Immunohistochemical Expression of Ki-67 in Central Giant Cell Lesion

La lesión central de células gigantes (LCCG) es una lesión osteolítica benigna que en algunos casos presenta un comportamiento agresivo, con recidiva y mal pronóstico. Ki-67 es una proteína nuclear cuya función general es la regulación de la proliferación celular. Este marcador es utilizado para el reconocimiento de células en proliferación y como herramienta de pronóstico en el diagnóstico de neoplasias. El objetivo de este estudio fue cuantificar la inmunoexpresión de Ki-67 en las diferentes poblaciones celulares de las LCCG y analizar su asociación con las características clínicas, demográficas y radiográficas. Se evaluó la inmunoexpresión de Ki-67 de 17 casos de LCCG en dos poblaciones celulares: células gigantes multinucleadas (CGM) y células mesenquimatosas estromales (CME). El análisis estadístico se efectuó con el programa SAS 9.0 y SPSS versión 23.0, con un nivel alfa impuesto de P<0,05. Las CME mostraron inmunoexpresión promedio de 9,4 % y las CGM de 0,65 %. No se encontró relación estadísticamente significativa entre las características clínicas, demográficas y radiográficas de las LCCG y la inmunoexpresión de Ki-67. La expresión de Ki-67 en CME sugiere que esta población se encuentra en constante actividad celular y que las LCCG son lesiones dinámicas y en constante proceso de diferenciación.The central giant cell lesion (CGCL) is a benign osteolytic lesion which in some cases presents an aggressive behavior with recurrence and poor prognosis. Ki67 is a nuclear protein whose general function is the regulation of cell proliferation. This marker is used to identify proliferating cells and as a prognostic tool in the diagnosis of neoplasms. The aim of this study was to quantify the immune expression of Ki-67 in the different cell populations of CGCL and analyze its association with clinical, demographic and radiographic characteristics. The Ki-67 immune expression of 17 cases of LCCG was evaluated in two cell populations: multinucleated giant cells (CGM) and stromal mesenchymal cells (SMC). The statistical analysis was carried out with SAS 9.0 and SPSS version 23.0, with an alpha tax level of P <0.05. The CME showed average immune expression of 9.4 % and the CGM of 0.65 %. No statistically significant relationship was found between the clinical, demographic and radiographic characteristics of the CGCL and the immune expression of Ki-67. The expression of Ki-67 in CME suggests that this population is in constant cellular activity, and that the CGCL are dynamic lesions in a continuous differentiation process

An Unusually Large Peripheral Giant Cell Granuloma: a Case Report

Peripheral giant cell granuloma (PGCG) is a benign reactive lesion of the oral cavity. Although PGCG is classified as a tumor-like lesion, it does not represent a true neoplasm, however it is often associated with a response of local irritation and trauma. Clinically, it appears as an exophytic growth with either sessile or pedunculated base, it can be located in gingiva or edentulous alveolar mucosa and usually does not exceed two cm in diameter. The following report describes the case of a 64-year-old female diagnosed with a PGCG of a particularly large size and rapidly evolving, located in the upper jaw area. The lesion was completely excised, and the diagnosis was confirmed by histopathology, there is no apparent recurrence in the area after 12 months of follow-up. A few cases of PGCG greater than 5 cm in diameter have been reported. Furthermore, exceptional cases might present an abnormal rapid growth as well. An opportune diagnosis based on clinical examination, radiographic and histopathological study are fundamental for a prompt and efficient treatment

Functional Relevance of Extracellular Vesicle-Derived Long Non-Coding and Circular RNAs in Cancer Angiogenesis

Extracellular vesicles (EVs) are defined as subcellular structures limited by a bilayer lipid membrane that function as important intercellular communication by transporting active biomolecules, such as proteins, amino acids, metabolites, and nucleic acids, including long non-coding RNAs (lncRNAs). These cargos can effectively be delivered to target cells and induce a highly variable response. LncRNAs are functional RNAs composed of at least 200 nucleotides that do not code for proteins. Nowadays, lncRNAs and circRNAs are known to play crucial roles in many biological processes, including a plethora of diseases including cancer. Growing evidence shows an active presence of lnc- and circRNAs in EVs, generating downstream responses that ultimately affect cancer progression by many mechanisms, including angiogenesis. Moreover, many studies have revealed that some tumor cells promote angiogenesis by secreting EVs, which endothelial cells can take up to induce new vessel formation. In this review, we aim to summarize the bioactive roles of EVs with lnc- and circRNAs as cargo and their effect on cancer angiogenesis. Also, we discuss future clinical strategies for cancer treatment based on current knowledge of circ- and lncRNA-EVs

Functional Relevance of the Long Intergenic Non-Coding RNA Regulator of Reprogramming (Linc-ROR) in Cancer Proliferation, Metastasis, and Drug Resistance

Cancer is responsible for more than 10 million deaths every year. Metastasis and drug resistance lead to a poor survival rate and are a major therapeutic challenge. Substantial evidence demonstrates that an increasing number of long non-coding RNAs are dysregulated in cancer, including the long intergenic non-coding RNA, regulator of reprogramming (linc-ROR), which mostly exerts its role as an onco-lncRNA acting as a competing endogenous RNA that sequesters micro RNAs. Although the properties of linc-ROR in relation to some cancers have been reviewed in the past, active research appends evidence constantly to a better comprehension of the role of linc-ROR in different stages of cancer. Moreover, the molecular details and some recent papers have been omitted or partially reported, thus the importance of this review aimed to contribute to the up-to-date understanding of linc-ROR and its implication in cancer tumorigenesis, progression, metastasis, and chemoresistance. As the involvement of linc-ROR in cancer is elucidated, an improvement in diagnostic and prognostic tools could promote and advance in targeted and specific therapies in precision oncology

Second asymptomatic carotid surgery trial (ACST-2) : a randomised comparison of carotid artery stenting versus carotid endarterectomy

Background: Among asymptomatic patients with severe carotid artery stenosis but no recent stroke or transient cerebral ischaemia, either carotid artery stenting (CAS) or carotid endarterectomy (CEA) can restore patency and reduce long-term stroke risks. However, from recent national registry data, each option causes about 1% procedural risk of disabling stroke or death. Comparison of their long-term protective effects requires large-scale randomised evidence. Methods: ACST-2 is an international multicentre randomised trial of CAS versus CEA among asymptomatic patients with severe stenosis thought to require intervention, interpreted with all other relevant trials. Patients were eligible if they had severe unilateral or bilateral carotid artery stenosis and both doctor and patient agreed that a carotid procedure should be undertaken, but they were substantially uncertain which one to choose. Patients were randomly allocated to CAS or CEA and followed up at 1 month and then annually, for a mean 5 years. Procedural events were those within 30 days of the intervention. Intention-to-treat analyses are provided. Analyses including procedural hazards use tabular methods. Analyses and meta-analyses of non-procedural strokes use Kaplan-Meier and log-rank methods. The trial is registered with the ISRCTN registry, ISRCTN21144362. Findings: Between Jan 15, 2008, and Dec 31, 2020, 3625 patients in 130 centres were randomly allocated, 1811 to CAS and 1814 to CEA, with good compliance, good medical therapy and a mean 5 years of follow-up. Overall, 1% had disabling stroke or death procedurally (15 allocated to CAS and 18 to CEA) and 2% had non-disabling procedural stroke (48 allocated to CAS and 29 to CEA). Kaplan-Meier estimates of 5-year non-procedural stroke were 2·5% in each group for fatal or disabling stroke, and 5·3% with CAS versus 4·5% with CEA for any stroke (rate ratio [RR] 1·16, 95% CI 0·86-1·57; p=0·33). Combining RRs for any non-procedural stroke in all CAS versus CEA trials, the RR was similar in symptomatic and asymptomatic patients (overall RR 1·11, 95% CI 0·91-1·32; p=0·21). Interpretation: Serious complications are similarly uncommon after competent CAS and CEA, and the long-term effects of these two carotid artery procedures on fatal or disabling stroke are comparable