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Biomedical subjects

P Bevilacqua

Publications and source records attributed to P Bevilacqua.

65 records · Page 4Linked to original sources
PubMedDate not supplied

Characterization of node-negative breast cancer by clinico-pathologic and biologic factors.

About 30% of node-negative breast cancer (NNBC) patients relapse and about 20-25% die after local treatment. This is a heterogenous disease and at present no single factor completely distinguishes those patients destined to have a recurrence and to die, for whom an adjuvant treatment seems indicated. With the objective of subdividing NNBC into different prognostic groups, we studied the expression and relationship of eight factors related both to the clinico-pathologic characteristics and to the tumor biology in 78 consecutive patients: menopausal status, tumor size, grading (G), intratumoral vascular invasion (IVI) steroid hormonal receptors, proliferative rate and epidermal growth factor receptor (EGFr) expression. The frequencies of the risk factors examined were: pre- or perimenopausal status in 29.5%, tumor size greater than 2 cm (pT2) in 28%, GIII in 45%, IVI in 13% estrogen receptor (ER)-negative in 43% and progesterone receptor (PgR)-negative in 60%. There were 23% high proliferating (Ki-67 antibody greater than 20%) and 54% EGFr positive tumors. The distribution of the above risk factors in each tumor were: no factor in 4%; one in 15%; two in 30%; three in 23%; four in 14%; five in 8%; six in 2%; seven in 4% and no case had the sum of all the factors. The mean distribution value was of two per case. Twenty-eight percent of patients had more than the sum of four factors. A significant correlation was observed among: premenopausal status with G III (61% vs 45% in postmenopausal status; p less than 0.05), premenopausal status with ER-negative tumors (65 vs 29% in postmenopasual; p less than 0.05) and between the lack of expression of the two hormonal receptors (overall agreement of 77; p less than 0.05). The prognostic value of these findings needs to be verified with an adequate follow-up.

Adult↗
PubMedDate not supplied

[A case of epidermoid cyst of the testis].

The epidermoid cyst of the testis represents about 1% of all testicle tumours. The average age of presentation ranges from the second and the fourth decade of life. Its clinical features do not differ from those of a testis malignancy. Preliminary clinical and laboratory findings do not determine the diagnosis. The Authors report a case and review the Literature (about 150 cases up to 1985). Therapeutic strategy is also discussed: orchiectomy or simple removal of the cyst.

Adolescent↗
PubMedDate not supplied

[Recent advances concerning etiopathogenesis of nasal polyposis].

The way nasal polyps arise and why they tend to recur is still unknown. Quite frequently they are found in association with asthma, rhinitis and ASA-intolerance, thus suggesting a multifactorial etiopathogenesis. The incidence of atopy in patients affected with nasal polyposis is quite low (16.8%). Recent studies stress the involvement of mast cell mediators due to various degranulating stimuli other than those mediated by IgE. The finding of the interleukin-2 receptor (IL2-R) on murine mast cells and on human peripheral blood basophils, together with the possibility of inducing basophil degranulation through IL2 stimulation, have led the authors to seek IL2R on human nasal polyp mast cells and to study subpopulations of nasal polyp lymphoid infiltrates. Nasal polyps obtained from 4 patients, admitted to the E.N.T. Department of the Catholic University of Rome in 1988, were snap frozen soon after their surgical removal through transmaxillary ethmoidectomy. In this study the following monoclonal antibodies (MoAb) were used: Leu-2a (CD8), Leu-3a/3b (CD4), Leu-4 (CD3), anti-HLA-DR and anti-IL2-R (CD25), OKM1 (CD11), OKB2 (CD24) and 1HT4-4H3 (CD 25). In no patient was there evidence of atopy, asthma or ASA-intolerance. Several mast cells (MC) were observed, chiefly in the connective axis and perivascular areas. These cells were characterized by a large number of cytoplasmatic monomorphic granules. The MC displayed the IL2-R and they were very often close to T-lymphocytes. T-cell subpopulations were predominantly composed of CD4-positive cells (about 75% of all lymphocytes) often associated in clusters and located both in the submucosa and in the connective axis. CD8-positive cells (10-15% of the lymphoid cells) were located most often just under the epithelium. They were hardly ever scattered within the CD4-positive cell clusters. Almost all T cells were activated, above all those surrounding the MC. These results would appear to suggest the presence of a cell-mediated immune response in nasal polyp pathogenesis where MC degranulation, determined by activated T-cell cytokines, plays an important role.

Adult↗
PubMedDate not supplied

Panencephalopathic type of Creutzfeldt-Jakob disease with neuropathologic features similar to Pick's disease.

The panencephalopathic type of Creutzfeldt-Jakob disease is characterized by a serious degeneration of the white matter in addition to the other pathological features of the classic Creutzfeldt-Jakob disease. The clinical and neuropathological findings of a new case are described in a woman aged 62, who died after a year of illness. The brain appeared seriously affected by atrophy and white matter degeneration. Microscopically, it showed a marked cortical spongiosis, with gemistocytic astrogliosis and degeneration of the white matter of both hemispheres. Although a serious loss of nerve cells was evident, some residual neurons with a ballooned aspect were found in the fronto-temporal cortex. Other neurons presented argyrophilic inclusions similar to Pick bodies. By means of immunohistochemical techniques and monoclonal antineurofilaments antibodies some neurons with swollen cytoplasm and enlargement of the first tract of the neurites were detected in the basal layers of the frontal and temporal cortex. These abnormal features were due to the accumulation of phosphorylated 200 Kd neurofilaments. The relations between Creutzfeldt-Jakob and Pick's diseases are analyzed on the basis of the neuropathological findings. There is evidence from the immunohistochemical data of an interference in the axonal transport of neurofilaments.

Axonal Transport↗
PubMedDate not supplied

Invasive node-negative breast carcinoma: multivariate analysis of the prognostic value of peritumoral vessel invasion compared with that of conventional clinico-pathologic features.

The prognostic value of the determination of peritumoral vessel invasion (PVI) in node-negative breast cancer (NNBC) patients is still controversial. This is mainly related to the subjective criteria of evaluation of this histologic finding using morphological methods only. In this study, to assess PVI by stricter criteria, we used both conventional morphological and immunocytochemical techniques, using antibodies specific to endothelial cells (i.e. factor VIII-related antigen and the CD-31 antibody). In a series of 233 evaluable NNBC, with a median follow-up of 5 years, we found that 11% of the tumors (25 out of 233) were PVI-positive. A weak association was observed only between PVI and tumor size (p = 0.076). In univariate analysis PVI significantly predicted relapse-free survival (p = 0.0009), but not overall survival (p = 0.1208). The odds of relapse and death for patients with PVI-positive carcinomas were 4.36 and 2.24 times higher than for those with PVI-negative tumors. As far as relapse-free survival is concerned, tumor size (p = 0.0012), histologic grading (p = 0.022), estrogen receptor (p = 0.016) and progesterone receptor expression (p = 0.017) also had a significant prognostic value. Only tumor size significantly predicted overall survival (p = 0.0038) in this series. For 5-year relapse-free survival both PVI (p = 0.014) and tumor size (p = 0.017) were significant and independent prognostic variables by multivariate analysis. Our results demonstrate that PVI and tumor size are important histological features to identify high-risk NNBC patients. Further studies are needed to compare the prognostic significance of PVI and tumor size with that of novel biological prognostic indicators of emerging importance in this neoplasia.

Adult↗
PubMedDate not supplied

Tumor angiogenesis predicts clinical outcome of node-positive breast cancer patients treated with adjuvant hormone therapy or chemotherapy.

PURPOSE: Experimental studies suggest that angiogenesis is necessary for breast cancer progression and metastasis and that it may play a role in responsiveness to some chemotherapeutic agents and to tamoxifen. To investigate whether angiogenesis predicts the clinical outcome of patients with node-positive breast cancer, we determined intratumoral microvessel density in a series of patients treated with either adjuvant hormone therapy (n=84) or chemotherapy (n= 107). PATIENTS AND METHODS: We monitored 191 patients for a median of 62 months. Intratumoral microvessel density was measured using light microscopy, and microvessels were immunostained using the anti-CD31 antibody. Microvessels were carefully counted (per 200x field) in the most vascularized area of each tumor. The results of intratumoral microvessel density were analyzed by both univariate and multivariate statistical analysis and were correlated with clinical outcome. RESULTS: In univariate analysis, intratumoral microvessel density was significantly associated with relapse-free survival and overall survival, both in patients who received adjuvant hormone therapy and those who received chemotherapy. In the group treated with adjuvant hormone therapy, estrogen receptor status was also predictive for both relapse-free and overall survival. The number of involved nodes was predictive for overall survival. In patients treated with adjuvant chemotherapy, the number of involved nodes, tumor size, and progesterone receptor status were significantly predictive for relapse-free and overall survival. Multivariate analysis showed that intratumoral microvessel density was the strongest independent predictor of outcome in both treatment groups. CONCLUSIONS: Intratumoral microvessel density is an independent predictive indicator in node-positive breast cancer patients treated with either adjuvant chemotherapy or adjuvant hormone therapy. Assessment of tumor angiogenesis may therefore be useful in selection of those patients who are more likely to benefit from conventional adjuvant therapies (i.e., those with minimally vascularized tumors) from those with highly vascularized and more aggressive tumors, for whom novel forms of systemic therapy are advocated.

Adult↗