Studio di marcatori biologici prognostici nel linfoma di Hodgkin

Recent reports showed that early-interim PET-scan is the only tool predicting treatment outcome in advanced-stage classical Hodgkin lymphoma (asCHL). We evaluated the prognostic impact of a series of immunohistochemical markers, mentioned in literature as prognostic factors, on tissue microarrays assembled from biopsies of 220 patients: STAT1, SAP, TOP2A, PCNA and CD20, both in neoplastic (HRSC) and microenvironment cells (MC); RRM2, MAD2, CDC2, BCL2, P53, BCL11A and EBER in HRSC; ALDH1A1, TIA-1, granzyme B, perforin, FOXP3, and PD-1 in MC. All patients had been treated with standard ABVD ± Rx therapy. Interim-PET after 2 ABVD courses was evaluated according to the criteria indicated by Gallamini in his study (Journal of Clinical Oncology, 2007). The survival analysis has been performed in a subset of 138 patients whose complete clinical information were available: the mean age was 33.3 years (14-79), the stage III-IVB in 98 and IIB in 40, and the mean follow-up 38.1 months (7.6-71.9). Histopathology review showed: NS-I 75, NS-II 22, MC 20, DL 3, and CHL/nos 18 cases. Interim-PET was positive in 30 patients, while treatment failure was recorded in 32. In univariate analysis the factors related to treatment outcome were BCL2 on HRSC (cut-off value 50%), STAT1/SAP on MC, and PET (Log-rank 6.9, 7.9 and 93.9 respectively). The combined expression of STAT1 and SAP was scored in three levels depending on the architectural pattern: score 0 for expression of both with a diffuse/rosetting pattern; score 1 for discordant combination of diffuse/rosetting and scattered patterns; score 2 for both markers with a scattered pattern; the 3y-PFS were 87.4%, 69.9% and 61.9% respectively. In multivariate analysis PET, BCL2 and STAT1/SAP remained significant (HR: 24.8, 4.6, 7.5 and 5.6, respectively; p<.01). The proposed model is able to predict treatment response in AsCHL, even if with a lower efficacy than PET. However, unlike PET, it can be applied upfront therapy.

Studio di marcatori immunoistochimici, analisi FISH e ruolo dei microRNA nelle neoplasie gliali di basso e di alto grado

Gliomas are the most common primary brain tumours. Despite advances in surgical techniques, postoperative supportive care, radiation and adjuvant systemic therapy, the life expectancy of patients with high grade glioma has remained essentially poor. Furthermore differential diagnosis among astrocytomas, oligodendrogliomas and oligoastrocytomas is very challenging and subject to inter-observer variability. The purpose of the research was: 1) to investigate a series of high grade and low grade gliomas at gene and protein (immunohistochemistry) levels to disclose possible genetic portraits of malignancy; 2) to verify the utility of Nogo-A, Olig-2 and synaptophysin in providing a correct histological diagnosis of oligodendroglioma and to investigate a possible complementary role in selecting the best areas suitable for detecting 1p/19q codeletion using FISH analysis; 3) to study the role of microRNA in high grade gliomas. In order to obtain these goals large series of brain tumors were studied with DNA microarrays, immunohistochemistry and RT-PCR The results demonstrated that: - Overexpression of IGFBP-2 and CDC20 is highly related to glioblastomas and their immunopositivity can be useful for the identification of glioblastoma in small biopsies. - Nogo-A is the most useful and specific marker in differentiating oigodendrogliomas from other gliomas. Furthermore, using a Nogo-A driven FISH analysis, it is possible to identify a larger number of 1p19q codeletions in gliomas. - microRNAs can be studied in paraffin embedded tissues better than in fresh tissues. A series of six microRNA, significatively deregulated in glioblastomas, may represent a genetic signature with prognostic and predictive value and could constitute candidates for novel anti-cancer therapeutics.

Tumori primitivi multipli del polmone. Profilo clinico e biologico in pazienti affetti da neoplasie polmonari multiple. Analisi di elementi clinici e marcatori biologici come possibili fattori di differenziazione dei tumori polmonari multipli

Background: MPLC represents a diagnostic challenge. Topic of the discussion is how to distinguish these patients as a metastatic or a multifocal disease. While in case of the different histology there are less doubt on the opposite in case of same histology is mandatory to investigate on other clinical features to rule out this question. Matherials and Methods: A retrospective review identified all patients treated surgically for a presumed diagnosis of SPLC. Pre-operative staging was obtained with Total CT scan and fluoro-deoxy positron emission tomography and mediastinoscopy. Patients with nodes interest or extra-thoracic location were excluded from this study. Epidermal growth factor receptor (EGFR) expression with complete immunohistochemical analisis was evaluated. Survival was estimated using Kaplan-Meyer method, and clinical features were estimated using a long-rank test or Cox proportional hazards model for categorical and continuous variable, respectively. Results: According to American College Chest Physician, 18 patients underwent to surgical resection for a diagnosis of MPLC. Of these, 8 patients had 3 or more nodules while 10 patients had less than 3 nodules. Pathologic examination demonstrated that 13/18(70%) of patients with multiple histological types was Adenocarcinoma, 2/18(10%) Squamous carcinoma, 2/18(10%) large cell carcinoma and 1/18(5%) Adenosquamosu carcinoma. Expression of EGFR has been evaluated in all nodules: in 7 patients of 18 (38%) the percentage of expression of each nodule resulted different. Conclusions: MPLC represent a multifocal disease where interactions of clinical informations with biological studies reinforce the diagnosis. EGFR could contribute to differentiate the nodules. However, further researches are necessary to validate this hypothesis.

Identificazione e dosaggio di marcatori molecolari dell'endometriosi nel sangue periferico

Purpose: to quantify the mRNA levels of MMP-3, MMP-9, VEGF and Survivin in peripheral blood and the serum levels of CA-125, Ca19-9 in women with and without endometriosis and to investigate the performance of these markers to differentiate between deep and ovarian endometriosis. Methods: a case controls study enrolled a series of 60 patients. Twenty controls have been matched with 20 cases of ovarian and 20 cases of deep endometriosis. Univariable and multivariable performance of serum CA125 and CA19-9, mRNA for Survivin, MMP9, MMP3 and VEGF genes have been evaluated by means of ROC curves and logistic regression respectively. Results: No difference in markers concentration were detected between ovarian and deep endometriosis. In comparison with controls serum CA19 and CA125 yielded the better sensitivity followed by mRNA for Survivin gene (81.5%, 51.9% and 7.5% at 10% false positive rate respectively). Multivariable estimated odds of endometriosis yielded a sensitivity of 87% at the same false positive rate. Conclusions: A combination of serum and molecular markers could allow a better diagnosis of endometriosis.

Marcatori molecolari circolanti: quale ruolo nei pazienti con tumori solidi?

Background: Circulating tumor cells (CTCs) and circulating free plasma DNA (FPDNA) have been proposed as biomarkers predictive of outcome and response to therapy in solid tumors. We investigated the multiple associations of the presence of CTC and the levels of FPDNA with the outcome and/or the response to chemotherapy in patients with localized breast cancer (LBC), metastatic breast cancer (MBC) and advanced ovarian cancer (AOC). Experimental Design: Blood samples were collected before (baseline), during and after therapy in 40 LBC and 50 AOC patients treated with neo-adjuvant chemotherapy. In 20 MBC patients blood was sampled at baseline and every each cycle of adjuvant chemotherapy. Real time PCR was applied to quantify FPDNA using the Quantifiler Human Quantification kit and CTCs through the detection of tumor-cell specific mRNA levels with or without epithelial enrichment. Results: At baseline CTCs were detected in 90% MBC, 42.5% LBC and 33% AOC patients respectively. The presence of baseline CTC was significantly associated with shorter overall survival (OS) in MBC and AOC patients, and shorter progression free survival (PFS) in LBC patients. Presence of CTCs at the end of neo-adjuvant chemotherapy was detected in 42% LBC and 18% AOC patients and was associated with shorter PFS and OS only in LBC. Increased FPDNA levels at baseline were found in 65% MBC, 17.5% LBC and 76% AOC patients but never related to OS. Baseline FPDNA high levels were associated with shorter PFS only in LBC patients. High FPDNA levels after neo-adjuvant chemotherapy were detected in 57% LBC and 48% AOC patients. Increased FPDNA after neo-adjuvant was associated with response to therapy and shorter PFS in AOC patients. Conclusions: Detection of CTCs may represent a prognostic and predictive biomarker in LBC, MBC and AOC. Quantification of FPDNA could be useful for monitoring response to therapy in AOC patients.

Ricerca di marcatori molecolari nella prevenzione dei tumori di testa e collo

Oral cavity cancers (OSCC) are among the most malignances worldwide. OSCC tipically affects men in their IV or V dedade of life, and the most relevant risk factors are tobacco and alcohol consumption. OSCCs generally exhibit poor prognosis, and late stage identification correlates with higher mortality rates. Basic prognostic factors, are tumor size and presence of lymph node and/or distance metastases (T classification, N, M). However, tumors with the same TNM grade and similar morphology may have completely different evolution, because of their intrinsic biological characteristics. For these reasons, the identification of new molecular markers with a predictive value, could represent useful tools in OSCC prevention, prognosis and treatment. In the first part of my PhD project I evaluated the loss of heterozygosity as a possible cause of deregulation of well-known tumor suppressors genes. Obtained data put on light the importance of this rearrangement and genes PDCD4, CTNB1, CASP4 and HSP23, in the onset and progression of OSCC. Subsequently, the analysis of the expression profile of miRNAs, led to the identification of some miRNAs that seems to be involved in cancer development and metastatic progression. In both cases, we need further investigations to understand whether these molecules may be used ideal markers in OSCC diagnosis and treatment.

Dispositivi di ultima generazione per l'immunorivelazione di marcatori proteici in fase solida

Oggetto della presente tesi di Laurea è lo studio delle nuove tecnologie disponibili per l’immunorivelazione di marcatori proteici in fase solida. Particolare attenzione è stata rivolta alle problematiche e alle esigenze tecniche nella quantificazione del complesso proteico in esame a seguito della rivelazione di un segnale, testimone proporzionale della grandezza biologica in esame. In altre parole l’identificazione e la quantificazione di proteine di interesse avviene a valle di un processo, chiamato “western blotting”, che genera un segnale (colore, luce, fluorescenza) al quale riferire la sostanza molecolare della misura. L’accuratezza della quantificazione, a seguito degli errori sperimentali dovuti alla tecnologia, rappresenta un problema complesso nella pratica biochimica e nello studio dei fenomeni di variazione dell’espressione genica, ovvero del fenotipo, in un organismo. Il primo capitolo si apre con la descrizione del processo di discriminazione delle proteine in base al loro rapporto carica/massa molecolare tramite elettroforesi su gel. Il capitolo prosegue con la disamina della tecnologia di ultima generazione per la visualizzazione delle proteine risolte e la loro eventuale quantificazione, paragonandone le prestazioni rispetto ai sistemi di visualizzazione e quantificazione classici. Argomenti del secondo capitolo sono lo studio delle prestazioni delle nuove tecnologie per l’esecuzione del “blotting” su supporto solido e per l’incubazione delle proteine con immunoglobuline. Seguono, rispettivamente nei capitoli terzo e quarto, l’analisi delle tecnologie analogiche e digitali per la rivelazione del segnale e la quantificazione tramite opportuni software.

Analisi di paternità sulla specie Anguilla anguilla con l'utilizzo di marcatori loci microsatelliti

L’anguilla europea, Anguilla anguilla, è una specie gravemente minacciata, sia da impatti diretti legati al sovrasfruttamento della specie a tutti gli stadi del ciclo vitale, che indiretti come l’urbanizzazione costiera e la perdita di habitat lagunari. Negli ultimi 45 anni è stata documentata una riduzione del tasso di reclutamento di anguilla europea del 90%. Lo scopo di questo studio è stato approfondire le modalità riproduttive di A. anguilla per via indiretta, attraverso un’analisi di paternità. Il Centro di ricerca universitario di Cesenatico (Laboratori di Acquacoltura ed Igiene delle Produzioni Ittiche – Università di Bologna) ha avviato le prime sperimentazioni su A. anguilla, al fine di mettere a punto un protocollo di riproduzione artificiale. Nell’estate 2015 i ricercatori hanno ottenuto sette riproduzioni spontanee in ambiente controllato, da queste sono state campionate casualmente e genotipizzate circa 40 larve per ogni mandata riproduttiva e i relativi riproduttori per condurre l’analisi di paternità. In ogni riproduzione è stata utilizzata sempre e soltanto una femmina e tre o quattro maschi; le analisi genetiche, condotte utilizzando 9 loci microsatelliti, si sono focalizzate sull’individuazione dei padri e l’assegnamento di paternità è avvenuto con un livello di confidenza medio dell’89%. Dalle analisi effettuate è emerso che: 1) i maschi di questa specie, precedentemente sottoposti a stimolazioni ormonali per indurne la riproduzione e la fertilità, sono in grado di partecipare con successo a più di una riproduzione; 2) più esemplari riescono a fecondare gli ovociti di una sola femmina e sembrano stabilirsi modelli gerarchici di dominanza in quanto si è osservato generalmente che un maschio prevale sugli altri, generando da solo più del 50% della prole. Questo studio pilota rappresenta, quindi, un punto di partenza per approfondimenti futuri sulle modalità riproduttive dell’anguilla europea.