Perturbation of specific transcripts in peripheral blood mononuclear cells in breast cancer: a case control pilot study

Introduction: Breast cancer (BC) is the most common type of diagnosed cancer worldwide and the leading cause of cancer death in women and it is the second most frequent cancer-causing mortality for women worldwide. Peripheral blood-based biopsy for BC could be a promising tool for risk prediction and diagnosis. In this study, we aimed to evaluate the gene expression profile of PBMCs in Italian patients with BC. Methods: In this case-control pilot study, we isolated PBMCs from 22 BC patients and 21 healthy controls and evaluated the expression of a panel of 52 target genes related to BC or circadian rhythm by a customized TaqMan Open Array Real-Time PCR panel. Results: Among the differentially expressed genes, 22 remained unchanged. These unchanged genes are mainly involved in cellular processes, including the circadian clock, cellular responses to stress/stimuli, the immune system, signal transduction, and metabolism. We found a total of 30 significantly de-regulated genes. In particular, 8 genes, including PARP6, IGFR1, EZH2, VEGFA, NOTCH1, CD44, BCAR1, and CD24A, resulted significantly down-regulated in patients with BC compared to Controls, while 22 genes were significantly up-regulated in BCs patients compared to Controls. We found several already reported BC-associated genes up-regulated in PBMCs of our BC patients, but FOXO3, ARNTL, and ADAM17 emerged as the most strongly up-regulated. The enrichment pathways analysis highlight that de-regulated genes are mainly involved in the regulation of gene expression and transcription, signal transduction, and immune system response. Discussion: The results of our pilot study demonstrated that the evaluation of PBMC gene signature could be a valuable tool for primary prevention and early diagnosis of BC in several high-risk settings, thus reducing the global mortality associated with this tumour. Take-home message: Non-invasive screening programs, particularly those adopted in workplaces, may have a great impact on early diagnosis and good prognosis for BC. Our study provided proof of concept that the development of a screening test based on PBMC-derived gene expression biomarkers could be a viable route

Monitoring COVID-19 transmission risks by quantitative real-time PCR tracing of droplets in hospital and living environments

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) environmental contamination occurs through droplets and biological fluids released in the surroundings from patients or asymptomatic carriers. Surfaces and objects contaminated by saliva or nose secretions represent a risk for indirect transmission of coronavirus disease 2019 (COVID-19). We assayed surfaces from hospital and living spaces to identify the presence of viral RNA and the spread of fomites in the environment. Anthropic contamination by droplets and biological fluids was monitored by detecting the microbiota signature using multiplex quantitative real-time PCR (qPCR) on selected species and massive sequencing on 16S amplicons. A total of 92 samples (flocked swabs) were collected from critical areas during the pandemic, including indoor (three hospitals and three public buildings) and outdoor surfaces exposed to anthropic contamination (handles and handrails, playgrounds). Traces of biological fluids were frequently detected in spaces open to the public and on objects that are touched with the hands (.80%). However, viral RNA was not detected in hospital wards or other indoor and outdoor surfaces either in the air system of a COVID hospital but only in the surroundings of an infected patient, in consistent association with droplet traces and fomites. Handled objects accumulated the highest level of multiple contaminations by saliva, nose secretions, and fecal traces, further supporting the priority role of handwashing in prevention. In conclusion, anthropic contamination by droplets and biological fluids is widespread in spaces open to the public and can be traced by qPCR. Monitoring fomites can support evaluation of indirect transmission risks for coronavirus or other flu-like viruses in the environment

De novo secondary adenocarcinoma in the colon used as urinary diversion not in contact with the fecal stream. Systematic review and meta-analysis

L'articolo descrive la correlazione tra infiammazione e formazione di adenocarcinoma nel colon trasposto chirurgicamente e non in contatto con le feci

Usefulness of Harmonic Focus During Axillary Lymph Node Dissection: A Prospective Study

Background: Axillary node dissection (ALND) is affected by various complications, (hematoma, seroma, lymphocele, infections). The aim of this study was to evaluate the effectiveness of Harmonic Focus (HF) in reducing these complications. Materials and Methods: 92 patients requiring ALND, were divided into two group: Group A (HF) (33 women, 14 men), and Group B (control) (28 women, 17 men). Results: Operating time was lower in Group A than in Group B. The amount of drain volume was lower in Group A than in Group B, the drain was removed earlier in Group A than in Group B. Seroma incidence was lower in Group A than in Group B. Conclusions: The use of HF during ALND is effective in reducing operating time, drain volume and complications

Selected Patients With Peritoneal Metastases From Breast Cancer May Benefit From Cytoreductive Surgery: The Results of a Multicenter Survey

Background: Even though breast cancer is the most frequent extra-abdominal tumor causing peritoneal metastases, clear clinical guidelines are lacking. Our aim is to establish whether cytoreductive surgery (CRS) could be considered in selected patients with peritoneal metastases from breast cancer (PMBC) to manage abdominal spread and allow patients to resume or complete other medical treatments. Methods: We considered patients with PMBC treated in 10 referral centers from January 2002 to May 2019. Clinical data included primary cancer characteristics (age, histology, and TNM) and data on metastatic disease (interval between primary BC and PM, molecular subtype, other metastases, and peritoneal spread). Overall survival (OS) was estimated using the Kaplan–Meier method. Univariate and multivariable data for OS were analyzed using the Cox proportional hazards model. Results: Of the 49 women with PMBC, 20 were treated with curative aim (CRS with or without HIPEC) and 29 were treated with non-curative procedures. The 10-year OS rate was 27%. Patients treated with curative intent had a better OS than patients treated with non-curative procedures (89.2% vs. 6% at 36 months, p < 0.001). Risk factors significantly influencing survival were age at primary BC, interval between BC and PM diagnosis, extra-peritoneal metastases, and molecular subtype. Conclusions: The improved outcome in selected cases after a multidisciplinary approach including surgery should lead researchers to regard PMBC patients with greater attention despite their scarce epidemiological impact. Our collective efforts give new information, suggest room for improvement, and point to further research for a hitherto poorly studied aspect of metastatic BC

Patterns of Care for Breast Radiotherapy in Italy: Breast IRRadiATA (Italian Repository of Radiotherapy dATA) Feasibility Study

Aim. Breast IRRADIATA (Italian Repository of RADIotherapy dATA) is a collaborative nationwide project supported by the Italian Society of Radiotherapy and Clinical Oncology (AIRO) and the Italian League Against Cancer (LILT). It focuses on breast cancer (BC) patients treated with radiotherapy (RT) and was developed to create a national registry and define the patterns of care in Italy. A dedicated tool for data collection was created and pilot tested. The results of this feasibility study are reported here. Methods. To validate the applicability of a user-friendly data collection tool, a feasibility study involving 17 Italian Radiation Oncology Centers was conducted from July to October 2021, generating a data repository of 335 BC patients treated between January and March 2020, with a minimum follow-up time of 6 months. A snapshot of the clinical presentation, treatment modalities and radiotherapy toxicity in these patients was obtained. A Data Entry Survey and a Satisfaction Questionnaire were also sent to all participants. Results. All institutions completed the pilot study. Regarding the Data Entry survey, all questions achieved 100% of responses and no participant reported spending more than 10 min time for either the first data entry or for the updating of follow-up. Results from the Satisfaction Questionnaire revealed that the project was described as excellent by 14 centers (82.3%) and good by 3 (17.7%). Conclusion. Current knowledge for the treatment of high-prevalence diseases, such as BC, has evolved toward patient-centered medicine, evidence-based care and real-world evidence (RWE), which means evidence obtained from real-world data (RWD). To this aim, Breast IRRADIATA was developed as a simple tool to probe the current pattern of RT care in Italy. The pilot feasibility of IRRADIATA encourages a larger application of this tool nationwide and opens the way to the assessment of the pattern of care radiotherapy directed to other cancers