SO045A NATIONWIDE SURVEY ON RADIATION RISK OF CANCER FROM MEDICAL IMAGING IN END STAGE KIDNEY DISEASE AND IN TRANSPLANT PATIENTS

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Clinico‐histopathological review of 255 patients who underwent parotidectomy for pleomorphic adenoma: a 10‐year retrospective study—a proposal for an optimal diagnostic and therapeutic algorithm for patients with recurrent pleomorphic adenoma

Purpose Pleomorphic adenoma (mixed tumor) is the most common neoplasm of the parotid gland and one of the most frequent types of salivary gland tumor, generally with benign behavior and relatively slow growing. The adenomas could arise from the superficial, deep or from both superficial and deep parotid’s lobes. Methods The aim of this review is to retrospectively analyze the surgical management of patients with pleomorphic adenoma of the parotid gland performed at the Department of Otorhinolaryngology (Department of Sense Organs of “Azienda Policlinico Umberto I” in Rome), from 2010 to 2020, with a focus on the percentage of recurrence and on the complication related to surgery to suggest an optimal diagnostic and therapeutic algorithm for patients with recurrent pleomorphic adenoma. The analysis of the complications observed in case of different surgical approaches was performed using the X2 test. Results The choice of a surgical approach (superficial parotidectomy—SP, total parotidectomy—TP, extracapsular dissec- tion—ECD) depends on several elements, such as the location and the size of the adenoma, the availability of existing technical facilities and the professional experience of the surgeon. A transient facial palsy was present in 37.6%, 2.7% reported a permanent facial nerve palsy, 1.6% developed a salivary fistula, 1.6% a post-operative bleeding and 2.3% showed Frey Syndrome. Conclusion The surgical management of this benign lesion is required, even in asymptomatic cases, to prevent the progressive growing and to reduce the risk of malignant transformation. The goal of surgical excision is to obtain the complete resection to minimize the risk of tumor recurrence and avoiding facial nerve disability. Therefore, an accurate preoperative study of the lesion and the choice of the most appropriate surgical treatment are essential to minimize the rate of recurrence

Diagnostic predictors of immunotherapy response in head and neck squamous cell carcinoma

Programmed cell death ligand-1 (PD-L1) binds PD-1 on CD8+ lymphocytes, inhibiting their cytotoxic action. Its aberrant expression by head and neck squamous cell carcinoma (HNSCC) cells leads to immune escape. Pembrolizumab and nivolumab, two humanized monoclonal antibodies against PD-1, have been approved in HNSCC treatment, but similar to 60% of patients with recurrent or metastatic HNSCC fail to respond to immunotherapy and only 20 to 30% of treated patients have long-term benefits. The purpose of this review is to analyze all the fragmentary evidence present in the literature to identify what future diagnostic markers could be useful for predicting, together with PD-L1 CPS, the response to immunotherapy and its durability. We searched PubMed, Embase, and the Cochrane Register of Controlled Trials and we summarize the evidence collected in this review. We confirmed that PD-L1 CPS is a predictor of response to immunotherapy, but it should be measured across multiple biopsies and repeatedly over time. PD-L2, IFN-gamma, EGFR, VEGF, TGF-beta, TMB, blood TMB, CD73, TILs, alternative splicing, tumor microenvironment, and some macroscopic and radiological features are promising predictors worthy of further studies. Studies comparing predictors appear to give greater potency to TMB and CXCR9

Molecular pathology, oxidative stress, and biomarkers in obstructive sleep apnea

Obstructive sleep apnea syndrome (OSAS) is characterized by intermittent hypoxia (IH) during sleep due to recurrent upper airway obstruction. The derived oxidative stress (OS) leads to complications that do not only concern the sleep-wake rhythm but also systemic dysfunctions. The aim of this narrative literature review is to investigate molecular alterations, diagnostic markers, and potential medical therapies for OSAS. We analyzed the literature and synthesized the evidence collected. IH increases oxygen free radicals (ROS) and reduces antioxidant capacities. OS and metabolic alterations lead OSAS patients to undergo endothelial dysfunction, osteoporosis, systemic inflammation, increased cardiovascular risk, pulmonary remodeling, and neurological alterations. We treated molecular alterations known to date as useful for understanding the pathogenetic mechanisms and for their potential application as diagnostic markers. The most promising pharmacological therapies are those based on N-acetylcysteine (NAC), Vitamin C, Leptin, Dronabinol, or Atomoxetine + Oxybutynin, but all require further experimentation. CPAP remains the approved therapy capable of reversing most of the known molecular alterations; future drugs may be useful in treating the remaining dysfunctions

Carcinoma cuniculatum of the larynx

Carcinoma cuniculatum (CC) is a rare clinicopathologic variant of squamous cell carcinoma. Histologically, it is characterized by invasive growth of bland, acanthotic, and keratinizing squamous epithelium that forms multiple rabbit burrow-like, keratin-filled crypts and sinuses. We present a 51-year-old male smoker with CC of the left vocal cord. The tumor was staged T1a and the patient was disease-free 12 months after surgery. To our knowledge, this is the fourth case of CC of the larynx reported in the English literature and the first, due to its early diagnosis, where radical surgery was not performed. We highlight the necessity for awareness of this entity and coordination between otolaryngologists, radiologists, and pathologists for early diagnosis and organ-sparing surgical treatment

The populations of planetary nebulae in the direction of the Galactic bulge

We have observed 44 planetary nebulae (PNe) in the direction of the Galactic bulge, and merged our data with published ones. We have distinguished, in the merged sample of 164 PNe, those PNe most likely to prtain physically to the Galactic bulge and those most likely to belong to the Galactic disk. We have determined the chemical composition of all the 164 objects in a coherent way. We looked for stellar emission features and discovered 14 new [WR] stars and 15 new weak emission line central stars. The analyzed data led us to the following conclusions: (1) The spectral type distribution of [WR] stars is very different in the bulge and in the disk of the Galaxy. However, the observed distributions are strongly dependent on selection effects. (2) The proportion of [WR] PNe is significantly larger in the bulge than in the disk. (3) The oxygen abundances in [WR] stars do no appear to be significantly affected by nucleosynthesis and mixing in the progenitors. (4) The O/H gradient of the Galactic disk PNe population flattens in the most internal parts of the Galaxy. (5) The median oxygen abundance in the bulge PN population is larger by 0.2 dex than in the disk population seen in the direction of the bulge. (6) Bulge PNe with smaller O/H tend to have smaller radial velocities. (7) The oxygen abundance distribution of bulge PNe is similar in shape to that of the metallicity distribution of bulge giants, but significantly narrower. (8) The location of SB 32 (PN G 349.7-09.1) in the (V_lsr, l_II) diagram and its low oxygen abundance argues that it probably belongs to the halo population.Comment: 14 pages, 16 figures. Accepted for publication in A&

New groups of planetary nebulae with peculiar dust chemistry towards the Galactic bulge

We investigate Galactic bulge planetary nebulae without emission-line central stars for which peculiar infrared spectra have been obtained with the Spitzer Space Telescope, including the simultaneous signs of oxygen and carbon based dust. Three separate sub-groups can be defined characterized by the different chemical composition of the dust and the presence of crystalline and amorphous silicates. We find that the classification based on the dust properties is reflected in the more general properties of these planetary nebulae. However, some observed properties are difficult to relate to the common view of planetary nebulae. In particular, it is challenging to interpret the peculiar gas chemical composition of many analyzed objects in the standard picture of the evolution of planetary nebulae progenitors. We confirm that the dual-dust chemistry phenomenon is not limited to planetary nebulae with emission-line central stars.Comment: 17 pages, 13 figure

The VMC survey - XI : Radial Stellar Population Gradients in the Galactic Globular Cluster 47 Tucanae

Copyright American Astronomical SocietyWe present a deep near-infrared color-magnitude diagram of the Galactic globular cluster 47 Tucanae, obtained with the Visible and Infrared Survey Telescope for Astronomy (VISTA) as part of the VISTA near-infrared Y, J, Ks survey of the Magellanic System (VMC). The cluster stars comprising both the subgiant and red giant branches exhibit apparent, continuous variations in color-magnitude space as a function of radius. Subgiant branch stars at larger radii are systematically brighter than their counterparts closer to the cluster core; similarly, red-giant-branch stars in the cluster's periphery are bluer than their more centrally located cousins. The observations can very well be described by adopting an age spread of ~0.5 Gyr as well as radial gradients in both the cluster's helium abundance (Y) and metallicity (Z), which change gradually from (Y = 0.28, Z = 0.005) in the cluster core to (Y = 0.25, Z = 0.003) in its periphery. We conclude that the cluster's inner regions host a significant fraction of second-generation stars, which decreases with increasing radius; the stellar population in the 47 Tuc periphery is well approximated by a simple stellar population.Peer reviewe

3D vs. 2D MRI radiomics in skeletal Ewing sarcoma: Feature reproducibility and preliminary machine learning analysis on neoadjuvant chemotherapy response prediction

ObjectiveThe extent of response to neoadjuvant chemotherapy predicts survival in Ewing sarcoma. This study focuses on MRI radiomics of skeletal Ewing sarcoma and aims to investigate feature reproducibility and machine learning prediction of response to neoadjuvant chemotherapy. Materials and methodsThis retrospective study included thirty patients with biopsy-proven skeletal Ewing sarcoma, who were treated with neoadjuvant chemotherapy before surgery at two tertiary sarcoma centres. 7 patients were poor responders and 23 were good responders based on pathological assessment of the surgical specimen. On pre-treatment T1-weighted and T2-weighted MRI, 2D and 3D tumour segmentations were manually performed. Features were extracted from original and wavelet-transformed images. Feature reproducibility was assessed through small geometrical transformations of the regions of interest mimicking multiple manual delineations, and intraclass correlation coefficient >0.75 defined feature reproducibility. Feature selection also consisted of collinearity and significance analysis. After class balancing in the training cohort, three machine learning classifiers were trained and tested on unseen data using hold-out cross-validation. Results1303 (77%) 3D and 620 (65%) 2D radiomic features were reproducible. 4 3D and 4 2D features passed feature selection. Logistic regression built upon 3D features achieved the best performance with 85% accuracy (AUC=0.9) in predicting response to neoadjuvant chemotherapy. ConclusionCompared to 2D approach, 3D MRI radiomics of Ewing sarcoma had superior reproducibility and higher accuracy in predicting response to neoadjuvant chemotherapy, particularly when using logistic regression classifier