121 research outputs found
Elastographic presentation of medullary thyroid carcinoma
Aim of the study was to evaluate the elastographic
appearance of medullary thyroid carcinoma (MTC)
by a retrospective evaluation of 18 nodules histologically
proven as MTC. Free-hand qualitative elastography was
performed using Hitachi Logos EUB 7500. The elasticity
score (ES), was assessed based on a colour elastogram, the
blue colour being correlated with hard tissue, red colour
with soft tissue, and green with intermediate hardness.
Nodules were classified into four classes. A alleged diagnosis
of malignancy was assigned to nodules with ES3 or 4
and a presumptive diagnosis of benignity was assigned to
nodules with an ES1 or 2. More than half (55.6 %) of
MTCs have a low-intermediate grade of elasticity. The
hardest lesions (ES4) were those with ultrasonographic
features highly suspicious for malignancy. In conclusion,
most of MTCs present an elastographic pattern of benignity.
Therefore, qualitative elastography does not add
useful information in pointing out MTC on the basis of its
hardness. Our data suggest a marginal role for this technique
in MTC evaluation
Immunoscintigraphy for therapy decision making and follow-up of biological therapies
With the availability of new biological therapies there is the need of more accurate diagnostic tools to noninvasively
assess the presence of their targets. In this scenario nuclear medicine offers many radiopharmaceuticals for
SPECT or PET imaging of many pathological conditions. The availability of monoclonal antibodies provides tools to
target specific antigens involved in angiogenesis, cell cycle or modulation of the immune systems. The radiolabelling of
such therapeutic mAbs is a promising method to evaluate the antigenic status of each cancer lesion or inflamed sites
before starting the therapy. It may also allow to perform follow-up of such biological therapies. In the present review we
provide an overview of the most studied radiolabelled antibodies for therapy decision making and follow-up of patients
affected by cancer and other pathological conditions
Recurrence following anastomotic leakage after surgery for carcinoma of the distal esophagus and gastroesophageal junction. a systematic review
BACKGROUND: Esophageal cancer is the ninth most common cancer. The only potentially curative treatment is surgical resection, which unfortunately is still associated with major complications, the most important being anastomotic leakage, currently with an overall rate of up to 26% morbidity. The aim of this systematic review was to evaluate the relationship between anastomotic leakage and recurrence of disease. MATERIALS AND METHODS: A literature search was systematically performed. Seven out of 312 articles dated between 2009 and 2018 fulfilled the selection for a total of 5,433 patients. RESULTS: The frequency of anastomotic leakage ranged from 7.2 to 11.2%. Patients affected by anastomotic leakage had a recurrence rate of 9-56%. CONCLUSION: Closer follow-up or even more aggressive oncological therapy should be considered for patients affected by anastomotic leakage after surgery for carcinoma of the distal esophagus and gastroesophageal junction
The use of x-ray CT and MRI in the study of sacroiliac joints in patients with Behcet disease and acute anterior uveitis
Objective: It's controversial if Behcet Disease (BD) must be included in the group of seronegative spondyloarthropathy (SpA). Our
aim was to establish the prevalence of sacroiliitis (SI) in patients with BD using X-Ray, CT and MRI, in comparison with patients with
Acute Anterior Uveitis (AAU), that is known to belong to the subgroups of SpA.
Methods: We considered, in the period from 04/2006 to 04/2009, 21 consecutive patients with BD, positive for HLA B51 and 28
consecutive patients with AAU, positive for HLA B27. These patients were previously selected by our Rheumatological Ward.
Altogether we evaluated 98 sacroiliac joints (SIJ); each side of any patient was graded separately.
Results: X-ray of the pelvis showed advanced SI (grade 4) in 14% of the cases in patients with AAU; in BD group only 7% CT
showed advanced SI in 14% within AAU patients versus 6-12% of advanced SI (right to left) within BD patients. MR showed 14%
of advanced SI (bilateral) within AAU versus 6-11% of advanced SI (right to left) in BD patients.
Conclusions: This study supports the trend to not consider BD within the SpA, being the prevalence of SI in BD patients not very
different from general population and anyway lower than that observed in patients with AAU. On the other side the prevalence of
SI in AAU patients is higher than in BD patients and very similar to the one observed in patients with seronegative arthritis, and
anyway high enough to consider joint involvement as an important feature of the disease
Cancer rate of the indeterminate lesions at low or high risk according to italian system for reporting of thyroid FNA
Background: Italian consensus for the classification and reporting of thyroid cytology
(ICCRTC) has been used in almost all Italian institutions since 2014. High reliability
of ICCRTC in classifying low and high risk indeterminate nodules (Tir 3A and Tir 3B,
respectively) was demonstrated. Here we reviewed our casuistry of thyroid indeterminate
lesions to analyze the histologic outcome.
Methods: All lesions undergone FNA and final histology at S. Andrea Hospital of Rome
after a cytologic assessment of Tir 3A and Tir 3B, according to ICCRTC, were included
in the study.
Results: A number of 157 indeterminate FNA was found after the introduction of
ICCRTC. Of these, 75 undergone surgery and were finally included for the study. At
histology we found a 33.3% of cancers and a 67.7% of benign lesions. Out of the overall
series, 25 were classified as Tir 3A and 50 as Tir 3B. Cancer rate observed in Tir 3A (1/25,
4%) was significantly (p = 0.0002) lower than that of Tir 3B (24/50, 48%). No significant
difference was found in age and size between the two subcategories.
Conclusions: We confirm in our series that Italian consensus for the classification and
reporting of thyroid cytology allows to discriminate indeterminate lesions at low and high
risk of malignancy
Searching for prognostic markers for Stage I epithelial ovarian cancer: A role for systemic inflammatory markers
Analysis of tissue surrounding thyroid nodules by ultrasound digital images
Since US is not easily reproducible, the digital image analysis (IA) has been proposed so that the image evaluation is not subjective. In fact, IA meets the criteria of objectivity, accurateness, and reproducibility by a matrix of pixels whose value is displayed in a gray level. This study aims at evaluating via IA the tissue surrounding a thyroid nodule (backyard tissue, BT) from goitres with benign (b-BT) and malignant (m-BT) lesions. Sixty-nine US images of thyroid nodules surrounded by adequate thyroid tissue was classified as normoechoic and homogeneous were enrolled as study group. Forty-three US images from normal thyroid (NT) glands were included as controls. Digital images of 800 × 652 pixels were acquired at a resolution of eight bits with a 256 gray levels depth. By one-way ANOVA, the 43 NT glands were not statistically different (P = 0.91). Mean gray level of normal glands was significantly higher than b-BT (P = 0.026), and m-BT (P = 0.0001), while no difference was found between b-BT and m-BT (P = 0.321). NT tissue boundary external to the nodule was found at 6.0 ± 0.5 mm in cancers and 4.0 ± 0.5 mm in benignancies (P = 0.001). These data should indicate that the tissue surrounding a thyroid nodule may be damaged even when assessed as normal by US. This is of interest to investigate the extranodular effects of thyroid tumors
The staging of gastritis with the olga system in the italian setting. histological features and gastric cancer risk
BACKGROUND: Recently OLGA (Operative Link on Gastritis Assessment) classification has been proposed to identify high-risk forms of gastritis that can evolve in gastric cancer (stages III and IV). Helicobacter pylori infection and age older than 40 have been considered as independent risk factor for high-risk OLGA stages
Detection rate of FNA cytology in medullary thyroid carcinoma. a meta-analysis
Background: The early detection of medullary thyroid carcinoma (MTC) can improve patient prognosis, because histological stage and patient age at diagnosis are highly relevant prognostic factors. As a consequence, delay in the diagnosis and/or incomplete surgical treatment should correlate with a poorer prognosis for patients. Few papers have evaluated the specific capability of fine-needle aspiration cytology (FNAC) to detect MTC, and small series have been reported. This study conducts a meta-analysis of published data on the diagnostic performance of FNAC in MTC to provide more robust estimates. Research Design and Methods: A comprehensive computer literature search of the PubMed/MEDLINE, Embase and Scopus databases was conducted by searching for the terms 'medullary thyroid' AND 'cytology', 'FNA', 'FNAB', 'FNAC', 'fine needle' or 'fine-needle'. The search was updated until 21 March 2014, and no language restrictions were used. Results: Fifteen relevant studies and 641 MTC lesions that had undergone FNAC were included. The detection rate (DR) of FNAC in patients with MTC (diagnosed as 'MTC' or 'suspicious for MTC') on a per lesion-based analysis ranged from 12·5% to 88·2%, with a pooled estimate of 56·4% (95% CI: 52·6-60·1%). The included studies were statistically heterogeneous in their estimates of DR (I-square >50%). Egger's regression intercept for DR pooling was 0·03 (95% CI: -3·1 to 3·2, P = 0·9). The study that reported the largest MTC series had a DR of 45%. Data on immunohistochemistry for calcitonin in diagnosing MTC were inconsistent for the meta-analysis. Conclusions: The presented meta-analysis demonstrates that FNAC is able to detect approximately one-half of MTC lesions. These findings suggest that other techniques may be needed in combination with FNAC to diagnose MTC and avoid false negative results. © 2014 John Wiley & Sons Ltd
Neoadjuvant treatment in pancreatic cance. Evidence-based medicine? A systematic review and meta-analysis
Neoadjuvant treatment in non-metastatic pancreatic cancer (PaC) has the theoretical advantages of downstaging the tumor, sterilizing any present systemic undetectable disease, selecting patients for surgery and administering therapy to each patient. The aim of this systematic review is to analyze the state of the art on neoadjuvant protocols for non-metastatic PaC. A literature search over the last 10 years was conducted, and papers had to be focused on resectable, borderline resectable (BLR) or locally advanced (LA) histo- or cytologically proven PaC; to be prospective studies or prospectively collected databases; to report percentage of protocol achievement and survival data at least in an intention-to-treat (ITT) analysis. Twelve studies were eligible for systematic review. Studies included a total of 624 patients: 248 resectable, 268 BLR, 71 LA and 37 non-specified. All studies were included for meta-analysis. ITT overall survival (OS) was 16.7 months (95% CI 15.16-18.26 months); for resected patients OS was 22.78 months (95% CI 20.42-25.16), and for eventually non-resected patients it was 9.89 months (95% CI 8.84-10.96). Neoadjuvant approaches for resectable, BLR and LA PaC are spreading. Outcomes tend to be better outside an RCT context, but strong evidences are lacking. Actually such treatments should be performed only in a randomized clinical trial setting
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