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Giancarlo Caletti

Publications and source records attributed to Giancarlo Caletti.

7 recordsLinked to original sources
PubMed2005

Mt 21-42: development and validation of an automatic device proposed for the endoscopic diagnosis of Helicobacter pylori infection and atrophic gastritis.

BACKGROUND: Gastric juice may give important clinico-pathological information, but measurements in this medium are difficult. In this study we present and validate an innovative device (Mt 21-42) performing gastric juice analyses during endoscopy and proposed for the endoscopic diagnosis of Helicobacter pylori infection and hypo/achlorhydria. METHODS: Analyses on both aqueous solutions (80 pH buffer + 120 ammonium chloride samples) and human gastric juice were carried out to assess the measuring performance of Mt 21-42 on the ideal and real matrix, respectively. Matrix spike and manipulation tests were also performed to investigate the matrix effect of gastric juice and to evaluate the consequences of its manipulation on the measurements. Furthermore, preliminary clinical tests were performed to evaluate the clinical potentiality of the device. RESULTS: Mt 21-42 showed a good measuring performance on ideal matrix (coefficient variation: pH = 1.3%, ammonium = 2.1%) and real matrix (coefficient variation: pH = 1.2%, ammonium = 1.9%). Analyses on gastric juice excluded a substantial matrix effect (percent recovery =96.5-98.7%) but demonstrated a significant influence of manipulation procedures (p < 0.05). CONCLUSIONS: Human gastric juice does not have a substantial matrix effect for pH and ammonium determination, but its manipulation may affect the measurement of these components. Mt 21-42 represents a precise instrument for the measurement of gastric juice and a potential precious tool for the endoscopic detection of H. pylori infection and hypo/achlorhydric conditions.

Adult↗
PubMed2005

Endoscopic ultrasonography: current clinical role.

Endoscopic ultrasonography appeared in the clinical arena almost 20 years ago and it has now become a well integrated technique in everyday hospital practice. More than 2000 scientific papers published in the literature have demonstrated its high accuracy for the diagnosis and staging of a variety of benign and malignant conditions. The instrumentation consists of a special endoscope, modified by a high-frequency ultrasound transducer placed on its tip, and an ultrasound driving unit. The main indications to endoscopic ultrasonography can be explained by its ability to visualize the gut wall as a multi-layer structure corresponding to histological layers. Other important indications derive from its capability of displaying, very closely, the structures and lesions surrounding the gut wall, such as the pancreato-biliary area, masses and lymph nodes. Fine-needle aspiration has become an indispensable adjunct to the technique since 1993, when it was shown to be feasible and safe to obtain tissue diagnosis in the majority of the lesions under the reach of endoscopic ultrasonography. In recent years, some authors have dealt with the practical clinical applications of endoscopic ultrasonography, validating its use in many diagnostic and staging algorithms and showing that it is cost-effective and significantly affects patient outcome.

Choledocholithiasis↗
PubMed2003

Consecutive regression of concurrent laryngeal and gastric MALT lymphoma after anti-Helicobacter pylori therapy.

The most common primary lymphoma of the gastrointestinal tract is B-cell lymphoma arising from mucosa-associated lymphoid tissue known as MALT lymphoma. Although the majority of these lesions affect the stomach and are associated with Helicobacter pylori organisms, sites other than the gastrointestinal tract may be affected. This case report describes a patient with concomitant laryngeal MALT lymphoma and Helicobacter pylori-related gastric MALT lymphoma derived from the same clone as confirmed by PCR. Treatment of Helicobacter pylori infection in this patient using antibiotics led to regression of both lesions. This patient remains in remission at 46-month follow-up. This is the first case report on the regression of a laryngeal MALT lymphoma after Helicobacter pylori eradication. We suggest that all patients presenting with extragastric MALT lymphoma should undergo upper gastrointestinal endoscopy with gastric biopsies for the determination of Helicobacter pylori status and presence of concomitant gastric MALT lymphoma, followed by a course of anti-Helicobacter pylori antibiotic therapy. Nonresponders may subsequently be considered for surgery and/or chemo/radiation therapy.

Anti-Bacterial Agents↗
PubMed2002

T(11;18) is a marker for all stage gastric MALT lymphomas that will not respond to H. pylori eradication.

BACKGROUND & AIMS: Eradication of Helicobacter pylori leads to cure of gastric mucosa-associated lymphoid tissue (MALT) lymphoma in 75% of localized cases. However, prolonged follow-up is necessary to determine whether a lymphoma responds to therapy. In a small series of cases, we showed that t(11;18)(q21;q21)-positive MALT lymphomas failed to respond to H. pylori eradication. The present study aimed to verify this finding in a large cohort and confirm whether the translocation predicts the response of stage I(E) tumors, for which clinical staging has little prognostic value. METHODS: A total of 111 patients with H. pylori-positive gastric MALT lymphoma treated with antibiotics were studied. Clinical staging was undertaken before therapy. The response of lymphoma to H. pylori eradication was determined by histologic examination of gastric biopsy specimens. Diagnostic biopsy specimens were analyzed for t(11;18)(q21;q21) by reverse-transcription polymerase chain reaction of the API2-MALT1 transcript. RESULTS: Forty-seven of the 48 patients who showed complete regression had lymphoma at stage I(E), whereas 43 of the 63 nonresponsive cases were at stage I(E) and the remaining cases at stage II(E) or above. t(11;18)(q21;q21) was detected in 2 of 48 complete-regression cases, and these positive cases showed relapse of lymphoma in the absence of H. pylori reinfection. In contrast, the translocation was present in 42 of the 63 nonresponsive cases, including 26 of 43 (60%) at stage I(E). CONCLUSIONS: t(11;18)(q21;q21)-positive gastric MALT lymphomas, including those at stage I(E), do not respond to H. pylori eradication. Detection of the translocation should help the clinical management of patients with gastric MALT lymphoma.

Adult↗
PubMed2002

Interobserver agreement in staging gastric malt lymphoma by EUS.

BACKGROUND: EUS is highly accurate for staging gastric lymphoma. Because stage correlates to outcome, interobserver agreement is mandatory. However, previous studies suggest that interobserver agreement might vary according to T-stage. A multicenter evaluation of observer agreement with respect to endosonographic staging of gastric mucosa-associated lymphoid tissue (MALT) lymphoma was therefore conducted. METHODS: Fifty-four patients were studied; 42 were also evaluated after eradication of Helicobacter pylori infection. EUS was performed at different institutions by 10 experienced endosonographers who collected the best photographs for each examination. Interobserver agreement was estimated with kappa statistics. RESULTS: Overall interobserver agreement for T-stage was fair, both before and after treatment (kappa = 0.38 and kappa = 0.37, respectively). Overall interobserver agreement for N-stage was substantial before treatment, but only fair after treatment (kappa = 0.63 and kappa = 0.34, respectively). The lowest values of agreement occurred with T1sm (submucosa) and T2 stage lesions. CONCLUSIONS: Interobserver agreement for staging of gastric MALT lymphoma by EUS is suboptimal before as well as after treatment of H pylori infection. This evidence suggests that gastric EUS may be more difficult technically compared with EUS of other organs. Lack of agreement is crucial because it influences the choice of therapy and assessment of response to treatment. Good interobserver agreement would permit better communication concerning the clinical status of patients, comparison of the results of different studies, and stratification of patients within clinical trials.

Clinical Competence↗