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Enrico Bollito

Publications and source records attributed to Enrico Bollito.

8 recordsLinked to original sources

Matrix metalloproteinase type 2 expression in malignant adrenocortical tumors: Diagnostic and prognostic significance in a series of 50 adrenocortical carcinomas.

The differential diagnosis of adrenocortical carcinoma from adrenocortical adenoma is based on different pathological parameters, usually incorporated in scoring systems, which unfortunately lack a 100% sensitivity and specificity. Little is known on the molecular mechanisms leading to the malignant phenotype in adrenocortical tumors. Among other molecules, metalloproteinases were demonstrated to be implicated in malignant progression and metastatization of solid tumors, including endocrine ones. Therefore, we aimed to investigate metalloproteinases and their inhibitors expression in a series of 50 adrenocortical carcinomas and 50 control adrenocortical adenomas, diagnosed according to the Weiss histological criteria. Immunohistochemical results were scored by semiquantitative analysis and compared with clinicopathological parameters and outcome. Metalloproteinase type 2 gave the most significant result, being detected in neoplastic cells in 1/50 adrenocortical adenomas (2%) and 37/50 adrenocortical carcinomas (74%) (P < 0.001), with a focal (score 1, <20% of positive cells--two-thirds of cases) or diffuse (score 2, >20% of positive cells--one-third of cases) pattern. In addition, diffuse (score 2) metalloproteinase type 2 protein expression, as compared to focal or negative immunostaining, correlated with shorter survival (P < 0.02) and disease-free interval (P = 0.05). No correlation was found comparing metalloproteinase type 2 expression and any clinicopathological parameter. Our data indicate that metalloproteinase type 2 immunohistochemical localization in tumor cells is significantly restricted to malignant adrenocortical tumors, with high specificity but low sensitivity. In addition, a strong metalloproteinase type 2 expression in adrenocortical carcinoma was for the first time recognized as an unfavorable prognostic factor.

Adolescent↗

Multilocular cystic renal cell carcinoma : a report of 45 cases of a kidney tumor of low malignant potential.

The 2004 World Health Organization (WHO) classification of kidney tumors recognizes multilocular cystic renal cell carcinoma (MCRCC) as a rare variant of clear cell renal cell carcinoma with a good prognosis. Available information on its clinical significance is limited. The study cohort included 45 MCRCC cases classified according to 2004 WHO criteria obtained through a multi-institutional international search. Most patients had unilateral MCRCC with no side predominance that was found incidentally; 62% were men, but women had tumors at an earlier age (P = .385). MCRCC occurred slightly more often in men than in women (1.7:1). At diagnosis, 82% of patients had stage T1 and 16%, stage T2; 1 patient had stage T3. The Fuhrman grade was 1 (62%) or 2 (38%), with smaller tumors (<or=4 cm) most likely Fuhrman grade 1 (P = .911). All 45 patients were alive with no evidence of disease at mean follow-up of 66.1 months, confirming an extremely good prognosis after surgery and a 5-year disease-specific survival rate of 100%. To rename this tumor as multilocular cystic renal cell neoplasm of low malignant potential might help urologists approach the patients conservatively.

Adult↗

Assessment of surgical margins in renal cell carcinoma after nephron sparing: a comparative study: laparoscopy vs open surgery.

PURPOSE: We compared the status of the peritumoral parenchyma after open and laparoscopic nephron sparing surgery for renal cell carcinoma. MATERIALS AND METHODS: The records of 64 consecutive patients who underwent nephron sparing surgery for renal cell carcinoma of 4 cm or less were reviewed retrospectively. Patients in group 1 underwent open retroperitoneal surgery (1998 to 2000) and patients in group 2 underwent laparoscopic (transperitoneal or retro peritoneal) surgery (2001 to March 2004). A single pathologist was employed to analyze the specimens, and comparative analysis included examination of tumor size, weight, histological cell type, intraoperative histological biopsies and margin status. RESULTS: The 2 groups were comparable in terms of clinical data, and mean lesion size was 31.4 mm in group 1 and 32 mm in group 2. Positive margins were found in 1 of 30 patients in group 1 and in 1 of 34 in group 2 (p = 0.9). An analysis of margins was performed by taking measurements at the minimum and maximum points of the section. The minimum mean measurement was 2 mm in group 1 and 2.08 mm in group 2 (p = 0.75). The maximum mean measurement was 4.56 mm in group 1 and 5.2 mm in group 2 (p = 0.09). The difference between minimum and maximum margin thickness was 2.56 mm in group 1 and 3.16 mm in group 2 (p = 0.04). Mean followup for group 1 was 50 months (range 30 to 72) and 16 months (range 2 to 35) for group 2. One local recurrence was recorded in group 1 and treated with radical nephrectomy, while no recurrence was recorded in group 2. CONCLUSIONS: In this study we further confirmed the efficiency of resectioning lesions using laparoscopy. In our experience there is no difference between the 2 procedures in terms of efficient surgical margins. However, despite these encouraging results it is necessary to obtain more extensive followup data, which will allow us to be more specific in reporting on laparoscopic margin quality.

Adult↗

PSA decrease after levofloxacin therapy in patients with histological prostatitis.

OBJECTIVE: To evaluate the effect of levofloxacin (LVX) oral therapy on total serum prostate specific antigen (PSA) values in patients with histological prostatitis. MATERIALS AND METHODS: All consecutive outpatients with histological evidence of chronic prostatitis, total PSA > 4 ng/ml, normal DRE and urinalysis and treated once daily with LVX 500 mg per os for 20 days were retrospectively evaluated for total serum PSA reduction. A decrease of PSA value > 5% was considered correlated with the antibiotic therapy. RESULTS: A total of 26 outpatients were evaluated (median age = 65 years). Median total serum PSA concentrations, before and after LVX therapy, were 7.1 ng/ml (range 4.1-15 ng/ml) and 5.8 ng/ml (2-15 ng/ml), respectively (p= n.s). The median reduction of total PSA was 16.6% (range 5.7 - 63.6%). A statistically significant decrease of median total PSA was observed in 15 out of 26 patients (57.6%): 7.2 ng/ml and 4.2 ng/ml before and after LVX therapy, respectively (p=0.002); the marker normalized in 7 out of 15 patients (46.7%). In all the remaining patients prostate biopsy was repeated: prostate cancer (Pca) was detected in 1 out of 8 patients with significant reduction of total PSA and in 4 out of 11 patients with no significant marker decrease. The incidence of Pca in second prostate biopsies raised from 19% (5 cases out of 26) to 26% (5 cases out of 19). CONCLUSIONS: Treatment with LVX significantly reduced PSA values in over half of the patients with asymptomatic prostatitis, elevated total PSA and normal DRE and urinalysis. This approach could be applied in the ambulatory setting in order to increase the specificity of total PSA testing, reducing the number of negative, unnecessary, prostate biopsies.

Aged↗

Preoperative cytology in the management of parotid neoplasms.

BACKGROUND: This study evaluates the diagnostic role of preoperative cytology of parotid neoplasms. The method is particularly useful in the evaluation of the parotid diseases in which the same clinical features may be treated variously. Fine-needle aspiration biopsy is a simple and well-tolerated diagnostic tool, which provides accurate information for diagnosis and follow-up of the disease. The accuracy of the method partly depends on the operator skill. MATERIALS AND METHODS: From a series of 452 subjects who underwent parotidectomy, preoperative cytological evaluation was available in 310 and compared with histological diagnosis in a retrospective review. RESULTS: The agreement between histotype determination using fine-needle aspiration biopsy and final histological diagnosis was 79%, specificity was 100%, sensitivity was 83%, and diagnostic accuracy was 97%. CONCLUSION: These findings demonstrated that, given the low complication rate, preoperative cytology is particularly useful in diagnosing parotid disease and in planning the surgical strategy and approach.

Biopsy, Fine-Needle↗

[Asymptomatic prostatitis: a frequent cause of raising PSA].

The Prostatic Specific Antigen (PSA) is one of the best tumour markers currently available, and it is widely employed in the diagnosis and follow up of prostate cancer. Nevertheless, it is not specific for prostatic carcinoma, and an increase in its serum levels can also be related to benign prostatic hyperplasia, inflammation/infection or traumatic manoeuvres on the prostatic gland. Because of its well-known clinical features acute prostatitis does not require PSA evaluation for diagnosis, but other prostatitis (such as category IV NIH prostatitis) can be responsible of an increase in PSA levels without associated symptoms. Category IV prostatitis has a fairly high prevalence, affecting about one third of the adult males. Recently some studies have showed that approximately half of the patients with PSA levels in the grey zone and without symptoms of prostatitis undergo a decrease in PSA levels after a 2-4-week treatment with antibiotics. Thanks to this approach, 20-30% of the patients obtain PSA normalization and consequently avoid prostatic biopsies. In conclusion, the use of antibiotic treatment allows an increase in PSA specificity and a decrease in the number of unnecessary prostatic biopsies. The cost-benefit ratio of this approach has to be verified by means of prospective randomized trials.

Anti-Bacterial Agents↗