Diagnostic and Specialty MedicineUniversity of Bologna–Molecular Diagnostic UnitAzienda USL di BolognaBologna 40138Italy division of Molecular Pathology Laboratory IRCCS Azienda Ospedaliero-Universitaria di BolognaBologna 40138Italy Medical Oncology Department Azienda USL/IRCCS Istituto Delle Scienze Neurologiche di BolognaBologna 40139Italy division of Surgery IRCCS Azienda Ospedaliero-Universitaria di BolognaBologna 40133Italy Internal Medicine Unit Budrio Hospital Azienda USLBologna 40133Italy Department of Pharmacy and Biotechnology University of BolognaBologna 40138Italy

Genetic alterations in pancreatic tumors can usually be classified in:(1)Mutational activation of oncogenes;(2)Inactivation of tumor suppressor genes;and(3)Inactivation of genome maintenance genes controlling the repair of DNA *** ultrasound-guided fine-needle aspiration has improved preoperative diagnosis,but the management of patients with a pancreatic lesion is still *** testing could help mainly in solving these“inconclusive”*** introduction of multi-gene analysis approaches,such as next-generation sequencing,has provided a lot of useful information on the molecular characterization of pancreatic *** types of pancreatic tumors(e.g.,pancreatic ductal adenocarcinomas,intraductal papillary mucinous neoplasms,solid pseudopapillary tumors)are characterized by specific molecular *** aim of this review is to summarize the main molecular alterations found in pancreatic tumors.

关键词： Pancreatic tumors Molecular alterations Pancreatic ductal adenocarcinomas Intraductal papillary mucinous neoplasm Mutations Molecular markers

Correlation of molecular alterations with pathological features in hepatocellular carcinoma:Literature review and experience of an Italian center

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World Journal of Gastroenterology 2022年第25期28卷 2854-2866页

作者： Thais Maloberti Antonio De leo Viviana Sanza Elisa Gruppioni Annalisa Altimari Mattia Riefolo MichelaVisani Deborah Malvi Antonia D’Errico giovanni Tallini Francesco Vasuri Dario de Biase Department of Experimental Diagnostic and Specialty MedicineUniversity of BolognaBologna 40138Italy Solid Tumor Molecular Pathology Laboratory IRCCS Azienda Ospedaliero-Universitaria di BolognaBologna 40138Italy Department of Pathology IRCCS Azienda Ospedaliero-Universitaria di BolognaBologna 40138Italy Department of Pharmacy and biotechnology(FaBiT) University of BolognaBologna 40138Italy

Hepatocellular carcinoma(HCC)represents the primary carcinoma of the liver and the fourth leading cause of cancer-related *** World Health Organization estimates an increase in cases in the coming *** risk factors of HCC are multiple,and the incidence in different countries is closely related to the different risk factors to which the population is *** molecular mechanisms that drive HCC tumorigenesis are extremely complex,but understanding this multistep process is essential for the identification of diagnostic,prognostic,and therapeutic *** development of multigenic nextgeneration sequencing panels through the parallel analysis of multiple markers can provide a landscape of the genomic status of the *** the literature and our preliminary data based on 36 HCCs,the most frequently altered genes in HCCs are TERT,CTNNB1,and *** the years,many groups have attempted to classify HCCs on a molecular basis,but a univocal classification has never been ***,statistically significant correlations have been found in HCCs between the molecular signature and morphologic features,and this leads us to think that it would be desirable to integrate the approach between anatomic pathology and molecular laboratories.

关键词： Hepatocarcinoma Mutation Next-generation sequencing Review TP53 CTNNB1 TERT

H pylori status and angiogenesis factors in human gastric carcinoma

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World Journal of Gastroenterology 2006年第34期12卷 5465-5472页

作者： Anita Mangia Annalisa Chiriatti Girolamo Ranieri Ines Abbate Maria Coviello giovanni Simone Francesco Alfredo Zito Severino Montemurro Antonello Rucci Alfredo di leo Stefania Tommasi Pasquale Berloco Jian Ming Xu Angelo Paradiso Clinical Experimental Oncology Laboratory National Cancer Institute 70126 Bari Italy Interventional Radiology Unit National Cancer Institute 70126 Bari Italy Chemical-Clinical-Microbiology and Immunology Laboratory Unit National Cancer Institute70126 Bari Italy Histopathology Unit National Cancer Institute 70126 Bari Italy Gastroenterology Surgical Unit National Cancer Institute Bari Italy Department of Emergency and Organ Transplantation Section of Gastroenterology University of Bari Italy Laboratory of Biochemistry IRCCS 'Saverio de Bellis' Castellana Grotte (BA) Italy Department of Gastrointestinal Cancer Beijing 307 Hospital Cancer Center Beijing China

AIM： To investigate H pylori expression in gastric cancer patients in relation to primary tumor angiogenic markers, such as microvessel density （MVD）, thymidine phosphorylase （TP）, vascular endothelial growth factor receptor-1 （VEGF-R1）, p53 and circulating VEGF levels. METHODS： Angiogenic markers were analyzed immunohistochemically in 56 primary gastric cancers. H pylori cytotoxin （vacA） and the cytotoxin-associated gene （cagA） amplification were evaluated using PCR assay. Serum H pylori IgG antibodies and serum/plasma circulating VEGF levels were detected in 39 and 38 patients by ELISA, respectively. RESULTS： A total of 69% of patients were positive for circulating IgG antibodies against Hpylori. cagA-positive H pylor/strains were found in 41% of gastric patients. vacA was found in 50% of patients; s1 strains were more highly expressed among vacA-positive patients. The presence of the s1 strain was significantly associated with cagA （P = 0.0001）. MVD was significantly correlated with both tumor VEGF expression （r = 0.361, P = 0.009） and serum VEGF levels （r = -0.347, P = 0.041）.Conversely, neither VEGF-R1 expression nor MVD was related to p53 expression. However, H pylori was not related to any angiogenic markers except for the plasma VEGF level （P = 0.026）. CONCLUSION： H pylori antigen is related to higher plasma VEGF levels, but not to angiogenic characteristics. It can be hypothesized that the toxic effects of H pylori on angiogenesis occurs in early preclinical disease phase or in long-lasting aggressive infections, but only when high H pylori IgG levels are persistent.

关键词： H pylori Gastric carcinoma Angiogenesis