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Post-transplantation hepatocellular carcinoma recurrence: Patterns and relation between vascularity and differentiation degree

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World Journal of Hepatology 2015年第2期7卷 276-284页

作者： Annarita Pecchi Giulia Besutti Mario De Santis Cinzia del Giovane Sofia Nosseir Giuseppe Tarantino Fabrizio Di Benedetto Pietro Torricelli Dipartimento di Diagnostica per Immagini Azienda Ospedaliero-Universitaria Policlinico di Modena Unità di Statistica Medica Dipartimento di Medicina Diagnostica Clinica e Sanità Pubblica Università di Modena e Reggio Emilia Dipartimento dei Laboratori Anatomia Patologica e Medicina Legale Università degli studi di Modena e Reggio Emilia Dipartimento Chirurgico Medico Odontoiatrico e di Scienze Morfologiche con interesse Trapiantologico Oncologico e di Medicina Rigenerativa Università di Modena e Reggio Emilia

AIM: To evaluate the relationship between hepatocellular carcinoma(HCC) vascularity and grade; to describe patterns and vascular/histopathological variations of post-transplantation recurrence.METHODS: This retrospective study included 165 patients(143 men, 22 women; median age 56.8 years, range 28-70.4 years) transplanted for HCC who had a follow-up period longer than 2 mo. Pre-transplantation dynamic computed tomography or magnetic resonance examinations were retrospectively reviewed, classifying HCC imaging enhancement pattern into hypervascular and hypovascular based on presence of wash-in during arterial phase. All pathologic reports of the explanted livers were reviewed, collecting data about HCC differentiation degree. The association between imaging vascular pattern and pathological grade was estimated using the Fisher exact test. All follow-up clinical and imaging data were reviewed for evidence of recurrence. Recurrence rate was calculated and imaging features of recurrent tumor were collected, classifying early and late recurrences based on timing(degree was collected where available. The presence of variations in imaging enhancement pattern and pathological grade between the primary tumor and the intrahepatic recurrence was evaluated and the association between imaging and histopatholgical variations was estimated by using the χ2 test. RESULTS: Of the 163 patients with imaging evidence of viable tumor, 156(95.7%) had hypervascular and 7(4.3%) hypovascular HCC. Among the 125 patients with evidence of viable tumor in the explanted liver, 19(15.2%) had grade 1, 56(44.8%) grade 2, 40(32%) grade 3 and 4(3.2%) grade 4 HCC, while the differentiation degree was not assessable for 6 patients(4.8%). A significant association was found between imaging vascularity and pathologi

关键词： Contrast media Hepatocellular carcinoma Liver transplantation Cell differentiation Recurrence

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Circulating tumor cells and the metastatic process: the complexity of malignancy

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Journal of Cancer Metastasis and Treatment 2018年第1期4卷 628-641页

作者： Tania Di Raimo Elena de santis Luigi Coppola mario Rosario D’Andrea Francesco Angelini Medical Oncology and Anatomic Pathology Unit San Filippo Neri HospitalRome 00135Italy Experimental&Clinical Pharmacology Centro Di Riferimento Oncologico-National Cancer CenterAviano(PN)33081Italy department of Anatomical HistologicalLegal Medical and of the Locomotor Apparatus SciencesSapienza UniversityRome 00135Italy Anatomic Pathology Unit Sandro Pertini HospitalRome 00157Italy

despite improvements achieved in terms of early detection and therapeutic approach,metastatic breast cancer remains one of the principal worldwide causes of death.In recent years,due to the heterogeneous response of each patient to chemotherapy,clinical research highlights the need of a personalized approach.Circulating tumor cells(CTCs)represents a promising tool for this purpose.Unfortunately,even if their correlation with sever-ity,outcome and metastatic nature of the tumor has been established,several issues,mainly concerning their characterization and isolation,need to be solved.In this review,latest knowledge on CTCs and metastatic pro-cess in breast cancer were analyzed,aiming to understand their clinical utility and validity for a prospective ther-apeutic scenario.

关键词： Breast cancer metastasis circulating tumor cells personalized therapy

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Intermittent gastric outlet obstruction due to a gallstone migrated through a cholecysto-gastric fistula:A new variant of “Bouveret’s syndrome”

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世界胃肠病学杂志：英文版 2008年第1期14卷 125-128页

作者： Dimitry Arioli Ivo Venturini Michele Masetti Elisa Romagnoli Antonella Scarcelli Pietro Ballesini Athos Borghi Alessandro Barberini Vincenzo Spina Mario De Santis Fabrizio Di Benedetto Giorgio Enrico Gerunda Maria Luisa Zeneroli Medicina Interna Ⅱ Department of Medicine and Medical Specialties Azienda Ospedaliera-Policlinico Università di Modena e Reggio Emilia Modena 41100 Italy Liver and Multivisceral Transplant Center Azienda Ospedaliera-Policlinico Università di Modena e Reggio Emilia Modena 41100 Italy Gastrointestinal Unit Department of Medicine and Medical Specialties Azienda Ospedaliera-Policlinico Università di Modena e Reggio Emilia Modena 41100 Italy department of Radiology and Liver and Multivisceral Transplant Center Azienda Ospedaliera-Policlinico Università di Modena e Reggio Emilia Modena 41100 Italy

Bouveret's syndrome, defined as gastric outlet obstruction due to a large gallstone, is still one of the most dramatic biliary gallstone complications. Although new radiological and endoscopic techniques have made pre-surgical diagnosis possible in most cases and the death rate has dropped dramatically, "one-stage surgery" (biliary surgery carried out at the same time as the removal of the gut obstruction) should be still considered as the gold standard for the treatment of gallstone ileus.In this case, partial gastric outlet obstruction resulted in an atypical and insidious clinical presentation that allowed us to perform the conventional one-stage laparatomic procedure that completely solved the problem, thus avoiding any further complications.

关键词：胆结石胃排空障碍外科学胆囊-胃瘘

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Systemic inflammation and immune response after laparotomy vs laparoscopy in patients with acute cholecystitis, complicated by peritonitis

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World Journal of Gastrointestinal Surgery 2013年第4期5卷 73-82页

作者： Federico Sista mario Schietroma Giuseppe de santis Antonella Mattei Emanuela Marina Cecilia Federica Piccione Sergio Leardi Francesco Carlei Gianfranco Amicucci department of Surgery University of L'Aquila department of Medicine Health and Environment Sciences University of L'Aquila

AIM: To evaluate acute cholecystitis, complicated by peritonitis, acute phase response and immunological status in patients treated by laparoscopic or open approach. METHODS: From January 2002 to May 2012, we conducted a prospective randomized study on 45 consecutive patients (27 women, 18 men; mean age 58 years). These subjects were taken from a total of 681 patients who were hospitalised presenting similar preoperative findings: acute upper abdominal pain with tenderness, involuntary guarding under the right hypochondrium and/or in the flank; fever higher than 38 ℃, leukocytosis greater than 10 × 10 9 /L or both, and ultrasonographic evidence of calculous cholecystitis possibly complicated by peritonitis. These patients had undergone cholecystectomy for acute calculous cholecystitis,complicated by bile peritonitis. Randomly, 23 patients were assigned to laparoscopic cholecystectomy (LC), and 22 patients to open cholecystectomy (OC). Blood samples were collected from all patients before operation and at days 1, 3 and 6 after surgery. Serum bacteraemia, endotoxaemia, white blood cells (WBCs), WBC subpopulations, human leukocyte antigen-DR (HLA-DR), neutrophil elastase, interleukin-1 (IL-1) and IL-6, and C-reactive protein (CRP) were measured at 0, 30, 60, 90, 120 and 180 min, at 4, 6, 12, 24 h, and then daily (8 A.M.) until post-operative day 6.RESULTS: The two groups were comparable in the severity of peritoneal contamination as indicated by the viable bacterial count (open group = 90% of positive cultures vs laparoscopic group = 87%) and endotoxin level (open group = 33.21 ± 6.32 pg/mL vs laparoscopic group = 35.02 ± 7.23 pg/mL). Four subjects in the OC group (18.1%) and 1 subject (4.3%) in the LC group (P developed intra-abdominal abscess. Severe leukocytosis (range 15.8-19.6/mL) was observed only after OC but not after LC, mostly due to an increase in neutrophils (days 1 and 3, P < 0.05). This value returned to the normal range within 3-4 d after LC and 5-7 d after OC. Other WBC types and lymphocyte s

关键词： Systemic inflammation Immune response Laparoscopy Cholecystectomy Bile peritonitis

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