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Chivasso P, Mastrogiovanni G, Bruno VD, Miele M, Colombino M, Triggiani D, Cafarelli F, Leone R, Rosapepe F, De Martino M, Morena E, Iesu I, Citro R, Masiello P, Iesu S. Systematic total arch replacement with thoraflex hybrid graft in acute type A aortic dissection: A single centre experience. Front Cardiovasc Med 2022; 9:997961. [PMID: 36312248 PMCID: PMC9614841 DOI: 10.3389/fcvm.2022.997961] [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: 07/19/2022] [Accepted: 09/20/2022] [Indexed: 12/03/2022] Open
Abstract
Introduction In the last two decades, a more aggressive approach has been encouraged to treat patients with acute type A aortic dissection (ATAAD), extending the repair to the aortic arch and proximal descending thoracic aorta with the frozen elephant trunk (FET) implantation. Here, we report our single-centre experience with the FET technique for the systematic treatment of emergency type A aortic dissection. Materials and methods Between December 2017 and January 2022, 69 consecutive patients were admitted with ATAAD; of those, 66 patients (62.9 ± 10.2 years of age, 81.8% men) underwent emergency hybrid aortic arch and FET repair with the multibranched Thoraflex hybrid graft and were enrolled in the study. Primary endpoints were 30 days- and in-hospital mortality. Secondary endpoints were postoperative morbidity and follow-up survival. To better clarify the impact of age on surgical outcomes, we have divided the study population into two groups: group A for patients <70 years of age (47 patients), and group B for patients ≥70 years (19 patients). Time-to-event analysis has been conducted using the Log-rank test and is displayed with Kaplan-Meier curves. A multiple Cox proportional Hazard model was developed to identify predictors of long-term survival with a stepwise backward/forward selection process. Results 30-days- and in-hospital mortality were 10.6 and 13.6%, respectively. Stroke occurred in three (4.5%) patients. Two (3.0%) patients experienced spinal cord ischemia. We did not find any statistically significant difference between the two groups in terms of main post-operative outcomes. The multivariable Cox proportional hazard model showed left ventricular ejection fraction (HR: 0.83, 95% CI: 0.79–0.92, p < 0.01), peripheral vascular disease (HR: 15.8, 95% CI: 3.9–62.9, p < 0.01), coronary malperfusion (HR: 0.10, 95% CI: 0.01–0.77, p =0.03), lower limbs malperfusion (HR: 5.1, 95% CI: 1.10–23.4, p = 0.04), and cardiopulmonary bypass time (HR: 1.02, 95% CI: 1–1.04, p = 0.01) as independent predictors of long term mortality. Conclusions Frozen elephant trunk repair to treat emergency type A aortic dissection appears to be associated with good early and mid-term clinical outcomes even in the elderly.
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Affiliation(s)
- Pierpaolo Chivasso
- Department of Emergency Cardiac Surgery, University Hospital San Giovanni di Dio e Ruggi d'Aragona, Salerno, Italy,*Correspondence: Pierpaolo Chivasso ;
| | - Generoso Mastrogiovanni
- Department of Emergency Cardiac Surgery, University Hospital San Giovanni di Dio e Ruggi d'Aragona, Salerno, Italy
| | - Vito Domenico Bruno
- Bristol Medical School, Translational Health Science Department, Bristol, United Kingdom
| | - Mario Miele
- Department of Emergency Cardiac Surgery, University Hospital San Giovanni di Dio e Ruggi d'Aragona, Salerno, Italy
| | - Mario Colombino
- Department of Emergency Cardiac Surgery, University Hospital San Giovanni di Dio e Ruggi d'Aragona, Salerno, Italy
| | - Donato Triggiani
- Department of Emergency Cardiac Surgery, University Hospital San Giovanni di Dio e Ruggi d'Aragona, Salerno, Italy
| | - Francesco Cafarelli
- Department of Emergency Cardiac Surgery, University Hospital San Giovanni di Dio e Ruggi d'Aragona, Salerno, Italy
| | - Rocco Leone
- Department of Emergency Cardiac Surgery, University Hospital San Giovanni di Dio e Ruggi d'Aragona, Salerno, Italy
| | - Felice Rosapepe
- Department of Emergency Cardiac Surgery, University Hospital San Giovanni di Dio e Ruggi d'Aragona, Salerno, Italy
| | - Matteo De Martino
- Department of Cardiac Anesthesia, University Hospital San Giovanni di Dio e Ruggi d'Aragona, Salerno, Italy
| | - Elvira Morena
- Department of Cardiac Anesthesia, University Hospital San Giovanni di Dio e Ruggi d'Aragona, Salerno, Italy
| | - Ivana Iesu
- Department of Cardiology, University Hospital San Giovanni di Dio e Ruggi d'Aragona, Salerno, Italy
| | - Rodolfo Citro
- Department of Cardiology, University Hospital San Giovanni di Dio e Ruggi d'Aragona, Salerno, Italy
| | - Paolo Masiello
- Department of Emergency Cardiac Surgery, University Hospital San Giovanni di Dio e Ruggi d'Aragona, Salerno, Italy
| | - Severino Iesu
- Department of Emergency Cardiac Surgery, University Hospital San Giovanni di Dio e Ruggi d'Aragona, Salerno, Italy
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Bruno W, Dalmasso B, Barile M, Andreotti V, Elefanti L, Colombino M, Vanni I, Allavena E, Barbero F, Passoni E, Merelli B, Pellegrini S, Morgese F, Danesi R, Calò V, Bazan V, D'Elia AV, Molica C, Gensini F, Sala E, Uliana V, Soma PF, Genuardi M, Ballestrero A, Spagnolo F, Tanda E, Queirolo P, Mandalà M, Stanganelli I, Palmieri G, Menin C, Pastorino L, Ghiorzo P. Predictors of germline status for hereditary melanoma: 5 years of multi-gene panel testing within the Italian Melanoma Intergroup. ESMO Open 2022; 7:100525. [PMID: 35777164 PMCID: PMC9434136 DOI: 10.1016/j.esmoop.2022.100525] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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: 04/15/2022] [Revised: 05/26/2022] [Accepted: 05/29/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND The incidence of cutaneous melanoma is increasing in Italy, in parallel with the implementation of gene panels. Therefore, a revision of national genetic assessment criteria for hereditary melanoma may be needed. The aim of this study was to identify predictors of susceptibility variants in the largest prospective cohort of Italian high-risk melanoma cases studied to date. MATERIALS AND METHODS From 25 Italian centers, we recruited 1044 family members and germline sequenced 940 cutaneous melanoma index cases through a shared gene panel, which included the following genes: CDKN2A, CDK4, BAP1, POT1, ACD, TERF2IP, MITF and ATM. We assessed detection rate according to familial status, region of origin, number of melanomas and presence and type of non-melanoma tumors. RESULTS The overall detection rate was 9.47% (5.53% analyzing CDKN2A alone), ranging from 5.14% in sporadic multiple melanoma cases (spoMPM) with two cutaneous melanomas to 13.9% in familial cases with at least three affected members. Three or more cutaneous melanomas in spoMPM cases, pancreatic cancer and region of origin predicted germline status [odds ratio (OR) = 3.23, 3.15, 2.43, P < 0.05]. Conversely, age > 60 years was a negative independent predictor (OR = 0.13, P = 0.008), and was the age category with the lowest detection rate, especially for CDKN2A. Detection rate was 19% when cutaneous melanoma and pancreatic cancer clustered together. CONCLUSIONS Gene panel doubled the detection rate given by CDKN2A alone. National genetic testing criteria may need a revision, especially regarding age cut-off (60) in the absence of strong family history, pancreatic cancer and/or a high number of cutaneous melanomas.
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Affiliation(s)
- W Bruno
- IRCCS Ospedale Policlinico San Martino, Genetics of Rare Cancers, Genoa, Italy; University of Genoa, Department of Internal Medicine and Medical Specialties (DiMI), Genoa, Italy.
| | - B Dalmasso
- IRCCS Ospedale Policlinico San Martino, Genetics of Rare Cancers, Genoa, Italy
| | - M Barile
- IRCCS Ospedale Policlinico San Martino, Genetics of Rare Cancers, Genoa, Italy
| | - V Andreotti
- IRCCS Ospedale Policlinico San Martino, Genetics of Rare Cancers, Genoa, Italy
| | - L Elefanti
- Immunology and Diagnostic Molecular Oncology Unit, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - M Colombino
- Unit of Cancer Genetics, Institute of Genetics and Biomedical Research of the National Research Council (IRGB-CNR), Sassari, Italy
| | - I Vanni
- IRCCS Ospedale Policlinico San Martino, Genetics of Rare Cancers, Genoa, Italy; University of Genoa, Department of Internal Medicine and Medical Specialties (DiMI), Genoa, Italy
| | - E Allavena
- University of Genoa, Department of Internal Medicine and Medical Specialties (DiMI), Genoa, Italy
| | - F Barbero
- IRCCS Ospedale Policlinico San Martino, Genetics of Rare Cancers, Genoa, Italy
| | - E Passoni
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - B Merelli
- Oncology Unit, ASST Papa Giovanni XXIIII, Bergamo, Italy
| | - S Pellegrini
- Immunology and Diagnostic Molecular Oncology Unit, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy; Department of Surgery, Oncology and Gastroenterology (DISCOG), University of Padua, Padua, Italy
| | - F Morgese
- Oncology Unit, AOU Ospedali Riuniti di Ancona, Ancona, Italy
| | - R Danesi
- Romagna Cancer Registry, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) 'Dino Amadori', Meldola, Italy
| | - V Calò
- Department of Surgical, Oncological and Oral Sciences, Section of Medical Oncology, University of Palermo, Palermo, Italy
| | - V Bazan
- Department of Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo, Palermo, Italy
| | - A V D'Elia
- Institute of Medical Genetics, ASUFC University Hospital of Udine, Udine, Italy
| | - C Molica
- Medical Oncology Unit, S. Maria della Misericordia Hospital, Perugia, Italy
| | - F Gensini
- Department of Experimental and Clinical Biomedical Sciences 'Mario Serio', University of Florence, Florence, Italy
| | - E Sala
- Cytogenetics and Medical Genetics Unit, H San Gerardo ASST Monza, Monza, Italy
| | - V Uliana
- Medical Genetics Unit, AOU di Parma, Parma, Italy
| | - P F Soma
- Casa di Cura Gibiino, Catania, Italy
| | - M Genuardi
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Medical Genetics Unit, Rome, Italy; Università Cattolica del Sacro Cuore, Department of Life Sciences and Public Health, Rome, Italy
| | - A Ballestrero
- IRCCS Ospedale Policlinico San Martino, Genetics of Rare Cancers, Genoa, Italy; University of Genoa, Department of Internal Medicine and Medical Specialties (DiMI), Genoa, Italy
| | - F Spagnolo
- IRCCS Ospedale Policlinico San Martino, Medical Oncology 2, Genoa, Italy
| | - E Tanda
- IRCCS Ospedale Policlinico San Martino, Medical Oncology 2, Genoa, Italy
| | - P Queirolo
- Division of Medical Oncology for Melanoma, Sarcoma, and Rare Tumors, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - M Mandalà
- Medical Oncology Unit, S. Maria della Misericordia Hospital, Perugia, Italy; Department of Surgery and Medicine, University of Perugia, Perugia, Italy
| | - I Stanganelli
- Skin Cancer Unit, IRCCS IRST Istituto Scientifico Romagnolo per lo Studio dei Tumori 'Dino Amadori' (IRST) IRCCS, Meldola, Italy; Dermatologic Unit, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - G Palmieri
- Unit of Cancer Genetics, Institute of Genetics and Biomedical Research of the National Research Council (IRGB-CNR), Sassari, Italy
| | - C Menin
- Immunology and Diagnostic Molecular Oncology Unit, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - L Pastorino
- IRCCS Ospedale Policlinico San Martino, Genetics of Rare Cancers, Genoa, Italy; University of Genoa, Department of Internal Medicine and Medical Specialties (DiMI), Genoa, Italy
| | - P Ghiorzo
- IRCCS Ospedale Policlinico San Martino, Genetics of Rare Cancers, Genoa, Italy; University of Genoa, Department of Internal Medicine and Medical Specialties (DiMI), Genoa, Italy
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Chivasso P, Masiello P, Miele M, Bruno VD, Genovino AC, Iesu I, Triggiani D, Colombino M, Cafarelli F, Leone R, Mastrogiovanni G, Iesu S. The need for custom made frozen elephant trunk: when and where. Cardiovasc Diagn Ther 2022; 12:516-520. [PMID: 36033221 PMCID: PMC9412212 DOI: 10.21037/cdt-22-191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 04/16/2022] [Accepted: 07/21/2022] [Indexed: 11/09/2022]
Abstract
The frozen elephant trunk (FET) technique is an increasingly common procedure to treat complex extensive aortic disease both in elective and emergency setting. In a contemporary era, several prostheses are available to be used by surgeons performing such procedures, merging the advantages of endovascular and conventional surgery and preparing a more useful landing zone for second-stage downstream endovascular or open repair. Thoraflex hybrid (Terumo Aortic, Scotland) is a largely used hybrid vascular device merging a conventional surgical vascular graft made of gelatin-sealed woven polyester graft with a nitinol self-expanding stent graft. Since its release in 2012, this prosthesis has gained a large consensus, mainly for the plexus version, which allows for single reimplantation of the epiaortic vessels. In the last few years, new devices have come out to offer new specific weapons to be used by the surgical team in different clinical scenarios. In this context, the need of making the supra-aortic vessel debranching easier and more functional to our surgical technique has pushed our demand for a customization of a conventional Thoraflex hybrid. Here we report a modification to its standard design, the concept beyond the “Custom device” and its potential advantages with regards to our peculiar implantation technique and intraoperative cerebral perfusion during circulatory arrest time.
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Affiliation(s)
- Pierpaolo Chivasso
- Department of Emergency Cardiac Surgery, University Hospital San Giovanni di Dio e Ruggi d’Aragona, Salerno, Italy
| | - Paolo Masiello
- Department of Emergency Cardiac Surgery, University Hospital San Giovanni di Dio e Ruggi d’Aragona, Salerno, Italy
| | - Mario Miele
- Department of Emergency Cardiac Surgery, University Hospital San Giovanni di Dio e Ruggi d’Aragona, Salerno, Italy
| | - Vito Domenico Bruno
- Bristol Medical School, Translational Health Science Department, Bristol, UK
| | - Alba Chiara Genovino
- Department of Emergency Cardiac Surgery, University Hospital San Giovanni di Dio e Ruggi d’Aragona, Salerno, Italy
| | - Ivana Iesu
- Department of Emergency Cardiac Surgery, University Hospital San Giovanni di Dio e Ruggi d’Aragona, Salerno, Italy
| | - Donato Triggiani
- Department of Emergency Cardiac Surgery, University Hospital San Giovanni di Dio e Ruggi d’Aragona, Salerno, Italy
| | - Mario Colombino
- Department of Emergency Cardiac Surgery, University Hospital San Giovanni di Dio e Ruggi d’Aragona, Salerno, Italy
| | - Francesco Cafarelli
- Department of Emergency Cardiac Surgery, University Hospital San Giovanni di Dio e Ruggi d’Aragona, Salerno, Italy
| | - Rocco Leone
- Department of Emergency Cardiac Surgery, University Hospital San Giovanni di Dio e Ruggi d’Aragona, Salerno, Italy
| | - Generoso Mastrogiovanni
- Department of Emergency Cardiac Surgery, University Hospital San Giovanni di Dio e Ruggi d’Aragona, Salerno, Italy
| | - Severino Iesu
- Department of Emergency Cardiac Surgery, University Hospital San Giovanni di Dio e Ruggi d’Aragona, Salerno, Italy
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Masiello P, Mastrogiovanni G, Presutto O, Chivasso P, Bruno VD, Colombino M, Miele M, Cafarelli F, Leone R, Triggiani D, Iesu S. Frozen elephant trunk procedure for complex aortic arch surgery: The Salerno experience with Thoraflex hybrid. J Card Surg 2021; 37:107-114. [PMID: 34662451 PMCID: PMC9297964 DOI: 10.1111/jocs.16086] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 07/15/2021] [Revised: 09/06/2021] [Accepted: 09/20/2021] [Indexed: 11/29/2022]
Abstract
Background and Aim of the Study To report early clinical outcomes of the frozen elephant trunk (FET) technique for the treatment of complex aortic diseases after transition from conventional elephant trunk. Methods A single‐center, retrospective study of patients who underwent hybrid aortic arch and FET repair for aortic arch and/or proximal descending aortic aneurysms, acute and chronic Stanford type A aortic dissection with arch and/or proximal descending involvement, Stanford type B acute and chronic aortic dissections with retrograde aortic arch involvement. Results Between December 2017 and May 2020, 70 consecutive patients (62.7 ± 10.6 years, 59 male) were treated: 41 (58.6%) for emergent conditions and 29 (41.4%) for elective. Technical success was 100%. In‐hospital mortality was 14.2% (n = 12, 17.1% emergent vs. 10.3% elective, P = NS); 2 (2.9%) major strokes; 1 (1.4%) spinal cord injury. Mean follow‐up was 12.5 months (interquartile range, 3.7–22.3). Overall survival at 3, 6, 12, and 24 months was 90% (95% confidence interval [CI], 83.2—97.3), 85.6% (95% CI, 77.7–94.3), 79.1% (95% CI, 69.9–89.5), 75.6% (95% CI, 65.8–86.9) and 73.5% (95% CI, 63.3–85.3). There were no aortic re‐interventions and no distal stent graft‐induced new entry (dSINE); 5 patients with residual type B dissection underwent TEVAR completion. Conclusions In a real‐world setting, FET with Thoraflex Hybrid demonstrated feasibility and good clinical outcomes, even in emergent setting. Our implant technique optimize cerebral perfusion reporting good results in terms of neurological complications. Techniques to perfect the procedure and to reduce remaining risks, and consensus on considerations such as standardized cerebral protection need to be reported.
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Affiliation(s)
- Paolo Masiello
- Department of Emergency Cardiac Surgery, Cardio-Thoracic-Vascular, University Hospital "San Giovanni di Dio e Ruggi D'Aragona", Salerno, Italy
| | - Generoso Mastrogiovanni
- Department of Emergency Cardiac Surgery, Cardio-Thoracic-Vascular, University Hospital "San Giovanni di Dio e Ruggi D'Aragona", Salerno, Italy
| | - Oreste Presutto
- Department of Emergency Cardiac Surgery, Cardio-Thoracic-Vascular, University Hospital "San Giovanni di Dio e Ruggi D'Aragona", Salerno, Italy
| | - Pierpaolo Chivasso
- Department of Emergency Cardiac Surgery, Cardio-Thoracic-Vascular, University Hospital "San Giovanni di Dio e Ruggi D'Aragona", Salerno, Italy
| | | | - Mario Colombino
- Department of Emergency Cardiac Surgery, Cardio-Thoracic-Vascular, University Hospital "San Giovanni di Dio e Ruggi D'Aragona", Salerno, Italy
| | - Mario Miele
- Department of Emergency Cardiac Surgery, Cardio-Thoracic-Vascular, University Hospital "San Giovanni di Dio e Ruggi D'Aragona", Salerno, Italy
| | - Francesco Cafarelli
- Department of Emergency Cardiac Surgery, Cardio-Thoracic-Vascular, University Hospital "San Giovanni di Dio e Ruggi D'Aragona", Salerno, Italy
| | - Rocco Leone
- Department of Emergency Cardiac Surgery, Cardio-Thoracic-Vascular, University Hospital "San Giovanni di Dio e Ruggi D'Aragona", Salerno, Italy
| | - Donato Triggiani
- Department of Emergency Cardiac Surgery, Cardio-Thoracic-Vascular, University Hospital "San Giovanni di Dio e Ruggi D'Aragona", Salerno, Italy
| | - Severino Iesu
- Department of Emergency Cardiac Surgery, Cardio-Thoracic-Vascular, University Hospital "San Giovanni di Dio e Ruggi D'Aragona", Salerno, Italy
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Chivasso P, Miele M, Romano R, Frunzo F, Presutto O, Colombino M, Cafarelli F, Baldi C, Fiore E, Masiello P, Mastrogiovanni G, Iesu S. Impella CP and ProtekDuo as a bridge to recovery following surgical revascularization complicated by electrical storm. Gen Thorac Cardiovasc Surg 2021; 69:877-881. [PMID: 33400196 DOI: 10.1007/s11748-020-01571-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Accepted: 12/12/2020] [Indexed: 10/22/2022]
Abstract
Short-term mechanical circulatory support (MCS) devices are designed to provide hemodynamic support for a wide range of clinical conditions such as high-risk cardiac surgery or interventional procedures, post-cardiotomy cardiogenic shock, acute decompensated heart failure. Electrical storm (defined as three or more sustained episodes of ventricular fibrillation-VF- in a 24-h period) is a rare but critical complication following revascularization in patients with ischemic heart disease and it is associated with a very high mortality (80-90%) both during the incident alone and during further observation. Here we report the case of a 38-year-old patient affected by coronary artery disease with moderate to severe left ventricular systolic dysfunction (EF 30-35%) who underwent emergency coronary artery bypass grafting (CABG) complicated by electrical storm and severe haemodynamic instability, successfully managed with a novel approach of biventricular mechanical circulatory support with extracorporeal life support (ECLS) in first instance, subsequently switched to Impella CP and ProtekDuo.
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Affiliation(s)
- Pierpaolo Chivasso
- Department of Emergency Cardiac Surgery, University Hospital 'San Giovanni di Dio e Ruggi d'Aragona', Via San Leonardo, 84125, Salerno, Italy.
| | - Mario Miele
- Department of Emergency Cardiac Surgery, University Hospital 'San Giovanni di Dio e Ruggi d'Aragona', Via San Leonardo, 84125, Salerno, Italy
| | - Rosalba Romano
- Department of Cardiac Anaethesia, University Hospital 'San Giovanni di Dio e Ruggi d'Aragona', Salerno, Italy
| | - Francesco Frunzo
- Department of Cardiac Anaethesia, University Hospital 'San Giovanni di Dio e Ruggi d'Aragona', Salerno, Italy
| | - Oreste Presutto
- Department of Emergency Cardiac Surgery, University Hospital 'San Giovanni di Dio e Ruggi d'Aragona', Via San Leonardo, 84125, Salerno, Italy
| | - Mario Colombino
- Department of Emergency Cardiac Surgery, University Hospital 'San Giovanni di Dio e Ruggi d'Aragona', Via San Leonardo, 84125, Salerno, Italy
| | - Francesco Cafarelli
- Department of Emergency Cardiac Surgery, University Hospital 'San Giovanni di Dio e Ruggi d'Aragona', Via San Leonardo, 84125, Salerno, Italy
| | - Cesare Baldi
- Department of Interventional Cardiology, University Hospital 'San Giovanni di Dio e Ruggi d'Aragona', Salerno, Italy
| | - Emanuele Fiore
- Department of Cardiac Anaethesia, University Hospital 'San Giovanni di Dio e Ruggi d'Aragona', Salerno, Italy
| | - Paolo Masiello
- Department of Emergency Cardiac Surgery, University Hospital 'San Giovanni di Dio e Ruggi d'Aragona', Via San Leonardo, 84125, Salerno, Italy
| | - Generoso Mastrogiovanni
- Department of Emergency Cardiac Surgery, University Hospital 'San Giovanni di Dio e Ruggi d'Aragona', Via San Leonardo, 84125, Salerno, Italy
| | - Severino Iesu
- Department of Emergency Cardiac Surgery, University Hospital 'San Giovanni di Dio e Ruggi d'Aragona', Via San Leonardo, 84125, Salerno, Italy
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Masiello P, Longobardi A, Mastrogiovanni G, Colombino M, Panza A, Cafarelli F, Del Negro G, Triggiani D, Rosapepe F, Iesu S. EP19 INFERIOR REVERSED J SHAPED MINI STERNOTOMY FOR MITRAL VALVE SURGERY. J Cardiovasc Med (Hagerstown) 2018. [DOI: 10.2459/01.jcm.0000549954.32347.fd] [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: 11/05/2022]
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Colombino M, Longobardi A, Panza A, Mastrogiovanni G, Masiello P, Del Negro G, Rosapepe F, Bisogno A, Di Domenico A, Iesu S. OC76 THE MORE PROCEDURE (MININVASIVE, OPCAB, RAPID SURGICAL INTENSIVE CARE UNIT EXIT, EXTUBATION INTO THE OPERATING ROOM). J Cardiovasc Med (Hagerstown) 2018. [DOI: 10.2459/01.jcm.0000549915.34133.ed] [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: 11/05/2022]
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D׳Auria F, Leone R, Mastrogiovanni G, Panza A, Colombino M, Longobardi A, Cafarelli F, Masiello P, D׳Auria C, Fiore E, Iesu S, Benedetto GD. The improvement of myocardial activity after coronary artery bypass grafting assessed by speckle tracking imaging. J Cardiothorac Vasc Anesth 2016. [DOI: 10.1053/j.jvca.2016.03.026] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Palomba G, Cossu A, Paliogiannis P, Pazzola A, Baldino G, Scartozzi M, Ionta M, Ortu S, Capelli F, Lanzillo A, Sedda T, Sanna G, Barca M, Virdis L, Colombino M, Casula M, Manca A, Tanda F, Budroni M, Palmieri G. Disease progression and overall survival in sardinian patients with colorectal cancer according to the kras mutational status. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv340.29] [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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Colombino M, Paliogiannis P, Defraia E, Porcu G, Pazzola A, Cordero L, Palomba G, Sini M, Manca A, Carta A, Saba E, Scotto T, Sarobba M, Capelli F, Ortu S, Baldino G, Sedda T, Pirina P, Budroni M, Cossu A, Palmieri G. Mutations in main candidate genes (egfr, kras, braf) among patients with non-small-cell lung cancer from sardinia. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv343.36] [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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De Giorgi V, Savarese I, D'Errico A, Gori A, Papi F, Colombino M, Sini MC, Stanganelli I, Palmieri G, Massi D. CDKN2A mutations could influence the dermoscopic pattern of presentation of multiple primary melanoma: a clinical dermoscopic genetic study. J Eur Acad Dermatol Venereol 2014; 29:574-80. [PMID: 25200134 DOI: 10.1111/jdv.12643] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2014] [Accepted: 06/17/2014] [Indexed: 01/02/2023]
Abstract
BACKGROUND Patients who develop cutaneous melanoma are at increased risk of developing a second primary melanoma. There are many aetiological reasons by which the risk of a second melanoma increases. Among others, genetic factors may contribute to modulating this risk. The risk of identifying a CDKN2A germline mutation increases with the number of primary melanomas and with the presence of familial history of melanoma. Patients with melanoma are especially encouraged to have regular follow-up visits with their dermatologist to perform clinical and dermatoscopic examination. In particular, dermoscopy could be very useful in multiple primary melanoma (MPM) patients. OBJECTIVES To analyse the clinical and dermatoscopic features of multiple melanomas, focusing on those features that are more frequently found in the same patient to recognize them earlier and understand whether they appear with the similar peculiar dermatoscopic features, especially in CDKN2A carriers. METHODS Medical records of MPM patients were selected from a database including 1065 patients with histopathologically proven melanoma diagnosis, all treated at the dermatology clinic of the University of Florence from 2000 to 2013. Pictures of melanoma were independently and blindly administered to three dermatologist experts in dermoscopy to evaluate the presence or absence of ABCD criteria for each clinical image, and the main pattern for the dermoscopic images. The results were then analyzed and crossed to rate the clinical and dermoscopic features of MPM. RESULTS Seventy five (7.0%) of 1065 patients included in our database were found to carry an MPM disease. Among them, we selected 12 (16%) patients with three or more MPMs. The presence of the CDKN2A melanoma susceptibility gene was observed in 4/12 (33.33%) patients; two patients presented the C500G and c.5 + 1delG polymorphisms in the CDKN2A gene. In CDKN2A carriers, each patient showed a similar and specific dermatoscopic pattern in their lesions. CONCLUSIONS Even being aware of the limitations of this study, according to hereditary characters and their modes of transmissions, we could speculate that for each patient with a CDKN2A germline mutation, it is possible to find the same kind of dermoscopical pattern among their melanocytic tumours.
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Affiliation(s)
- V De Giorgi
- Division Dermatology, Dept. of Surgery and Translational Medicine, University of Florence, Florence, Italy
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Colombino M, Sini M, De Giorgi V, Lissia A, Massi D, Rubino C, Cossu A, Ayala F, Ascierto P, Palmieri G. Multiple Primary Melanomas from Same Patients Present Discrepant Somatic Alterations in Main Candidate Genes. Ann Oncol 2012. [DOI: 10.1016/s0923-7534(20)33714-5] [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: 12/01/2022] Open
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Colombino M, Capone M, Maio M, De Giorgi V, Cossu A, Lissia A, Rubino C, Massidda B, Staibano S, Nappi O, Botti G, Caraco C, Mozzillo N, Manca A, Sini M, Ascierto PA, Palmieri G. Mutation frequency in BRAF and NRAS genes among primary tumors and different types of metastasis from melanoma patients. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.8574] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Palomba G, Colombino M, Contu AS, Massidda B, Baldino G, Ionta MT, Pazzola A, Capelli F, Trova V, Sedda T, Farris A, Tanda F, Budroni M, Palmieri G, Cossu A. Heterogeneous prevalence of mutations in KRAS, BRAF, and PIK3CA genes among Sardinian patients with colorectal carcinoma. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.e14100] [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: 11/20/2022] Open
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Palmieri G, Casula M, Budroni M, Cossu A, Tanda F, Ascierto PA, Canzanella S, Palomba G, Colombino M, Muggiano A. Correlation of polymorphic variants into the susceptibility of CDKN2 locus with melanoma outcome. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.8543] [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: 11/20/2022] Open
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Palmieri G, Sini MC, Casula M, Baldinu P, Palomba G, Colombino M, Ascierto PA, Botti G, Caracò C, Cossu A, Tanda F. Molecular classification for the management of melanoma patients. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.20028] [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: 11/20/2022] Open
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Palmieri G, Colombino M, Camboni MG, Manca A, Baldinu P, Izzo F, Tatangelo F, Calemma R, Cossu A, Galimi F. Assessment of the role of Fanconi Anemia (FA) genes in colorectal cancer: A new pathogenetic pathway? J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.3629] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
3629 Background: Fanconi Anemia (FA) is an autosomal recessive disease marked by congenital defects, bone marrow failure, and high incidence of leukemia and solid tumors. Eight FA associated genes have been cloned, and their products are thought to function in an integrated pathway which includes BRCA genes and maintains genomic stability. A molecular mechanism involved in the development and progression of some human malignancies, including colorectal cancer, is represented by a defective replication fidelity. Here we tested the role of the main FA genes in colorectal cancer (CRC). Methods: One hundred consecutively-collected patients with histologically-proven diagnosis of CRC and no mutation in the main mismatch repair genes (MLH1 and MSH2) were included into the study. Genomics DNA was screened using DHPLC for FANC-C/G/E/F genes and using MPLA for FANC-A/D2 genes. All PCR products with abnormal DHPLC profiles were sequenced on an automated sequencer. For 28 cases, tumor tissue samples were also analyzed. To date, total RNA was isolated from paired normal and tumor samples of 12 CRC patients. Gene expression was quantified by real-time RT-PCR using the Taqman approach. Results: At germline level, 2 cases presented FANC-C sequence variations (Asp267Ser, Val449Ser) and 5 cases showed a exon 26 deletion in FANC-A as detected by MLPA analysis. Among the 28 tumor samples available from patients negative for mutations in germline DNA, 2 (7%) cases presented a FANC-E mutation (Ala552Thr). Moreover, one of such somatic samples presented a BRCA2–8765delAG mutation (BRCA2 is also recognized as FANC-D1 gene). Assuming as significant difference in gene expression the presence of a variation of more than 50% in mRNA levels between normal and corresponding tumor samples, all tested FA genes (FANC-C/G/E/F) were found overexpressed in 5/12 (42%) tumor samples. Conclusions: Although preliminary, our findings seem to identify a subset of CRC patients with alterations in the FA/BRCA pathway which is required for the activation of DNA repair. Ongoing molecular analyses will better clarify the real frequency of each alteration in FA genes and their relationship with the histological and/or clinical features in colorectal cancer. No significant financial relationships to disclose.
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Affiliation(s)
- G. Palmieri
- Istituto Chimica Biomolecolare-CNR, Li Punti-Sassari, Italy; Istituto Nazionale Tumori Fondazione Pascale, Napoli, Italy; Servizio di Anatomia Patologica, Azienda USL1, Sassari, Italy; Università di Sassari, Sassari, Italy
| | - M. Colombino
- Istituto Chimica Biomolecolare-CNR, Li Punti-Sassari, Italy; Istituto Nazionale Tumori Fondazione Pascale, Napoli, Italy; Servizio di Anatomia Patologica, Azienda USL1, Sassari, Italy; Università di Sassari, Sassari, Italy
| | - M. G. Camboni
- Istituto Chimica Biomolecolare-CNR, Li Punti-Sassari, Italy; Istituto Nazionale Tumori Fondazione Pascale, Napoli, Italy; Servizio di Anatomia Patologica, Azienda USL1, Sassari, Italy; Università di Sassari, Sassari, Italy
| | - A. Manca
- Istituto Chimica Biomolecolare-CNR, Li Punti-Sassari, Italy; Istituto Nazionale Tumori Fondazione Pascale, Napoli, Italy; Servizio di Anatomia Patologica, Azienda USL1, Sassari, Italy; Università di Sassari, Sassari, Italy
| | - P. Baldinu
- Istituto Chimica Biomolecolare-CNR, Li Punti-Sassari, Italy; Istituto Nazionale Tumori Fondazione Pascale, Napoli, Italy; Servizio di Anatomia Patologica, Azienda USL1, Sassari, Italy; Università di Sassari, Sassari, Italy
| | - F. Izzo
- Istituto Chimica Biomolecolare-CNR, Li Punti-Sassari, Italy; Istituto Nazionale Tumori Fondazione Pascale, Napoli, Italy; Servizio di Anatomia Patologica, Azienda USL1, Sassari, Italy; Università di Sassari, Sassari, Italy
| | - F. Tatangelo
- Istituto Chimica Biomolecolare-CNR, Li Punti-Sassari, Italy; Istituto Nazionale Tumori Fondazione Pascale, Napoli, Italy; Servizio di Anatomia Patologica, Azienda USL1, Sassari, Italy; Università di Sassari, Sassari, Italy
| | - R. Calemma
- Istituto Chimica Biomolecolare-CNR, Li Punti-Sassari, Italy; Istituto Nazionale Tumori Fondazione Pascale, Napoli, Italy; Servizio di Anatomia Patologica, Azienda USL1, Sassari, Italy; Università di Sassari, Sassari, Italy
| | - A. Cossu
- Istituto Chimica Biomolecolare-CNR, Li Punti-Sassari, Italy; Istituto Nazionale Tumori Fondazione Pascale, Napoli, Italy; Servizio di Anatomia Patologica, Azienda USL1, Sassari, Italy; Università di Sassari, Sassari, Italy
| | - F. Galimi
- Istituto Chimica Biomolecolare-CNR, Li Punti-Sassari, Italy; Istituto Nazionale Tumori Fondazione Pascale, Napoli, Italy; Servizio di Anatomia Patologica, Azienda USL1, Sassari, Italy; Università di Sassari, Sassari, Italy
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Palmieri G, Casula M, Colombino M, Satta MP, Rozzo C, Ascierto PA, Castello G, Bianchi-Scarrà G, Cossu A, Tanda F. BRAF gene contributes to melanoma pathogenesis but not to melanoma susceptibility. J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.9584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- G. Palmieri
- Consiglio Nazionale Ricerche, Santa Maria La Palma, Italy; Istituto Nazionale Tumori, Napoli, Italy; Università degli Studi, Genova, Italy; Università degli Studi, Sassari, Italy
| | - M. Casula
- Consiglio Nazionale Ricerche, Santa Maria La Palma, Italy; Istituto Nazionale Tumori, Napoli, Italy; Università degli Studi, Genova, Italy; Università degli Studi, Sassari, Italy
| | - M. Colombino
- Consiglio Nazionale Ricerche, Santa Maria La Palma, Italy; Istituto Nazionale Tumori, Napoli, Italy; Università degli Studi, Genova, Italy; Università degli Studi, Sassari, Italy
| | - M. P. Satta
- Consiglio Nazionale Ricerche, Santa Maria La Palma, Italy; Istituto Nazionale Tumori, Napoli, Italy; Università degli Studi, Genova, Italy; Università degli Studi, Sassari, Italy
| | - C. Rozzo
- Consiglio Nazionale Ricerche, Santa Maria La Palma, Italy; Istituto Nazionale Tumori, Napoli, Italy; Università degli Studi, Genova, Italy; Università degli Studi, Sassari, Italy
| | - P. A. Ascierto
- Consiglio Nazionale Ricerche, Santa Maria La Palma, Italy; Istituto Nazionale Tumori, Napoli, Italy; Università degli Studi, Genova, Italy; Università degli Studi, Sassari, Italy
| | - G. Castello
- Consiglio Nazionale Ricerche, Santa Maria La Palma, Italy; Istituto Nazionale Tumori, Napoli, Italy; Università degli Studi, Genova, Italy; Università degli Studi, Sassari, Italy
| | - G. Bianchi-Scarrà
- Consiglio Nazionale Ricerche, Santa Maria La Palma, Italy; Istituto Nazionale Tumori, Napoli, Italy; Università degli Studi, Genova, Italy; Università degli Studi, Sassari, Italy
| | - A. Cossu
- Consiglio Nazionale Ricerche, Santa Maria La Palma, Italy; Istituto Nazionale Tumori, Napoli, Italy; Università degli Studi, Genova, Italy; Università degli Studi, Sassari, Italy
| | - F. Tanda
- Consiglio Nazionale Ricerche, Santa Maria La Palma, Italy; Istituto Nazionale Tumori, Napoli, Italy; Università degli Studi, Genova, Italy; Università degli Studi, Sassari, Italy
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Colombino M. Gene symbol: msh2. Disease: MSH2. Hum Genet 2004; 115:171. [PMID: 15300972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Affiliation(s)
- M Colombino
- Istituto di Genetica Molecolare, CNR Log Tramariglio, Santa Maria La Palma, Alghero, Italia.
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Colombino M. Gene symbol: msh2. Disease: MSH2. Hum Genet 2004; 115:170. [PMID: 15300970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Affiliation(s)
- M Colombino
- Istituto di Genetica Molecolare, CNR Log Tramariglio, Santa Maria La Palma, Alghero, Italia.
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Colombino M. Gene symbol: msh2. Disease: MSH2. Hum Genet 2004; 115:173. [PMID: 15300982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Affiliation(s)
- M Colombino
- Istituto di Genetica Molecolare, CNR Log Tramariglio, Santa Maria La Palma, Alghero, Italia.
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Colombino M, Cossu A, Arba A, Manca A, Curci A, Avallone A, Comella G, Botti G, Scintu F, Amoruso M, D'Abbicco D, d'Agnessa MR, Spanu A, Tanda F, Palmieri G. Microsatellite instability and mutation analysis among southern Italian patients with colorectal carcinoma: detection of different alterations accounting for MLH1 and MSH2 inactivation in familial cases. Ann Oncol 2004; 14:1530-6. [PMID: 14504054 DOI: 10.1093/annonc/mdg402] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Microsatellite instability (MSI) is due to defective DNA mismatch repair (MMR) and has been detected at various rates in colorectal carcinoma (CRC). The role of MSI in colorectal tumorigenesis was assessed further in this study by both microsatellite analysis of two CRC subsets [unselected patients (n = 215) and patients <50 years of age (n = 95)], and mutation screening of the two major MMR genes MLH1 and MSH2 among familial CRC cases. PATIENTS AND METHODS PCR-based microsatellite analysis was performed on paraffin-embedded tissues. In CRC families, MLH1/MSH2 mutation analysis and MLH1/MSH2 immunostaining were performed on germline DNA and MSI+ tumour tissues, respectively. RESULTS The MSI+ phenotype was detected in 75 (24%) patients, with higher incidence in early-onset or proximally located tumours. Among 220 patients investigated for family cancer history, MSI frequency was markedly higher in familial [18/27 (67%)] than in sporadic [32/193 (17%)] cases. Three MLH1 and six MSH2 germline mutations were identified in 14 out of 36 (39%) CRC families. Prevalence of MLH1/MSH2 mutations in CRC families was significantly increased by the presence of: (i) fulfilled Amsterdam criteria; (ii) four or more CRCs; or (iii) one or more endometrial cancer. While MSH2 was found mostly mutated, almost all [8/9 (89%)] familial MSI+ cases with loss of the MLH1 protein were negative for MLH1 germline mutations. CONCLUSIONS Both genetic (for MSH2) and gene-silencing (for MLH1) alterations seem to be involved in CRC pathogenesis.
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Affiliation(s)
- M Colombino
- Istituto Chimica Biomolecolare-Sezione di Sassari, C.N.R., Tramariglio, Alghero, Santa Maria La Palma, Italy
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Colombino M, Cossu A, Manca A, Dedola MF, Giordano M, Scintu F, Curci A, Avallone A, Comella G, Amoruso M, Margari A, Bonomo GM, Castriota M, Tanda F, Palmieri G. Prevalence and prognostic role of microsatellite instability in patients with rectal carcinoma. Ann Oncol 2002; 13:1447-53. [PMID: 12196371 DOI: 10.1093/annonc/mdf240] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Association between microsatellite instability (MSI) and favorable postoperative survival in patients with colorectal cancer receiving adjuvant chemotherapy has been indicated. To evaluate whether an analogous positive prognostic role of MSI could be present in rectal carcinoma (RC; most RC patients receive adjuvant radiotherapy), PCR-based microsatellite analysis of archival RCs and statistical correlation with clinico-pathological parameters were performed. PATIENTS AND METHODS DNA from paraffin-embedded paired samples of tumors and corresponding normal tissue from 91 RC patients was analyzed for MSI using five microsatellite markers (tumors were classified as MSI(+) when two or more markers were unstable). RESULTS Seventeen (19%) RC patients exhibited a MSI(+) phenotype. Prevalence of instability was found in patients with earlier RC onset (28% in cases with diagnosis age < or =55 years versus 15% in cases >55 years), whereas similar MSI frequencies were observed in patients with different disease stage or receiving different adjuvant therapies. While MSI was detected in seven (64%) of 11 familial patients, a remarkably lower MSI incidence was observed in sporadic cases (10/80; 12.5%). A significant association with better disease-free survival (DFS) and overall survival (OS) was found for MSI(+) patients (median DFS/OS, 30/32 months) in comparison to MSI(-) ones (median DFS/OS, 18/21 months) (P <0.001). CONCLUSIONS MSI was demonstrated to be a strong molecular prognostic marker in rectal carcinoma, independent of the administered treatment (radiotherapy, chemotherapy or both).
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Affiliation(s)
- M Colombino
- Istituto di Genetica delle Popolazioni, Consiglio Nazionale delle Ricerche, Alghero, Santa Maria la Palma, Italy
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Palmieri G, Cossu A, Ascierto PA, Botti G, Strazzullo M, Lissia A, Colombino M, Casula M, Floris C, Tanda F, Pirastu M, Castello G. Definition of the role of chromosome 9p21 in sporadic melanoma through genetic analysis of primary tumours and their metastases. The Melanoma Cooperative Group. Br J Cancer 2000; 83:1707-14. [PMID: 11104570 PMCID: PMC2363459 DOI: 10.1054/bjoc.2000.1513] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Malignant melanoma (MM) is thought to arise by sequential accumulation of genetic alterations in normal melanocytes. Previous cytogenetic and molecular studies indicated the 9p21 as the chromosomal region involved in MM pathogenesis. In addition to the CDKN genes (p16/CDKN2A, p15/CDKN2B and p19(ARF), frequently inactivated in familial MM), widely reported data suggested the presence within this region of other melanoma susceptibility gene(s). To clearly assess the role of the 9p21 region in sporadic melanoma, we evaluated the presence of microsatellite instability (MSI) and loss of heterozygosity (LOH) in primary tumours as well as in synchronous or asynchronous metastases obtained from the same MM patients, using 9 polymorphic markers from a 17-cM region at 9p21. LOH and MSI were found in 27 (41%) and 11 (17%), respectively, out of 66 primary tumours analysed. In corresponding 58 metastases, MSI was found at higher rate (22; 38%), whereas a quite identical pattern of allelic deletions with 27 (47%) LOH+ cases were observed. Although the CDKN locus was mostly affected by LOH, an additional region of common allelic deletion corresponding to marker D9S171 was also identified. No significant statistical correlation between any 9p21 genetic alteration (LOH, MSI or both) and clinicopathological parameters was observed.
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Affiliation(s)
- G Palmieri
- Institute of Molecular Genetics, C.N.R., Alghero (SS), Casella Postale, Santa Maria La Palma (Sassari), 07040, Italy
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