Carcinoma polmonare non a piccole cellule T1aN0M0: Ruolo prognostico della Microvessel Density

Obiettivi. Valutare l’angiogenesi tumorale mediante la Microvessel density (MVD) come fattore predittivo di mortalità per tumore polmonare non a piccole cellule (NSCLC) pT1aN0M0 trattato chirurgicamente. Metodi. I dati demografici, clinici e istopatologici sono stati registrati per 82 pazienti (60 maschi, 22 femmine) sottoposti a resezione chirurgica in due diverse Chirurgie Toraciche tra gennaio 2002 e dicembre 2007 per tumori polmonari non a piccole cellule pT1AN0M0. La MVD è stata valutata mediante il conteggio visivo dei microvasi positivi alla colorazione immunoistochimica con anticorpo monoclonale anti-CD31 e definita come il numero medio di microvasi per 1 mm2 di campo ottico. Risultati. Sono state eseguite 59 lobectomie (72%) e 23 resezioni sublobari (28%). Reperti istopatologici: 43 adenocarcinomi (52%) e 39 neoplasie non- adenocarcinoma (48%) pT1aN0M0; MVD media: 161 (CD31/mm2); mediana: 148; range 50-365, cut-off=150. Una MVD elevata (> 150 CD31/mm2) è stata osservata in 40 pazienti (49%), una MVD ridotta ( ≤ 150 CD31/mm2 ) in 42 pazienti (51%). Sopravvivenze a 5 anni: 70 % e 95%, rispettivamente per il gruppo ad elevata MVD vs il gruppo a ridotta MVD con una p = 0,0041, statisticamente significativa. Il tipo di resezione chirurgica, il diametro del tumore, le principali comorbidità e l’istotipo nono sono stati fattori predittivi significativi di mortalità correlata alla malattia. La MVD è risultata essere superiore nel gruppo “Adenocarcinoma” (MVD mediana=180) rispetto al gruppo “Non-Adenocarcinoma (MVD mediana=125), con un test di Mann-Whitney statisticamente significativo (p < 0,0001). Nel gruppo “Adenocarcinoma” la sopravvivenza a 5 anni è stata del 66% e 93 %, rispettivamente per i pazienti con MVD elevata e ridotta (p = 0.043. Conclusioni. Il nostro studio ha mostrato che la Microvessel density valutata con la colorazione immunoistochimica per CD31 ha un valore prognostico rilevante nel carcinoma polmonare in stadio precoce pT1aN0M0.

Cleavage Politics in Changing Times. Political Realignment Processes in Western European Countries

The dissertation fits the political realignment literature and aims to pro-vide further insights into cleavage politics by investigating voting behaviour in the Western European countries’ national elections. In particular, the dis-sertation focuses on the class and value voting patterns and on the change of these patterns in different countries and over the course of time. Peculiar pro-cesses affected all Western European party systems: whilst the «traditional» cleavage theory accounts for National and Industrial revolutions, those pro-cesses assumed to constitute the «societal modernization» determined chang-es in electoral competitions that questioned the relevance of individuals’ so-cial positions to study electoral preferences. Since the associations between social positions and voting behaviour underpin the so-called political cleav-age, the dealignment perspective assumes them to have been eroding since the second half of the XX century. On the other hand, the realignment perspective argues that the cleavage theory still accounts for individuals’ vote choices: of the four «traditional» cleavages, this perspective hypothesizes new class vot-ing patterns and alignments between electoral preferences and a new line of conflict, that is based on values. The dissertation provides a theoretical ac-count of the realignment of the class cleavage and a new conceptualization of value voting. Then, class and value voting patterns are explored. The analyses employ European Social Survey data and detect general and country-specific patterns. The dissertation adopts a mediation perspective and aims to observe how class voting patterns change when controlling for value orientations. The results are provided with a sensitivity analysis, indeed two versions of the measures computed for value orientations are compared. The findings show that social class continues to affect voting behaviour and that value orienta-tions both mediate this effect and affect electoral preferences.

Differential expression analysis for sequence count data via mixtures of negative binomials

The recent advent of Next-generation sequencing technologies has revolutionized the way of analyzing the genome. This innovation allows to get deeper information at a lower cost and in less time, and provides data that are discrete measurements. One of the most important applications with these data is the differential analysis, that is investigating if one gene exhibit a different expression level in correspondence of two (or more) biological conditions (such as disease states, treatments received and so on). As for the statistical analysis, the final aim will be statistical testing and for modeling these data the Negative Binomial distribution is considered the most adequate one especially because it allows for "over dispersion". However, the estimation of the dispersion parameter is a very delicate issue because few information are usually available for estimating it. Many strategies have been proposed, but they often result in procedures based on plug-in estimates, and in this thesis we show that this discrepancy between the estimation and the testing framework can lead to uncontrolled first-type errors. We propose a mixture model that allows each gene to share information with other genes that exhibit similar variability. Afterwards, three consistent statistical tests are developed for differential expression analysis. We show that the proposed method improves the sensitivity of detecting differentially expressed genes with respect to the common procedures, since it is the best one in reaching the nominal value for the first-type error, while keeping elevate power. The method is finally illustrated on prostate cancer RNA-seq data.