Clinicopathological and molecular characterization of gastroesophageal junction (GEJ) adenocarcinoma before age of 40 years

Gastroesophageal junction (GEJ) adenocarcinoma are uncommon before age of 40 years. While certain clinical, pathological and molecular features of GEJ adenocarcinoma in older patients have been extensively studied, these characteristics in the younger population remain to be determined. In the recent literature, a high sensitivity and specificity for the detection of dysplasia and esophageal adenocarcinoma was demonstrated by using multicolor fluorescence in situ hybridization (FISH) DNA probe set specific for the locus specific regions 9p21 (p16), 20q13.2 and Y chromosome. We evaluated 663 patients with GEJ adenocarcinoma and further divided them into 2 age-groups of or= 50 years, rispectively. FISH with selected DNA probe for Y chromosome, locus 9p21 (p16), and locus 20q13.2 was investigated with formalin fixed and parassin embedded tissue from surgical resections of 17 younger and 11 older patients. Signals were counted in > 100 cells with each given histopathological category. The chromosomal aberrations were then compared in the 2 age-groups with the focus on uninvolved squamous and columnar epithelium, intestinal metaplasia (Barrett's mucosa), glandular dysplasia, and adenocarcinoma. Comparisons were performed by the X2 test, Fisher's exact test, Student's t-test and Mann-Whitney U-test as appropriate. Survival was estimated by the Kaplan-Meier method with univariate analysis by the log-rank. Significance was taken at the 5% level. There was no difference in the surgical technique applied in both age groups and most patients underwent Ivor Lewis esophagectomy. Among clinical variables there was a higher incidence of smocking history in older patient group. We identified a progressive loss of Y chromosome from benign squamos epithelium to Barrett's mucosa and glandular dysplasia, and, ultimately, to a near complete loss in adenocarcinoma in both age groups. The young group revealed significantly more losses of 9p21 in both benign and neoplastic cells when compared to the older patients group. In addition, we demonstrated an increase in the percentage of cells showing gain of locus 20q13.2 with progression from benign epithelium through dysplasia to adenocarcinoma with almost the same trend in both the young and the older patients. When compared with the older age-group, younger patients with GEJ adenocarcinoma possess similar known demographics, environmental factors, clinical, and pathologic characteristics. The most commonly detected genetic aberrations of progressive Y chromosomal loss, 9p21 locus loss, and 20q13 gains were similar in the younger and older patients. However the rate of loss of 9p21 is significantly higher in young patients, in both the benign and the neoplastic cells. The loss of 9p21, and possibly, the subsequent inactivation of p16 gene may be one of the molecular mechanisms responsible for the accelerated neoplastic process in young patients.

La produzione drammatica dei fratelli Figueroa y Córdoba, con edizione critica di "Mentir y mudarse a un tiempo"

Diego e José de Figueroa y Córdoba furono due fratelli drammaturghi, attivi nella seconda metà del XVII secolo, che praticarono assiduamente la scrittura in collaborazione. Nel tentativo di rivalutare questi autori ingiustamente dimenticati dalla critica odierna, il presente lavoro si propone di offrire uno studio introduttivo alle figure e al teatro dei due fratelli. Nella prima parte, si offre un profilo biografico dei fratelli Figueroa, riunendo le seppur scarse notizie che possediamo sulla loro vita, in modo da inquadrarne le personalità all’interno degli ambienti letterari dell’epoca. Ci si concentra, poi, sul corpus, proponendo una panoramica delle commedie scritte da Diego e José, dando di ciascuna una breve sinossi e un rapido inquadramento all’interno dei generi tipici del teatro aureo, e segnalando gli eventuali problemi di attribuzione. Si accenna, infine, alla collaborazione dei fratelli nella scrittura di molte delle loro commedie, avanzando alcune ipotesi sulla tecnica compositiva. La seconda parte è costituita da un repertorio bibliografico del teatro “maggiore” dei due fratelli, in cui si descrivono analiticamente tutti gli esemplari conosciuti delle comedias dei Figueroa. Ogni descrizione si completa con una lista delle biblioteche in cui l’esemplare è conservato, lista compilata attraverso la consultazione di cataloghi, cartacei e on-line, delle principali biblioteche con fondi di teatro spagnolo del Siglo de Oro. Infine, la terza parte è dedicata all’edizione critica di una delle commedie scritte in collaborazione da Diego e José: Mentir y mudarse a un tiempo, condotta usando come testo base un manoscritto probabilmente autografo. L’edizione si completa di un apparato critico, con analisi dei testimoni, stemma codicum e registro delle varianti. Precede l’edizione uno studio generale introduttivo all’opera.