Prognostic and monitoring value of circulating tumour cells in adrenocortical carcinoma: a preliminary monocentric study.

Adrenocortical carcinoma (ACC), a rare and aggressive neoplasia, presents poor prognosis when metastatic at diagnosis and limited therapies are available. Specific and sensitive markers for early diagnosis and a monitoring system of therapy and tumor evolution are urgently needed. The liquid biopsy represents a source of tumor material within a minimally invasive blood draw that allows the recovery of circulating tumor cells (CTCs). CTCs have been recently shown to be detectable in ACC. In the present paper, we evaluated the prognostic value of CTCs obtained by size-filtration in a small pilot cohort of 19 ACC patients. We found CTCs in 68% of pre-surgery and in 38% of post-surgery blood samples. In addition, CTC clusters (CTMs) and cancer associated macrophages (CAMLs) were detectable in some ACC patients. The median number of CTCs significantly decreased after the mass removal. Finally, stratifying patients in high and low pre-surgery CTC number groups, assuming the 75th percentile CTC value as cut-off, CTCs significantly predicted patients’ overall survival (log rank = 0.005), also in a multivariate analysis adjusted for age and tumor stage. In conclusion, though preliminary and performed in a small cohort of patients, our study suggests that CTC number may represent a promising marker for prognosis and disease monitoring in ACC

A multicenter epidemiological study on second malignancy in non-syndromic pheochromocytoma/paraganglioma patients in Italy

SIMPLE SUMMARY: As no previous studies had assessed the risk of second malignant tumors in patients with pheochromocytomas/paragangliomas (PPGLs), we aimed to evaluate whether these patients could have an increased risk of additional malignancy, comparing them with patients in the general population who had a first malignancy and developed a second malignant tumor. We demonstrated that PPGL patients had higher incidence of additional malignant tumors and the risk of developing a second malignant tumor increased with age at diagnosis. As the main tumors were prostate, colorectal and lung/bronchial cancers in males, and breast cancer, differentiated thyroid cancer and melanoma in females, our findings could have an impact on the surveillance strategy. ABSTRACT: No studies have carried out an extensive analysis of the possible association between non-syndromic pheochromocytomas and paragangliomas (PPGLs) and other malignancies. To assess >the risk of additional malignancy in PPGL, we retrospectively evaluated 741 patients with PPGLs followed-up in twelve referral centers in Italy. Incidence of second malignant tumors was compared between this cohort and Italian patients with two subsequent malignancies. Among our patients, 95 (12.8%) developed a second malignant tumor, which were mainly prostate, colorectal and lung/bronchial cancers in males, breast cancer, differentiated thyroid cancer and melanoma in females. The standardized incidence ratio was 9.59 (95% CI 5.46–15.71) in males and 13.21 (95% CI 7.52–21.63) in females. At multivariable analysis, the risk of developing a second malignant tumor increased with age at diagnosis (HR 2.50, 95% CI 1.15–5.44, p = 0.021 for 50–59 vs. 60- vs. <50-year). In patients with available genetic evaluation, a positive genetic test was inversely associated with the risk of developing a second tumor (HR 0.25, 95% CI 0.10–0.63, p = 0.003). In conclusion, PPGLs patients have higher incidence of additional malignant tumors compared to the general population who had a first malignancy, which could have an impact on the surveillance strategy

A calculating sheet to optimize the design of modified Turkey Oak wooden laminated floors

The use of wooden floors has been for millennia the “compliant solution” for the horizontal elements of the buildings of the most different types, due to their lightness, elasticity, resistance, flexibility of use and ease of realization. Recently, particularly for buildings located in seismic areas, it has been argued that their deformability was a serious defect and not only in literature, but also in the Official Rules, it is recommended or required that both the existing wooden floors, and new ones, should be made infinitely rigid and non-buckle able in their plane, through the application of reinforced concrete slabs, tied through connectors to the wooden beams. This solution has, however, turned out to be worse than the disease that tried to cure, on one hand causing the rotting of the wooden parts in contact with the concrete, and on the other determining – under earthquake forces - torque such as to cause the collapse of parts of the walls, or of entire building units. At La.Te.C. - Laboratory of Building Technology - of the School of Engineering of the University of Basilicata, it is an ongoing a complex research which investigates for years the use and improvement of forest resources of Basilicata and the possibility to use for various purposes in construction the essence of hardwood Quercus Cerris L. (Turkey Oak). The research performed till now has shown the great interest on the use of thermohygrometric “modified” Quercus Cerris to tackle the problems set by the refurbishment and/or the restoration of buildings in the historical centres; it has been developed a construction system for wooden floors, based on the use, in addition to the traditional floor joists in vertical planes, of trusses of considerable height and therefore very rigid, arranged beside the external walls or internal ones in horizontal plane, with hinge tie at the ends to wooden chains bound to the perpendicular walls. These reticular trusses are able to retain rigidly in their position the external walls subject to seismic action, preventing from their tilting out of their plane, and then forcing them to express all the shear strength or buckling resistance of which they are capable. To facilitate the use of this system by the designers, it has been arranged and implemented a calculating sheet, upgraded to the most recent Italian Regulations