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Possible association between hepatitis C virus and malignancies different from hepatocellular carcinoma:A systematic review

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World Journal of Gastroenterology 2015年第45期21卷 12896-12953页

作者： Sirio Fiorino Letizia Bacchi-Reggiani Dario de Biase Adele Fornelli Michele Masetti Andrea Tura Fabio Grizzi Matteo Zanello Laura Mastrangelo Raffaele Lombardi Giorgia Acquaviva Luca di Tommaso Arrigo Bondi Michela Visani Sergio Sabbatani Laura Pontoriero Carlo Fabbri Andrea Cuppini Annalisa Pession Elio Jovine Unità Operativa di Medicina Interna Ospedale di Budrio dipartimento di Medicina Sperimentale Istituto di Cardiologia Policlinico S. Orsola-Malpighi Università degli Studi di Bologna dipartimento di Medicina Sperimentale Università di Bologna Unità Operativa Biologia Molecolare Anatomia Patologica Ospedale Bellaria Servizio di anatomia patologica Ospedale Maggiore Unità Operativa di Chirurgia A Ospedale Maggiore Institute of Neuroscience National Research Council Humanitas Clinical and Research Center Rozzano dipartimento di Farmacia e Biotecnologie Università di Bologna Istituto di Malattie Infettive Policlinico S. Orsola-Malpighi Università degli Studi di Bologna Unità di Cura Materno-Infantile Distretto Lametino U.O. Endoscopia Ospedale Maggiore

AIM: To summarize the current knowledge about the potential relationship between hepatitis C virus(HCV) infection and the risk of several extra-liver cancers. METHODS: We performed a systematic review of the literature, according to the Preferred Reporting Items for Systematic reviews and Meta-Analysis(PRISMA) Statement. We extracted the pertinent articles, published in MEDLINE and the Cochrane Library, using the following search terms: neoplasm/cancer/malignancy/tumor/carcinoma/adeno-carcinoma and non-Hodgkin lymphomas, kidney/renal-, cholangio-, pancreatic-, thyroid-, breast-,oral-, skin-, prostate-, lung-, colon-, stomach-, haematologic. Case series, case-series with control-group, case-control, cohort-studies as well as meta-analyses, written in English were collected. Some of the main characteristics of retrieved trials, which were designed to investigate the prevalence of HCV infection in each type of the above-mentioned human malignancies were summarised. A main table was defined and included a short description in the text for each of these tumours, whether at least five studies about a specific neoplasm, meeting inclusion criteria, were available in literature. According to these criteria, we created the following sections and the corresponding tables and we indicated the number of included or excluded articles, as well as of meta-analyses and reviews:(1) HCV and haematopoietic malignancies;(2) HCV and cholangiocarcinoma;(3) HCV and pancreatic cancer;(4) HCV and breast cancer;(5) HCV and kidney cancer;(6) HCV and skin or oral cancer; and(7) HCV and thyroid cancer. RESULTS: According to available data, a clear correlation between regions of HCV prevalence and risk of extra-liver cancers has emerged only for a very small group of types and histological subtypes of malignancies. In particular, HCV infection has been associated with:(1) a higher incidence of some B-cell Non-HodgkinLymphoma types, in countries, where an elevated prevalence of this pathogen is de

关键词： Neoplasm Cancer Hepatitis C virus Risk factors Ext

Complete pancreatic heterotopia of gallbladder with hypertrophic duct simulating an adenomyoma

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World Journal of Gastroenterology 2006年第11期12卷 1786-1787页

作者： Luca Pilloni Alessandro Cois Alessandro Uccheddu Rossano Ambu Pierpaolo Coni Gavino Faa Istituto di anatomia patologica dipartimento di Citomorfologia Universita degli Studi di CagliariItaly Semeiotica Chirurgica dipartimento Chirurgico Materno Infantile e di Scienze delle Immagini Università degli Studi di CagliariItaly Istituto di anatomia patologica dipartimento di Citomorfologia Università degli Studi di CagliariItaly

The gallbladder is an unusual location of pancreatic heterotopia, defined as the presence of pancreatic tissue lacking anatomical and vascular continuity with the main body of the gland. A 28-year-old man presented with anorexia, nausea and pain in the right upper abdomen. On physical examination, the abdomen was tender to palpation and Murphy sign was positive. The patient underwent a cholecystecomy. This case, in our opinion, is very interesting since it permits to consider a controversial issue in the pathology of the gallbladder. The histological appearance of ductal structure in pancreatic heterotopia resembles the histological picture of both Aschoff-Rokitansky （AR） sinuses and adenomyomas. This finding suggests that these lesions are linked by a common histogenetic origin. We suggest that the finding of an adenomyoma in the gallbladder should prompt an extensive sampling of the organ in order to verify the coexistence of pancreatic rests.

关键词： Pancreatic heterotopia Gallbladder Hypertrophic duct Adenomyoma Aschoff-Rokitansky sinuses

Anti-tumor necrosis factor α therapy associates to type 17 helper T lymphocytes immunological shift and significant microbial changes in dextran sodium sulphate colitis

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World Journal of Gastroenterology 2019年第12期25卷 1465-1477页

作者： Valentina Petito Cristina Graziani Loris R Lopetuso Marco Fossati Alessandra Battaglia Vincenzo Arena Domenico Scannone Gianluca Quaranta Andrea Quagliariello Federica Del Chierico Lorenza Putignani Luca Masucci Maurizio Sanguinetti Alessandro Sgambato Antonio Gasbarrini Franco Scaldaferri Istituto di Patologia Speciale Medica Università Cattolica del Sacro Cuore uoc di Medicina Interna e Gastroenterologia Area di Gastroenterologia e Oncologia Medica Dipartimento di Scienze Gastroenterologiche Endocrino-Metaboliche e Nefro-Urologiche Fondazione Policlinico Universitario "A. Gemelli" IRCCS dipartimento delle Scienze della Salute della Donna e del Bambino Fondazione Policlinico Universitario "A. Gemelli" IRCCS Istituto di Clinica Ostetrica e Ginecologica Università Cattolica del Sacro Cuore U.O.S.A. Gineco-Patologia e Patologia Mammaria Fondazione Policlinico Universitario "A. Gemelli" IRCCS Istituto di anatomia patologica Università Cattolica del Sacro Cuore dipartimento di anatomia patologica e Istologia Fondazione Policlinico Universitario "A. Gemelli" IRCCS dipartimento di Microbiologia Fondazione Policlinico Universitario "A. Gemelli" IRCCS Istituto di Microbiologia Università Cattolica del Sacro Cuore Unità di Microbioma Umano Ospedale Pediatrico Bambino Gesù IRCCS Unità di Parassitologia Ospedale Pediatrico Bambino Gesù IRCCS Istituto di Patologia Generale Università Cattolica del Sacro Cuore

BACKGROUND Anti-tumor necrosis factor α(TNFα) represents the best therapeutic option to induce mucosal healing and clinical remission in patients with moderate-severe ulcerative colitis. On the other side gut microbiota plays a crucial role in pathogenesis of ulcerative colitis but few information exists on how microbiota changes following anti-TNFα therapy and on microbiota role in mucosal *** To elucidate whether gut microbiota and immune system changes appear following anti TNFα therapy during dextran sulfate sodium(DSS) *** Eighty C57 BL/6 mice were divided into four groups: "No DSS", "No DSS + antiTNFα", "DSS" and "DSS + anti-TNFα". "DSS" and "DSS + anti-TNFα" were treated for 5 d with 3% DSS. At day 3, mice whithin "No DSS+anti-TNFα" and"DSS+anti-TNFα" group received 5 mg/kg of an anti-TNFα agent. Forty mice were sacrificed at day 5, forty at day 12, after one week of recovery post DSS. The severity of colitis was assessed by a clinical score(disease Activity Index), colon length and histology. Bacteria such as Bacteroides, Clostridiaceae, Enterococcaceae and Fecalibacterium prausnitzii(F. prausnitzii) were evaluated by quantitative *** 1 helper T lymphocytes(Th1), type 17 helper T lymphocytes(Th17) and CD4+ regulatory T lymphocytes(Treg) distributions in the mesenteric lymph node(MLN) were studied by flow *** Bacteria associated with a healthy state(i.e., such as Bacteroides, Clostridiaceae and F. prausnitzii) decreased during colitis and increased in course of anti-TNFαtreatment. Conversely, microorganisms belonging to Enterococcaceae genera,which are linked to inflammatory processes, showed an opposite ***, in colitic mice treated with anti-TNFα microbial changes were associated with an initial increase(day 5 of the colitis) in Treg cells and a consequent decrease(day 12 post DSS) in Th1 and Th17 frequency cells. Healthy mice treated with anti-TNFα showed the same histological, microbial and immune featur

关键词： Gut microbiota Dextran sodium sulphate colitis Immune system T cells Mesenchymal lymphnode Tumor necrosis factor α

A histomorphometric,prospective long-term study of bone loss in glucocorticoid treated patients:prednisone versus deflazacort

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A histomorphometric,prospective long-term study of bone loss...

Intratumoral sampling variability in hepatocellular carcinoma: A case report

第二届国际骨质疏松研讨会

作者： Vincenzo LoCascio Paola Ballanti Francesco Bertoldo Elisabetta M.Zanolin Ermanno Bonucci Università di Verona Dipartimento di Medicina Sperimentale e PatologiaSezione di Anatomia Patologica

＜正＞Introduction Osteoporosis is a common and well known side-effect of corticosteroid-therapy（1） and an effective form of prevention should be administration of a glucocorticoid with minor osteopenic ***,an oxazolinic derivative of prednisolone,is reported to have fewer effects on bone cell function and bone mass than other equally effective corticosteroids（2,3）.However,comparative long-term studies of the time course of steroid-induced bone loss are requested before the "bone sparing" effect of deflazacort can be *** conducted a prospective long-term study to compare the prednisone and deflazacort effects on trabecular bone mass using histomorphometric analysis of iliac bone.

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World Journal of Gastroenterology 2007年第29期13卷 4019-4021页

作者： Giancarlo Senes Daniela Fanni Alessandro Cois Alessandro Uccheddu Gavino Faa dipartimento di Citomorfologia Divisione di Anatomia Patologica University of Cagliari Cagliari Italy dipartimento Chirurgico Materno Infantile e di Scienze delle Immagini Clinica Chirurgica University of Cagliari Cagliari Italy

The differential diagnosis between hepatocellular carcinoma （HCC） and regenerative liver nodules and other primary liver tumors may be very difficult, particularly when performed on liver biopsies. difficulties in histological typing may be often minimized by immunohistochemistry. Among the numerous markers proposed, CK18, Hep Par1 and glypican 3 （GPC3） are considered the most useful in HCC diagnosis. Here we report a case of HCC in a 72-year-old male with HBV- related chronic liver disease, characterized by a marked morphological and immunohistochemical intratumoral variability. In this case, tumor grading ranged from areas extremely well differentiated, similar to regenerative nodule, to undifferentiated regions, with large atypical multinucleated cells. While almost all sub nodules were immunostained by Hep Par 1, immunoreactivity for glypican 3 and for Ckl8 was patchy, with negative tumor region adjacent to the highly immunoreactive areas. Our case stresses the relevance of sampling variability in the diagnosis of HCC, and indicates that caution should be taken in grading an HCC and in the interpretation of immunohistochemical stains when only small core biopsies from liver nodules are available.

关键词： Liver Hepatocellular carcinoma Sampling variability Hep Par 1 GPC3 differentiation

Human cytomegalovirus and Epstein-Barr virus infection in inflammatory bowel disease:Need for mucosal viral load measurement

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World Journal of Gastroenterology 2015年第6期21卷 1915-1926页

作者： Rachele Ciccocioppo Francesca Racca Stefania Paolucci Giulia Campanini Lodovica Pozzi Elena Betti Roberta Riboni Alessandro Vanoli Fausto Baldanti Gino Roberto Corazza Centre for the Study and Cure of Inflammatory Bowel disease Clinica Medica I IRCCS San Matteo Hospital Foundation University of Pavia SS Virologia Molecolare - SC Virologia e Microbiologia Fondazione IRCCS Policlinico San Matteo Servizio di Endoscopia digestiva Fondazione IRCCS Policlinico San Matteo Servizio di anatomia patologica Fondazione IRCCS Policlinico San Matteo

AIM:To evaluate the best diagnostic technique and risk factors of the human Cytomegalovirus(HCMV)and Epstein-Barr virus(EBV)infection in inflammatory bowel disease(IBD).METHODS:A cohort of 40 IBD patients(17 refractory)and 40 controls underwent peripheral blood and endoscopic colonic mucosal sample *** infection was assessed by quantitative real-time polymerase chain reaction and immunohistochemistry,and correlations with clinical and endoscopic indexes of activity,and risk factors were ***:All refractory patients carried detectable levels of HCMV and/or EBV mucosal load as comparedto 13/23(56.5%)non-refractory and 13/40(32.5%)*** median DNA value was significantly higher in refractory(HCMV 286 and EBV 5.440 copies/105cells)than in non-refractory(HCMV 0 and EBV 6copies/105 cells;Pdiseased mucosa in comparison to non-diseased mucosa(Pdisplayed levels below this threshold,thus allowing us to differentiate viral colitis from mucosal ***,the mucosal load positively correlated with the values found in the peripheral blood,whilst no correlation with the number of positive cells at immunohistochemistry was *** use was identified as a significant risk factor for both HCMV(P=0.018)and EBV(P=0.002)***,a course of specific antiviral therapy with ganciclovir was successful in all refractory patients with HCMV colitis,whilst refractory patients with EBV colitis did not show any improvement despite steroid tapering and discontinuation of the other ***:Viral colitis appeared to contribute to mucosal lesions in refractory IBD,and its correct diagnosis and management require quantitative real-time polymerase chain reaction assay of mucosal specime

关键词： Inflammatory bowel disease quantitative real-time

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 ***: 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(differentiation 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

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

Giardia lamblia infection in patients with irritable bowel syndrome and dyspepsia:A prospective study

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World Journal of Gastroenterology 2006年第12期12卷 1941-1944页

作者： Barbara Grazioli Giovanni Matera Costanza Laratta Giuseppina Schipani Giovanni Guarnieri Ester Spiniello Maria Imeneo Andrea Amorosi Alfredo Focà Francesco Luzza dipartimento di Medicina Sperimentale e Clinica Cattedra di Gastroenterologia Università di Catanzaro 'Magma Graecia' Catanzaro Italy dipartimento di Scienze Mediche Istituto di Microbiologia Università di Catanzaro 'Magna Graecia' Catanzaro Italy dipartimento di Medicina Sperimentale e Clinica Cattedra di Anatomia Patologica Universith di Catanzaro 'Magna Graecia' Catanzaro Italy

AIM： To evaluate the prevalence of Giardia lamblia （G. lamblia） infection in patients with irritable bowel syndrome （IBS） and dyspepsia and to establish which is the most accurate test to diagnose the infection in this setting. METHODS： One hundred and thirty-seven patients who consecutively attended the Outpatient Gastroenterology Clinic for the first time between January 2002 and Decernber 2003 due to symptoms of IBS and/or dyspepsia were recruited. All patients underwent clinical evaluation, first-step haematology and chemistry tests, serologic assays for celiac disease, lactose-H2 breath test, abdominal ultrasonography, and esophagogastroduodenoscopy. Helicobacterpylon status was evaluated. In patients with symptoms of IBS older than 45 years, colonoscopy was also performed. In all patients, duodenal biopsies and stool samples were examined for trophozoites and cysts of G. lamblia by several methods. RESULTS： G. lamblia was identified in 9 patients. The following diagnoses were also made： IBS （100/137, 73%）, functional dyspepsia （62/137, 45%）, organic dyspepsia （33/137, 24%）, and lactose intolerance （75/137, 55%）. A significant association was found between giardiasis and H pylori infection （x^2= 6.632, OR= 12.4, CI= 1.5-68.1）. There were no symptoms that reliably allowed the recognition of giardiasis. direct search of the parasite in duodenal biopsy and stool sample examinations gave concordant results in all cases while histological examination of duodenal biopsies displayed a low sensitivity （e.g., 22.2%）. CONCLUSION： In this consecutive series, diagnosis of *** infection accounted for 6.5% of patients with IBS and dyspepsia. Duodenal biopsies for diagnosis of giardiasis may be unnecessary if stool sample examination is performed.

关键词： Dyspepsia Giardiasis H pylori Irritablebowel syndrome

Interleukin-6 and its soluble receptor in patients with liver cirrhosis and hepatocellular carcinoma

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World Journal of Gastroenterology 2006年第16期12卷 2563-2568页

作者： Soresi Maurizio Giannitrapani Lydia D'Antona Fabio Florena Ada Maria La Spada Emanuele Terranova Angela Cervello Melchiorre D'Alessandro Natale Montalto Giuseppe dipartimento di Medicina Clinica e delle Patologie Emergenti Policlinico UniversitarioPalermoItaly Istituto di anatomia ed Istologia patologica Policlinico UniversitarioPalermoItaly Istituto di Biomedicina ed Immunologia Molecolare C.N.R.PalermoItaly dipartimento di Scienze Farmacologiche Pohclinico UniversitarioPalermoItaly

AIM： To evaluate the immunohistochemical localization of interleukin-6 （IL-6） and IL-6 receptor （IL-6R） on tumor tissue specimens from patients with hepatocellular carcinoma （HCC） and the serum levels of IL-6 and sIL-6R in a group of patients with HCC as well as liver cirrhosis （LC） in a group of patients with LC alone and in a control group. METHODS： Three groups of subjects were studied： group Ⅰ （n =83） suffering from HCC and LC, group Ⅱ （n = 72） suffering from LC alone and group Ⅲ （n =42） as healthy controls. All patients had hepatitis C virus infection. Serum IL-6 and IL-6R levels were determined using a commercially available ELISA kit. Immunohistochemistry was performed using the streptavidin-biotin complex and rabbit polyclonal antibodies against IL-6 and IL-6R. RESULTS： Immunohistochemistry analysis showed a medium to strong cytoplasmic and membrane reactivity for IL-6 and IL-6R respectively, in at least 40% of cases of HCC, whereas liver cirrhosis patients and controls were negative for IL-6 or showed a very mild and focal dot-like cytoplasmic reaction for IL-6R. Serum IL-6 levels in HCC group were significantly higher than those in LC and control groups （P〈 0.0001）. There was no significant difference in sIL-6R concentrations among 3 groups. When the patients with HCC were divided into groups according to Okuda＇s classification, a significant serum increase of IL-6 and slL-6R level was observed from stage Ⅰ to stage Ⅲ （P〈0.02, P〈0.0005）. When HCC and LC patients were divided into 3 classes of cirrhosis severity according to Child-Pugh, values in HCC patients were significantly higher than those in LC patients for each corresponding class （P〈 0.01）. CONCLUSION： IL-6 serum levels in HCC patients are higher than those in LC patients and controls, suggesting an increased production of this cytokine by neoplastic cells, sIL-6R values are similar in all groups, increasing only in stage III HCC patients. These data suggest that they have a closer relationship wit

关键词： Interleukin-6 Cytokine Chronic liver disease Immunohistochemistry