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Zullo A, Germanà B, Galliani E, Iori A, de Pretis G, Manfredi G, Buscarini E, Ciuffi M, Ignomirelli O, Farinati F, Savarino E, Pallini P, Milan L, Conigliaro R, Grande G, Cannizzaro R, Maiero S, Pisani A, Marangi S, Manta R, Morelli O, Peralta S, La Mantia A, Buonocore MR, Khalaf K, Hassan C, Monica F. Real-time determination of gastric juice pH with EndoFaster® for atrophic gastritis assessment. Dig Liver Dis 2022; 54:1646-1648. [PMID: 35794064 DOI: 10.1016/j.dld.2022.06.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 06/08/2022] [Accepted: 06/09/2022] [Indexed: 12/30/2022]
Abstract
BACKGROUND In patients with atrophic gastritis involving gastric body mucosa the pH value of gastric juice is distinctly increased, so that pH assessment would allow predict this precancerous lesion. We tested whether EndoFaster® - a device allowing real-time pH measure and H. pylori diagnosis - may optimize the need of taking gastric biopsies. METHODS In this prospective, multicentre study, the accuracy of EndoFaster® for ruling out gastric atrophy involving corporal mucosa was assessed. Real-time pH and ammonium determination was performed by aspirating 3-6 ml gastric juice during endoscopy. Histology performed on 5 standard gastric biopsies was used as gold standard. RESULTS A total of 1008 consecutive patients were observed in 12 centres. At histology, gastric body mucosa atrophy/metaplasia was detected in 65 (6.4%) cases, and a pH value >4.5 in the gastric juice was observed in 150 patients. The values of EndoFaster® performance in predicting the presence of atrophic gastritis were as follow: 51% sensitivity, 84% specificity, 18% PPV, 96% NPV, and 82% accuracy. The NPV value was not distinctly affected by neither ongoing proton pump inhibitor therapy nor H. pylori infection. By considering also data of ammonium concentrations, the values of EndoFaster® in detecting extensive atrophy on gastric mucosa were 74% sensitivity, 84% specificity, 24% PPV, 98% NPV, and 83% accuracy. CONCLUSION The very high NPV of EndoFaster® might allow to safely rule out presence of atrophic gastritis, reducing the need of taking gastric biopsies in unselected patients managed in clinical practice.
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Affiliation(s)
- Angelo Zullo
- Gastroenterology Unit, Gastroenterologia ed Endoscopia Digestiva, 'Nuovo Regina Margherita' Hospital, Via Emilio Morosini, 30, Rome 00153 , Italy.
| | - Bastianello Germanà
- Gastroenterology and Digestive Endoscopy Unit, 'San Martino' Hospital, Belluno, Italy
| | - Ermenegildo Galliani
- Gastroenterology and Digestive Endoscopy Unit, 'San Martino' Hospital, Belluno, Italy
| | - Andrea Iori
- Gastroenterology and Digestive Endoscopy Unit, Santa Chiara' Hospital, Trento, Italy
| | - Giovanni de Pretis
- Gastroenterology and Digestive Endoscopy Unit, Santa Chiara' Hospital, Trento, Italy
| | - Guido Manfredi
- Gastroenterology and Digestive Endoscopy Unit, 'Maggiore' Hospital, Crema, Italy
| | - Elisabetta Buscarini
- Gastroenterology and Digestive Endoscopy Unit, 'Maggiore' Hospital, Crema, Italy
| | - Mario Ciuffi
- Endoscopy Unit, IRCCS CROB, Rionero in Vulture, Italy
| | | | - Fabio Farinati
- Gastroenterology Unit, University of Padua, Padua, Italy
| | | | - Paolo Pallini
- Gastroenterology Unit, 'San Bortolo' Hospital, Vicenza, Italy
| | - Luisa Milan
- Gastroenterology Unit, 'San Bortolo' Hospital, Vicenza, Italy
| | - Rita Conigliaro
- Gastroenterology Unit, 'Ospedale Civile Baggiovara', Modena, Italy
| | - Giuseppe Grande
- Gastroenterology Unit, 'Ospedale Civile Baggiovara', Modena, Italy
| | | | - Stefania Maiero
- Experimental Oncological Gastroenterology Unit, CRO, Aviano, Italy
| | - Antonio Pisani
- Gastroenterology Unit, 'Saverio De Bellis' Research Hospital, Castellana Grotte, Italy
| | - Stefania Marangi
- Gastroenterology Unit, 'Saverio De Bellis' Research Hospital, Castellana Grotte, Italy
| | - Raffaele Manta
- Gastroenterology Unit, 'Santa Maria della Misericordia' Hospital, Perugia, Italy
| | - Olivia Morelli
- Gastroenterology Unit, 'Santa Maria della Misericordia' Hospital, Perugia, Italy
| | - Sergio Peralta
- Gastroenterology Unit, 'AOU Policlinico', Palermo, Italy
| | | | | | - Kareem Khalaf
- Division of Gastroenterology and Digestive Endoscopy, Humanitas Research Hospital - IRCCS, Milan, Italy
| | - Cesare Hassan
- Division of Gastroenterology and Digestive Endoscopy, Humanitas Research Hospital - IRCCS, Milan, Italy
| | - Fabio Monica
- Gastroenterology and Digestive Endoscopy, 'Cattinara' Academic Hospital, Trieste, Italy
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Zullo A, Germanà B, Galliani E, Iori A, de Pretis G, Manfredi G, Buscarini E, Ciuffi M, Ignomirelli O, Farinati F, Savarino E, Pallini P, Milan L, Conigliaro R, Grande G, Cannizzaro R, Maiero S, Pisani A, Marangi S, Manta R, Morelli O, Peralta S, Mantia AL, Rossano Buonocore M, Monica F. Real-time gastric juice analysis with EndoFaster for H. pylori diagnosis: a large, multicentre study. Eur J Gastroenterol Hepatol 2022; 34:1121-1124. [PMID: 36170680 DOI: 10.1097/meg.0000000000002429] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
BACKGROUND Helicobacter pylori infection is the main cause of the most frequent gastroduodenal diseases. Because its prevalence is decreasing in developed countries, gastric biopsies are negative in several patients. By measuring ammonium in the gastric juice, EndoFaster allows to exclude H. pylori infection during endoscopy. This study aimed to assess the accuracy of device versions working with either 6 ml or 3 ml of gastric juice. STUDY DESIGN This prospective study involved 12 endoscopic units. During endoscopy, EndoFaster testing was performed and standard five gastric biopsies were taken. The accuracy was calculated by considering histological assessment as the gold standard for H. pylori diagnosis. RESULTS Gastric juice analysis was attempted in 1279 patients, but it failed in 131 (15.5%) and in 10 (2.3%), with the 6 ml and the 3 ml device, respectively (P < 0.001). Overall, EndoFaster detected H. pylori infection with an 86.3% sensitivity, 83.3% specificity, 52.7% positive predictive value, 96.6% negative predictive value and 83.8% accuracy. The performance was not affected either by ongoing proton pump inhibitor therapy or a previous H. pylori eradication. No significant difference in accuracy emerged between the two versions of the device. CONCLUSION The novel version of the EndoFaster device operating with 3 ml gastric juice may be performed in virtually all patients, and it allows excluding H. pylori infection with a very high accuracy. Gastric biopsies can be avoided in a definite portion of cases without endoscopic lesions or other clinical indications.
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Affiliation(s)
- Angelo Zullo
- Gastroenterology Unit, 'Nuovo Regina Margherita' Hospital, Rome
| | - Bastianello Germanà
- Gastroenterology and Digestive Endoscopy Unit, 'San Martino' Hospital, Belluno
| | | | - Andrea Iori
- Gastroenterology and Digestive Endoscopy Unit,' Santa Chiara' Hospital, Trento
| | - Giovanni de Pretis
- Gastroenterology and Digestive Endoscopy Unit,' Santa Chiara' Hospital, Trento
| | - Guido Manfredi
- Gastroenterology and Digestive Endoscopy Unit, 'Maggiore' Hospital, Crema
| | | | | | | | | | | | - Paolo Pallini
- Gastroenterology Unit, 'San Bortolo' Hospital, Vicenza
| | - Luisa Milan
- Gastroenterology Unit, 'San Bortolo' Hospital, Vicenza
| | | | | | | | | | - Antonio Pisani
- Gastroenterology Unit, 'Saverio De Bellis' Research Hospital, Castellana Grotte
| | - Stefania Marangi
- Gastroenterology Unit, 'Saverio De Bellis' Research Hospital, Castellana Grotte
| | - Raffaele Manta
- Gastroenterology Unit, 'Santa Maria della Misericordia' Hospital, Perugia
| | - Olivia Morelli
- Gastroenterology Unit, 'Santa Maria della Misericordia' Hospital, Perugia
| | | | | | | | - Fabio Monica
- Gastroenterology and Digestive Endoscopy, 'Cattinara' Academic Hospital, Trieste, Italy
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Andreuzzi E, Fejza A, Polano M, Poletto E, Camicia L, Carobolante G, Tarticchio G, Todaro F, Di Carlo E, Scarpa M, Scarpa M, Paulitti A, Capuano A, Canzonieri V, Maiero S, Fornasarig M, Cannizzaro R, Doliana R, Colombatti A, Spessotto P, Mongiat M. Colorectal cancer development is affected by the ECM molecule EMILIN-2 hinging on macrophage polarization via the TLR-4/MyD88 pathway. J Exp Clin Cancer Res 2022; 41:60. [PMID: 35148799 PMCID: PMC8840294 DOI: 10.1186/s13046-022-02271-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 01/22/2022] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Colorectal cancer is one of the most frequent and deadly tumors. Among the key regulators of CRC growth and progression, the microenvironment has emerged as a crucial player and as a possible route for the development of new therapeutic opportunities. More specifically, the extracellular matrix acts directly on cancer cells and indirectly affecting the behavior of stromal and inflammatory cells, as well as the bioavailability of growth factors. Among the ECM molecules, EMILIN-2 is frequently down-regulated by methylation in CRC and the purpose of this study was to verify the impact of EMILIN-2 loss in CRC development and its possible value as a prognostic biomarker. METHODS The AOM/DSS CRC protocol was applied to Emilin-2 null and wild type mice. Tumor development was monitored by endoscopy, the molecular analyses performed by IHC, IF and WB and the immune subpopulations characterized by flow cytometry. Ex vivo cultures of monocyte/macrophages from the murine models were used to verify the molecular pathways. Publicly available datasets were exploited to determine the CRC patients' expression profile; Spearman's correlation analyses and Cox regression were applied to evaluate the association with the inflammatory response; the clinical outcome was predicted by Kaplan-Meier survival curves. Pearson correlation analyses were also applied to a cohort of patients enrolled in our Institute. RESULTS In preclinical settings, loss of EMILIN-2 associated with an increased number of tumor lesions upon AOM/DSS treatment. In addition, in the early stages of the disease, the Emilin-2 knockout mice displayed a myeloid-derived suppressor cells-rich infiltrate. Instead, in the late stages, lack of EMILIN-2 associated with a decreased number of M1 macrophages, resulting in a higher percentage of the tumor-promoting M2 macrophages. Mechanistically, EMILIN-2 triggered the activation of the Toll-like Receptor 4/MyD88/NF-κB pathway, instrumental for the polarization of macrophages towards the M1 phenotype. Accordingly, dataset and immunofluorescence analyses indicated that low EMILIN-2 expression levels correlated with an increased M2/M1 ratio and with poor CRC patients' prognosis. CONCLUSIONS These novel results indicate that EMILIN-2 is a key regulator of the tumor-associated inflammatory environment and may represent a promising prognostic biomarker for CRC patients.
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Affiliation(s)
- Eva Andreuzzi
- Department of Research and Diagnosis, Division of Molecular Oncology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy.
| | - Albina Fejza
- Department of Research and Diagnosis, Division of Molecular Oncology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | - Maurizio Polano
- Experimental and Clinical Pharmacology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | - Evelina Poletto
- Department of Research and Diagnosis, Division of Molecular Oncology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | - Lucrezia Camicia
- Department of Research and Diagnosis, Division of Molecular Oncology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | - Greta Carobolante
- Department of Research and Diagnosis, Division of Molecular Oncology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | - Giulia Tarticchio
- Department of Research and Diagnosis, Division of Molecular Oncology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | - Federico Todaro
- Department of Research and Diagnosis, Division of Molecular Oncology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | - Emma Di Carlo
- Department of Medicine and Sciences of Aging, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy.,Anatomic Pathology and Immuno-Oncology Unit, Center for Advanced Studies and Technology (CAST), "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy
| | - Melania Scarpa
- Ricerca Traslazionale Avanzata, Istituto Oncologico Veneto IOV - IRCCS, Padua, Italy
| | - Marco Scarpa
- Clinica Chirurgica I- Azienda Ospedaliera di Padova, Padua, Italy
| | - Alice Paulitti
- Department of Research and Diagnosis, Division of Molecular Oncology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | - Alessandra Capuano
- Department of Research and Diagnosis, Division of Molecular Oncology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | - Vincenzo Canzonieri
- Pathology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | - Stefania Maiero
- Division of Oncological Gastroenterology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | - Mara Fornasarig
- Division of Oncological Gastroenterology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | - Renato Cannizzaro
- Division of Oncological Gastroenterology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | - Roberto Doliana
- Department of Research and Diagnosis, Division of Molecular Oncology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | - Alfonso Colombatti
- Department of Research and Diagnosis, Division of Molecular Oncology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | - Paola Spessotto
- Department of Research and Diagnosis, Division of Molecular Oncology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | - Maurizio Mongiat
- Department of Research and Diagnosis, Division of Molecular Oncology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy.
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4
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Repici A, Spada C, Cannizzaro R, Traina M, Maselli R, Maiero S, Galtieri A, Guarnieri G, Di Leo M, Lorenzetti R, Capogreco A, Spadaccini M, Antonelli G, Zullo A, Amata M, Ferrara E, Correale L, Granata A, Cesaro P, Radaelli F, Minelli Grazioli L, Anderloni A, Fugazza A, Finati E, Pellegatta G, Carrara S, Occhipinti P, Buda A, Fuccio L, Manno M, Hassan C. Novel 1-L polyethylene glycol + ascorbate versus high-volume polyethylene glycol regimen for colonoscopy cleansing: a multicenter, randomized, phase IV study. Gastrointest Endosc 2021; 94:823-831.e9. [PMID: 33940043 DOI: 10.1016/j.gie.2021.04.020] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Accepted: 04/18/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND AIMS Adequate bowel cleansing is critical to ensure quality and safety of a colonoscopy. A novel 1-L polyethylene glycol plus ascorbate (1L-PEG+ASC) regimen was previously validated against low-volume regimens but was never compared with high-volume regimens. METHODS In a phase IV study, patients undergoing colonoscopy were randomized 1:1 to receive split-dose 1L PEG+ASC or a split-dose 4-L PEG-based regimen (4L-PEG) in 5 Italian centers. Preparation was assessed with the Boston Bowel Preparation Scale (BBPS) by local endoscopists and centralized reading, both blinded to the randomization arm. The primary endpoint was noninferiority of 1L-PEG+ASC in colon cleansing. Secondary endpoints were superiority of 1L-PEG+ASC, patient compliance, segmental colon cleansing, adenoma detection rate, tolerability, and safety. RESULTS Three hundred eighty-eight patients (median age, 59.8 years) were randomized between January 2019 and October 2019: 195 to 1L-PEG+ASC and 193 to 4L-PEG. Noninferiority of 1L-PEG+ASC was demonstrated for cleansing in both the entire colon (BBPS ≥ 6: 97.9% vs 93%; relative risk [RR], 1.03; 95% confidence interval [CI], 1.001-1.04; P superiority = .027) and in the right-sided colon segment (98.4% vs 96.0%; RR, 1.02; 95% CI, .99-1.02; P noninferiority = .013). Compliance was higher with 1L-PEG+ASC than with 4L-PEG (178/192 [92.7%] vs 154/190 patients [81.1%]; RR, 1.10; 95% CI, 1.05-1.12), whereas no difference was found regarding safety (moderate/severe side effects: 20.8% vs 25.8%; P = .253). No difference in adenoma detection rate (38.8% vs 43.0%) was found. CONCLUSIONS One-liter PEG+ASC showed noninferiority compared with 4L-PEG in achieving adequate colon cleansing and provided a higher patient compliance. No differences in tolerability and safety were detected. (Clinical trial registration number: NCT03742232.).
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Affiliation(s)
- Alessandro Repici
- Endoscopy Unit, Humanitas Clinical and Research Center, IRCCS, Milan, Italy; Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Cristiano Spada
- Digestive Endoscopy Unit and Gastroenterology, Fondazione Poliambulanza, Brescia, Italy; Digestive Endoscopy Unit, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Renato Cannizzaro
- UO Oncological Gastroenterology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | - Mario Traina
- Endoscopy Service, Department of Diagnostic and Therapeutic Services, Istituto ISMETT, Palermo, Italy
| | - Roberta Maselli
- Endoscopy Unit, Humanitas Clinical and Research Center, IRCCS, Milan, Italy
| | - Stefania Maiero
- UO Oncological Gastroenterology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | - Alessia Galtieri
- Endoscopy Unit, Humanitas Clinical and Research Center, IRCCS, Milan, Italy
| | - Giovanni Guarnieri
- UO Oncological Gastroenterology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | - Milena Di Leo
- Endoscopy Unit, Humanitas Clinical and Research Center, IRCCS, Milan, Italy
| | | | - Antonio Capogreco
- Endoscopy Unit, Humanitas Clinical and Research Center, IRCCS, Milan, Italy
| | - Marco Spadaccini
- Endoscopy Unit, Humanitas Clinical and Research Center, IRCCS, Milan, Italy
| | - Giulio Antonelli
- Digestive Endoscopy, Nuovo Regina Margherita Hospital, Rome, Italy
| | - Angelo Zullo
- Digestive Endoscopy, Nuovo Regina Margherita Hospital, Rome, Italy
| | - Michele Amata
- Endoscopy Service, Department of Diagnostic and Therapeutic Services, Istituto ISMETT, Palermo, Italy
| | - Elisa Ferrara
- Endoscopy Unit, Humanitas Clinical and Research Center, IRCCS, Milan, Italy
| | | | - Antonino Granata
- Endoscopy Service, Department of Diagnostic and Therapeutic Services, Istituto ISMETT, Palermo, Italy
| | - Paola Cesaro
- Digestive Endoscopy Unit and Gastroenterology, Fondazione Poliambulanza, Brescia, Italy
| | | | | | - Andrea Anderloni
- Endoscopy Unit, Humanitas Clinical and Research Center, IRCCS, Milan, Italy
| | - Alessandro Fugazza
- Endoscopy Unit, Humanitas Clinical and Research Center, IRCCS, Milan, Italy
| | - Elena Finati
- Endoscopy Unit, Humanitas Clinical and Research Center, IRCCS, Milan, Italy
| | - Gaia Pellegatta
- Endoscopy Unit, Humanitas Clinical and Research Center, IRCCS, Milan, Italy
| | - Silvia Carrara
- Endoscopy Unit, Humanitas Clinical and Research Center, IRCCS, Milan, Italy
| | - Pietro Occhipinti
- Department of Gastroenterology, "Maggiore Della Carità" Hospital, Novara, Italy
| | - Andrea Buda
- Gastroenterology Unit, Santa Maria del Prato Hospital, Feltre, Italy
| | - Lorenzo Fuccio
- Gastroenterology Unit, Department of Medical and Surgical Sciences, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Mauro Manno
- Digestive Endoscopy Unit, Carpi-Mirandola Hospitals, Azienda USL Modena
| | - Cesare Hassan
- Digestive Endoscopy, Nuovo Regina Margherita Hospital, Rome, Italy
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5
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Andreuzzi E, Fejza A, Capuano A, Poletto E, Pivetta E, Doliana R, Pellicani R, Favero A, Maiero S, Fornasarig M, Cannizzaro R, Iozzo RV, Spessotto P, Mongiat M. Deregulated expression of Elastin Microfibril Interfacer 2 (EMILIN2) in gastric cancer affects tumor growth and angiogenesis. Matrix Biol Plus 2020; 6-7:100029. [PMID: 33543026 PMCID: PMC7852313 DOI: 10.1016/j.mbplus.2020.100029] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2019] [Revised: 02/13/2020] [Accepted: 02/13/2020] [Indexed: 02/06/2023] Open
Abstract
Gastric cancer is a frequent human tumor and often a lethal disease. Targeted therapy for gastric carcinomas is far behind vis-à-vis other solid tumors, primarily because of the paucity of cancer-driving mutations that could be efficiently and specifically targeted by current therapy. Thus, there is a need to discover actionable pathways/proteins and new diagnostic and prognostic biomarkers. In this study, we explored the role of the extracellular matrix glycoprotein EMILIN2, Elastin Microfibril Interfacer 2, in a cohort of gastric cancer patients. We discovered that EMILIN2 expression was consistently suppressed in gastric cancer and high expression levels of this glycoprotein were linked to abnormal vascular density. Furthermore, we found that EMILIN2 had a dual effect on gastric carcinoma cells: on one hand, it decreased tumor cell proliferation by triggering apoptosis, and on the other hand, it evoked the production of a number of cytokines involved in angiogenesis and inflammation, such as IL-8. Collectively, our findings posit EMILIN2 as an important onco-regulator exerting pleiotropic effects on the gastric cancer microenvironment. EMILIN2 is localized in the gastric lamina propria and its expression is down-regulated in gastric cancer. High levels of EMILIN2 associate with elevated vascular density. EMILIN2 impairs the proliferation of gastric cancer cells by evoking apoptosis. Surprisingly, EMILIN2 triggers the expression of pro-angiogenic and pro-inflammatory cytokines.
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Key Words
- 5-FU, 5-fluorouracil
- Angiogenesis
- CAFCA, Centrifugal Assay for Fluorescence-based Cell Adhesion
- CD31, cluster of differentiation 31 also known as PECAM-1
- ECM, extracellular matrix
- EGFR, epidermalgrowth factor receptor
- EMILIN 2, Elastin Microfibril Interfacer 2
- Extracellular matrix
- GC, gastric cancer
- Gastric cancer
- HER2, human epidermal growth factor receptor 2
- IGFBP2, insulin growth factor-binding protein 2
- Inflammation
- PFS, progression free survival
- Serpin 1, serine protease inhibitor 1
- Tumor microenvironment
- VEGFA, vascular endothelial growth factor A
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Affiliation(s)
- Eva Andreuzzi
- Department of Research and Diagnosis, Division of Molecular Oncology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Italy
| | - Albina Fejza
- Department of Research and Diagnosis, Division of Molecular Oncology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Italy
| | - Alessandra Capuano
- Department of Research and Diagnosis, Division of Molecular Oncology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Italy
| | - Evelina Poletto
- Department of Research and Diagnosis, Division of Molecular Oncology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Italy
| | - Eliana Pivetta
- Department of Research and Diagnosis, Division of Molecular Oncology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Italy
| | - Roberto Doliana
- Department of Research and Diagnosis, Division of Molecular Oncology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Italy
| | - Rosanna Pellicani
- Department of Research and Diagnosis, Division of Molecular Oncology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Italy
| | - Andrea Favero
- Department of Research and Diagnosis, Division of Molecular Oncology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Italy
| | - Stefania Maiero
- Department of Clinical Oncology, Experimental Gastrointestinal, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Italy
| | - Mara Fornasarig
- Department of Clinical Oncology, Experimental Gastrointestinal, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Italy
| | - Renato Cannizzaro
- Department of Clinical Oncology, Experimental Gastrointestinal, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Italy
| | - Renato V Iozzo
- Department of Pathology, Anatomy, and Cell Biology and the Cancer Cell Biology and Signaling Program, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, USA
| | - Paola Spessotto
- Department of Research and Diagnosis, Division of Molecular Oncology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Italy
| | - Maurizio Mongiat
- Department of Research and Diagnosis, Division of Molecular Oncology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Italy
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6
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Lenti MV, Lahner E, Bergamaschi G, Miceli E, Conti L, Massironi S, Cococcia S, Zilli A, Caprioli F, Vecchi M, Maiero S, Cannizzaro R, Corazza GR, Annibale B, Di Sabatino A. Cell Blood Count Alterations and Patterns of Anaemia in Autoimmune Atrophic Gastritis at Diagnosis: A Multicentre Study. J Clin Med 2019; 8:jcm8111992. [PMID: 31731715 PMCID: PMC6912578 DOI: 10.3390/jcm8111992] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2019] [Revised: 11/11/2019] [Accepted: 11/12/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Autoimmune atrophic gastritis (AAG) leads to iron and/or vitamin B12 malabsorption, with subsequent haematological alterations which could represent the sole clinical manifestation. We aimed to assess patterns of anaemia and micronutrient deficiencies in patients with AAG at the time of diagnosis. METHODS Observational, multicentre, cross-sectional study including consecutive adult patients diagnosed with AAG within the last ten years. Cell blood count, red cell distribution width, serum vitamin B12, and ferritin were collected. Multivariate analysis for predictive factors of anaemia was computed. RESULTS 654 AAG patients (mean age 59.2 ± 13.8 years, female (F): male (M) ratio = 2.3:1) were included. Anaemia was present in 316 patients (48.3%; mean age 60.1 ± 15.8 years, F:M ratio = 2.3:1). Pernicious anaemia (132/316 cases, 41.7%) was more common in males (27.1% versus 12.4%; p = 0.001) and in older patients (63.0 ± 14.6 versus 58.9 ± 14.9 years; p = 0.014), while iron deficiency anaemia (112/316 cases, 35.4%) was more common in females (16.9% versus 10.0%; p = 0.039) and in younger patients (56.8 ± 16.6 versus 60.2 ± 14.6 years; p = 0.043). The prevalence of iron deficiency was equally distributed between anaemic and non-anaemic patients (p = 0.9). Anisocytosis (odds ratio: 10.65, 95% confidence interval: 6.13-18.50, p < 0.0001) was independently associated with anaemia. CONCLUSIONS Anaemia is a common manifestation in AAG patients, mostly due to micronutrient deficiencies. Scant haematologic alterations and micronutrient deficiencies may precede overt anaemia.
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Affiliation(s)
- Marco Vincenzo Lenti
- First Department of Medicine, Istituto di Ricovero e Cura a Carattere Scientifico San Matteo Hospital Foundation, University of Pavia, Piazzale Golgi 19, 27100 Pavia, Italy (G.B.); (E.M.); (S.C.); (G.R.C.)
| | - Edith Lahner
- Department of Surgical-Medical Sciences and Translational Medicine, Digestive and Liver Disease Unit, Sant’Andrea Hospital, Sapienza University of Rome, 00185 Roma, Italy; (E.L.); (L.C.); (B.A.)
| | - Gaetano Bergamaschi
- First Department of Medicine, Istituto di Ricovero e Cura a Carattere Scientifico San Matteo Hospital Foundation, University of Pavia, Piazzale Golgi 19, 27100 Pavia, Italy (G.B.); (E.M.); (S.C.); (G.R.C.)
| | - Emanuela Miceli
- First Department of Medicine, Istituto di Ricovero e Cura a Carattere Scientifico San Matteo Hospital Foundation, University of Pavia, Piazzale Golgi 19, 27100 Pavia, Italy (G.B.); (E.M.); (S.C.); (G.R.C.)
| | - Laura Conti
- Department of Surgical-Medical Sciences and Translational Medicine, Digestive and Liver Disease Unit, Sant’Andrea Hospital, Sapienza University of Rome, 00185 Roma, Italy; (E.L.); (L.C.); (B.A.)
| | - Sara Massironi
- Department of Gastroenterology and Endoscopy, IRCCS Ca’ Granda Foundation, University of Milan, 20122 Milano, Italy; (S.M.); (A.Z.); (F.C.); (M.V.)
| | - Sara Cococcia
- First Department of Medicine, Istituto di Ricovero e Cura a Carattere Scientifico San Matteo Hospital Foundation, University of Pavia, Piazzale Golgi 19, 27100 Pavia, Italy (G.B.); (E.M.); (S.C.); (G.R.C.)
| | - Alessandra Zilli
- Department of Gastroenterology and Endoscopy, IRCCS Ca’ Granda Foundation, University of Milan, 20122 Milano, Italy; (S.M.); (A.Z.); (F.C.); (M.V.)
| | - Flavio Caprioli
- Department of Gastroenterology and Endoscopy, IRCCS Ca’ Granda Foundation, University of Milan, 20122 Milano, Italy; (S.M.); (A.Z.); (F.C.); (M.V.)
| | - Maurizio Vecchi
- Department of Gastroenterology and Endoscopy, IRCCS Ca’ Granda Foundation, University of Milan, 20122 Milano, Italy; (S.M.); (A.Z.); (F.C.); (M.V.)
| | - Stefania Maiero
- Oncological Gastroenterology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, 33081 Aviano, Italy; (S.M.)
| | - Renato Cannizzaro
- Oncological Gastroenterology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, 33081 Aviano, Italy; (S.M.)
| | - Gino Roberto Corazza
- First Department of Medicine, Istituto di Ricovero e Cura a Carattere Scientifico San Matteo Hospital Foundation, University of Pavia, Piazzale Golgi 19, 27100 Pavia, Italy (G.B.); (E.M.); (S.C.); (G.R.C.)
| | - Bruno Annibale
- Department of Surgical-Medical Sciences and Translational Medicine, Digestive and Liver Disease Unit, Sant’Andrea Hospital, Sapienza University of Rome, 00185 Roma, Italy; (E.L.); (L.C.); (B.A.)
| | - Antonio Di Sabatino
- First Department of Medicine, Istituto di Ricovero e Cura a Carattere Scientifico San Matteo Hospital Foundation, University of Pavia, Piazzale Golgi 19, 27100 Pavia, Italy (G.B.); (E.M.); (S.C.); (G.R.C.)
- Correspondence: ; Tel.: +39-038-2502-973; Fax: +39-038-2502-618
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Cannizzaro R, Maiero S, Fornasarig M, Canzonieri V, Magris R, Guarnieri G, Urbani M, Buonadonna A, Baresic T, Spessotto P. Probe-based confocal laser endomicroscopy (pCLE) is a suitable method for extrapulmonary high grade neuroendocrine rectal carcinoma (HGNEC) evaluation. Onco Targets Ther 2019; 12:4577-4583. [PMID: 31354291 PMCID: PMC6590055 DOI: 10.2147/ott.s198034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Accepted: 03/18/2019] [Indexed: 11/30/2022] Open
Abstract
The potential role of the probe-based confocal laser endomicroscopy (pCLE) has been analyzed in different pathologic conditions of the gastrointestinal tract. Here, we analyzed a case of extrapulmonary high grade neuroendocrine rectal carcinoma (HGNEC) using, for the first time, the pCLE system. A 72-year old man was diagnosed with an 8 cm diameter rectal HGNEC by standard colonoscopy integrated with the pCLE system. The diagnosis of neuroendocrine carcinoma was confirmed by immunohistochemical analyses. By using the pCLE system, we well defined and resolved vascular structures and mucosal architecture. An altered mucosal pattern and vascular defects, peculiar for HGNEC, were observed at high magnification, allowing the identification of a pattern which was quite different from that observed in poorly differentiated adenocarcinomas (PDA) where tissues appear darker, very irregular, even if glandular structures can still be recognized. This underlines the usefulness of pCLE in discriminating HGNECs from PDAs. In conclusion, pCLE could represent a valid and helpful method for in vivo HGNEC diagnosis, allowing prompt and careful management of the patient.
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Affiliation(s)
- Renato Cannizzaro
- Oncological Gastroenterology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | - Stefania Maiero
- Oncological Gastroenterology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | - Mara Fornasarig
- Oncological Gastroenterology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | - Vincenzo Canzonieri
- Pathology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | - Raffaella Magris
- Oncological Gastroenterology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | - Giovanni Guarnieri
- Oncological Gastroenterology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | - Martina Urbani
- Oncologic Radiation Therapy and Diagnostic Imaging, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | - Angela Buonadonna
- Medical Oncology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | - Tanja Baresic
- Nuclear Medicine, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | - Paola Spessotto
- Molecular Oncology, Department of Translational Research, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
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8
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Cannizzaro R, Magris R, Fornasarig M, Pivetta E, Maiero S, Mongiat M, De Re V, Canzonieri V, De Paoli A, Turriziani V, Guarnieri G, Buonadonna A, Belluco C, Serraino D, Spessotto P. Evaluation of neoangiogenesis in locally advanced gastric cancer before and after neoadjuvant radiochemotherapy by probe confocal laser endomicroscopy (PCLE). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz155.292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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9
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Guarnieri G, Magris R, Maiero S, Fornasarig M, Belluco C, Canzonieri V, Cannizzaro R. Is FNA always necessary in submucosal lesion miming GIST? Ann Oncol 2019. [DOI: 10.1093/annonc/mdz155.322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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10
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Capuano A, Andreuzzi E, Pivetta E, Doliana R, Favero A, Canzonieri V, Maiero S, Fornasarig M, Magris R, Cannizzaro R, Mongiat M, Spessotto P. The Probe Based Confocal Laser Endomicroscopy (pCLE) in Locally Advanced Gastric Cancer: A Powerful Technique for Real-Time Analysis of Vasculature. Front Oncol 2019; 9:513. [PMID: 31263680 PMCID: PMC6584847 DOI: 10.3389/fonc.2019.00513] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Accepted: 05/29/2019] [Indexed: 12/24/2022] Open
Abstract
Probe based confocal laser endomicroscopy (pCLE) is an advanced technique which provides imaging of gastrointestinal mucosa at subcellular resolution and, importantly, a valid tool for the evaluation of microvasculature during endoscopic examination. In order to assess intratumoral vascularization and the efficiency of blood flow in locally advanced gastric cancer, we examined 57 patients through pCLE imaging. The vascular alterations in gastric cancer were mainly characterized by leakage and by the presence of tortuous and large size vessels. Defects in blood flow were detected very rarely. No association between the angiogenic score and the gastric tumor site or histological type was observed. Interestingly, no correlation was also found with the tumor grading indicating that the vascular angiogenic anomalies in gastric cancer represent an early pathological event to be observed and detected. The majority of patients displayed unchanged vascular alterations following neoadjuvant chemotherapy and this positively correlated with stable or progressive disease, suggesting that an unaltered angiogenic score could per se be indicative of poor therapeutic efficacy. Different vascular parameters were evaluated by immunofluorescence using bioptic samples and the vessel density did not correlate with clinical staging, site or histologic type. Interestingly, only CD105, Multimerin-2 and GLUT1 were able to discriminate normal from tumoral gastric mucosa. Taken together, these findings indicate that functional and structural angiogenic parameters characteristic of tumor blood network were fully detectable by pCLE. Moreover, the evaluation of tumor vasculature by real-time assessment may provide useful information to achieve tailored therapeutic interventions for gastric cancer patients.
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Affiliation(s)
- Alessandra Capuano
- Molecular Oncology, Centro di Riferimento Oncologico (CRO), IRCCS, Aviano, Italy
| | - Eva Andreuzzi
- Molecular Oncology, Centro di Riferimento Oncologico (CRO), IRCCS, Aviano, Italy
| | - Eliana Pivetta
- Molecular Oncology, Centro di Riferimento Oncologico (CRO), IRCCS, Aviano, Italy
| | - Roberto Doliana
- Molecular Oncology, Centro di Riferimento Oncologico (CRO), IRCCS, Aviano, Italy
| | - Andrea Favero
- Molecular Oncology, Centro di Riferimento Oncologico (CRO), IRCCS, Aviano, Italy
| | | | - Stefania Maiero
- Oncological Gastroenterology, Centro di Riferimento Oncologico (CRO), IRCCS, Aviano, Italy
| | - Mara Fornasarig
- Oncological Gastroenterology, Centro di Riferimento Oncologico (CRO), IRCCS, Aviano, Italy
| | - Raffaella Magris
- Oncological Gastroenterology, Centro di Riferimento Oncologico (CRO), IRCCS, Aviano, Italy
| | - Renato Cannizzaro
- Oncological Gastroenterology, Centro di Riferimento Oncologico (CRO), IRCCS, Aviano, Italy
| | - Maurizio Mongiat
- Molecular Oncology, Centro di Riferimento Oncologico (CRO), IRCCS, Aviano, Italy
| | - Paola Spessotto
- Molecular Oncology, Centro di Riferimento Oncologico (CRO), IRCCS, Aviano, Italy
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11
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Fornasarig M, Magris R, De Re V, Bidoli E, Canzonieri V, Maiero S, Viel A, Cannizzaro R. Molecular and Pathological Features of Gastric Cancer in Lynch Syndrome and Familial Adenomatous Polyposis. Int J Mol Sci 2018; 19:ijms19061682. [PMID: 29882764 PMCID: PMC6032275 DOI: 10.3390/ijms19061682] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Revised: 05/28/2018] [Accepted: 06/01/2018] [Indexed: 12/12/2022] Open
Abstract
Lynch syndrome (LS) and familial adenomatous polyposis (FAP) are autosomal dominant hereditary diseases caused by germline mutations leading to the development of colorectal cancer. Moreover, these mutations result in the development of a spectrum of different tumors, including gastric cancers (GCs). Since the clinical characteristics of GCs associated with LS and FAP are not well known, we investigated clinical and molecular features of GCs occurring in patients with LS and FAP attending our Institution. The Hereditary Tumor Registry was established in 1994 at the Department of Oncologic Gastroenterology, CRO Aviano National Cancer Institute, Italy. It includes 139 patients with LS and 86 patients with FAP. Patients were recruited locally for prospective surveillance. Out of 139 LS patients, 4 developed GC—3 in the presence of helicobacter pylori infection and 1 on the background of autoimmune diseases. All GCs displayed a high microsatellite instability (MSI-H) and loss of related mismatch repair (MMR) protein. One of the FAP patients developed a flat adenoma, displaying low-grade dysplasia at the gastric body, and another poorly differentiated adenocarcinoma with signet ring cells like Krukenberg without HP infection. LS carriers displayed a risk of GC. The recognition of HP infection and autoimmune diseases would indicate those at higher risk for an endoscopic surveillance. Regarding FAP, the data suggested the need of suitable endoscopic surveillance in long survivals with diffuse fundic gland polyps.
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Affiliation(s)
- Mara Fornasarig
- SOC di Gastroenterologia Oncologica, Centro di Riferimento Oncologico IRCSS, 33081 Aviano, Italy.
| | - Raffaella Magris
- SOC di Gastroenterologia Oncologica, Centro di Riferimento Oncologico IRCSS, 33081 Aviano, Italy.
| | - Valli De Re
- SOSD Immunopatologia e biomarcatori Oncologico, Centro di Riferimento Oncologico IRCSS, 33081 Aviano, Italy.
| | - Ettore Bidoli
- SOC di Epidemiologia, Centro di Riferimento Oncologico IRCSS, 33081 Aviano, Italy.
| | - Vincenzo Canzonieri
- SOSD di Anatomia Patologica, Centro di Riferimento Oncologico IRCSS, 33081 Aviano, Italy.
| | - Stefania Maiero
- SOC di Gastroenterologia Oncologica, Centro di Riferimento Oncologico IRCSS, 33081 Aviano, Italy.
| | - Alessandra Viel
- SOSD Oncogenetica e Oncogenomica Funzionale, Centro di Riferimento Oncologico IRCSS, 33081 Aviano, Italy.
| | - Renato Cannizzaro
- SOC di Gastroenterologia Oncologica, Centro di Riferimento Oncologico IRCSS, 33081 Aviano, Italy.
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12
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Fornasarig M, Magris R, Maiero S, Viel A, Canton E, Canzonieri V, Cannizzaro R. Gastric cancer in Lynch Syndrome: Are precancerous conditions co- risk factors? Ann Oncol 2018. [DOI: 10.1093/annonc/mdy151.088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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13
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Cannizzaro R, Magris R, Maiero S, Fornasarig M, De Zorzi M, Zanette G, Mazzon C, Canton E, Steffan A, Canzonieri V, De Re V. Genetic polymorphisms and PG1/PG2 and G17 levels can predict gastric carcinoids in autoimmune atrophic chronic gastritis patients. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy151.087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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14
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Spessotto P, Fornasarig M, Pivetta E, Maiero S, Magris R, Mongiat M, Canzonieri V, De Paoli P, De Paoli A, Buonadonna A, Serraino D, Panato C, Belluco C, Cannizzaro R. Probe-based confocal laser endomicroscopy for in vivo evaluation of the tumor vasculature in gastric and rectal carcinomas. Sci Rep 2017; 7:9819. [PMID: 28852161 PMCID: PMC5575283 DOI: 10.1038/s41598-017-10963-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Accepted: 08/17/2017] [Indexed: 12/17/2022] Open
Abstract
Probe-based Confocal Laser Endomicroscopy (pCLE) is a powerful imaging technique that allows to perform gastrointestinal endomicroscopy at subcellular resolution. The aim of this study was to assess the use of pCLE to evaluate tumor angiogenesis in rectal and gastric cancers. A total of 35 consecutive patients with gastric and 91 with rectal carcinomas underwent endoscopy and pCLE during the same examination. Vascular assessment was based on vessel shape and size, vessel permeability and blood flow, and allowed the creation of an angiogenic score ranging from 0, for normal vasculature, to 4, for aberrant vasculature. A significant difference for the presence of vessels with large diameter and defective blood flow was found between rectal and gastric cancers. Overall, rectal cancers displayed a higher angiogenic score compared to gastric cancers. Conventional therapy induced a striking reduction in the angiogenic score only in rectal cancer patients. Taken together, our findings suggest that the pCLE technology is suitable for the evaluation of the tumor microvasculature abnormalities. Therefore, the real-time assessment of the vasculature status may represent a promising approach to predict the efficacy of the treatments and improve the clinical management of patients with gastric or rectal carcinomas.
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Affiliation(s)
- Paola Spessotto
- Molecular Oncology, Department of Translational Research, CRO-IRCCS, National Cancer Institute, Aviano, Italy
| | - Mara Fornasarig
- Gastroenterology, CRO-IRCCS, National Cancer Institute, Aviano, Italy
| | - Eliana Pivetta
- Molecular Oncology, Department of Translational Research, CRO-IRCCS, National Cancer Institute, Aviano, Italy
| | - Stefania Maiero
- Gastroenterology, CRO-IRCCS, National Cancer Institute, Aviano, Italy
| | - Raffaella Magris
- Gastroenterology, CRO-IRCCS, National Cancer Institute, Aviano, Italy
| | - Maurizio Mongiat
- Molecular Oncology, Department of Translational Research, CRO-IRCCS, National Cancer Institute, Aviano, Italy
| | | | - Paolo De Paoli
- Scientific Directorate, CRO-IRCCS, National Cancer Institute, Aviano, Italy
| | - Antonino De Paoli
- Radiation Oncology, CRO-IRCCS, National Cancer Institute, Aviano, Italy
| | - Angela Buonadonna
- Medical Oncology, CRO-IRCCS, National Cancer Institute, Aviano, Italy
| | - Diego Serraino
- Epidemiology and Biostatistics, CRO-IRCCS, National Cancer Institute, Aviano, Italy
| | - Chiara Panato
- Epidemiology and Biostatistics, CRO-IRCCS, National Cancer Institute, Aviano, Italy
| | - Claudio Belluco
- Surgical Oncology, CRO-IRCCS, National Cancer Institute, Aviano, Italy
| | - Renato Cannizzaro
- Gastroenterology, CRO-IRCCS, National Cancer Institute, Aviano, Italy.
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Cannizzaro R, Magris R, De Zorzi M, Maiero S, Caggiari L, Fornasarig M, Repetto O, De Re V. Interference of PG2 TATA BOX region with the serum PG2 level in gastric cancer. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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16
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Cannizzaro R, Andreuzzi E, Tarticchio G, Paulitti A, Marastoni S, Pellicani R, Di Carlo E, Magris R, Maiero S, Fornasarig M, Colombatti A, Mongiat M. EMILIN2, extracellular matrix protein, as a regulator of the myeloid response in a model of inflammation-induced colon carcinogenesis. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx261.241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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17
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Maiero S, Cannizzaro R, Fornasarig M, Magris R, Spessotto P, Mongiat M, De Re V, De Paoli A, Bertola G, Canzonieri V, Buonadonna A. Angiogenesis evaluation in locally advanced colo-rectal and gastric cancers by probe-based Confocal Laser Endomicroscopy (pCLE). Ann Oncol 2016. [DOI: 10.1093/annonc/mdw335.30] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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18
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De Re V, Orzes E, Canzonieri V, Maiero S, Fornasarig M, Alessandrini L, Cervo S, Steffan A, Zanette G, Mazzon C, De Paoli P, Cannizzaro R. Pepsinogens to Distinguish Patients With Gastric Intestinal Metaplasia and Helicobacter pylori Infection Among Populations at Risk for Gastric Cancer. Clin Transl Gastroenterol 2016; 7:e183. [PMID: 27441820 PMCID: PMC5543486 DOI: 10.1038/ctg.2016.42] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Accepted: 06/08/2016] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVES The objectives of this study were to investigate the serum pepsinogen test for the prediction of OLGIM (Operative Link on Gastric Intestinal Metaplasia Assessment) stages in first-degree relatives (FDR-GC) of patients with gastric cancer (GC) and autoimmune chronic atrophic gastritis (ACAG). METHODS In 67 consecutive patients with ACAG, 82 FDR-GC, and 53 controls (CTRL) without gastric disease (confirmed by biopsy), serum levels of pepsinogen 1 (PG1), pepsinogen 2 (PG2), G17, and the PG1/2 ratio were assessed by enzyme-linked immunosorbent assay kit. All ACAG patients had positive antiparietal cell antibody levels, estimated by indirect immunofluorescence. Biopsies taken in duplicate from the antrum, corpus, and fundus were stained with Giemsa for Helicobacter pylori detection. Endoscopic detection of metaplasia was confirmed by histological diagnosis. Histological classification of OLGIM stages was applied by using the criteria of severity and topography of intestinal metaplasia (IM). RESULTS The highest discrimination capacity for distinguishing ACAG from other groups of patients was the gastrin G17 test. The lowest mean for PG1 and PG2 serum levels was found in ACAG. In multivariate analysis by age, PG1 and PG1/PG2 were independent prognostic factors for metaplasia, and PG2 also for the presence of a histological H. pylori infection. The serum PG1 level was significantly lower in individuals with IM at OLGIM stage >2 than in those with IM at OLGIM stage <2, resulting in a useful method for the prediction of OLGIM stage. With the inclusion of patient age at diagnosis in the prediction of ≥2 vs. 0-1 OLGIM stages, the receiver operating characteristic (ROC) curve at 47.9 ng/ml PG1 level reached a significant area under the curve (AUC) value (0.978, P<0.001). We also observed a slight difference in PG2 serum levels between histological H. pylori-positive and H. pylori-negative subjects (ROC AUC: 0.599). CONCLUSIONS This study demonstrated an important increase in gastrin G17 serum level in autoimmune gastritis. PG1 serum level corrected by patient age can be used in the management of patients at risk for GC with a high predicted probability of having an OLGIM stage ≥2. Using a cutoff of 47.9 ng/ml, PG1 testing in FDR-GC and ACAG patients had a sensitivity of 95.83% and a specificity of 93.37. Although these results could be validated in a prospective study, the known importance of higher OLGIM stages in increasing the risk of GC development supports the rationale of proposing PG1 algorithm as a diagnostic tool for the selection of high-risk FDR-GC and ACAG patients at high-risk stages for subsequent detailed endoscopic examination to detect dysplasia and asymptomatic GC. In addition, serum PG1 and PG2 levels could stratify patients based on both H. pylori infection and OLGIM risk in consideration of the increased acknowledge regarding the role of H. pylori in the progression of gastritis to GC.
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Affiliation(s)
- Valli De Re
- Bio-Immunotherapy/Bio-Proteomics, National Cancer Institute, IRCCS, Centro di Riferimento Oncologico, Aviano, Italy
| | - Enrico Orzes
- Division of Oncological Gastroenterology, National Cancer Institute, IRCCS, Centro di Riferimento Oncologico, Aviano, Italy
| | - Vincenzo Canzonieri
- Division of Pathology, National Cancer Institute, IRCCS, Centro di Riferimento Oncologico, Aviano, Italy
| | - Stefania Maiero
- Division of Oncological Gastroenterology, National Cancer Institute, IRCCS, Centro di Riferimento Oncologico, Aviano, Italy
| | - Mara Fornasarig
- Division of Oncological Gastroenterology, National Cancer Institute, IRCCS, Centro di Riferimento Oncologico, Aviano, Italy
| | - Lara Alessandrini
- Division of Pathology, National Cancer Institute, IRCCS, Centro di Riferimento Oncologico, Aviano, Italy
| | - Silvia Cervo
- Clinical Pathology, National Cancer Institute, IRCCS, Centro di Riferimento Oncologico, Aviano, Italy
| | - Agostino Steffan
- Clinical Pathology, National Cancer Institute, IRCCS, Centro di Riferimento Oncologico, Aviano, Italy
| | - Giorgio Zanette
- Division of Diabetology, Pordenone Hospital, Pordenone, Italy
| | - Cinzia Mazzon
- Division of Endocrinology, Pordenone Hospital, Pordenone, Italy
| | - Paolo De Paoli
- Scientific Direction, National Cancer Institute, IRCCS, Centro di Riferimento Oncologico, Aviano, Italy
| | - Renato Cannizzaro
- Division of Oncological Gastroenterology, National Cancer Institute, IRCCS, Centro di Riferimento Oncologico, Aviano, Italy
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Zucchi E, Fornasarig M, Martella L, Maiero S, Lucia E, Borsatti E, Balestreri L, Giorda G, Annunziata MA, Cannizzaro R. Decompressive percutaneous endoscopic gastrostomy in advanced cancer patients with small-bowel obstruction is feasible and effective: a large prospective study. Support Care Cancer 2016; 24:2877-82. [PMID: 26838026 DOI: 10.1007/s00520-016-3102-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2015] [Accepted: 01/24/2016] [Indexed: 10/22/2022]
Abstract
PURPOSE The purpose of this study was to evaluate patient-centered outcomes of decompressive percutaneous endoscopic gastrostomy (dPEG) in patients with malignant bowel obstruction due to advanced gynecological and gastroenteric malignancies. METHODS This is a prospective analysis of 158 consecutive patients with small-bowel obstruction from advanced gynecological and gastroenteric cancer who underwent PEG or percutaneous endoscopic jejunostomy (PEJ) positioning for decompressive purposes from 2002 to 2012. All of them had previous abdominal surgery and were unfit for any other surgical procedures. Symptom relief, procedural complications, and post dPEG palliation were assessed. Global Quality of Life (QoL) was evaluated in the last 2 years (25 consecutive patients) before and 7 days after dPEG placement using the Symptom Distress Scale (SDS). RESULTS dPEG was successfully performed in 142 out of 158 patients (89.8 %). Failure of tube placement occurred in 16 patients (10.1 %). In 8/142 (5.6 %) patients, dPEG was guided by abdominal ultrasound. In 3/142 patients, dPEG was CT-guided. In 14 (9.8 %) patients, who had previously undergone total or subtotal gastrectomy, decompressive percutaneous endoscopic jejunostomy (dPEJ) was performed. In 1/14 patients, dPEJ was CT-guided. Out of 142 patients, 110 (77.4 %) experienced relief from nausea and vomiting 2 days after PEG. Out of 142 patients, 116 (81.6 %) were discharged. The median postoperative hospital stay was 9 days (range 3-60). Peristomal infection (14 %) and intermittent obstruction (8.4 %) were the most frequent complications associated with PEG. Median survival time was 57 days (range 4-472) after PEG placement. Twenty-five patients had QoL properly evaluated with SDS score before and 7 days after dPEG. Sixteen patients (64 %) out of 25 exhibited an improvement of QoL (p < 0.05), 7 (28 %) patients exhibited a non-significant worsening of QoL (p = 0.18), and in 2 (8 %) patients, it remained unmodified. CONCLUSIONS dPEG is feasible, effective, relieves nausea and vomiting in patients with unremitting small-bowel obstruction from advanced gynecological and gastroenteric cancer, and improves QoL.
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Affiliation(s)
- Elena Zucchi
- Department of Gastroenterology, National Cancer Institute, Centro di Riferimento Oncologico IRCCS, Via Franco Gallini, 2 33081, Aviano, PN, Italy
| | - Mara Fornasarig
- Department of Gastroenterology, National Cancer Institute, Centro di Riferimento Oncologico IRCCS, Via Franco Gallini, 2 33081, Aviano, PN, Italy
| | - Luca Martella
- Department of Surgery, National Cancer Institute, Centro di Riferimento Oncologico IRCCS, Aviano, PN, Italy
| | - Stefania Maiero
- Department of Gastroenterology, National Cancer Institute, Centro di Riferimento Oncologico IRCCS, Via Franco Gallini, 2 33081, Aviano, PN, Italy
| | - Emilio Lucia
- Division of Gynecologic Oncology, National Cancer Institute, Centro di Riferimento Oncologico IRCCS, Aviano, PN, Italy
| | - Eugenio Borsatti
- Department of Nuclear Medicine, National Cancer Institute, Centro di Riferimento Oncologico IRCCS, Aviano, PN, Italy
| | - Luca Balestreri
- Department of Radiology, National Cancer Institute, Centro di Riferimento Oncologico IRCCS, Aviano, PN, Italy
| | - Giorgio Giorda
- Division of Gynecologic Oncology, National Cancer Institute, Centro di Riferimento Oncologico IRCCS, Aviano, PN, Italy
| | - Maria Antonietta Annunziata
- Unit of Oncological Psychology, National Cancer Institute, Centro di Riferimento Oncologico IRCCS, Aviano, PN, Italy
| | - Renato Cannizzaro
- Department of Gastroenterology, National Cancer Institute, Centro di Riferimento Oncologico IRCCS, Via Franco Gallini, 2 33081, Aviano, PN, Italy.
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Cannizzaro R, De Re V, Spessotto P, Mongiat M, Maiero S, Orzes E, Fornasarig M, Buonadonna A, De Paoli A, Bertola G, Canzonieri V. P-319 Angiogenesis evaluation in locally advanced colo-rectal and gastric cancers by probe-based Confocal Laser Endomicroscopy (pCLE). Ann Oncol 2015. [DOI: 10.1093/annonc/mdv233.315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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21
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Garziera M, Canzonieri V, Cannizzaro R, Geremia S, Caggiari L, De Zorzi M, Maiero S, Orzes E, Perin T, Zanussi S, De Paoli P, De Re V. Identification and characterization of CDH1 germline variants in sporadic gastric cancer patients and in individuals at risk of gastric cancer. PLoS One 2013; 8:e77035. [PMID: 24204729 PMCID: PMC3812172 DOI: 10.1371/journal.pone.0077035] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2013] [Accepted: 09/05/2013] [Indexed: 02/06/2023] Open
Abstract
Objective To screen and characterize germline variants for E-cadherin (CDH1) in non-hereditary gastric cancer (GC) patients and in subjects at risk of GC. Methods 59 GCs, 59 first degree relatives (FDRs) of GC, 20 autoimmune metaplastic atrophic gastritis (AMAGs) and 52 blood donors (BDs) were analyzed for CDH1 by direct sequencing, structural modelling and bioinformatics. Functional impact on splicing was assessed for intronic mutations. E-cadherin/β-catenin immunohistochemical staining and E-cadherin mRNA quantification using RT-PCR were performed. Results In GCs, 4 missense variants (p.G274S; p.A298T; p.T470I; p.A592T), 1 mutation in the 5′UTR (−71C>G) and 1 mutation in the intronic IVS12 (c.1937-13T>C) region were found. First pathogenic effect of p.A298T mutation was predicted by protein 3D modelling. The novel p.G274S mutation showed a no clear functional significance. Moreover, first, intronic IVS12 (c.1937-13T>C) mutation was demonstrated to lead to an aberrant CDH1 transcript with exon 11 deletion. This mutation was found in 2 GCs and in 1 BD. In FDRs, we identified 4 variants: the polymorphic (p.A592T) and 3 mutations in untranslated regions with unidentified functional role except for the 5′UTR (−54G>C) that had been found to decrease CDH1 transcription. In AMAGs, we detected 2 alterations: 1 missense (p.A592T) and 1 novel variant (IVS1 (c.48+7C>T)) without effect on CDH1 splicing. Several silent and polymorphic substitutions were found in all the groups studied. Conclusions Overall our study improves upon the current characterization of CDH1 mutations and their functional role in GC and in individuals at risk of GC. Mutations found in untranslated regions and data on splicing effects deserve a particular attention like associated with a reduced E-cadherin amount. The utility of CDH1 screening, in addition to the identification of other risk factors, could be useful for the early detection of GC in subjects at risk (i.e. FDRs and AMAGs), and warrants further study.
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Affiliation(s)
- Marica Garziera
- Departement of Translational Research, Centro di Riferimento Oncologico (CRO), National Cancer Institute, Aviano, Pordenone, Italy
| | - Vincenzo Canzonieri
- Pathology Unit, Centro di Riferimento Oncologico (CRO), National Cancer Institute, Aviano, Pordenone, Italy
| | - Renato Cannizzaro
- Gastroenterology Unit, Centro di Riferimento Oncologico (CRO), National Cancer Institute, Aviano, Pordenone, Italy
| | - Silvano Geremia
- CEB-Centre of Excellence in Biocrystallography, Department of Chemical Sciences, University of Trieste, Trieste, Italy
| | - Laura Caggiari
- Departement of Translational Research, Centro di Riferimento Oncologico (CRO), National Cancer Institute, Aviano, Pordenone, Italy
| | - Mariangela De Zorzi
- Departement of Translational Research, Centro di Riferimento Oncologico (CRO), National Cancer Institute, Aviano, Pordenone, Italy
| | - Stefania Maiero
- Gastroenterology Unit, Centro di Riferimento Oncologico (CRO), National Cancer Institute, Aviano, Pordenone, Italy
| | - Enrico Orzes
- Gastroenterology Unit, Centro di Riferimento Oncologico (CRO), National Cancer Institute, Aviano, Pordenone, Italy
| | - Tiziana Perin
- Pathology Unit, Centro di Riferimento Oncologico (CRO), National Cancer Institute, Aviano, Pordenone, Italy
| | - Stefania Zanussi
- Microbiology-Immunology and Virology Unit, Centro di Riferimento Oncologico (CRO), National Cancer Institute, Aviano, Pordenone, Italy
| | - Paolo De Paoli
- Scientific Director, Centro di Riferimento Oncologico (CRO), National Cancer Institute, Aviano, Pordenone, Italy
| | - Valli De Re
- Departement of Translational Research, Centro di Riferimento Oncologico (CRO), National Cancer Institute, Aviano, Pordenone, Italy
- * E-mail:
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Hassan C, Fuccio L, Bruno M, Pagano N, Spada C, Carrara S, Giordanino C, Rondonotti E, Curcio G, Dulbecco P, Fabbri C, Della Casa D, Maiero S, Simone A, Iacopini F, Feliciangeli G, Manes G, Rinaldi A, Zullo A, Rogai F, Repici A. A predictive model identifies patients most likely to have inadequate bowel preparation for colonoscopy. Clin Gastroenterol Hepatol 2012; 10:501-6. [PMID: 22239959 DOI: 10.1016/j.cgh.2011.12.037] [Citation(s) in RCA: 193] [Impact Index Per Article: 16.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2011] [Revised: 12/13/2011] [Accepted: 12/20/2011] [Indexed: 12/14/2022]
Abstract
BACKGROUND & AIMS An inadequate level of bowel preparation can affect the efficacy and safety of colonoscopy. Although some factors have been associated with outcome, there is no strategy to identify patients at high risk for inadequate preparation. We searched for factors associated with an inadequate level of preparation and tested the validity of a predictive clinical rule based on these factors. METHODS We performed a prospective study of 2811 consecutive patients who underwent colonoscopy examinations at 18 medical centers; clinical and demographic data were collected before the colonoscopy. Bowel preparation was classified as adequate or inadequate; 925 patients (33%) were found to have inadequate preparation. Multivariate analysis was used to identify factors associated with inadequate preparation, which were expressed as odds ratio (OR) and used to build a predictive model. RESULTS Factors associated with inadequate bowel preparation included being overweight (OR, 1.5), male sex (OR, 1.2), a high body mass index (OR, 1.1), older age (OR, 1.01), previous colorectal surgery (OR, 1.6), cirrhosis (OR, 5), Parkinson disease (OR, 3.2), diabetes (OR, 1.8), and positive results in a fecal occult test (OR, 0.6). These factors predicted which patients would have inadequate cleansing with 60% sensitivity, 59% specificity, 41% positive predictive value, and 76% negative predictive value; they had an under the receiver operating characteristic curve value of 0.63. Assuming 100% efficacy of a hypothetical regimen to address patients predicted to be at risk of inadequate preparation, the rate would decrease from 33% to 13%. CONCLUSIONS We identified factors associated with inadequate bowel preparation for colonoscopy and used these to build an accurate predictive model.
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Affiliation(s)
- Cesare Hassan
- Endoscopy Unit, Humanitas Irccs, Rozzano, Milano, Italy.
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Girelli CM, Maiero S, Porta P, Cannizzaro R. Small bowel capsule endoscopy performance in octogenarians: a case-control study. J Gerontol A Biol Sci Med Sci 2010; 66:68-73. [PMID: 20974730 DOI: 10.1093/gerona/glq186] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND AND STUDY AIMS Capsule endoscopy is a high-sensitive tool for the investigation of suspected small bowel disorders, but its effectiveness in elderly patients is unknown. We sought to determine capsule endoscopy feasibility and diagnostic yield in octogenarians. PATIENTS AND METHODS Records of patients ≥ 80 years old (Group A) were retrieved from a database of 827 consecutive capsule endoscopy performed on as many patients. Capsule endoscopy failures, complications, diagnostic yield, and findings were recorded and compared with those of patients younger than 80 (Group B), randomly extracted from the same database in a > 2:1 ratio. RESULTS Group A consisted of 79 patients, 84 ± 6 years old and Group B of 188, 44 ± 11 years old (p < .0001). We visualized the entire small bowel in 59 (74.6%) patients of Group A and in 169 (89%) of Group B (odds ratio = 0.33, 95% confidence interval: 0.16-0.66, p = .0025), mainly for capsule failures in reaching the duodenum; this event occurred in 10 patients of Group A and in 3 of Group B (odds ratio = 9, 95% confidence interval: 2.4-33.4, p = .0004). The rate of adverse events and diagnostic yield did not differ between the two groups. Inflammatory and neoplastic lesions were more common in Group A (odds ratio = 2.60, 95% confidence interval: 1.07-6.28, p = .03 and odds ratio = 2.01, 95% confidence interval: 1.02-3.97, p = .04, respectively). CONCLUSIONS In octogenarians, small bowel capsule endoscopy may be troublesome for capsule failure in reaching the duodenum. However, the diagnostic yield of small bowel capsule endoscopy and the rate of clinically significant lesions are high.
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Affiliation(s)
- Carlo M Girelli
- First Division of Internal Medicine, Service of Gastroenterology and Digestive Endoscopy, Hospital of Busto Arsizio, Busto Arsizio, Italy.
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Simula MP, Cannizzaro R, Canzonieri V, Pavan A, Maiero S, Toffoli G, De Re V. PPAR signaling pathway and cancer-related proteins are involved in celiac disease-associated tissue damage. Mol Med 2010; 16:199-209. [PMID: 20454521 DOI: 10.2119/molmed.2009.00173] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2009] [Accepted: 03/02/2010] [Indexed: 12/13/2022] Open
Abstract
Celiac disease (CD) is an immune-mediated disorder triggered by the ingestion of wheat gliadin and related proteins in genetically predisposed individuals. To find a proteomic CD diagnostic signature and to gain a better understanding of pathogenetic mechanisms associated with CD, we analyzed the intestinal mucosa proteome alterations using two dimensional difference gel electrophoresis (2D-DIGE) coupled with matrix assisted laser desorption ionization time of flight mass spectrometry (MALDI-TOF ms) of CD patients with varying degrees of histological abnormalities defined by Marsh criteria and controls. Our results clearly evidenced the presence of two groups of patients: Group A, including controls and Marsh 0-I CD patients; and Group B, consisting of CD subjects with grade II-III Oberhuber-Marsh classification. Differentially expressed proteins were involved mainly in lipid, protein and sugar metabolism. Interestingly, in Group B, several downregulated proteins (FABP1, FABP2, APOC3, HMGCS2, ACADM and PEPCK) were implicated directly in the peroxisome proliferator-activated receptor (PPAR) signaling pathway. Moreover, Group B patients presented a deregulation of some proteins involved in apoptosis/survival pathways: phosphatidylethanolamine-binding protein 1 (PEBP1), Ras-related nuclear protein (Ran) and peroxiredoxin 4 (PRDX4). PEBP1 downregulation and RAN and PRDX4 upregulation were associated with more severe tissue damage. Likewise, IgMs were found strongly upregulated in Group B. In conclusion, our results indicate that a downregulation of proteins involved in PPAR signaling and the modulation of several cancer-related proteins are associated with the highest CD histological score according to Oberhuber-Marsh classification.
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Affiliation(s)
- Maria Paola Simula
- Experimental and Clinical Pharmacology Unit, CRO Centro diRiferimento Oncologico, IRCCS National Cancer Institute, AVIANO (PN), Italy
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Sorrentino D, Terrosu G, Avellini C, Maiero S. Infliximab with low-dose methotrexate for prevention of postsurgical recurrence of ileocolonic Crohn disease. ACTA ACUST UNITED AC 2007; 167:1804-7. [PMID: 17846401 DOI: 10.1001/archinte.167.16.1804] [Citation(s) in RCA: 105] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Abstract
A simple extraction-free or direct quantitative ELISA for progesterone in bovine milk whey was developed. Whey samples are easy to collect, transport, and store. This method also allows for monitoring progesterone levels in cattle, which is important in reproductive management. The assay was designed to cover the concentration range 0.05 to 2 ng/mL, and the sensitivity of the method was 1.5 pg/mL. The intra- and interassay coefficients of variation were 8 and 12%, respectively. A high correlation (r = 0.90) between ELISA and radioimmunoassay measurements of progesterone in the same milk whey samples was obtained. The method can be easily applied in practice because samples can be stored at room temperature (22 to 26 degrees C) for 4 d. Moreover, because analysis requires milk coagulation, that process can be initiated during transport by standard mail services to the laboratory. Upon arrival at the laboratory, whey can be kept refrigerated for 1 wk before analysis. This tool is useful for monitoring luteal activity of dairy cows.
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Affiliation(s)
- A Comin
- Dipartimento di Scienze degli Alimenti, Università di Udine, Italy
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