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C Ferrara

Publications and source records attributed to C Ferrara.

43 records · Page 3Linked to original sources
PubMedDate not supplied

Ki-67 and c-jun expression in pancreatic cancer: a prognostic marker?

The proto-oncogene c-jun is involved in cell proliferation and Ki-67 antigen permits determination of the proportion of proliferating tumour cells. The expression of c-jun and Ki-67 in pancreatic cancer and their relation with tumour histological features and patients survival were evaluated. Specimens were obtained as follows: 14 pancreatic cancer from patients radically operated, 8 liver metastases from subjects submitted to palliation, 5 normal pancreas from organs donors and 5 chronic pancreatitis. Ki-67 and c-jun were studied by immunohistochemistry. The percentage of tumour cells stained for c-jun was increased in 11/14 cases. A high c-jun expression was more frequently found in liver metastases than in pancreatic cancer tissue (p=0.031). The frequency of high c-jun expression was more elevated in short-term as compared to long-term survivors (Fisher's exact test, p=0.031 and log-rank, p=0.03). The percentage of tumour positive cells for Ki-67 showed a mean value of 12.8% in primary pancreatic cancer and was lower than in the liver metastases (32.5%) (p=0.029). Significantly lower values were found in long-term (6.5%) as compared to the short-term survivors (18.1%) (p=0.032 and log-rank, p=0.006). A positive relation was demonstrated with stage (p<0.05), lymph node state (p=0.045) and perineural invasion (p=0.0001). In the multivariate analysis the Ki-67 staining was the most important determinant of long-term survival (p=0.005). c-jun and Ki-67 are overexpressed in pancreatic carcinoma, but only Ki-67 is a strong predictive factor.

Aged↗
PubMedDate not supplied

The expression of proto-oncogene c-jun in human pancreatic cancer.

The proto-oncogene c-jun is involved in cellular proliferation by interfering with signals that lead to cellular differentiation. Moreover the induction of metalloproteinase gene appears to utilise the c-jun oncogene as intracellular messenger. The aims of this study were to evaluate a) the expression of c-jun oncogene in pancreatic cancer b) its relation with tumor histological features. Surgical specimens of pancreatic cancer were collected from 22 patients radically operated upon, and from 11 submitted to palliation. As a control group, 5 specimens of normal pancreas and 5 specimens of chronic pancreatitis were studied. C-jun staining was graded as follows: (-) positive cells < 10%, (+) from 10 to 30%, (+2), from 30 to 60%, (+3) from 60 to 90%. Glucagon and somatostatin staining was graded counting the positive cells of total numer of Langherans islet cells counted. c-Jun expression (low: < 30% and high: > 30%) was related to stage, architectural and cytological grading, vascular, lymph nodal, perineural invasion. Normal pancreas and chronic pancreatitis tissues appear to express the c-jun protein in less than 10% of ductal cells. The percentage of tumor cells stained for c-jun is increased as compared to the control group in 28/33 cases: in 13 (46%) it ranges from 10 to 30%; in 10 (36%) from 30 to 60% and in 5 (18%) from 60 to 90%. The frequency of high or low c-jun expression is not different in relation to the histological features of tumor. Moreover, c-jun protein is present in 40% of cells of Langherans islets in normal pancreas, chronic pancreatitis and pancreatic cancer. The Langherans islet cells stained for c-jun exhibit also a positivity for glucagon. In conclusion; a) in pancreatic cancer, the expression of c-jun is increased in tumour cells in majority of cases as compared to the control group, b) a c-jun positivity is also found in alpha cells with a pattern not different from control group, but the relation between the alpha cells and c-jun production is unknown, c) c-jun expression does not vary in relation to histological findings.

Adult↗
PubMedDate not supplied

[Magnetic resonance arthrography in chronic wrist pain].

PURPOSE: To investigate the clinical role of Magnetic Resonance Arthrography (MRA) of the wrist in subjects with chronic pain. MATERIAL AND METHODS: Thirty-five patients complaining of wrist pain for more 6 months were submitted to MRI and MRA. All patients received an intra-articular (monocompartment radiocarpal joint) injection of 2-10 mL of a 10 mmol saline solution of Gd-DPTA. Two radiologists independently evaluated the conspicuity of the intrinsic intercarpal ligaments and of the triangular fibrocartilage complex and expressed it on a 3-grade semiquantitative scale. On MRI images, complete visualization of the two structures was graded as 0, partial visualization as 1 and no visualization as 2. On MRA images, no contrast agent passage through the ligament or the complex was graded as 0, minimal passage as 1 and complete passage as 2. Sixteen patients had surgical confirmation (arthroscopy in 10 and open surgery in 6 patients). RESULTS: On MRI images the scapholunate ligament was completely visualized in 7 patients (21%) and partially or not visualized in 28 patients (89%). MRA images showed an intact ligament in 15 cases (44%) and a partial or total tear in 20 cases (48% and 8% respectively, 56% in all). On MRI images the luno-pyramidal ligament was completely visualized in 6 patients (18%) and partially or not visualized in 29 cases (82%). On MRA images the luno-pyramidal ligament was intact in 21 cases (58%) and had a partial or total tear in 14 cases (27% and 15% respectively, 42% in all). On MRI images the triangular fibrocartilage complex was normal in 27 cases (76%) and it was only partially visualized in 8 cases (24%). On MRA images the triangular fibrocartilage complex was normal in 13 cases (37%) and had a partial injury in 22 cases (63%). There were no severe side-effects to contrast agent injection, nor severe complications. The overall diagnostic accuracy rates of MRI and MRA were 40% and 81% respectively, with sensitivity and specificity of 63% and 39% (MRI) and of 82% and 79% (MRA). CONCLUSIONS: Compared with MRI, MRA can be considered a useful tool for the visualization of interosseous carpal ligaments and of the triangular fibrocartilage complex. MRA also helps detect injuries in these structures.

Adult↗
PubMedDate not supplied

CAR-3 and CA 19-9 serum levels in pancreatic cancer: any differences between two epitopes of the same mucin-like glycoprotein?

The aim of this study was to compare the utility of two recently identified tumour markers of pancreatic cancer, CA 19-9 and CAR-3, and to ascertain the roles of some factors influencing both antigens. CA 19-9 and CAR-3 were measured in sera of 18 control subjects, 27 patients with pancreatic cancer, 25 with chronic pancreatitis, and 29 with extra-pancreatic diseases. CA 19-9 and CAR-3 were, respectively, found to be increased in 85 per cent and 44 per cent of patients with pancreatic cancer, 28 per cent and 0 per cent with chronic pancreatitis and 72 per cent and 28 per cent with extra-pancreatic diseases. The ROC curves showed that, for any serum value considered, CA 19-9 is more effective than CAR-3 in discriminating between pancreatic cancer and control subjects and chronic pancreatitis. With the combined use of both antigens the results were no better than those given by CA 19-9 alone. Correlations were found between liver function tests and CA 19-9 levels and between cholestasis indices only and CAR-3 values. Our findings show that CAR-3 is not a sufficiently reliable marker of pancreatic cancer, due to its low sensitivity. Nor does it offer any more information than CA 19-9. Both assays are influenced, at least in part, by the extent of the neoplasia. Cholestasis which can greatly influence a serum glycoproteic marker such as CA 19-9, was found also to affect, to a lesser extent, CAR-3, an epitope on the same mucin molecule.

Adult↗
PubMedDate not supplied

Acute phase proteins in chronic pancreatic disease.

In order to evaluate the behaviour of some acute phase proteins in chronic pancreatic disease and to correlate these reactants with different factors, C-reactive protein, ceruloplasmin and alpha-1-antitrypsin were assayed in the sera of 24 control subjects, 26 patients with pancreatic cancer, 22 patients with chronic pancreatitis and 22 patients with a variety of diseases not of pancreatic origin. Alpha-1-antitrypsin, C-reactive protein and ceruloplasmin concentrations were found to be increased in 63%, 50% and 42% of patients with chronic pancreatic disease, respectively. In patients with pancreatic cancer no difference was found between the values of each protein considering the presence or otherwise the absence of liver metastases. Patients with chronic pancreatitis had higher C-reactive protein or alpha-1-antitrypsin values when increased serum amylase or pseudocysts were present. Significant correlations were found between the three acute-phase proteins considering the subjects as a whole; however in the single subjects they were not found to be concomitantly abnormal. Correlations were detected between these proteins and liver function test values. Alpha-1-antitrypsin is probably the most sensitive index in chronic pancreatic disease, while C-reactive protein seems better to reflect the stage of the disease. The variations of the levels of these proteins seem to be, at least in part, independent of each other; they are all partially influenced by the presence of liver damage.

Acute-Phase Proteins↗
PubMedDate not supplied

C-peptide pattern in patients with pancreatic cancer.

The pathogenetic mechanism underlying glucose intolerance in pancreatic cancer is still unclear. We studied the pattern of three glucose regulating hormones (C-peptide, glucagon and GH) in pancreatic cancer patients with (N = 34) and without (N = 8) hyperglycemia, and compared the findings made with those from subjects with other hyperglycemic conditions of well-known origin [type I diabetes mellitus (8 cases) and diabetes mellitus secondary to chronic pancreatitis (13 cases) or liver cirrhosis (4 cases)]. In hyperglycemic pancreatic cancer patients, C-peptide was absent in 26% of the cases, reduced in 24%, elevated in 29% and within the normal range in the remaining 21%. In normoglycemic pancreatic cancer this hormone was reduced in two cases (25%) and within the normal range in all the others. GH was within the normal range in all cases: glucagon was below the normal range in some hyperglycemic pancreatic cancer patients (41%) or within the normal range in all the remaining patients. No correlations were found between the three hormones when findings from subjects were considered all together. However, in pancreatic cancer C-peptide and glucagon presented consensual variations. C-peptide, glucagon and GH levels were not related to tumor volume; glucagon was found to be associated with liver metastases. C-peptide was correlated with serum ALT and ALP. We may conclude that hyperglycemia associated with pancreatic cancer may be caused by different mechanisms. In some cases a reduced secretion of both insulin and glucagon was observed, as occurs in chronic pancreatitis. In the majority of patients, beta cell function appears normal, and the hyperglycemic state may depend on an altered peripheral sensitivity to insulin due to the pancreatic pathology itself or to consensual liver involvement.

Adult↗