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Biomedical subjects

L Puzzo

Publications and source records attributed to L Puzzo.

At least 19 recordsLinked to original sources

Thyroid transcription factor 1 (TTF-1) and p63 expression in two primary thyroid papillary carcinomas of branchial cleft cysts.

Malignant lateral cervical cysts can be related to metastatic tumors or rarely to primary thyroid carcinoma arising in branchial cleft cysts. This study evaluates the expression of thyroid-associated transcription factor-1 (TTF-1) and p63 in three branchial cleft cysts and in two primary thyroid papillary carcinoma of branchial cleft cysts. TTF-1 was negative in the nuclei of the lining epithelia of branchial cleft cysts, but positive in the adjacent normal thyroid tissue, while TTF-1 was positive in the nuclei of the lining epithelia and in the nuclei of the papillae and follicles in branchial cleft cysts with ectopic thyroid carcinoma. P63 was positive in the nuclei of the lining epithelia of branchial cleft cysts, but negative in the adjacent normal thyroid tissue. Papillary thyroid carcinoma of branchial cleft cysts displayed p63-positive foci. In conclusion, our results demonstrate that TTF-1 cannot distinguish between primary and metastatic tumors of branchial cleft cysts. The detection of p63 in papillary thyroid carcinomas of branchial cleft cysts could suggest that p63 contributes to the onset of this tumor. It is really important to evaluate if the case has a metastatic derivation or represents papillary thyroid carcinoma arising in ectopic thyroid tissue in a branchial cleft cyst.

Adenocarcinoma, Papillary↗

p53 overexpression on the resection margins as a marker of local recurrence in glottic T1a carcinoma.

Glottic carcinoma, in the early stage, may benefit, with excellent results "quoad vitam atque quoad valitudinem", from various modes of treatment--radiotherapy, laser microsurgery and cordectomy being the most common--in definitive cure of the disease. Nevertheless, recurrence, in relation to treatment, oscillates between 4.3-24.1% with laser CO2 surgery, 5.5-32.4% for cordectomy and 5.3-34% for radiotherapy. Prognostic biological markers of recurrence remain to be elucidated, mainly due to the clinical differences in the subjects examined. The present study focused on patients with glottic T1a carcinoma treated with CO2 laser surgery in which correlation between histo-pathological aspects and expression of p53 protein on resection borders were confirmed by onset of local recurrence. Study population comprised 39 patients treated with CO2 laser surgery (January 1985-December 1991) in Clinical Division of Otorhinolarygology, University of Catania. Survival rate, free from recurrence, at 3 and 5 years for this patient group was 87.1% (34/39) and 82% (32/39), respectively. Disease-free survival at 3 and 5 years, was 86.6% in patients with positive resection margins for carcinoma and 87.5% and 79.1%, respectively, for patients with negative resection margins. Survival rate, free from local recurrence, in p53 positive patients, at 3 and 5 years was 78.9% and 68.4%, respectively. In p53 negative patients, survival, free from local recurrence, at 3 and 5 years, was 94.7%. Presence of overexpression of oncoprotein p53 on borders of resection with aspects of dysplasia of various degrees seems, therefore, a marker of high risk of tumour progression and recurrence.

Adult↗

[Quality control in pathology: prospective peer review on routine cases].

To describe a prospective method of quality assurance adjusted to an ideal group of pathologists, easily feasible in routine surgical pathology. The Authors examined the same slides (EE) independently and without time-limits. In the same session the individual diagnosis were compared and discussed in order to provide only one conclusive diagnoses. After the discussion, diagnostic agreement is 100%. Peer and simultaneous review yields sufficient benefits in increasing the accuracy of diagnostic reports. It stimulates discussion of diagnostic criteria and terminology, creates more uniform reports, and serves as an educational vehicle for pathologists.

Humans↗

[The role of p53 tumor suppressor gene as prognostic factor in laryngeal squamous cell carcinoma].

Mutations in the p53 gene--which codifies anuclear phosphoprotein that acts as a tumor suppressor gene--is the most common genetic alteration in head and neck cancers. The aim of the present study was to investigate the prognostic significance of p53 protein over expression in squamous cell laryngeal carcinoma. To do so we analyzed 31 patients affected by precancerous lesions of the larynx who had undergone multiple biopsy between 1980 and 1995. Twenty-five of these patients later developed laryngeal carcinoma. In this group of patients, 51 biopsies were performed for precancerous lesions (17 hyperplasia, 3 light dysplasia, 23 moderate dysplasia, 8 severe dysplasia) prior to evidence of laryngeal cancer (2.04 biopsies/patient). In the group of patients who did not develop laryngeal cancer, 18 biopsy were performed (2.2 biopsies/patient) and histology revealed: 5 keratosis, 5 light dysplasia, 4 moderate dysplasia and 4 grave dysplasia. Using the immunohistopathological staining technique, 69 formalin-fixed, paraffin-embedded precancerous samples and 25 laryngeal carcinomas were examined for p53 over expression. The monoclonal antibody Pab 1801 was used with the avidinbiotin immunoperoxidase technique; p53 intensity of expression was assessed and correlated with clinical-pathological parameters. Over expression of the p53 protein was found in 56.8% of the precancerous lesions (41% of the hyperplastic lesions, 66% of light dysplastic lesions, 60% of moderate dysplastic lesions and 75% of severe dysplastic lesions) in the group patients who did develop laryngeal cancer and in 22.2% of the precancerous lesions in the group of patients that did not. The transformed lesions showed a strong correlation between intensity of positivity and grade of cellular atypia. Further in 93.3% of the patients with p53 positive precancerous lesions which later developed into laryngeal cancer, p53 over expression was present in the cancerous lesions. There was no significant correlation between p53 immuno reactivity and such clinico pathological tumor parameters as TNM staging and tumorrecurrence. On the other hand, there was a correlation between p53 overexpression and differentiation grading: p53 overexpression was found in 75% of the poorly differentiated tumors, 58.3% of moderately differentiated and 44.4% of well differentiated tumors. The fact that p53 is detected in preneoplastic lesions suggests that p53 gene alteration takes place very early in laryngeal carcinoma and moderate-to-high p53 expression constitutes a high risk of transformation into cancer; on the other hand low expression may reflect reversible changes that can be attributed to the genotoxic effects of tobacco smoking. In conclusion the present data suggest that p53 over expression could be a good prognostic marker in predicting which precancerous laryngeal lesions will progress into cancer.

Adult↗

[Surgical treatment of spontaneous pneumothorax: comparison of thoracotomy and thoracoscopy].

The video-thoracoscopic treatment of spontaneous pneumothorax currently has the same role of laparoscopic cholecystectomy in abdominal surgery. The Authors consider thoracoscopic approach and traditional thoracotomy examining advantages versus disadvantages, comparing 50 patients with spontaneous pneumothorax treated by thoracoscopy, from February 1992 up to February 1995, and 50 patients, previously treated by open surgery. Video-thoracoscopy has the same percentage of recurrences of thoracotomic approach but assures a quicker functional recovery and, above all, a remarkable reduction of pain.

Adult↗

[Multilocular cysts of the kidney in the adult].

Multilocular cyst of the adult kidney is a benign lesion of uncertain pathogenesis. We report a case studied by immunohistochemical techniques. A malformative histogenesis is suggested.

Biomarkers, Tumor↗

[Pleuroscopy and talc pleurodesis in recurrent pleural effusions: experience with 51 cases].

From January '92 up to January '94 thoracoscopy was performed in 51 patients with recurrent pleural effusion: 49 of these patients underwent talc pleurodesis. 10 pleural mesotheliomas, 29 diffuse metastasic pleural involvement and 12 benign effusions were diagnosed. Intrapleural talc therapy allowed a definitive pleurodesis in 43 patients with a success rate of 87%.

Female↗

[Low anterior resection of the rectum using mechanical anastomosis in intestinal endometriosis].

A case of sigmoid-rectal endometriosis prompted the authors to focus attention on the question of indications for surgery and operative tactics in intestinal endometriosis. In this case, the presence of a pelvic mass which could not be cut away from the intestinal wall without the risk of perforation led to the performance of a low anterior resection of the rectum with mechanical stapler, a choice which was certainly radical but necessary in view of the impossibility of excluding the malignant nature of the mass either macroscopically or extemporaneously.

Adult↗

[Surgery in neoplasms of the low rectum. Analysis of the Knight-Griffen technique].

The major advantage offered by the "double stapling technique" in the treatment of low rectum cancers is sphincter preservation while respecting oncological criteria of radicality. The authors report their experience in surgical treatment of rectal neoplasms, considering a 24 patient group observed between 1989 and 1991, when new staplers were available in Italy. They also present primary results obtained with modified Knight-Griffen technique evaluating a series of 10 patients with rectal cancers placed between 5 and 10 cm from the anal verge. The authors describe surgical procedures and, analyse the complication rate, report a 10% anastomotic leak with no clinical stenosis and 20% relapses. Showing a 2-year follow-up data, a 61.1% surviving actually free of disease in the all 24-patient group is referred. The authors conclude that double stapling technique, while safe and effective, should be always performed accordingly to oncological radicality, reminding that the aim of surgery is the treatment of cancer and sphincter saving should be considered secondary.

Adenocarcinoma↗

[Malignant mesothelioma located in the pleura: its radical surgical treatment].

The authors report a rare case of localized malignant pleural mesothelioma infiltrating the thoracic wall. The absence of widespread pleural involvement allowed for a radical operation with removal of a large portion of the thoracic wall. However, due to rarity of such tumor, an hypothesis on long term prognosis is difficult to formulate.

Humans↗

[Cerebral gliosarcoma. On the possible pericytial origin of the sarcomatous component].

We have reported two cases of cerebral gliosarcoma by immunohistochemical method. The antibodies anti S-100, anti GFAP and anti vimentin have supported the presence of glial and mesenchymal elements. Factor VIII has labeled the endothelium of the newly formed vessels. Collagen IV has shown atypical cells in the thickness of the vascular walls, and ribbons of adventitial cells throwing in the surrounding parenchyma. By these results, the pericitic origin of the sarcomatous elements could be hypothesized.

Brain Neoplasms↗

[Medullary carcinoma of the breast. Co-expression of keratin intermediate filaments and protein S-100 in tumor cells].

We have chosen 10 medullary carcinomas from a retrospective investigation on 450 cases of breast carcinoma (2.2%), according to the histomorphological criteria of Ridolfi and colleagues. By immunoperoxidase staining, we have evaluated the distribution of keratin and vimentin intermediate filaments, of CEA and S-100 protein in cancer cells. A widespread positivity to keratins has been proved in 70% of medullary carcinomas. Numerous neoplastic cells have coexpressed S-100 protein. We hypothesize the epithelial and myoepithelial "intermediate" differentiation of keratin and S-100 protein positive tumour cells.

Adult↗

[Pneumatosis cystoides intestinalis].

Pneumatosis Cystoides Intestinalis. Pneumatosis Cystoides Intestinalis is usually associated with intrinsic disease of the bowel. A case of the ileum associated with duodenal ulcer and a case of the large bowel associated with diverticular disease are reported. It was an unexpected finding in both patients. The histiocytic origin of the cells which line the gas cysts and the pathogenesis are discussed.

Colonic Diseases↗