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Biomedical subjects

P Barillari

Publications and source records attributed to P Barillari.

At least 19 recordsLinked to original sources
PubMed2005

[Colorectal carcinoma metastasis in livers infected with hepatitis B or C virus].

AIM: Metastases from colorectal cancers rarely occur in injured livers, however in western countries this phenomenon has not been investigated in patients with various forms of chronic hepatitis. Therefore in this study we evaluated the incidence of synchronous hepatic metastases of colorectal carcinomas in patients with hepatitis B (HBV) or C (HBC) infection. METHODS: Six hundred and thirty patients undergoing surgical treatment for colorectal carcinomas were analysed: the clinicopathological data of 87 patients with HBV or HCV infection (there were 29 patients with hepatitis C infection and 58 with hepatitis B infection) were compared to those of 543 non infected patients. RESULTS: Patients distribution was similar in both groups in terms of gender, age, type of operative procedures performed, histological grading and lymph node metastases. Stage I, II or III tumours were similarly represented in non infected and infected patients, while stage IV tumours were 33.1% in the non infection group and 17.2% in the infection group (P < 0.001). At the time of surgery, synchronous extrahepatic metastases were present in 14.9% of non infected patients and 15% of infected patients, while synchronous hepatic metastases were found in 32% and 17.2% of patients respectively (P < 0.01). CONCLUSIONS: Results of our study show that synchronous hepatic metastases of colorectal cancers are less frequently observed in chronic HBV or HCV infected patients than in non infected patients, while the incidence of extrahepatic metastases is comparable in both groups, suggesting that virus-related mechanisms and specific liver mediated immunity may have a protective role against neoplastic cell colonization of the liver.

Aged↗
PubMed2005

[Occurrence of synchronous colorectal cancer metastasis in the cirrhotic or fatty liver].

AIM: Metastases from colorectal cancers rarely occur in injured livers, however this phenomenon has not been fully investigated in patients with different degree of liver damage. Therefore in this study we evaluated the incidence of synchronous hepatic metastases in patients with fatty or cirrhotic liver submitted to surgery for colorectal neoplasms. METHODS: Seven hundred and forty-seven patients undergoing surgical treatment for colorectal neoplasms were evaluated: the clinicopathological data of 171 patients with liver cirrhosis and 33 with fatty liver were compared to those of 543 patients without liver damage. RESULTS: Gender, age, type of operative procedures performed and histological grading were similar in patients with or without liver damage. In patients with liver cirrhosis the incidence of stage II tumour was greater, while stage IV tumours (P < 0.001) and nodal involvement were significantly lower than in patients with non injured or fatty liver (P < 0.02 and P < 0.001 respectively) . At the time of surgery, synchronous hepatic metastases were present in 32% of patients with normal liver, in 15% of patients with fatty liver (P < 0.02) and in 4.7% of patients with liver cirrhosis (P < 0.001). CONCLUSIONS: Results of our study show that synchronous hepatic metastases of colorectal cancer are less frequently observed in patients with fatty or cirrhotic liver than in patients with non injured liver, indicating that chronically damaged livers are protected from the spread of secondary cancers.

Aged↗
PubMed2002

Axillary lymphectomy in breast cancer.

BACKGROUND: The aim of the study was to demonstrate the prognostic value of sentinel node biopsy compared to the sampling of clinically suspected nodes and lymphectomy of the 3 axillary levels. METHODS. From October 1996 to January 1999, 60 patients with breast cancer with a diameter of 4 cm or under using different procedures of axillary lymphadenectomy. Sentinel node biopsy was performed using Giuliano's technique, followed by lymph nodes larger than 5 cm (lymph node sampling) and lastly all axillary lymph nodes (axillary lymphectomy at 3 levels). RESULTS: Sentinel nodes were identified in all patients and a mean of 3 sentinel nodes (range 1-5) were removed during the procedure. Histological analysis showed metastatic sentinel nodes in 21 cases. Lymph node sampling was possible in 43 patients who presented enlarged nodes. The mean number of lymph nodes removed was 6 (range 3-10). Lymph node metastasis was found in 10 patients and of these 7 had a metastatic sentinel node, whereas 3 had presented negative results. Histological tests in all 60 cases of complete axillary lymphectomy showed positive results in 4 cases confirming metastasis present in sentinel nodes. CONCLUSIONS: The results show that the association of lymph node sampling can improve the efficacy of sentinel node dissection, highlighting the rare cases of false negatives. In our study, total axillary lymphectomy did not add any information to the N parameter and was resolutive in a small percentage of cases.

Adult↗
PubMed2001

Carbohydrate antigen 19-9 and carcinoembryonic antigen immunostaining in benign multicystic mesothelioma of the peritoneum.

A 58-year-old Italian man was incidentally discovered to have an elevated carbohydrate antigen 19-9 (CA-19-9) level of 132 U/mL on routine blood testing. Multisystem imaging studies revealed multiple benign-appearing cysts of the liver and single cysts in the pancreas and kidney parenchyma. Throughout 14 months, fluctuations were observed in the elevated serum CA-19-9 levels from 99 to 450 U/mL. Serum carcinoembryonic antigen (CEA) and other tumor markers were normal. Laparoscopy disclosed multiple cystic lesions on the surface of the liver, on the serosal surface of the ileum, and in the mesentery. Electron microscopy characterized the cells as mesothelial. The pathologic diagnosis was benign multicystic mesothelioma of the peritoneum (BMMP). Aspirated fluid from the liver cyst revealed CA-19-9 levels at 28 500 U/mL, strongly linking the elevated serum CA-19-9 levels with mesothelial cyst secretion. Immunostaining was positive for CA-19-9, CEA, and cancer antigen 125 (CA-125). We believe this is the first documented instance of CA-19-9 and CEA secretion in BMMP.

CA-19-9 Antigen↗
PubMed2001

[Ambulatory surgical treatment for breast carcinoma].

BACKGROUND: The aim of the study is to demonstrate the feasibility and the oncologic effectiveness of quadrantectomy plus sentinel node biopsy performed under local anesthesia, and to demonstrate the economic and psychologic advantages. METHODS: From October 1996 to March 2000, 71 patients affected with clinical T1 N0 breast cancer, underwent quadrantectomy or tumor resection plus sentinel node biopsy and clinically suspicion axillary nodes biopsy, under local anesthesia at the Casa di Cura "Villa Mafalda" in Rome. RESULTS: Twenty tumors were T1a, 26 T1b e 25 T1c. A mean of 2 sentinel nodes (range 1-4) and a mean of 8 axillary nodes were removed during the procedure. In 2 cases sentinel nodes were not identified. Intraoperative histologic examination showed metastatic sentinel nodes in 11 cases. An axillary node dissection was performed in all cases (>12 nodes) and no other metastatic nodes were found. In all patients clinically suspected nodes were removed. In two cases no evidence of metastasis was found in sentinel nodes, while histologic examination revealed in a patient micrometastasis in one node, and in another patient two metastatic nodes. CONCLUSIONS: Fifty-three patients rated the overall surgical, anesthetic and recovery experience as "very satisfactory", 13 "satisfactory" and 5 "unsatisfactory". Patients typically expressed their pleasure at the possibility to return home and stressed the ease of recovery.

Adult↗
PubMed1998

The basic residues of placenta growth factor type 2 retrieve sequestered angiogenic factors into a soluble form: implications for tumor angiogenesis.

Placenta growth factor type 1 (PIGF-1) can be synthesized by neoplastic cells in an alternative form (PIGF-2) by the addition of basic amino acids to its classic sequence. Here we show that the basic residues of PIGF-2 compete for the binding of basic fibroblast growth factor (bFGF) and vascular endothelial growth factor (VEGF) to heparan sulfate proteoglycans of the cell surface and extracellular matrix. In doing so, PIGF-2 basic sequences inhibit the sequestering of VEGF and bFGF and maintain them in a highly diffusible form, thus enhancing their angiogenic effect. In agreement with these in vitro data, the presence of PIGF-2 transcripts in tumors correlates with their blood vessel number. These results suggest a mechanism by which growth factor isoforms produced by neoplastic cells enhance the formation of new blood vessels supporting tumor growth and progression.

Angiogenesis Inducing Agents↗
PubMed1997

Superiority of laparoscopy compared to ultrasonography in diagnosis of widespread liver diseases.

The aim of the study was to compare the results of ultrasonography (US) and laparoscopy in a series of 210 patients referred to our institution for the diagnosis of widespread liver diseases. Among 205 patients, laparoscopy revealed cirrhosis in 114, chronic widespread disease in 70 (chronic persistent hepatitis in 21, chronic active hepatitis in 28, steatosis in 14, acute hepatitis in 5, fibrosis in 2), and absence of liver disease in 21. Four of these cases had minor complications. A corroborative diagnosis was obtained in 122 patients (59.5%). Overall sensitivity of US was 84% with a low specificity due to the high rate of false negatives. From the results of this study we conclude that laparoscopy is a safe and essential diagnostic tool in the final diagnosis of widespread liver diseases and that US is not a reliable screening method because of its incidence of false negatives.

Adolescent↗
PubMed1997

[Intravenous omeprazole versus ranitidine in the treatment of hemorrhagic duodenal ulcer: a prospective randomized study].

This prospective randomized trial compares the results of i.v. omeprazole and i.v. ranitidine in 45 patients admitted as an emergency with an endoscopic diagnosis of bleeding duodenal ulcer. The patients were randomized to receive i.v. omeprazole, 40 mg bolus followed by 80 mg/day by continuous infusion for 3 days (group A), or ranitidine 50 mg i.v. bolus followed by 400 mg/day i.v., continuous infusion for 3 days (group B). Follow-up endoscopy on day 4 demonstrated successful therapy, except when more than 4 units of blood/day had to be transfused to maintain hemoglobin level above 10 g/l. Bleeding stopped in 20/21 patients in group A (95.2%), and in 17/24 patients in group B (70.80%) (p < 0.05). From the results of the study, it can be concluded that intravenous omeprazole seems to be effective in the control of bleeding duodenal ulcer.

Aged↗
PubMed1997

[Carcinoma of the gastric stump. Our experience in 28 treated cases].

A chart review was conducted on 28 patients with gastric stump cancer who were radically treated at the First Department of Surgery of University "La Sapienza" of Rome between 1978 and 1990. The data obtained were compared with those of 401 patients radically treated, in the same period, for primary cancer of the proximal third of the stomach. There were no significant differences between the two groups in terms of stage and nodal involvement. Surgical treatment was total gastrectomy in 86% of cases, and an extended procedure in 57% of patients. The morbidity rate was similar to patients treated for primary gastric cancer, as well the 5-year survival, which depend on the stage of disease. We can conclude that gastric stump cancer must be treated surgically with radical intent as the prognosis is similar to that of primary gastric cancer.

Adenocarcinoma↗
PubMed1996

Surveillance of colorectal cancer: effectiveness of early detection of intraluminal recurrences on prognosis and survival of patients treated for cure.

PURPOSE: The authors evaluate the effectiveness of routine colonoscopy and marker evaluation in diagnosis of intraluminal recurrent cancer. METHODS: Chart review was conducted on 481 patients who underwent curative resection for colorectal cancer between 1980 and 1990. Clinical visits were scheduled and carcinoembryonic antigen evaluation was performed every three months, and colonoscopy was performed preoperatively, 12 to 15 months after surgical treatment, and then with intervals of 12 to 24 months or when symptoms appeared. RESULTS: About 10 percent of patients developed intraluminal recurrences. More than one-half of metachronous lesions arose within the first 24 months, and median time to diagnosis was 25 months. Patients with left-sited tumors in the advanced stage had a higher risk of developing recurrent intraluminal disease. Twenty-nine patients underwent a second surgical operation, of which 17 cases were radical. In this group, the five-year survival was 70.6 percent, although no nonradically treated or nonresected patients survived longer than 31 months. Twenty-two patients were asymptomatic at time of diagnosis of recurrence, and of these, 12 patients underwent radical operation; on the other hand, of the 24 symptomatic patients, only 5 were treated radically. Carcinoembryonic antigen was the first sign of recurrence in eight cases. Colonoscopy must be performed within the first 12 to 15 months after operation, whereas an interval of 24 months between examinations seems sufficient to guarantee early detection of metachronous lesions. CONCLUSION: Serial tumor marker evaluation is of help in earlier diagnosis of local recurrences. Asymptomatic patients more frequently undergo another operation for cure and thus have a better survival rate.

Aged↗
PubMed1996

[The role of colonoscopy in early diagnosis of intraluminal recurrences in patients already treated for colorectal cancer].

It is a common opinion that the more often and the more rigorously the colon is examined, the more lesions will be discovered and diagnosed. However it has not been shown which methods of colonic examination and which regimen of surveillance should be used. Chart review was conducted on 481 patients who underwent curative resection for colorectal cancer between 1980 and 1990. Colonoscopy was performed preoperatively, after 12-15 months from surgical treatment, and then at an interval of 12-24 months, or when symptoms appeared. About ten percent of patients developed intraluminal recurrences, and more than 25% adenomatous polyps. More than one half of the metachronous lesions arise within the first 24 months. The median time to diagnosis was 25 months for intraluminal recurrences and 22 months for adenomatous polyps. Patients with left sited tumor at an advanced stage run a higher risk of developing recurrent intraluminal disease, and patients who presented associated polyps at the time of the operation for the index cancer have a higher risk of developing new polyps. About 50% of recurrences were detected when patients were asymptomatic. Colonoscopy must be performed within the first 12-15 months after operation, while an interval of 24 months between each examination seems sufficient to guarantee an early detection of metachronous lesion. Asymptomatic patients are more frequently reoperated for cure and thus have a better survival rate.

Adult↗
PubMed1994

[Results of conservative surgery in T1 breast carcinoma. Our experience in 66 treated cases].

Between 1989 and 1991, 66 women affected by breast cancer smaller than 2 cm in diameter, were treated with conservative procedure plus radiotherapy. Conservative procedure consisted in quadrantectomy and axillary dissection of the 3 axillary nodes levels. Neoplasms were grouped according to TNM classification. Eleven were classified as Tis, 9 as T1aN0M0, 12 as T1bN0M0, one case T1bN1M0, 24 as T1cN0M0 and finally 9 as T1cN1M0. Actuarial 5-year survival rate was related to TNM. It has been reported to be 100% in Tis and T1aN0M0 neoplasms; 91.7% in pT1bN0M0 tumors, 95.8% in pT1cN0M0 neoplasms, 55.6% in patients affected with pT1cN1M0 tumors. According to the relationship between receptor status of the neoplasm and survival, this was 88.9% in ER+ and 77.8% in ER- tumors, and 97.1% against 71.4% (p < 0.05) in PR+ and PR- neoplasms respectively. Two patients presented (3%) local recurrence which were treated by means of a tumorectomy and radiotherapy. Both patients are still living and disease free after 6 and 9 months from re-operation.

Adult↗
PubMed1994

[Effectiveness of quarterly assessment of CEA, TPA and GICA serum levels in gastric and colorectal carcinomas: Prospective study of 174 patients undergoing radical surgery].

One-hundred seventy four consecutive patients who underwent curative resection for gastric and colorectal cancer between 1983 and 1985, were studied prospectively to evaluate the roles of sequential CEA, TPA and GICA determinations and independent clinical examinations, in the early diagnosis of resectable recurrences. Sixty-six recurrences (33 from gastric and 33 from colorectal cancer) were detected between 6 and 42 months after primary surgery. In gastric cancer CEA, TPA and GICA showed a sensitivity of 64%, 73%, and 60%, and a specificity of 67%, 65% and 54% respectively. Nine patients (27%) underwent surgical treatment for the recurrent disease, and 4 of them (44.4%) had resectable recurrence, for a total resectability rate of 12%. Out of these four patients, three patients are still living after 12, 36 and 44 months respectively from re-operation without evidence of neoplastic disease. In one of these patients re-operation was performed on the basis of the elevation of the three markers, without any other clinical sign of disease, this patient had a resectable solitary hepatic recurrence. In colorectal cancer CEA, TPA and GICA showed a sensitivity of 73%, 73%, and 49%, and a specificity of 77%, 87%, and 97% respectively. Fourteen patients (42.4%) underwent surgical treatment for the recurrent disease, and 8 of them (57%) showed a resectable recurrence, for a total resectability rate of 24.2%. Six patients are still living after 9, 16, 21, 31, 41 and 53 months respectively from reoperation without evidence of neoplastic disease.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

The surgical choice in neutropenic patients with hematological disorders and acute abdominal complications.

The clinical course of patients with hematological disease, especially after treatment, is often complicated by gastrointestinal infections. Between 1986 and 1990 a total of 18 patients affected with hematologic disease and presenting with an acute abdomen were admitted to the surgery department at the University of Rome "La Sapienza". Most patients were affected with acute or chronic myeloid leukemia (61%) and lymphoma. Five patients with acute appendicitis, three with necrotizing enterocolitis, three with spontaneous hemoperitoneum, three with cholecystitis, two splenic infarctions and two intestinal occlusions were diagnosed. Symptoms were often vague and non specific and blood counts revealed neutropenia in all but two patients, while anemia was characteristic in spontaneous hemoperitoneum and in neutropenic enterocolitis. Fungemia occurred in only two cases while bacteremia was present in seven. The most critical patients were those affected by neutropenic enterocolitis and acute cholecystitis. Sonography was meaningful in the diagnosis of hemoperitoneum, splenic infarct and acute cholecystitis. All patients underwent surgical procedures within 48 hours of admission to the department. In all cases peritoneal washing was performed and at least one peritoneal drainage was left. In all cases of necrotizing enterocolitis, intestinal resections, either ileal or colonic, were followed by an immediate anastomosis in two layers. Intensive hematological and antibiotic post surgical care was performed in all patients. Seven patients presented minor complications (38.8%), and only one died (5.5%). Emergency surgical treatment may be safely carried out in patients with hematological diseases presenting with an acute abdomen. Intensive postsurgical care is mandatory for the recovery of patients and the patient's critical condition should not be a deterrent to surgical intervention.

Abdomen, Acute↗
PubMed1992

[Localized pleural mesotheliomas. Clinicopathological considerations on a case report].

Pleural mesotheliomas are rare, and their diagnosis and treatment not clear. The case observed in our Department leads us to an analysis of the literature. This showed that differential diagnosis with pulmonary carcinoma is very difficult, even in cases of parietal mesothelioma; however local treatment may be performed even in malignant mesothelioma.

Humans↗
PubMed1992

Role of CEA, TPA, and Ca 19-9 in the early detection of localized and diffuse recurrent rectal cancer.

Sixty-six consecutive patients who underwent curative resection for rectal cancer were studied prospectively to evaluate the roles of sequential carcinoembryonic antigen (CEA), tissue plasminogen activator (TPA), and carcinomatous antigen 19-9 (Ca 19-9) determinations in the early diagnosis of resectable recurrences. Thirty-three recurrences were detected between 6 and 42 months. CEA, TPA, and Ca 19-9 showed a sensitivity of 72.7 percent, 78.8 percent, and 60.1 percent, respectively, and a specificity of 60.6 percent, 60.6 percent, and 87.9 percent, respectively. In 23 cases the rise in the value of CEA and/or TPA and/or Ca 19-9 was the first sign of recurrences, and the diagnosis was established later by clinical methods. In this group, the lead time was two months for liver metastases and four months for disseminated metastases. As far as the relationship between localization of recurrence and marker level increase is concerned, of 16 hepatic metastases CEA, TPA, and Ca 19-9 showed a sensitivity of 94 percent (P less than 0.05), 69 percent, and 62 percent, respectively. Of six patients with local recurrences, CEA, TPA, and Ca 19-9 showed a sensitivity of 50 percent, 100 percent (P less than 0.05), and 83.3 percent, respectively. Of three patients with peritoneal carcinomatosis, CEA, TPA (P less than 0.05), and Ca 19-9 showed a sensitivity of 0 percent, 100 percent, and 0 percent, respectively. No significant differences were reported among the three markers according to multiple metastases and metachronous polyps. Fourteen patients (42.4 percent) underwent surgical treatment for recurrent disease, and eight of them (57 percent) showed a resectable disease, for a total resectability rate of 24.2 percent. The findings of our study indicate that a follow-up program based on CEA, TPA, and Ca 19-9 assays is related to an early diagnosis and a good resectability rate for both local and metastatic recurrences from rectal cancer.

Antigens, Tumor-Associated, Carbohydrate↗
PubMed1991

Gastrointestinal cancer follow-up: the effectiveness of sequential CEA, TPA and Ca 19-9 evaluation in the early diagnosis of recurrences.

One-hundred and seventy-four consecutive patients who underwent curative resection for gastric and colorectal cancer between 1983 and 1985 were studied prospectively to evaluate the roles of sequential carcinoembryonic antigen (CEA), tissue polypeptide antigen (TPA) and Ca 19-9 determinations and independent clinical examinations, in the early diagnosis of resectable recurrences. Sixty-six recurrences (33 from gastric and 33 from colorectal cancer) were detected between 6 and 42 months after primary surgery. In gastric cancer CEA, TPA and Ca 19-9 showed a sensitivity of 64%, 73% and 60% respectively and a specificity of 67%, 65% and 54% respectively. Nine patients (27%) underwent surgical treatment for recurrent disease, and four of these (44.4%) had resectable recurrence, for a total resectability rate of 12%. Of these four patients, three are still living after 12, 36 and 44 months respectively from re-operation without evidence of neoplastic disease. In one of these patients, re-operation was performed on the basis of the elevation of the three markers, without any other clinical sign of disease. This patient had a resectable solitary hepatic recurrence. In colorectal cancer. CEA, TPA and Ca 19-9 showed a sensitivity of 73%, 73% and 49% respectively, and a specificity of 77%, 87% and 97% respectively. Fourteen patients (42.4%) underwent surgical treatment for recurrent disease and eight of these (57%) showed resectable recurrence, for a total resectability rate of 24.2%. Six patients are still living after 9, 16, 21, 31, 41 and 53 months respectively from re-operation without evidence of neoplastic disease.(ABSTRACT TRUNCATED AT 250 WORDS)

Antigens, Neoplasm↗