Metastatic mixed gestational trophoblastic tumour of the uterus: A case report

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Pituitary macroadenomas: preoperative evaluation of consistency with diffusion-weighted MR imaging--initial experience

Purpose: To prospectively evaluate use of diffusion-weighted (DW) magnetic resonance (MR) images and apparent diffusion coefficient (ADC) maps for determination of the consistency of macroadenomas. Materials and Methods: The study protocol was approved by the institutional ethics committee, and informed consent was obtained from all patients. Twenty-two patients with pituitary macroadenoma (10 men, 12 women; mean age, 54 years ± 17.09 [standard deviation]; range, 21-75 years) were examined. All patients underwent MR examination, which included T1-weighted spin-echo and T2-weighted turbo spin-echo DW imaging with ADC mapping and contrast material-enhanced T1-weighted spin-echo imaging. Regions of interest (ROIs) were drawn in the macroadenomas and in normal white matter on DW images, ADC maps, and conventional MR images. Consistency of macroadenomas was evaluared at surgery and was classified as soft, intermediate, or hard. Histologic examination was performed on surgical specimens of macroadenomas. Mean ADC values, signal intensity (SI) ratios of tumor to white matter within ROIs on conventional and DW MR images, and degree of enhancement were compared with tumor consistency and with percentage of collagen content at histologic examination by using analysis of variance for linear trend. Results: The mean value of ADC in the soft group was (0.663 ± 0.109) × 10-3 mm2/sec; in the intermediate group, (0.842 ± 0.081) × 10-3 mm2/sec; and in the hard group, (1.363 ± 0.259) × 10-3 mm 2/sec. Statistical analysis revealed a significant correlation between tumor consistency and ADC values, DW image SI ratios, T2-weighted image SI ratios, and percentage of collagen content (P <"001, analysis of variance). No other statistically significant correlations were found. Conclusion: Findings in this study suggest that DW MR images with ADC maps can provide information about the consistency of macroadenomas

MODULAZIONE DELL\u2019ESPRESSIONE DI BIOMARCATORI E PROGNOSI IN PAZIENTI AFFETTE DA CARCINOMA MAMMARIO OPERABILE SOTTOPOSTE A CHEMIOTERAPIA PREOPERATORIA

Obiettivi. La terapia preoperatoria (TP) offre l\u2019opportunit\ue0 di valutare in vivo l\u2019effetto del trattamento sul tumore e sul suo microambiente. Questa analisi si propone di correlare l\u2019espressione di una serie di biomarcatori cellulari alla risposta dopo TP e di valutare l\u2019effetto della TP sull\u2019espressione di tali biomarkers (ed il loro significato prognostico). Pazienti e metodi. Sono state incluse 189 pazienti (pz.) con diagnosi di carcinoma mammario in stadio II-IIIB all\u2019esordio e trattate con TP (antracicline e taxani nel 84% dei casi). I seguenti biomarcatori sono stati valutati sul prelievo bioptico (basale) e, dopo 3-4 cicli di TP, sul pezzo operatorio: RE, RPg, grading, HER2, Ki-67, p53, EGFR e VEGFR. Risultati. Caratteristiche delle pz. Et\ue0 mediana alla diagnosi: 51 anni (27-73 anni); stadio clinico: IIA-B 78%, IIIA-B 22%; RE+ e/o RPg+: 77%; HER2+: 20%; grado istologico 3: 58%. Una risposta obiettiva si \ue8 osservata nel 70% dei casi; il 39% delle pz. si \ue8 sottoposta a chirurgia conservativa. Una risposta patologica completa (pRC) si \ue8 ottenuta nel 8.3% dei casi. La probabilit\ue0 di ottenere una pRC \ue8 risultata significativamente maggiore nelle pz. con RE- rispetto a quelle con RE+ (20% vs 3%, p=0.005) e con grado istologico 3 verso 1-2 (14% vs 2%, p=0.049). L\u2019espressione mediana dei biomarcatori al basale \ue8 risultata: RE 62.5%, RPg 9%, Ki-67 25%, p53 2%, EGFR 0%, VEGFR 2%. L\u2019espressione mediana dopo TP \ue8 risultata: RE 60%, RPg 3%, Ki-67 15%, p53 4%, EGFR 0%, VEGFR 0%. La differenza nell\u2019espressione dei biomarcatori prima e dopo TP \ue8 stata valutata con il Wilcoxon-matched- pairs-signed-rank-test: si \ue8 osservata una riduzione significativa nell\u2019espressione di RPg (p=0.017), Ki-67 (p15% e la positivit\ue0 per il VEGFR predicono una ridotta DFS. Conclusioni. In questa casistica, la TP induce una significativa riduzione di Ki-67 e dell\u2019espressione di RPg e VEGFR. La modulazione di Ki-67 e di VEGFR indotta dal trattamento pu\uf2 rivelarsi utile per selezionare pazienti a diverso rischio di ripresa di malattia dopo TP

Immunohistochemical expression of fatty acid synthase, Ki-67 and p53 in squamous cell carcinomas of the larynx

Fatty acid synthase (FAS) is a recently discovered molecule involved in the energy supply to normal cells. FAS is overexpressed in neoplastic tissues because of their increased energy needs. We explored the immunohistochemical expression of FAS, Ki-67 and p53 in squamous cell carcinomas (SCC) of the larynx and their association with clinicopathological features and outcome. Specimens from 43 patients with SCC were evaluated. Statistical analysis revealed an association between poorly differentiated laryngeal carcinomas and FAS expression (p0.005) and between FAS and Ki-67 overexpression (p0.001). Finally, FAS expression was associated with overall survival (p0.001). We suggest that FAS is a powerful prognostic indicator whose strength can be enhanced when it is evaluated together with clinicopathological data and Ki-67 expression