Sabato 27 ottobre 2012 - Pacini Editore

COmuNiCaziONi ORali
patients who had undergone cystoprostatectomy for bladder cancer
(controls). Immunostainings and confocal microscopy were
used to visualize SLUG expression at the protein level.
Results. SLUG gene expression levels were significantly
(P < 0.05) lower in the neoplastic (with no appreciable difference
between low and high-grade PCa) versus normal prostatic
epithelia (~12 times in low grade, ~16 times in high grade) and in
neoplastic versus normal stroma (~4 times in both grades).
SLUG was predominantly expressed in the stromal rather than
the epithelial compartment, with higher levels in the neoplastic
stroma. The mean expression level of SLUG in normal samples
from the untreated patients was not significantly different to that
obtained in normal samples from controls.
Immunostainings showed that, in the normal prostate glands,
both basal and luminal secretory cells strongly expressed SLUG
in their nuclei, whereas SLUG staining ranged from very weak
to moderate in the neoplastic glands. SLUG expression was inversely
related to that of the cell cycle regulator cyclin D1, and
the proliferation marker Ki-67.
Lastly, ADT generally enhanced SLUG expression in the stroma,
particularly in that of low-grade PCa.
Conclusions. These preliminary findings suggest that, as observed
in PCa cell lines (3), in the human prostate tissues, SLUG
may inhibit neoplastic epithelial cell proliferation rather than act
as an EMT promoter. It may also have a different role in the PCaassociated
stroma, whose response to ADT may have important
clinical and pathological implications. All these issues are the
subject of ongoing investigation in our laboratories.
references
1 Nieto MA, Sargent MG, Wilkinson DG, et al. Control of cell behavior
during vertebrate development by Slug, a zinc finger gene. Science
1994;264:835-9.
2 Barrallo-Gimeno A, Nieto MA. The Snail genes as inducers of cell
movement and survival: implications in development and cancer.
Development 2005;132:3151-61.
3 Liu J, Uygur B, Zhang Z, et al. Slug inhibits proliferation of human
prostate cancer cells via downregulation of cyclin D1 expression.
Prostate 2010;70:1768-77.
Pathological staging of uterine cervical carcinoma
after neoadjuvant chemotherapy: a predictor
of survival
V.G. Vellone1 , D. Lorusso2 , V. Masciullo2 , G. Amodio2 , G. Chiarello1
, E.D. Rossi1 , G. Fadda1 , G. Scambia1 , G.F. Zannoni2 1 Istituto di Anatomia ed Istologia Patologica, Policlinico A. Gemelli, Università
Cattolica S.Cuore, Roma; 2 Istituto di Ostetricia e Ginecologia,
Policlinico A. Gemelli, Università Cattolica S.Cuore, Roma
Background. Radio-chemotherapy represents a relevant therapeutic
option for cervical carcinoma. Surgical removal of uterus,
ovaries, lymph nodes and peritoneal sampling after the neoadjuavant
treatment give us the unique opportunity to evaluate the real
ammount of the residual, its anatomic location and its impact on
overall survival. A staging method is proposed and its implication
in prognosis is investigated.
Materials and methods. Study population: 114 cervical cancer
patients (stage IB-IV FIGO)
Treatment: platinum based chemotherapy with concomitant
external beam radioterapy and then radical hysterectomy, lyphadenectomy
and peritoneal sampling
Local response classificated as follow 1 2 :
pR0: Pathological Complete Response
pR1: Pathological Partial Response
pR2: Pathological No Response.
325
All patients were re-staged according to ypTNM and FIGO staging
and then combined with pR as follow:
No Residual Disease (NRD): pR0 Stage 0
Minimal Residual Disease (MRD): pR1 Stage IA and IB; pR2
Stage IA
Local Residual Disease (LRD): pR1 Stage IIA and IIB; pR2
Stage IB, IIA, IIB
Metastatic Disease (MD): any pR Stage III and IV
Mean follow-up: 39 months
Results. 46 patients resulted NRD; 25 MRD; 23 LRD; 20 MD.
NRD patients showed a significant advantage in suvival if compared
to LRD (p < 0,001) and MD (p < 0,001). No significant
difference were observed with MRD
LRD showed a slight better survival if compared to MD (p = 0,1).
Conclusions. A complete pathological staging confirmed its crucial
role in risk stratification. Furthermore it could be useful for planning
a second line treatment after surgery in patient with residual.
referencies
1 Zannoni GF, Vellone VG, Carbone A. Morphological effects of radiochemotherapy
on cervical carcinoma: a morphological study of
50 cases of hysterectomy specimens after neoadjuvant treatment. Int J
Gynecol Pathol 2008;27:274-81.
2 Zannoni GF, Vellone VG. Accuracy of Papanicolaou smears in cervical
cancer patients treated with radiochemotherapy followed by radical
surgery. Am J Clin Pathol 2008;130:787-94.
Clinical, pathological and molecular prognostic
factors for non-endometrioid (type II) endometrial
carcinoma
V.G. Vellone1 , A. Fagotti2 , D. Gallo2 , C. Bottoni2 , L. Santoro1 ,
E.D. Rossi1 , G. Fadda1 , G. Scambia1 , G.F. Zannoni2 1 Istituto di Anatomia ed Istologia Patologica, Policlinico A.Gemelli, Università
Cattolica S.Cuore, Roma; 2 Istituto di Ostetricia e Ginecologia,
Policlinico A.Gemelli, Università Cattolica S.Cuore, Roma
Background. Non Endometrioid Endometrial Carcinoma (NEC)
are an heterogeneus group of neoplasms with a notorius highly
malignant behaviour, with different features and a worse prognosis
if compared to conventional endometrioid carcinomas 1 .
The impact in prognosis of a series of clinical, pathological and
molecular markers is investigated.
Materials and methods. Study population: 28 non endometrioid
endometrial carcinoma patients treated withradical hysterectomy,
lymph adenectomy and peritoneal sampling.
Mean Follow up duration: 32 months
Impact in overall survivall of Patients age, Tumor size, % of
Myometrial Invasion, Lymph nodes metastases, extralimphonodal
metastases, Stage, ER, PR, Her2/neu, Ki67, p53, bcl-2 is
investigated
Results. NEC confirmed its fame of deadly disease: half of the
patients died of the disease. We found no prognostic significance
for Age, Tumor size, % of Myometrial Invasion, Lymph nodes
metastases, extralimphonodal metastases, Stage, ER, PR, Ki67,
p53, bcl-2 (p > 0,05).
Only positivity for Her2/neu (2+ FISH+ or 3+) identified a sub
population of cases with a worse prognosis (p = 0,03).
Conclusions. This finding confirm the aggressiveness of these
neoplasms but rise new opportunities in target terapies for these
unlucky patients.
references
1 Zannoni GF, Vellone VG, Arena V, et al. Does high-grade endometrioid
carcinoma (grade 3 FIGO) belong to type I or type II endometrial
cancer? A clinical-pathological and immunohistochemical study. Virchows
Arch 2010;457:27-34.