Gianluca Baiocchi

A multicentric Western analysis of prognostic factors in advanced, node-negative gastric cancer patients

Background:The presence of lymph node metastasis is one of the most important prognostic factors in patients with gastric carcinoma. Node-negative patients have a better outcome, nevertheless a subgroup of them experience disease recurrence. Aim:To analyze the clinicopathological characteristics of lymph node-negative advanced gastric carcinoma patients submitted to gastrectomy and D2 lymphadenectomy with a retrieved number of nodes greater than 15, after an actual follow-up of almost 5 years, and to evaluate outcome indicators. Study Design:The records of 301 patients who underwent curative gastrectomy for gastric carcinoma and were adequately staged as N0 between 1992 and 2002 were retrospectively analyzed from the prospectively collected database of 7 centers participating to the Italian Research Group for Gastric Cancer. Results:Disease-specific and disease-free survival after 3, 5, and 10 years were 90.4%, 86.1%, 75.9%, and 72.1%, 57.3%, 57.3%, respectively. Mortality was 1.7%. The factors associated with a better disease-free survival at univariate analysis were age <60, T2 tumors, distal location, intestinal histotype, and number of retrieved nodes >25; depth of infiltration and histotype were the only 2 independent predictors of 5-year recurrence-free survival at multivariate analysis. Conclusion:These parameters must be considered to stratify node-negative gastric cancer patients for an adjuvant treatment and follow-up scheduling. Survival was similar to that previously reported by Eastern Centers. Lymphadenectomy is suggested to be effective, and retrieval of more than 25 nodes may be warranted.

Molecular characterization of LASP-1 expression reveals vimentin as its new partner in human hepatocellular carcinoma cells

Hepatocellular carcinoma (HCC) is the third most common cause of cancer-related mortality worldwide. We have previously reported that LASP-1 is a downstream protein of the urokinase type plasminogen activator (uPA). Here we investigated the role of LASP-1 in HCC by a molecular and biological characterization of LASP-1 expression in human HCC specimens and in cultured HCC cells. We determined the LASP-1 mRNA expression levels in 55 HCC cases with different hepatic background disease. We identified 3 groups of patients with high, equal or low LASP-1 mRNA levels in HCC tissues compared to the peritumoral (PT) tissues. In particular we found that i) the HCCs displayed a higher LASP-1 mRNA level in HCC compared to PT tissues; ii) the expression levels of LASP-1 mRNA in female HCCs were significantly higher compared to male HCCs; iii) the cirrhotic HCCs displayed a higher LASP-1 mRNA. Further, the biological characterization of the ectopic LASP-1 overexpression in HCC cells, using MALDI-TOF mass spectrometer on the LASP-1 co-immunoprecipitated fractions, displayed vimentin as a novel putative partner of LASP-1. Our results suggest that LASP-1 mRNA overexpression may be mainly implicated in female HCCs and cirrhotic HCCs; and that LASP1 may play its role with vimentin in HCC cells.

Functional Role of microRNA-23b-3p in Cancer Biology

MicroRNAs (miRNAs) constitute a class of short non coding RNAs that have crucial biological roles by acting mainly as negative regulators of gene expression. The alteration of miRNAs expression has been frequently demonstrated in cancer. Furthermore, miRNAs expression data clearly revealed their possible use as diagnostic, prognostic and predictive biomarkers. In this review, we focus on the biological role of human miR-23b-3p in cancer. Several data demonstrated that miR-23b-3p targeted different genes involved in cancer aggressive properties such as proliferation, migration, invasion, and metastasis. In this context, it is known that miR-23b-3p, as other miRNAs, can target either tumor-suppressor genes or oncogenes in different types of tumors. Therefore, its net biological effect can be tumor-specific, mainly depending on the consequent alterations on the downstream effects of the altered pathways. MiR-23b-3p has been found down-regulated or up-regulated in primary tumors and dysregulated in plasma and serum of cancer patients. Its expression levels correlate with the overall survival, disease-free survival and prognosis in several malignancies, thus assuming a remarkable role as molecular biomarker with clinical relevance. Finally, miR-23b-3p is generally considered a responsive molecular therapeutic target as reported in several in vitro and in vivo studies. This suggests that the ectopic modulation of its expression may potentially be important for translational medicine approaches.

Gunshot wound without entrance hole: where is the trick? - a case report and review of the literaturer.

The presence at CT scan of more retained bullets than expected could be a very difficult interpretation challenge in the early management of gunshot wounds. The modern non operative management of haemodinamically stable patients without peritonitis requires that the trajectory of the bullet is clearly recognized. This clinical case reporting of a gunshot wound without evident entry hole, allows to discuss the diagnostic and therapeutic implications in the management of gunshot wounds cases with atypical entry and/or exit holes.

Laparoscopy in Small Bowel Obstruction

Small bowel obstruction (SBO) due to adhesions is a common disease. Incidence, natural history, treatment approach, and preventability of SBO have very little changed over the years. Little progresses have been made in prevention and treatment until around 15 years ago. The introduction of the laparoscopic approach, the availability of more established criteria for conservative management, and improvement in imaging techniques have all contributed to advancements in this field. This chapter focuses on current evidences about laparoscopy for SBO, including its place in a comprehensive algorithm of management, and some technical tips and tricks to be respected when this surgical approach is adopted.