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|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
39056996_p42
|
39056996
|
sec[1]/sec[4]/p[2]
|
2.5. Statistic Analysis
| 3.8125 |
biomedical
|
Study
|
[
0.99951171875,
0.0002830028533935547,
0.0001881122589111328
] |
[
0.998046875,
0.0014057159423828125,
0.00041985511779785156,
0.00009298324584960938
] |
The nonparametric Mann–Whitney U test was used to compare the significance of the difference between the medians of individual salivary biomarkers stratified by sampling time (T1, T2, and T3). A p value < 0.05 was considered statistically significant.
|
[
"Angela Pia Cazzolla",
"Vincenzo Brescia",
"Roberto Lovero",
"Antonietta Fontana",
"Arcangela Giustino",
"Mario Dioguardi",
"Maria Severa Di Comite",
"Francesca Di Serio",
"Domenico Ciavarella",
"Vito Crincoli"
] |
https://doi.org/10.3390/dj12070209
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999997 |
39056996_p43
|
39056996
|
sec[1]/sec[4]/p[3]
|
2.5. Statistic Analysis
| 3.400391 |
biomedical
|
Study
|
[
0.9990234375,
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0.0006928443908691406
] |
[
0.99560546875,
0.0038013458251953125,
0.0005917549133300781,
0.00013124942779541016
] |
Multiple Comparison Graphs reporting the individual determinations and a connecting line for the median were used to evaluate the trend of the distribution of the concentration of BMT cells with respect to sampling time.
|
[
"Angela Pia Cazzolla",
"Vincenzo Brescia",
"Roberto Lovero",
"Antonietta Fontana",
"Arcangela Giustino",
"Mario Dioguardi",
"Maria Severa Di Comite",
"Francesca Di Serio",
"Domenico Ciavarella",
"Vito Crincoli"
] |
https://doi.org/10.3390/dj12070209
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999996 |
39056996_p44
|
39056996
|
sec[1]/sec[4]/p[4]
|
2.5. Statistic Analysis
| 2.498047 |
biomedical
|
Study
|
[
0.99658203125,
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0.0018606185913085938
] |
[
0.994140625,
0.0047149658203125,
0.0010595321655273438,
0.0003268718719482422
] |
The percentage change in the concentration of the biomarkers measured at T1, T2, and T3 in the individual subjects was evaluated.
|
[
"Angela Pia Cazzolla",
"Vincenzo Brescia",
"Roberto Lovero",
"Antonietta Fontana",
"Arcangela Giustino",
"Mario Dioguardi",
"Maria Severa Di Comite",
"Francesca Di Serio",
"Domenico Ciavarella",
"Vito Crincoli"
] |
https://doi.org/10.3390/dj12070209
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999999 |
39056996_p45
|
39056996
|
sec[1]/sec[4]/p[5]
|
2.5. Statistic Analysis
| 3.691406 |
biomedical
|
Study
|
[
0.9990234375,
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] |
[
0.99853515625,
0.0009703636169433594,
0.0002968311309814453,
0.00006443262100219727
] |
The critical difference (RCV) of the biomarkers on salivary matrix (21.18%, 56.81%, 68.44% respectively for P1NP, TRAcP and PTHrP) 70 was used to evaluate the significance of the variation obtained .
|
[
"Angela Pia Cazzolla",
"Vincenzo Brescia",
"Roberto Lovero",
"Antonietta Fontana",
"Arcangela Giustino",
"Mario Dioguardi",
"Maria Severa Di Comite",
"Francesca Di Serio",
"Domenico Ciavarella",
"Vito Crincoli"
] |
https://doi.org/10.3390/dj12070209
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999999 |
39056996_p46
|
39056996
|
sec[1]/sec[4]/p[6]
|
2.5. Statistic Analysis
| 2.234375 |
biomedical
|
Study
|
[
0.99560546875,
0.0009551048278808594,
0.0036067962646484375
] |
[
0.98828125,
0.01065826416015625,
0.0008158683776855469,
0.0003771781921386719
] |
The multiple variable grap.hs were used to visualize the different concentrations of the biomarkers at T1, T2, and T3 for each individual included in the study.
|
[
"Angela Pia Cazzolla",
"Vincenzo Brescia",
"Roberto Lovero",
"Antonietta Fontana",
"Arcangela Giustino",
"Mario Dioguardi",
"Maria Severa Di Comite",
"Francesca Di Serio",
"Domenico Ciavarella",
"Vito Crincoli"
] |
https://doi.org/10.3390/dj12070209
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999998 |
39056996_p47
|
39056996
|
sec[1]/sec[4]/p[7]
|
2.5. Statistic Analysis
| 1.503906 |
biomedical
|
Other
|
[
0.978515625,
0.0014371871948242188,
0.0199432373046875
] |
[
0.228759765625,
0.76806640625,
0.0018053054809570312,
0.0014791488647460938
] |
For statistical analysis, the MedCalc software program, version 11.6.1.0 (MedCalc Software, Mariakerke, Belgium) and Analite.it were used.
|
[
"Angela Pia Cazzolla",
"Vincenzo Brescia",
"Roberto Lovero",
"Antonietta Fontana",
"Arcangela Giustino",
"Mario Dioguardi",
"Maria Severa Di Comite",
"Francesca Di Serio",
"Domenico Ciavarella",
"Vito Crincoli"
] |
https://doi.org/10.3390/dj12070209
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999998 |
39056996_p48
|
39056996
|
sec[2]/sec[0]/p[0]
|
Subject Clinic
| 3.912109 |
biomedical
|
Study
|
[
0.9990234375,
0.0004849433898925781,
0.0003046989440917969
] |
[
0.9990234375,
0.000598907470703125,
0.00012946128845214844,
0.00007134675979614258
] |
A total of 25 young subjects were enrolled in the present study. Their average age was 15.6 years, and 10 subjects were female. The power analysis of the sample size provided for 25 patients with a significance of 95. Power analysis using G*Power software (ver. 3.1.9.7; Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Germany) indicated that the required minimum sample size was 25 subjects to determine this effect size with 95% power and a significance level of 5% . For this calculation, the values of the mean, median, and standard deviation of PINP, TRAcP, and PTHrP at the different sampling times were taken into consideration.
|
[
"Angela Pia Cazzolla",
"Vincenzo Brescia",
"Roberto Lovero",
"Antonietta Fontana",
"Arcangela Giustino",
"Mario Dioguardi",
"Maria Severa Di Comite",
"Francesca Di Serio",
"Domenico Ciavarella",
"Vito Crincoli"
] |
https://doi.org/10.3390/dj12070209
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999998 |
39056996_p49
|
39056996
|
sec[2]/sec[0]/p[1]
|
Subject Clinic
| 3.660156 |
biomedical
|
Study
|
[
0.9892578125,
0.01004791259765625,
0.0005450248718261719
] |
[
0.99658203125,
0.001972198486328125,
0.0005984306335449219,
0.0007009506225585938
] |
The clinical gingival condition was evaluated at the beginning and during the experimental period. All patients maintained good oral hygiene throughout the study. No significant changes in the PI, BOP, PPD, and FMPS indexes were found. At each orthodontic check-up, all patients had GI < 1. Salivary biomarker values were tested 24 h after insertion and were used for comparison with subsequent measurements.
|
[
"Angela Pia Cazzolla",
"Vincenzo Brescia",
"Roberto Lovero",
"Antonietta Fontana",
"Arcangela Giustino",
"Mario Dioguardi",
"Maria Severa Di Comite",
"Francesca Di Serio",
"Domenico Ciavarella",
"Vito Crincoli"
] |
https://doi.org/10.3390/dj12070209
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999997 |
39056996_p50
|
39056996
|
sec[2]/sec[0]/p[2]
|
Subject Clinic
| 3.556641 |
biomedical
|
Study
|
[
0.99951171875,
0.0003063678741455078,
0.00037169456481933594
] |
[
0.9990234375,
0.000621795654296875,
0.0002810955047607422,
0.00007897615432739258
] |
The descriptive statistics of the distribution of the concentrations of the different biomarkers, the distribution at 95% Confidence Interval (CI), and the evaluation of the normal distribution (D’Agostino–Pearson test) are reported in Table 1 .
|
[
"Angela Pia Cazzolla",
"Vincenzo Brescia",
"Roberto Lovero",
"Antonietta Fontana",
"Arcangela Giustino",
"Mario Dioguardi",
"Maria Severa Di Comite",
"Francesca Di Serio",
"Domenico Ciavarella",
"Vito Crincoli"
] |
https://doi.org/10.3390/dj12070209
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999997 |
39056996_p51
|
39056996
|
sec[2]/sec[0]/p[3]
|
Subject Clinic
| 4.101563 |
biomedical
|
Study
|
[
0.99951171875,
0.00022602081298828125,
0.00024819374084472656
] |
[
0.99951171875,
0.00041365623474121094,
0.00021147727966308594,
0.000058710575103759766
] |
The evaluation with the D’Agostino–Pearson test showed a parametric distribution of the data. Minimum concentrations of PINP, PTHrP, and TRAcP were 0.80 µg/L, 0.21 ng/mL, and 0.90 U/L above the LoD of the method. The distribution range was 8.04 µg/L, 2.73 ng/mL, and 6.03 U/L for PINP, PTHrP, and TRAcP, respectively.
|
[
"Angela Pia Cazzolla",
"Vincenzo Brescia",
"Roberto Lovero",
"Antonietta Fontana",
"Arcangela Giustino",
"Mario Dioguardi",
"Maria Severa Di Comite",
"Francesca Di Serio",
"Domenico Ciavarella",
"Vito Crincoli"
] |
https://doi.org/10.3390/dj12070209
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999997 |
39056996_p52
|
39056996
|
sec[2]/sec[0]/p[4]
|
Subject Clinic
| 3.896484 |
biomedical
|
Study
|
[
0.99951171875,
0.00039958953857421875,
0.0003063678741455078
] |
[
0.99951171875,
0.0002930164337158203,
0.000263214111328125,
0.0000655055046081543
] |
The descriptive statistics of the distribution of the concentrations of the different biomarkers stratified as a function of the times of sampling (T1, T2, and T3), including the distribution at the 95% Confidence Interval (CI), and the evaluation of the normal distribution (D’Agostino–Pearson test), are shown in Table 2 .
|
[
"Angela Pia Cazzolla",
"Vincenzo Brescia",
"Roberto Lovero",
"Antonietta Fontana",
"Arcangela Giustino",
"Mario Dioguardi",
"Maria Severa Di Comite",
"Francesca Di Serio",
"Domenico Ciavarella",
"Vito Crincoli"
] |
https://doi.org/10.3390/dj12070209
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999996 |
39056996_p53
|
39056996
|
sec[2]/sec[0]/p[5]
|
Subject Clinic
| 2.917969 |
biomedical
|
Study
|
[
0.998046875,
0.0007486343383789062,
0.0011281967163085938
] |
[
0.998046875,
0.0011730194091796875,
0.0004703998565673828,
0.000125885009765625
] |
The data obtained highlighted a progressive increase in the median concentrations from T1 to T2 and T3 in all the biomarkers evaluated, although with different trends.
|
[
"Angela Pia Cazzolla",
"Vincenzo Brescia",
"Roberto Lovero",
"Antonietta Fontana",
"Arcangela Giustino",
"Mario Dioguardi",
"Maria Severa Di Comite",
"Francesca Di Serio",
"Domenico Ciavarella",
"Vito Crincoli"
] |
https://doi.org/10.3390/dj12070209
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999995 |
39056996_p54
|
39056996
|
sec[2]/sec[0]/p[6]
|
Subject Clinic
| 4.003906 |
biomedical
|
Study
|
[
0.99951171875,
0.00019407272338867188,
0.00027632713317871094
] |
[
0.99853515625,
0.0010538101196289062,
0.0002911090850830078,
0.00007331371307373047
] |
Median concentrations T1 vs. T3 ranged from 2.10 to 5.20 µg/L for PINP, from 0.21 to 0.52 ng/mL for PTHrP, and from 0.90 to 2.01 U/L for TRAcP.
|
[
"Angela Pia Cazzolla",
"Vincenzo Brescia",
"Roberto Lovero",
"Antonietta Fontana",
"Arcangela Giustino",
"Mario Dioguardi",
"Maria Severa Di Comite",
"Francesca Di Serio",
"Domenico Ciavarella",
"Vito Crincoli"
] |
https://doi.org/10.3390/dj12070209
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999998 |
39056996_p55
|
39056996
|
sec[2]/sec[0]/p[7]
|
Subject Clinic
| 3.271484 |
biomedical
|
Study
|
[
0.998046875,
0.00023877620697021484,
0.001956939697265625
] |
[
0.97705078125,
0.0222015380859375,
0.0005698204040527344,
0.00019419193267822266
] |
The D’Agostino–Pearson test rejects normality in T1 and T3 for PINP, in T2 for PTHrP, and in T2 and T3 for TRAcP.
|
[
"Angela Pia Cazzolla",
"Vincenzo Brescia",
"Roberto Lovero",
"Antonietta Fontana",
"Arcangela Giustino",
"Mario Dioguardi",
"Maria Severa Di Comite",
"Francesca Di Serio",
"Domenico Ciavarella",
"Vito Crincoli"
] |
https://doi.org/10.3390/dj12070209
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999997 |
39056996_p56
|
39056996
|
sec[2]/sec[0]/p[8]
|
Subject Clinic
| 2.521484 |
biomedical
|
Study
|
[
0.9970703125,
0.0008358955383300781,
0.0021343231201171875
] |
[
0.9404296875,
0.057891845703125,
0.0009307861328125,
0.0007181167602539062
] |
The boxplot of the PINP tot (μg/L), PTHrP tot (ng/mL), and TRAcP tot (U/L) confirms the absence of any outside values included .
|
[
"Angela Pia Cazzolla",
"Vincenzo Brescia",
"Roberto Lovero",
"Antonietta Fontana",
"Arcangela Giustino",
"Mario Dioguardi",
"Maria Severa Di Comite",
"Francesca Di Serio",
"Domenico Ciavarella",
"Vito Crincoli"
] |
https://doi.org/10.3390/dj12070209
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999998 |
39056996_p57
|
39056996
|
sec[2]/sec[0]/p[9]
|
Subject Clinic
| 4.050781 |
biomedical
|
Study
|
[
0.99951171875,
0.00031375885009765625,
0.00023496150970458984
] |
[
0.99951171875,
0.0002560615539550781,
0.0002677440643310547,
0.00006252527236938477
] |
The non-parametric Mann–Whitney U test, used to compare the significance of the difference between the median concentrations of salivary biomarkers stratified by sampling period (T1, T2, and T3), highlighted statistically significant differences by sampling period (T1, T2, and T3) ( Table 3 ).
|
[
"Angela Pia Cazzolla",
"Vincenzo Brescia",
"Roberto Lovero",
"Antonietta Fontana",
"Arcangela Giustino",
"Mario Dioguardi",
"Maria Severa Di Comite",
"Francesca Di Serio",
"Domenico Ciavarella",
"Vito Crincoli"
] |
https://doi.org/10.3390/dj12070209
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999998 |
39056996_p58
|
39056996
|
sec[2]/sec[0]/p[10]
|
Subject Clinic
| 3.859375 |
biomedical
|
Study
|
[
0.99951171875,
0.00029754638671875,
0.0003199577331542969
] |
[
0.9990234375,
0.00044655799865722656,
0.000316619873046875,
0.00006783008575439453
] |
The “Multiple Comparison Graphs” relating to the bone biomarkers PINP, TRAcP, and PTHrP showing the distribution of the analyte concentration measurements with respect to the time of sampling are shown in Figure 2 . The trend line connects the median of the values to the different relative times. Each biomarker shows a progressive increase from T1 to T3.
|
[
"Angela Pia Cazzolla",
"Vincenzo Brescia",
"Roberto Lovero",
"Antonietta Fontana",
"Arcangela Giustino",
"Mario Dioguardi",
"Maria Severa Di Comite",
"Francesca Di Serio",
"Domenico Ciavarella",
"Vito Crincoli"
] |
https://doi.org/10.3390/dj12070209
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999998 |
39056996_p59
|
39056996
|
sec[2]/sec[0]/p[11]
|
Subject Clinic
| 2.248047 |
biomedical
|
Study
|
[
0.994140625,
0.002445220947265625,
0.003570556640625
] |
[
0.9931640625,
0.004970550537109375,
0.0015468597412109375,
0.0003864765167236328
] |
The percentage change in biomarker concentrations measured at T1, T2, and T3 is reported in Table 4 .
|
[
"Angela Pia Cazzolla",
"Vincenzo Brescia",
"Roberto Lovero",
"Antonietta Fontana",
"Arcangela Giustino",
"Mario Dioguardi",
"Maria Severa Di Comite",
"Francesca Di Serio",
"Domenico Ciavarella",
"Vito Crincoli"
] |
https://doi.org/10.3390/dj12070209
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999997 |
39056996_p60
|
39056996
|
sec[2]/sec[0]/p[12]
|
Subject Clinic
| 2.398438 |
biomedical
|
Study
|
[
0.9931640625,
0.0014696121215820312,
0.0054779052734375
] |
[
0.98046875,
0.0176239013671875,
0.0015239715576171875,
0.0005326271057128906
] |
The significance of the change was assessed using the RCV of the single marker.
|
[
"Angela Pia Cazzolla",
"Vincenzo Brescia",
"Roberto Lovero",
"Antonietta Fontana",
"Arcangela Giustino",
"Mario Dioguardi",
"Maria Severa Di Comite",
"Francesca Di Serio",
"Domenico Ciavarella",
"Vito Crincoli"
] |
https://doi.org/10.3390/dj12070209
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999999 |
39056996_p61
|
39056996
|
sec[2]/sec[0]/p[13]
|
Subject Clinic
| 3.847656 |
biomedical
|
Study
|
[
0.9990234375,
0.0004012584686279297,
0.00037550926208496094
] |
[
0.9990234375,
0.0007171630859375,
0.0001819133758544922,
0.00006347894668579102
] |
The change in T2 versus T1 concentrations was significant in 19 (76%) subjects for PINP, in 18 subjects (72%) for TRAcP, and in 11 subjects (44%) for PTHrP.
|
[
"Angela Pia Cazzolla",
"Vincenzo Brescia",
"Roberto Lovero",
"Antonietta Fontana",
"Arcangela Giustino",
"Mario Dioguardi",
"Maria Severa Di Comite",
"Francesca Di Serio",
"Domenico Ciavarella",
"Vito Crincoli"
] |
https://doi.org/10.3390/dj12070209
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999996 |
39056996_p62
|
39056996
|
sec[2]/sec[0]/p[14]
|
Subject Clinic
| 2.171875 |
biomedical
|
Study
|
[
0.9892578125,
0.004222869873046875,
0.006336212158203125
] |
[
0.9833984375,
0.014434814453125,
0.0015735626220703125,
0.0005631446838378906
] |
All subjects evaluated had a statistically significant difference between T2 vs. T3.
|
[
"Angela Pia Cazzolla",
"Vincenzo Brescia",
"Roberto Lovero",
"Antonietta Fontana",
"Arcangela Giustino",
"Mario Dioguardi",
"Maria Severa Di Comite",
"Francesca Di Serio",
"Domenico Ciavarella",
"Vito Crincoli"
] |
https://doi.org/10.3390/dj12070209
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999995 |
39056996_p63
|
39056996
|
sec[2]/sec[0]/p[15]
|
Subject Clinic
| 2.0625 |
biomedical
|
Study
|
[
0.99462890625,
0.001354217529296875,
0.003864288330078125
] |
[
0.970703125,
0.026947021484375,
0.0016508102416992188,
0.0006275177001953125
] |
The “Multiple Comparison Graphs” showed the distribution of the values obtained in the individual subjects (a–ac) included in the study as a function of time .
|
[
"Angela Pia Cazzolla",
"Vincenzo Brescia",
"Roberto Lovero",
"Antonietta Fontana",
"Arcangela Giustino",
"Mario Dioguardi",
"Maria Severa Di Comite",
"Francesca Di Serio",
"Domenico Ciavarella",
"Vito Crincoli"
] |
https://doi.org/10.3390/dj12070209
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999998 |
39056996_p64
|
39056996
|
sec[2]/sec[0]/p[16]
|
Subject Clinic
| 2.472656 |
biomedical
|
Study
|
[
0.99658203125,
0.0007276535034179688,
0.00247955322265625
] |
[
0.9794921875,
0.018951416015625,
0.0011854171752929688,
0.00040030479431152344
] |
The Multiple Comparison Graphs highlighted the high individuality of the concentration of biomarkers in the individual subject in fact concentrations did not cover the entire range of distribution of values.
|
[
"Angela Pia Cazzolla",
"Vincenzo Brescia",
"Roberto Lovero",
"Antonietta Fontana",
"Arcangela Giustino",
"Mario Dioguardi",
"Maria Severa Di Comite",
"Francesca Di Serio",
"Domenico Ciavarella",
"Vito Crincoli"
] |
https://doi.org/10.3390/dj12070209
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999999 |
39056996_p65
|
39056996
|
sec[3]/p[0]
|
4. Discussion
| 2.736328 |
biomedical
|
Other
|
[
0.9970703125,
0.0008053779602050781,
0.0023479461669921875
] |
[
0.08355712890625,
0.91162109375,
0.0038433074951171875,
0.00122833251953125
] |
The periodontal ligament, the alveolar bone, and the gum are involved in a series of histological and biochemical reactions that are generated by and related to OTM determined by orthodontic therapies .
|
[
"Angela Pia Cazzolla",
"Vincenzo Brescia",
"Roberto Lovero",
"Antonietta Fontana",
"Arcangela Giustino",
"Mario Dioguardi",
"Maria Severa Di Comite",
"Francesca Di Serio",
"Domenico Ciavarella",
"Vito Crincoli"
] |
https://doi.org/10.3390/dj12070209
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999998 |
39056996_p66
|
39056996
|
sec[3]/p[1]
|
4. Discussion
| 3.134766 |
biomedical
|
Other
|
[
0.99609375,
0.00220489501953125,
0.0018968582153320312
] |
[
0.017486572265625,
0.97900390625,
0.0021800994873046875,
0.0011243820190429688
] |
The application of a controlled mechanical force on the teeth activates a cascade of events in the alveolar and periodontal bone that allows tooth movement .
|
[
"Angela Pia Cazzolla",
"Vincenzo Brescia",
"Roberto Lovero",
"Antonietta Fontana",
"Arcangela Giustino",
"Mario Dioguardi",
"Maria Severa Di Comite",
"Francesca Di Serio",
"Domenico Ciavarella",
"Vito Crincoli"
] |
https://doi.org/10.3390/dj12070209
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999997 |
39056996_p67
|
39056996
|
sec[3]/p[2]
|
4. Discussion
| 3.507813 |
biomedical
|
Other
|
[
0.9990234375,
0.0003864765167236328,
0.0007433891296386719
] |
[
0.46044921875,
0.52734375,
0.01126861572265625,
0.0011224746704101562
] |
The mechanical stimulus of the OTM causes inflammatory responses in periodontal tissues and alterations in blood flow, as well as the formation and release of various biochemical mediators .
|
[
"Angela Pia Cazzolla",
"Vincenzo Brescia",
"Roberto Lovero",
"Antonietta Fontana",
"Arcangela Giustino",
"Mario Dioguardi",
"Maria Severa Di Comite",
"Francesca Di Serio",
"Domenico Ciavarella",
"Vito Crincoli"
] |
https://doi.org/10.3390/dj12070209
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999997 |
39056996_p68
|
39056996
|
sec[3]/p[3]
|
4. Discussion
| 2.625 |
biomedical
|
Other
|
[
0.994140625,
0.0014314651489257812,
0.0045928955078125
] |
[
0.042205810546875,
0.95458984375,
0.002105712890625,
0.0010004043579101562
] |
The force produced by orthodontic systems results in greater resorption on the pressure side and greater bone formation on the tension side .
|
[
"Angela Pia Cazzolla",
"Vincenzo Brescia",
"Roberto Lovero",
"Antonietta Fontana",
"Arcangela Giustino",
"Mario Dioguardi",
"Maria Severa Di Comite",
"Francesca Di Serio",
"Domenico Ciavarella",
"Vito Crincoli"
] |
https://doi.org/10.3390/dj12070209
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999997 |
39056996_p69
|
39056996
|
sec[3]/p[4]
|
4. Discussion
| 3.660156 |
biomedical
|
Other
|
[
0.99853515625,
0.0004241466522216797,
0.001232147216796875
] |
[
0.248779296875,
0.74560546875,
0.004756927490234375,
0.0008411407470703125
] |
The release of BTM into saliva is consequent to the state of remodeling of the bone as a whole; the physiology of the basic multicellular units of the bone begins with the resorption phase by osteoclasts which have a short lifespan compared to osteoblasts (2 weeks versus 3 months) .
|
[
"Angela Pia Cazzolla",
"Vincenzo Brescia",
"Roberto Lovero",
"Antonietta Fontana",
"Arcangela Giustino",
"Mario Dioguardi",
"Maria Severa Di Comite",
"Francesca Di Serio",
"Domenico Ciavarella",
"Vito Crincoli"
] |
https://doi.org/10.3390/dj12070209
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999997 |
39056996_p70
|
39056996
|
sec[3]/p[5]
|
4. Discussion
| 4.085938 |
biomedical
|
Study
|
[
0.99951171875,
0.00021028518676757812,
0.00023090839385986328
] |
[
0.99951171875,
0.00022113323211669922,
0.0003230571746826172,
0.00005745887756347656
] |
Consistently in this study, TRAcP changed more rapidly after orthodontic treatment, while PINP changed in its concentration later as a consequence of subsequent new bone formation. The apparent absence of a regular and specific variation of PTHrP over time and a highly individual trend supports the hypothesis of a paracrine secretion of the hormone aimed at a local regulatory activity rather than a direct action on the bone .
|
[
"Angela Pia Cazzolla",
"Vincenzo Brescia",
"Roberto Lovero",
"Antonietta Fontana",
"Arcangela Giustino",
"Mario Dioguardi",
"Maria Severa Di Comite",
"Francesca Di Serio",
"Domenico Ciavarella",
"Vito Crincoli"
] |
https://doi.org/10.3390/dj12070209
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999997 |
39056996_p71
|
39056996
|
sec[3]/p[6]
|
4. Discussion
| 2.78125 |
biomedical
|
Study
|
[
0.9970703125,
0.0009870529174804688,
0.0021724700927734375
] |
[
0.953125,
0.04278564453125,
0.0030345916748046875,
0.0008325576782226562
] |
The variation in biomarker concentrations over time suggests that the process may be an exaggerated result of physiological turnover following mechanical stimulation .
|
[
"Angela Pia Cazzolla",
"Vincenzo Brescia",
"Roberto Lovero",
"Antonietta Fontana",
"Arcangela Giustino",
"Mario Dioguardi",
"Maria Severa Di Comite",
"Francesca Di Serio",
"Domenico Ciavarella",
"Vito Crincoli"
] |
https://doi.org/10.3390/dj12070209
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999998 |
39056996_p72
|
39056996
|
sec[3]/p[7]
|
4. Discussion
| 2.753906 |
biomedical
|
Study
|
[
0.99853515625,
0.0004911422729492188,
0.0009489059448242188
] |
[
0.98046875,
0.01094818115234375,
0.00821685791015625,
0.0003943443298339844
] |
Other authors have evaluated the concentrations of biomarkers in the saliva of patients undergoing fixed orthodontic treatment before and 14 days after the initial application of orthodontic forces, but they did not obtain significant variations between serial determinations .
|
[
"Angela Pia Cazzolla",
"Vincenzo Brescia",
"Roberto Lovero",
"Antonietta Fontana",
"Arcangela Giustino",
"Mario Dioguardi",
"Maria Severa Di Comite",
"Francesca Di Serio",
"Domenico Ciavarella",
"Vito Crincoli"
] |
https://doi.org/10.3390/dj12070209
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999997 |
39056996_p73
|
39056996
|
sec[3]/p[8]
|
4. Discussion
| 3.988281 |
biomedical
|
Study
|
[
0.9990234375,
0.0004868507385253906,
0.0002779960632324219
] |
[
0.99951171875,
0.000255584716796875,
0.0002186298370361328,
0.00007855892181396484
] |
This study involved the collection of three salivary samples: before the start of orthodontic treatment (T1), 25 days (T2), and 45 days after starting treatment (T3). The results suggested that it is possible to have information on the state of bone remodeling in the individual subject, especially if monitoring is carried out for a sufficient time to allow the activation of the remodeling processes; 45 days after the application of an orthodontic appliance was found to be a suitable time.
|
[
"Angela Pia Cazzolla",
"Vincenzo Brescia",
"Roberto Lovero",
"Antonietta Fontana",
"Arcangela Giustino",
"Mario Dioguardi",
"Maria Severa Di Comite",
"Francesca Di Serio",
"Domenico Ciavarella",
"Vito Crincoli"
] |
https://doi.org/10.3390/dj12070209
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999996 |
39056996_p74
|
39056996
|
sec[3]/p[9]
|
4. Discussion
| 4.109375 |
biomedical
|
Study
|
[
0.99951171875,
0.00041794776916503906,
0.0002415180206298828
] |
[
0.9990234375,
0.0003192424774169922,
0.00045228004455566406,
0.00005799531936645508
] |
To reduce the potential clinical and methodological heterogeneity of the study, data were provided on the relationships between dosages and physiological or pre-analytical factors that would have contributed to the variability of BTM concentrations. The inclusion criteria involved the selection of subjects in good general and periodontal health without a history of orthodontic and periodontal therapy during the months before the saliva collection. None of the samples were collected within 30 min of consuming a meal or drink, all subjects avoided smoking and brushed their teeth after and not before collecting saliva . The decision to use the assay of analytes capable of expressing the results obtained in standardized units, the use of objective analytical quality values for these markers, and the use of measurement with monoclonal antibodies made it possible to obtain comparable measurements .
|
[
"Angela Pia Cazzolla",
"Vincenzo Brescia",
"Roberto Lovero",
"Antonietta Fontana",
"Arcangela Giustino",
"Mario Dioguardi",
"Maria Severa Di Comite",
"Francesca Di Serio",
"Domenico Ciavarella",
"Vito Crincoli"
] |
https://doi.org/10.3390/dj12070209
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999997 |
39056996_p75
|
39056996
|
sec[3]/p[10]
|
4. Discussion
| 2.5625 |
biomedical
|
Study
|
[
0.99267578125,
0.0006175041198730469,
0.00672149658203125
] |
[
0.8671875,
0.1300048828125,
0.0018644332885742188,
0.000698089599609375
] |
To allow unambiguous interpretation, it was necessary to express the data in quantitative mode according to specific detection limits and within the analytical range of the method .
|
[
"Angela Pia Cazzolla",
"Vincenzo Brescia",
"Roberto Lovero",
"Antonietta Fontana",
"Arcangela Giustino",
"Mario Dioguardi",
"Maria Severa Di Comite",
"Francesca Di Serio",
"Domenico Ciavarella",
"Vito Crincoli"
] |
https://doi.org/10.3390/dj12070209
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999997 |
39056996_p76
|
39056996
|
sec[3]/p[11]
|
4. Discussion
| 3.248047 |
biomedical
|
Study
|
[
0.99853515625,
0.00027561187744140625,
0.0009813308715820312
] |
[
0.931640625,
0.06549072265625,
0.0022430419921875,
0.00040459632873535156
] |
For PINP, TRAcP, and PTHrP, the detection/quantification limits have been assessed, as these are essential analytical elements for the interpretation of the results. Biomarkers that are not detected are not necessarily absent, but concentrations are likely to be below or near the limit of detection with the analytical methods used.
|
[
"Angela Pia Cazzolla",
"Vincenzo Brescia",
"Roberto Lovero",
"Antonietta Fontana",
"Arcangela Giustino",
"Mario Dioguardi",
"Maria Severa Di Comite",
"Francesca Di Serio",
"Domenico Ciavarella",
"Vito Crincoli"
] |
https://doi.org/10.3390/dj12070209
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999996 |
39056996_p77
|
39056996
|
sec[3]/p[12]
|
4. Discussion
| 2.382813 |
biomedical
|
Study
|
[
0.9970703125,
0.0009469985961914062,
0.002033233642578125
] |
[
0.97412109375,
0.0247802734375,
0.0007276535034179688,
0.0005526542663574219
] |
Contamination can lead to false positive detection of biomarkers. In this study measures have been taken to avoid contamination of saliva with blood; a preliminary clinical and laboratory evaluation has been performed to exclude samples with potential contamination .
|
[
"Angela Pia Cazzolla",
"Vincenzo Brescia",
"Roberto Lovero",
"Antonietta Fontana",
"Arcangela Giustino",
"Mario Dioguardi",
"Maria Severa Di Comite",
"Francesca Di Serio",
"Domenico Ciavarella",
"Vito Crincoli"
] |
https://doi.org/10.3390/dj12070209
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999997 |
39056996_p78
|
39056996
|
sec[3]/p[13]
|
4. Discussion
| 2.677734 |
biomedical
|
Study
|
[
0.99755859375,
0.0007686614990234375,
0.0019140243530273438
] |
[
0.86376953125,
0.1339111328125,
0.0011310577392578125,
0.0009860992431640625
] |
The saliva collection method involved the use of the Salivette device (Sarstedt, Numbrecht, Germany) used for the dosage of other salivary proteins .
|
[
"Angela Pia Cazzolla",
"Vincenzo Brescia",
"Roberto Lovero",
"Antonietta Fontana",
"Arcangela Giustino",
"Mario Dioguardi",
"Maria Severa Di Comite",
"Francesca Di Serio",
"Domenico Ciavarella",
"Vito Crincoli"
] |
https://doi.org/10.3390/dj12070209
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999994 |
39056996_p79
|
39056996
|
sec[3]/p[14]
|
4. Discussion
| 3.330078 |
biomedical
|
Study
|
[
0.998046875,
0.00153350830078125,
0.00041174888610839844
] |
[
0.97119140625,
0.027557373046875,
0.0006465911865234375,
0.0005888938903808594
] |
Subjects were advised to chew the absorbent cotton for 2–3 min; subsequently, the samples were stored at 4–8 °C. The simplicity of salivary collection and sufficient standardization suggested that periodic measurement of BMT on saliva may represent a simple and effective way to early identify insufficient responses to orthodontic treatment even in pediatric subjects.
|
[
"Angela Pia Cazzolla",
"Vincenzo Brescia",
"Roberto Lovero",
"Antonietta Fontana",
"Arcangela Giustino",
"Mario Dioguardi",
"Maria Severa Di Comite",
"Francesca Di Serio",
"Domenico Ciavarella",
"Vito Crincoli"
] |
https://doi.org/10.3390/dj12070209
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999996 |
39056996_p80
|
39056996
|
sec[3]/p[15]
|
4. Discussion
| 3.835938 |
biomedical
|
Study
|
[
0.99951171875,
0.0001310110092163086,
0.0002982616424560547
] |
[
0.994140625,
0.0049285888671875,
0.0007061958312988281,
0.0001017451286315918
] |
It was considered that the evaluation of the dynamic process of bone remodeling during OTM does not lend itself to being interpreted on the measurement of a single bone biomarker. Therefore, the variation in monitoring a biomarker of bone deposition (PINP) and resorption (TRAcP) was more useful for detecting the dynamics of the metabolic imbalance .
|
[
"Angela Pia Cazzolla",
"Vincenzo Brescia",
"Roberto Lovero",
"Antonietta Fontana",
"Arcangela Giustino",
"Mario Dioguardi",
"Maria Severa Di Comite",
"Francesca Di Serio",
"Domenico Ciavarella",
"Vito Crincoli"
] |
https://doi.org/10.3390/dj12070209
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999996 |
39056996_p81
|
39056996
|
sec[3]/p[16]
|
4. Discussion
| 4.183594 |
biomedical
|
Study
|
[
0.99951171875,
0.0003821849822998047,
0.00014221668243408203
] |
[
0.99462890625,
0.0005960464477539062,
0.00475311279296875,
0.00015306472778320312
] |
The use of BTMs for treatment monitoring requires a baseline evaluation with repeated measurement at a defined time during orthodontic treatment. To do this effectively, it is important to monitor the effect of the treatment in the individual, having as a yardstick for evaluating the clinical effectiveness the possibility of evaluating the results in the individual subject on the basis of pre-established interpretative diagnostic criteria . A change in the salivary level of a single bone marker, observed in a patient during OTM, can be interpreted in light of the biological variability of the respective marker . The availability of data on the significant percentage deviation (RVC), determined by biological variability and analytical variability , limited the errors in the interpretation of the responses on the variation in concentrations and allowed an objective evaluation of the variations . Based on RCV, all subjects included in the study presented a significant change in TRAcP and PINP concentrations 45 days after the application of the orthodontic appliance, despite presenting specific concentration variations for each subject (inter-individual variability). The study of changes in biomarkers linked to bone turnover can introduce new possibilities in orthodontics to understand bone growth and remodeling. Knowledge of the process that occurs in the periodontal tissues during orthodontic therapies can lead to the correct choice of mechanical load; this would allow the treatment period to be optimized and the adverse effects associated with orthodontic treatment to be avoided.
|
[
"Angela Pia Cazzolla",
"Vincenzo Brescia",
"Roberto Lovero",
"Antonietta Fontana",
"Arcangela Giustino",
"Mario Dioguardi",
"Maria Severa Di Comite",
"Francesca Di Serio",
"Domenico Ciavarella",
"Vito Crincoli"
] |
https://doi.org/10.3390/dj12070209
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999996 |
39056996_p82
|
39056996
|
sec[3]/p[17]
|
4. Discussion
| 3.966797 |
biomedical
|
Study
|
[
0.99951171875,
0.00017499923706054688,
0.0003218650817871094
] |
[
0.998046875,
0.001682281494140625,
0.00027871131896972656,
0.00008499622344970703
] |
The amount and duration of force to be used during OTM could be decided based on knowledge of the levels of these biomarkers evaluated on the basis of a deviation that is greater than the critical difference. Previous studies have shown that TRAcP provides information on bone resorption and shows a peak in the fifth week, at the site of compression; TRAcP levels were greater at the 150 g strength compared to the 100 g strength .
|
[
"Angela Pia Cazzolla",
"Vincenzo Brescia",
"Roberto Lovero",
"Antonietta Fontana",
"Arcangela Giustino",
"Mario Dioguardi",
"Maria Severa Di Comite",
"Francesca Di Serio",
"Domenico Ciavarella",
"Vito Crincoli"
] |
https://doi.org/10.3390/dj12070209
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999998 |
39056996_p83
|
39056996
|
sec[3]/p[18]
|
4. Discussion
| 3.927734 |
biomedical
|
Other
|
[
0.99853515625,
0.000774383544921875,
0.0005240440368652344
] |
[
0.13671875,
0.642578125,
0.218994140625,
0.001941680908203125
] |
Salivary diagnostics require adequate identification and validation of biomarkers for pathological conditions. A biomarker is a parameter that can interact physiologically and biochemically at the molecular or cellular level, and acts sequentially as an indicator of normality, pathological behavior, and in response to therapy. The analytical validation of biomarkers in the salivary matrix and their clinical usefulness in the dental field are fundamental for activating initiatives and creating reliable models for diagnosis and treatment also with the help of innovative technologies such as point-of-care (PoCT) .
|
[
"Angela Pia Cazzolla",
"Vincenzo Brescia",
"Roberto Lovero",
"Antonietta Fontana",
"Arcangela Giustino",
"Mario Dioguardi",
"Maria Severa Di Comite",
"Francesca Di Serio",
"Domenico Ciavarella",
"Vito Crincoli"
] |
https://doi.org/10.3390/dj12070209
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999996 |
39056996_p84
|
39056996
|
sec[3]/p[19]
|
4. Discussion
| 2.582031 |
biomedical
|
Other
|
[
0.99609375,
0.0007987022399902344,
0.00296783447265625
] |
[
0.09210205078125,
0.9013671875,
0.005207061767578125,
0.0010938644409179688
] |
The impact of salivary diagnostics on the healthcare system is enormous, being a non-invasive, convenient method with excellent credentials, and the introduction of BMTs in the evaluation of the dynamic process of bone remodeling during OTM, evaluated as a function of the critical difference (RCV), will raise performance standards.
|
[
"Angela Pia Cazzolla",
"Vincenzo Brescia",
"Roberto Lovero",
"Antonietta Fontana",
"Arcangela Giustino",
"Mario Dioguardi",
"Maria Severa Di Comite",
"Francesca Di Serio",
"Domenico Ciavarella",
"Vito Crincoli"
] |
https://doi.org/10.3390/dj12070209
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999998 |
39056996_p85
|
39056996
|
sec[3]/p[20]
|
4. Discussion
| 3.970703 |
biomedical
|
Study
|
[
0.9990234375,
0.0004363059997558594,
0.00037980079650878906
] |
[
0.77197265625,
0.007354736328125,
0.2203369140625,
0.0005030632019042969
] |
Currently, the methods of evaluating and monitoring orthodontic treatment are based on clinical evidence and/or the use of intraoral scanners. These methods are not sufficient to highlight very small tooth movements and do not give adequate information regarding what happens at the level of the alveolar bone and periodontal ligament during orthodontic treatment. Such information, on the contrary, could be acquired by measuring biomarkers in saliva. The use of the scanner, as reported in the literature, has limitations related to the operator’s experience and manual skills, the presence of blood and/or saliva during the impression, rescanning, and post-processing scans , and the accuracy scanner . Meanwhile, the dosage of the biomarkers in the saliva cannot be influenced by the operator and is easy to measure. Therefore, biomarker monitoring could be useful in providing information relative to the bone remodeling processes during orthodontic treatment, even in the absence of evident clinical signs of tooth movement (assessed via clinical evaluation and/or through a scanner). This can be used to optimize orthodontic treatment in the individual subject with the choice of the most suitable forces to reduce treatment time .
|
[
"Angela Pia Cazzolla",
"Vincenzo Brescia",
"Roberto Lovero",
"Antonietta Fontana",
"Arcangela Giustino",
"Mario Dioguardi",
"Maria Severa Di Comite",
"Francesca Di Serio",
"Domenico Ciavarella",
"Vito Crincoli"
] |
https://doi.org/10.3390/dj12070209
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999996 |
39056996_p86
|
39056996
|
sec[4]/p[0]
|
5. Conclusions
| 3.984375 |
biomedical
|
Study
|
[
0.99951171875,
0.0003046989440917969,
0.0001659393310546875
] |
[
0.9912109375,
0.002532958984375,
0.005859375,
0.00017321109771728516
] |
The data obtained on the relationship between clinical and physiological factors that contribute to the changes and variability of salivary BTM concentrations after OTM stimulation are promising. In the first months of monitoring, the variations in the concentration of TRAcP and PINP on the salivary matrix in the individual subject, when compared with the RCV, provide information on the progress of the orthodontic treatment, especially in the absence of evident clinical signs. The use of BTMs on saliva could lead to the determination of the correct mechanical load in the OTM, improving durability and preventing adverse effects of the treatment.
|
[
"Angela Pia Cazzolla",
"Vincenzo Brescia",
"Roberto Lovero",
"Antonietta Fontana",
"Arcangela Giustino",
"Mario Dioguardi",
"Maria Severa Di Comite",
"Francesca Di Serio",
"Domenico Ciavarella",
"Vito Crincoli"
] |
https://doi.org/10.3390/dj12070209
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999998 |
PMC11276314_p0
|
PMC11276314
|
sec[0]/p[0]
|
1. Introduction
| 4.136719 |
biomedical
|
Review
|
[
0.9990234375,
0.0004475116729736328,
0.0004379749298095703
] |
[
0.49658203125,
0.00540924072265625,
0.49755859375,
0.0006651878356933594
] |
Neuroendocrine neoplasms (NENs) are heterogeneous tumors, ranging from indolent (well-differentiated neuroendocrine tumors, NETs) to aggressive forms, which are more biologically and clinically similar to their exocrine counterpart (poorly differentiated neuroendocrine carcinomas, NECs) . The risk of harboring a metastatic disease ranges from 3 to 60%, depending on the NEN type, grade, and stage . The gastrointestinal tract, together with the lungs, is a frequent site of origin of NENs, with the small intestine ranking first and the rectum second in terms of frequency , with the latter representing 12–27% of all gastrointestinal NENs .
|
[
"Roberta Elisa Rossi",
"Maria Terrin",
"Silvia Carrara",
"Roberta Maselli",
"Alexia Francesca Bertuzzi",
"Silvia Uccella",
"Andrea Gerardo Antonio Lania",
"Alessandro Zerbi",
"Cesare Hassan",
"Alessandro Repici"
] |
https://doi.org/10.3390/diagnostics14141484
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999998 |
PMC11276314_p1
|
PMC11276314
|
sec[0]/p[1]
|
1. Introduction
| 2.367188 |
biomedical
|
Other
|
[
0.9951171875,
0.0035305023193359375,
0.0013971328735351562
] |
[
0.0240631103515625,
0.9697265625,
0.0027294158935546875,
0.0033969879150390625
] |
Most rectal NENs (up to 90%) are, in fact, NETs, and their diagnosis is usually incidental, as the occurrence of symptoms, such as anal pain or discomfort, rectal bleeding, or obstruction, is rare .
|
[
"Roberta Elisa Rossi",
"Maria Terrin",
"Silvia Carrara",
"Roberta Maselli",
"Alexia Francesca Bertuzzi",
"Silvia Uccella",
"Andrea Gerardo Antonio Lania",
"Alessandro Zerbi",
"Cesare Hassan",
"Alessandro Repici"
] |
https://doi.org/10.3390/diagnostics14141484
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999996 |
PMC11276314_p2
|
PMC11276314
|
sec[0]/p[2]
|
1. Introduction
| 2.533203 |
biomedical
|
Other
|
[
0.998046875,
0.0006775856018066406,
0.0011644363403320312
] |
[
0.16943359375,
0.81201171875,
0.0164642333984375,
0.002231597900390625
] |
Among all rectal tumors, 1–2% are estimated to be NETs , but an increasing incidence has been reported over recent decades, likely as a consequence of the progressive spread of screening colonoscopies .
|
[
"Roberta Elisa Rossi",
"Maria Terrin",
"Silvia Carrara",
"Roberta Maselli",
"Alexia Francesca Bertuzzi",
"Silvia Uccella",
"Andrea Gerardo Antonio Lania",
"Alessandro Zerbi",
"Cesare Hassan",
"Alessandro Repici"
] |
https://doi.org/10.3390/diagnostics14141484
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999996 |
PMC11276314_p3
|
PMC11276314
|
sec[0]/p[3]
|
1. Introduction
| 2.033203 |
biomedical
|
Other
|
[
0.98876953125,
0.0010156631469726562,
0.01025390625
] |
[
0.08050537109375,
0.91552734375,
0.00315093994140625,
0.0009870529174804688
] |
rNET’s estimated prevalence is approximately 0.05% , and in the United States, the incidence rate reaches approximately 1.1 per 100,000 people, with a 10-fold increase between 1970 and the 2000s .
|
[
"Roberta Elisa Rossi",
"Maria Terrin",
"Silvia Carrara",
"Roberta Maselli",
"Alexia Francesca Bertuzzi",
"Silvia Uccella",
"Andrea Gerardo Antonio Lania",
"Alessandro Zerbi",
"Cesare Hassan",
"Alessandro Repici"
] |
https://doi.org/10.3390/diagnostics14141484
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999997 |
PMC11276314_p4
|
PMC11276314
|
sec[0]/p[4]
|
1. Introduction
| 4.054688 |
biomedical
|
Study
|
[
0.99853515625,
0.0011377334594726562,
0.0002810955047607422
] |
[
0.50390625,
0.177978515625,
0.3125,
0.0054473876953125
] |
rNETs usually appear as small (<10 mm), roundish, and yellowish polypoid lesions, coated with normal mucosa (pit pattern type I according to the Kudo classification), while the typical “doughnut” appearance is usually seen in lesions > 10 mm . They are generally located at the medial-inferior portion of the rectum (4 to 10 cm from the anal verge) . Less-frequent endoscopic appearances include the semi-pedunculated shape, hyperemia, central depression, erosion, or ulceration, especially in lesions > 5 mm . They usually involve the mucosal and submucosal layers, without the involvement of muscularis propria .
|
[
"Roberta Elisa Rossi",
"Maria Terrin",
"Silvia Carrara",
"Roberta Maselli",
"Alexia Francesca Bertuzzi",
"Silvia Uccella",
"Andrea Gerardo Antonio Lania",
"Alessandro Zerbi",
"Cesare Hassan",
"Alessandro Repici"
] |
https://doi.org/10.3390/diagnostics14141484
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999996 |
PMC11276314_p5
|
PMC11276314
|
sec[0]/p[5]
|
1. Introduction
| 3.923828 |
biomedical
|
Review
|
[
0.9833984375,
0.01507568359375,
0.0016584396362304688
] |
[
0.0131072998046875,
0.057647705078125,
0.9267578125,
0.002513885498046875
] |
In terms of treatment, available guidelines suggest the use of modified endoscopic mucosal resection (EMR) for ≤10 mm rNETs, particularly EMR performed with a suction cap, which is able to reach an en bloc resection success rate of nearly 100%, endoscopic submucosal dissection (ESD), or endoscopic full thickness resection (eFTR) . Conversely, standard polypectomy (with both hot or cold snare) and conventional EMR are thought to not guarantee a sufficiently complete resection rate of the lesion margins; thus, these techniques are no longer recommended .
|
[
"Roberta Elisa Rossi",
"Maria Terrin",
"Silvia Carrara",
"Roberta Maselli",
"Alexia Francesca Bertuzzi",
"Silvia Uccella",
"Andrea Gerardo Antonio Lania",
"Alessandro Zerbi",
"Cesare Hassan",
"Alessandro Repici"
] |
https://doi.org/10.3390/diagnostics14141484
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999997 |
PMC11276314_p6
|
PMC11276314
|
sec[0]/p[6]
|
1. Introduction
| 3.738281 |
biomedical
|
Other
|
[
0.99462890625,
0.004428863525390625,
0.000698089599609375
] |
[
0.053558349609375,
0.70068359375,
0.2418212890625,
0.004077911376953125
] |
The standardized use of endoscopic ultrasound (EUS) before resection in small lesions (<10 mm) is controversial but usually suggested to exclude the occurrence of lymphatic invasion and to evaluate the depth of invasions to plan the most feasible and optimal endoscopic resection , although its lower accuracy for small tumors should be considered .
|
[
"Roberta Elisa Rossi",
"Maria Terrin",
"Silvia Carrara",
"Roberta Maselli",
"Alexia Francesca Bertuzzi",
"Silvia Uccella",
"Andrea Gerardo Antonio Lania",
"Alessandro Zerbi",
"Cesare Hassan",
"Alessandro Repici"
] |
https://doi.org/10.3390/diagnostics14141484
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999997 |
PMC11276314_p7
|
PMC11276314
|
sec[0]/p[7]
|
1. Introduction
| 3.951172 |
biomedical
|
Study
|
[
0.9873046875,
0.01250457763671875,
0.00041294097900390625
] |
[
0.61376953125,
0.200927734375,
0.177978515625,
0.0070648193359375
] |
In real-life clinical practice, the endoscopic removal of unrecognized rNETs frequently takes place with “simple” techniques and without preliminary imaging staging, as their macroscopic appearance resembles that of hyperplastic or adenomatous polyps and the endoscopist might fail to recognize them upfront . As a matter of fact, only 18% of NET lesions were previously suspected as neuroendocrine . On the other hand, rNETs correctly identified before endoscopic removal have higher complete resection rates compared to tumors resected as ordinary colonic polyps . Therefore, if the management of correctly classified rNETs can be complex, that of unrecognized rNETs is even more challenging.
|
[
"Roberta Elisa Rossi",
"Maria Terrin",
"Silvia Carrara",
"Roberta Maselli",
"Alexia Francesca Bertuzzi",
"Silvia Uccella",
"Andrea Gerardo Antonio Lania",
"Alessandro Zerbi",
"Cesare Hassan",
"Alessandro Repici"
] |
https://doi.org/10.3390/diagnostics14141484
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999997 |
PMC11276314_p8
|
PMC11276314
|
sec[0]/p[8]
|
1. Introduction
| 3.482422 |
biomedical
|
Study
|
[
0.994140625,
0.005161285400390625,
0.0005865097045898438
] |
[
0.99755859375,
0.0017728805541992188,
0.00022339820861816406,
0.0003898143768310547
] |
Based on these observations, the aim of the current study is to describe a real-life cohort of patients followed at a referral center for both endoscopy and NEN management, with a specific focus on patients who received a diagnosis of rNETs only after endoscopic resection.
|
[
"Roberta Elisa Rossi",
"Maria Terrin",
"Silvia Carrara",
"Roberta Maselli",
"Alexia Francesca Bertuzzi",
"Silvia Uccella",
"Andrea Gerardo Antonio Lania",
"Alessandro Zerbi",
"Cesare Hassan",
"Alessandro Repici"
] |
https://doi.org/10.3390/diagnostics14141484
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999999 |
PMC11276314_p9
|
PMC11276314
|
sec[1]/p[0]
|
2. Methods
| 3.068359 |
biomedical
|
Study
|
[
0.9716796875,
0.0276031494140625,
0.0006160736083984375
] |
[
0.98388671875,
0.00888824462890625,
0.0012826919555664062,
0.005832672119140625
] |
This is a retrospective case series. We collected data on all consecutive patients with endoscopically resected rNETs followed at the IRRCS Humanitas Research Hospital, Rozzano, Milan, Italy, between 2014 and 2023.
|
[
"Roberta Elisa Rossi",
"Maria Terrin",
"Silvia Carrara",
"Roberta Maselli",
"Alexia Francesca Bertuzzi",
"Silvia Uccella",
"Andrea Gerardo Antonio Lania",
"Alessandro Zerbi",
"Cesare Hassan",
"Alessandro Repici"
] |
https://doi.org/10.3390/diagnostics14141484
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999996 |
PMC11276314_p10
|
PMC11276314
|
sec[1]/p[1]
|
2. Methods
| 3.835938 |
biomedical
|
Study
|
[
0.978515625,
0.021026611328125,
0.0005350112915039062
] |
[
0.9931640625,
0.005401611328125,
0.00054168701171875,
0.0010585784912109375
] |
Patients with a rectal lesion endoscopically resected, diagnosed as NET before or after resection, were included. The exclusion criteria included age < 18 years old; incomplete clinical data; insufficient histopathology data to confirm the diagnosis of rNET; absence of adequate follow-up (namely, patients were included if, after resection, they underwent at least one evaluation among simple endoscopy, EUS, or imaging).
|
[
"Roberta Elisa Rossi",
"Maria Terrin",
"Silvia Carrara",
"Roberta Maselli",
"Alexia Francesca Bertuzzi",
"Silvia Uccella",
"Andrea Gerardo Antonio Lania",
"Alessandro Zerbi",
"Cesare Hassan",
"Alessandro Repici"
] |
https://doi.org/10.3390/diagnostics14141484
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999999 |
PMC11276314_p11
|
PMC11276314
|
sec[1]/p[2]
|
2. Methods
| 1.367188 |
biomedical
|
Other
|
[
0.93115234375,
0.00740814208984375,
0.0614013671875
] |
[
0.1439208984375,
0.85009765625,
0.0023651123046875,
0.00365447998046875
] |
Informed consent was waived, given the use of retrospective historic de-identified data.
|
[
"Roberta Elisa Rossi",
"Maria Terrin",
"Silvia Carrara",
"Roberta Maselli",
"Alexia Francesca Bertuzzi",
"Silvia Uccella",
"Andrea Gerardo Antonio Lania",
"Alessandro Zerbi",
"Cesare Hassan",
"Alessandro Repici"
] |
https://doi.org/10.3390/diagnostics14141484
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999997 |
PMC11276314_p12
|
PMC11276314
|
sec[1]/p[3]
|
2. Methods
| 3.339844 |
biomedical
|
Study
|
[
0.95166015625,
0.047637939453125,
0.0006651878356933594
] |
[
0.98974609375,
0.00623321533203125,
0.001346588134765625,
0.0025882720947265625
] |
Data on patients’ general characteristics, indications for endoscopy, lesions’ endoscopic features (including tumor location, size, morphology, and surface color), endoscopic technique, complications (such as bleeding and perforation), histology, outcomes, and follow-up modalities were collected from the electronic medical records and revision of procedures images.
|
[
"Roberta Elisa Rossi",
"Maria Terrin",
"Silvia Carrara",
"Roberta Maselli",
"Alexia Francesca Bertuzzi",
"Silvia Uccella",
"Andrea Gerardo Antonio Lania",
"Alessandro Zerbi",
"Cesare Hassan",
"Alessandro Repici"
] |
https://doi.org/10.3390/diagnostics14141484
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999999 |
PMC11276314_p13
|
PMC11276314
|
sec[1]/p[4]
|
2. Methods
| 3.953125 |
biomedical
|
Study
|
[
0.9296875,
0.06982421875,
0.0006756782531738281
] |
[
0.986328125,
0.00977325439453125,
0.0012636184692382812,
0.0028133392333984375
] |
Two subgroups were considered: patients with a previous known or suspected diagnosis of rNET and patients in whom rNETs were removed without awareness of their nature. In the first subgroup, patients usually presented with lesions with “typical” features of rNET; they frequently underwent a preliminary diagnostic biopsy and/or received previous rectal EUS evaluation. The subsequent endoscopic resection was planned in a dedicated setting and performed as per guidelines. In the latter subgroup, rNETs did not present with features suggestive of a possible neuroendocrine nature; therefore, these lesions were not recognized by the endoscopist and were removed based on the operator’s preference, usually with simple endoscopic techniques; the actual diagnosis was provided by histology thereafter.
|
[
"Roberta Elisa Rossi",
"Maria Terrin",
"Silvia Carrara",
"Roberta Maselli",
"Alexia Francesca Bertuzzi",
"Silvia Uccella",
"Andrea Gerardo Antonio Lania",
"Alessandro Zerbi",
"Cesare Hassan",
"Alessandro Repici"
] |
https://doi.org/10.3390/diagnostics14141484
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999998 |
PMC11276314_p14
|
PMC11276314
|
sec[1]/p[5]
|
2. Methods
| 4.066406 |
biomedical
|
Other
|
[
0.9892578125,
0.01007080078125,
0.0007944107055664062
] |
[
0.12255859375,
0.83203125,
0.04058837890625,
0.004974365234375
] |
The endoscopic resection techniques included: - Cold-forceps polypectomy. - Standard cold polypectomy. - Traditional endoscopic submucosal resection (EMR), i.e., resection by snare electrosurgery (hot snare) with previous injection of a solution into the submucosal space to separate a mucosal lesion from the underlying muscularis propria to reduce the risk of thermal or mechanical injury to the underlying muscularis propria . Injection of submucosa is performed with adrenaline and methylene blue diluted in saline solution. - cap-assisted EMR: EMR performed with adjunct use of transparent plastic cap (Olympus, straight, 12.4–14 mm–Olympus, Tokyo, Japan; or US Endoscopy, straight, 12.6–13.2 mm–US Endoscopy, Mentor, OH, USA), positioned extending approximately 3–4 mm beyond the distal end of the endoscope, in order to enhance lesion lifting using suction inside the cap and subsequent hot snare polypectomy. - Endoscopic submucosal dissection (ESD), i.e., removal of the lesion dissecting the submucosa using a dedicated endoscopic through-the-scope needle-type knife with previous submucosal injection of colloid/crystalloid solution and dye .
|
[
"Roberta Elisa Rossi",
"Maria Terrin",
"Silvia Carrara",
"Roberta Maselli",
"Alexia Francesca Bertuzzi",
"Silvia Uccella",
"Andrea Gerardo Antonio Lania",
"Alessandro Zerbi",
"Cesare Hassan",
"Alessandro Repici"
] |
https://doi.org/10.3390/diagnostics14141484
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999997 |
PMC11276314_p15
|
PMC11276314
|
sec[1]/p[6]
|
2. Methods
| 3.476563 |
biomedical
|
Other
|
[
0.9970703125,
0.0027065277099609375,
0.00044465065002441406
] |
[
0.0943603515625,
0.8916015625,
0.01171112060546875,
0.0021457672119140625
] |
“Simple” endoscopic treatments included forceps polypectomy or cold snare polypectomy, whereas “advanced” techniques included EMR and/or ESD.
|
[
"Roberta Elisa Rossi",
"Maria Terrin",
"Silvia Carrara",
"Roberta Maselli",
"Alexia Francesca Bertuzzi",
"Silvia Uccella",
"Andrea Gerardo Antonio Lania",
"Alessandro Zerbi",
"Cesare Hassan",
"Alessandro Repici"
] |
https://doi.org/10.3390/diagnostics14141484
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999995 |
PMC11276314_p16
|
PMC11276314
|
sec[1]/p[7]
|
2. Methods
| 3.613281 |
biomedical
|
Study
|
[
0.98974609375,
0.00936126708984375,
0.0006642341613769531
] |
[
0.6708984375,
0.322509765625,
0.00141143798828125,
0.00501251220703125
] |
All the “advanced” endoscopic resection techniques were performed at IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy by expert endoscopists (i.e., >5 years of practice) using Fujifilm instruments (Fujifilm Corporation, Tokyo, Japan) and processor and stiff open 10–15 mm hot resection snare (Boston Scientific Captivator, Marlborough, MA, USA) or a hybrid knife (Erbe Elektromedizin GmbH, Tübingen, Germany).
|
[
"Roberta Elisa Rossi",
"Maria Terrin",
"Silvia Carrara",
"Roberta Maselli",
"Alexia Francesca Bertuzzi",
"Silvia Uccella",
"Andrea Gerardo Antonio Lania",
"Alessandro Zerbi",
"Cesare Hassan",
"Alessandro Repici"
] |
https://doi.org/10.3390/diagnostics14141484
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999995 |
PMC11276314_p17
|
PMC11276314
|
sec[1]/p[8]
|
2. Methods
| 3.34375 |
biomedical
|
Study
|
[
0.994140625,
0.0055694580078125,
0.0005006790161132812
] |
[
0.69189453125,
0.301513671875,
0.0014734268188476562,
0.005069732666015625
] |
All preliminary and surveillance EUS examinations were performed at IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy by expert endosonographers (i.e., >5 years of practice) using the Olympus GF-UCT180 series linear array echo-endoscope (Olympus Europa SE & CO. KG, Hamburg, Germany) combined with the new EU-ME2 echo-processor (Olympus SE & CO. KG, Hamburg, Germany).
|
[
"Roberta Elisa Rossi",
"Maria Terrin",
"Silvia Carrara",
"Roberta Maselli",
"Alexia Francesca Bertuzzi",
"Silvia Uccella",
"Andrea Gerardo Antonio Lania",
"Alessandro Zerbi",
"Cesare Hassan",
"Alessandro Repici"
] |
https://doi.org/10.3390/diagnostics14141484
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999995 |
PMC11276314_p18
|
PMC11276314
|
sec[1]/p[9]
|
2. Methods
| 3.855469 |
biomedical
|
Study
|
[
0.99951171875,
0.0004973411560058594,
0.00016117095947265625
] |
[
0.9892578125,
0.00864410400390625,
0.001987457275390625,
0.0002543926239013672
] |
Tumors were classified as G1, G2, or G3 lesions according to the WHO 2010 or 2019 classification of digestive system tumors based on the proliferation index (mitotic count and Ki67-related proliferation index) .
|
[
"Roberta Elisa Rossi",
"Maria Terrin",
"Silvia Carrara",
"Roberta Maselli",
"Alexia Francesca Bertuzzi",
"Silvia Uccella",
"Andrea Gerardo Antonio Lania",
"Alessandro Zerbi",
"Cesare Hassan",
"Alessandro Repici"
] |
https://doi.org/10.3390/diagnostics14141484
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999996 |
PMC11276314_p19
|
PMC11276314
|
sec[1]/p[10]
|
2. Methods
| 1.342773 |
biomedical
|
Other
|
[
0.9287109375,
0.0535888671875,
0.017547607421875
] |
[
0.020965576171875,
0.958984375,
0.0019855499267578125,
0.0182647705078125
] |
All the cases were discussed at the multidisciplinary NEN meeting at our European Neuroendocrine Tumor Society (ENETS) Center of Excellence (CoE).
|
[
"Roberta Elisa Rossi",
"Maria Terrin",
"Silvia Carrara",
"Roberta Maselli",
"Alexia Francesca Bertuzzi",
"Silvia Uccella",
"Andrea Gerardo Antonio Lania",
"Alessandro Zerbi",
"Cesare Hassan",
"Alessandro Repici"
] |
https://doi.org/10.3390/diagnostics14141484
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999996 |
PMC11276314_p20
|
PMC11276314
|
sec[1]/p[11]
|
2. Methods
| 3.779297 |
clinical
|
Other
|
[
0.48876953125,
0.509765625,
0.0016222000122070312
] |
[
0.40234375,
0.53955078125,
0.00841522216796875,
0.049774169921875
] |
The follow-up plan was based on the characteristics of the lesion and the state of the margins . Patients diagnosed with rNETs before endoscopic resection that were properly removed were generally followed up with endoscopies every 6–12 months, including a rectal EUS generally performed after 6–12 months. Conversely, for patients whose tumor was not diagnosed before resection, a rectal EUS was generally planned 3–6 months after. Conventional radiological imaging (i.e., CT or MRI) as well as functional imaging were planned only on the suspicion of recurrence.
|
[
"Roberta Elisa Rossi",
"Maria Terrin",
"Silvia Carrara",
"Roberta Maselli",
"Alexia Francesca Bertuzzi",
"Silvia Uccella",
"Andrea Gerardo Antonio Lania",
"Alessandro Zerbi",
"Cesare Hassan",
"Alessandro Repici"
] |
https://doi.org/10.3390/diagnostics14141484
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999997 |
PMC11276314_p21
|
PMC11276314
|
sec[2]/p[0]
|
3. Results
| 2.878906 |
biomedical
|
Study
|
[
0.86962890625,
0.128662109375,
0.0014934539794921875
] |
[
0.93701171875,
0.0379638671875,
0.0012388229370117188,
0.0236053466796875
] |
We included 19 patients (M:F 12:7, median age 54 years, range 27–70 years) with a total of 19 rectal lesions. Twelve patients underwent colonoscopy for screening indication, seven patients because of gastro-intestinal symptoms (including abdominal pain, diarrhea, or bleeding).
|
[
"Roberta Elisa Rossi",
"Maria Terrin",
"Silvia Carrara",
"Roberta Maselli",
"Alexia Francesca Bertuzzi",
"Silvia Uccella",
"Andrea Gerardo Antonio Lania",
"Alessandro Zerbi",
"Cesare Hassan",
"Alessandro Repici"
] |
https://doi.org/10.3390/diagnostics14141484
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999996 |
PMC11276314_p22
|
PMC11276314
|
sec[2]/p[1]
|
3. Results
| 4.003906 |
biomedical
|
Study
|
[
0.9912109375,
0.00833892822265625,
0.0002130270004272461
] |
[
0.99560546875,
0.0018405914306640625,
0.0008678436279296875,
0.00182342529296875
] |
The lesions were described as sessile polyps in eleven cases, semi-peduncolated in one, and sub-epithelial in seven cases, with a median size of 5 mm (range 3–10 mm). The median distance from the anal verge was 6 cm (range 3–10 cm). All sub-epithelial lesions (SELs) were described as yellowish, and two were additionally described as stiff-elastic. Endoscopic and EUS appearances of rNETs are represented in Figure 1 and Figure 2 .
|
[
"Roberta Elisa Rossi",
"Maria Terrin",
"Silvia Carrara",
"Roberta Maselli",
"Alexia Francesca Bertuzzi",
"Silvia Uccella",
"Andrea Gerardo Antonio Lania",
"Alessandro Zerbi",
"Cesare Hassan",
"Alessandro Repici"
] |
https://doi.org/10.3390/diagnostics14141484
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999996 |
PMC11276314_p23
|
PMC11276314
|
sec[2]/p[2]
|
3. Results
| 3.964844 |
biomedical
|
Study
|
[
0.90380859375,
0.09588623046875,
0.00037288665771484375
] |
[
0.86669921875,
0.0255889892578125,
0.00392913818359375,
0.10369873046875
] |
Only five lesions were correctly suspected to be NETs during index colonoscopy, based on their macroscopic characteristics; all were described as SELs, yellowish, covered by normal-appearing mucosa. All five lesions underwent EUS before resection, revealing hypoecoic lesions originating in the submucosa (#2) or in the mucosa (#3), with two lesions described as hypervascular. No lymph node involvement was reported, and all EUS reports suggested neuroendocrine lesions. Three lesions were also subjected to biopsy (forceps), confirming their neuroendocrine nature.
|
[
"Roberta Elisa Rossi",
"Maria Terrin",
"Silvia Carrara",
"Roberta Maselli",
"Alexia Francesca Bertuzzi",
"Silvia Uccella",
"Andrea Gerardo Antonio Lania",
"Alessandro Zerbi",
"Cesare Hassan",
"Alessandro Repici"
] |
https://doi.org/10.3390/diagnostics14141484
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999997 |
PMC11276314_p24
|
PMC11276314
|
sec[2]/p[3]
|
3. Results
| 3.943359 |
biomedical
|
Study
|
[
0.8603515625,
0.13916015625,
0.0006527900695800781
] |
[
0.9453125,
0.016204833984375,
0.0025482177734375,
0.035797119140625
] |
These lesions were subsequently removed by ESD in one case (8 mm lesion with submucosal origin) and cap-assisted EMR in the other four cases. At histology, four lesions were classified as G1 (Ki67 proliferation index, PI: 1% in three patients and 2,4% in one patient) and one as G2 (Ki67 4% PI). Resection margins were all described as negative. For all the lesions, the follow-up was negative (median follow-up time: 48 months, range: 5–81 months).
|
[
"Roberta Elisa Rossi",
"Maria Terrin",
"Silvia Carrara",
"Roberta Maselli",
"Alexia Francesca Bertuzzi",
"Silvia Uccella",
"Andrea Gerardo Antonio Lania",
"Alessandro Zerbi",
"Cesare Hassan",
"Alessandro Repici"
] |
https://doi.org/10.3390/diagnostics14141484
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999995 |
PMC11276314_p25
|
PMC11276314
|
sec[2]/p[4]
|
3. Results
| 4.011719 |
biomedical
|
Study
|
[
0.95947265625,
0.040008544921875,
0.0004494190216064453
] |
[
0.99169921875,
0.0030670166015625,
0.0013866424560546875,
0.00394439697265625
] |
In the other 14 patients, the diagnosis of NET was made only after endoscopic resection. These lesions were removed by cold polypectomy in eleven cases, by EMR in two cases, and by avulsion with biopsy forceps in one case. At histology, eleven lesions were classified as G1 and three as G2 (Ki67 PI 4%, 6%, and 5%, respectively). When resection margins were described, they were negative in four cases, positive in four (i.e., R1), and indeterminate in one. In five cases, the margins were not described by the pathologist. The median follow-up time was 40 months (range 5–138 months).
|
[
"Roberta Elisa Rossi",
"Maria Terrin",
"Silvia Carrara",
"Roberta Maselli",
"Alexia Francesca Bertuzzi",
"Silvia Uccella",
"Andrea Gerardo Antonio Lania",
"Alessandro Zerbi",
"Cesare Hassan",
"Alessandro Repici"
] |
https://doi.org/10.3390/diagnostics14141484
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999996 |
PMC11276314_p26
|
PMC11276314
|
sec[2]/p[5]
|
3. Results
| 3.275391 |
clinical
|
Clinical case
|
[
0.473388671875,
0.52392578125,
0.0028476715087890625
] |
[
0.030303955078125,
0.0506591796875,
0.0016698837280273438,
0.91748046875
] |
A 10 mm polypoid lesion removed with cold snare polypectomy (G2, Ki67 PI 6%, R1) needed immediate subsequent surgical resection with lymphadenectomy (six of the sixteen lymph nodes that were removed were positive).
|
[
"Roberta Elisa Rossi",
"Maria Terrin",
"Silvia Carrara",
"Roberta Maselli",
"Alexia Francesca Bertuzzi",
"Silvia Uccella",
"Andrea Gerardo Antonio Lania",
"Alessandro Zerbi",
"Cesare Hassan",
"Alessandro Repici"
] |
https://doi.org/10.3390/diagnostics14141484
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999997 |
PMC11276314_p27
|
PMC11276314
|
sec[2]/p[6]
|
3. Results
| 3.253906 |
clinical
|
Clinical case
|
[
0.395263671875,
0.6025390625,
0.002292633056640625
] |
[
0.027740478515625,
0.027679443359375,
0.0018739700317382812,
0.94287109375
] |
Local recurrence occurred after 14 months in a 7 mm polypoid lesion removed with cold snare polypectomy (G1, Ki67 PI 2%, R1), which was then treated with cap-assisted EMR with a negative subsequent 50-month follow-up.
|
[
"Roberta Elisa Rossi",
"Maria Terrin",
"Silvia Carrara",
"Roberta Maselli",
"Alexia Francesca Bertuzzi",
"Silvia Uccella",
"Andrea Gerardo Antonio Lania",
"Alessandro Zerbi",
"Cesare Hassan",
"Alessandro Repici"
] |
https://doi.org/10.3390/diagnostics14141484
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999999 |
PMC11276314_p28
|
PMC11276314
|
sec[2]/p[7]
|
3. Results
| 1.756836 |
clinical
|
Clinical case
|
[
0.395751953125,
0.59814453125,
0.00591278076171875
] |
[
0.2364501953125,
0.2138671875,
0.005321502685546875,
0.54443359375
] |
For all the other lesions, including two lesions that resulted in R1 and lesions with missing data about margin status, the subsequent follow-up was negative.
|
[
"Roberta Elisa Rossi",
"Maria Terrin",
"Silvia Carrara",
"Roberta Maselli",
"Alexia Francesca Bertuzzi",
"Silvia Uccella",
"Andrea Gerardo Antonio Lania",
"Alessandro Zerbi",
"Cesare Hassan",
"Alessandro Repici"
] |
https://doi.org/10.3390/diagnostics14141484
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999999 |
PMC11276314_p29
|
PMC11276314
|
sec[2]/p[8]
|
3. Results
| 3.876953 |
biomedical
|
Study
|
[
0.87255859375,
0.1265869140625,
0.0006546974182128906
] |
[
0.974609375,
0.0095062255859375,
0.00217437744140625,
0.0139312744140625
] |
Overall, 18 patients underwent subsequent EUS evaluation, with a median time of first evaluation from the endoscopic removal of 6.5 months (range 2–130 months). In seven cases, the EUS evaluation was within normal limits; in ten cases, the regular scarring results of the endoscopic removal were visible, while in one case, only the EUS evaluation performed 12 months after the first procedure highlighted the persistence of the disease, which was then re-treated with cap-EMR as previously reported. The subsequent EUS examinations were all negative.
|
[
"Roberta Elisa Rossi",
"Maria Terrin",
"Silvia Carrara",
"Roberta Maselli",
"Alexia Francesca Bertuzzi",
"Silvia Uccella",
"Andrea Gerardo Antonio Lania",
"Alessandro Zerbi",
"Cesare Hassan",
"Alessandro Repici"
] |
https://doi.org/10.3390/diagnostics14141484
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999996 |
PMC11276314_p30
|
PMC11276314
|
sec[2]/p[9]
|
3. Results
| 2.537109 |
biomedical
|
Study
|
[
0.89892578125,
0.09918212890625,
0.0019817352294921875
] |
[
0.9140625,
0.0733642578125,
0.0018606185913085938,
0.01067352294921875
] |
In 10 patients, the rectal EUS was also repeated during the follow-up every 6–12 months after the resection.
|
[
"Roberta Elisa Rossi",
"Maria Terrin",
"Silvia Carrara",
"Roberta Maselli",
"Alexia Francesca Bertuzzi",
"Silvia Uccella",
"Andrea Gerardo Antonio Lania",
"Alessandro Zerbi",
"Cesare Hassan",
"Alessandro Repici"
] |
https://doi.org/10.3390/diagnostics14141484
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999999 |
PMC11276314_p31
|
PMC11276314
|
sec[2]/p[10]
|
3. Results
| 1.783203 |
biomedical
|
Study
|
[
0.9638671875,
0.028839111328125,
0.007049560546875
] |
[
0.95263671875,
0.038818359375,
0.003658294677734375,
0.004825592041015625
] |
Table 1 and Table 2 summarize the clinical characteristics of the 19 included patients.
|
[
"Roberta Elisa Rossi",
"Maria Terrin",
"Silvia Carrara",
"Roberta Maselli",
"Alexia Francesca Bertuzzi",
"Silvia Uccella",
"Andrea Gerardo Antonio Lania",
"Alessandro Zerbi",
"Cesare Hassan",
"Alessandro Repici"
] |
https://doi.org/10.3390/diagnostics14141484
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999998 |
PMC11276314_p32
|
PMC11276314
|
sec[3]/p[0]
|
4. Discussion
| 2.146484 |
biomedical
|
Other
|
[
0.99658203125,
0.0019311904907226562,
0.0016450881958007812
] |
[
0.1488037109375,
0.82177734375,
0.0259552001953125,
0.0036373138427734375
] |
The incidence of rNETs has significantly increased in recent years, likely due to the widespread adoption of endoscopic colorectal cancer screening programs .
|
[
"Roberta Elisa Rossi",
"Maria Terrin",
"Silvia Carrara",
"Roberta Maselli",
"Alexia Francesca Bertuzzi",
"Silvia Uccella",
"Andrea Gerardo Antonio Lania",
"Alessandro Zerbi",
"Cesare Hassan",
"Alessandro Repici"
] |
https://doi.org/10.3390/diagnostics14141484
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999997 |
PMC11276314_p33
|
PMC11276314
|
sec[3]/p[1]
|
4. Discussion
| 3.578125 |
biomedical
|
Other
|
[
0.9296875,
0.06884765625,
0.0012407302856445312
] |
[
0.0418701171875,
0.93603515625,
0.0128326416015625,
0.00916290283203125
] |
This represents a challenge in clinical practice, as the majority of small rNETs are not correctly recognized and classified before endoscopic resection . Consequently, they are often removed without an accurate a priori assessment of the metastatic risk and with the use of standard endoscopic techniques not recommended by the available guidelines.
|
[
"Roberta Elisa Rossi",
"Maria Terrin",
"Silvia Carrara",
"Roberta Maselli",
"Alexia Francesca Bertuzzi",
"Silvia Uccella",
"Andrea Gerardo Antonio Lania",
"Alessandro Zerbi",
"Cesare Hassan",
"Alessandro Repici"
] |
https://doi.org/10.3390/diagnostics14141484
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999997 |
PMC11276314_p34
|
PMC11276314
|
sec[3]/p[2]
|
4. Discussion
| 2.601563 |
biomedical
|
Other
|
[
0.994140625,
0.004718780517578125,
0.001148223876953125
] |
[
0.0160064697265625,
0.97802734375,
0.0022430419921875,
0.0036296844482421875
] |
Given their small size and non-specific macroscopic characteristics (i.e., the round shape, the yellowish color), it is difficult to distinguish rNETs from colonic diminutive polyps, both hyperplastic and adenomatous . Therefore, efforts should be made to improve the prompt recognition of rNETs by endoscopists.
|
[
"Roberta Elisa Rossi",
"Maria Terrin",
"Silvia Carrara",
"Roberta Maselli",
"Alexia Francesca Bertuzzi",
"Silvia Uccella",
"Andrea Gerardo Antonio Lania",
"Alessandro Zerbi",
"Cesare Hassan",
"Alessandro Repici"
] |
https://doi.org/10.3390/diagnostics14141484
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999997 |
PMC11276314_p35
|
PMC11276314
|
sec[3]/p[3]
|
4. Discussion
| 3.855469 |
biomedical
|
Review
|
[
0.998046875,
0.0007200241088867188,
0.00124359130859375
] |
[
0.062103271484375,
0.034149169921875,
0.9033203125,
0.0006628036499023438
] |
The adjunct use of virtual-assisted techniques is promising, but both virtual chromoendoscopy and artificial intelligence (AI) are still of limited help in distinguishing luminal NENs. Narrow band imaging (NBI) is described as helpful only in recognizing invasive rNETs, when the absence of a pit pattern with large amorphous areas (Kudo V) is detected . AI is rapidly advancing, but for diminutive polyps, it is mainly effective in distinguishing between adenomatous and non-adenomatous lesions . However, given the increase in the incidence of these tumors, it is likely that in the near future, AI will be able to provide concrete help.
|
[
"Roberta Elisa Rossi",
"Maria Terrin",
"Silvia Carrara",
"Roberta Maselli",
"Alexia Francesca Bertuzzi",
"Silvia Uccella",
"Andrea Gerardo Antonio Lania",
"Alessandro Zerbi",
"Cesare Hassan",
"Alessandro Repici"
] |
https://doi.org/10.3390/diagnostics14141484
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999997 |
PMC11276314_p36
|
PMC11276314
|
sec[3]/p[4]
|
4. Discussion
| 2.048828 |
biomedical
|
Other
|
[
0.974609375,
0.0206756591796875,
0.00493621826171875
] |
[
0.00832366943359375,
0.98046875,
0.006511688232421875,
0.004535675048828125
] |
Incorrect rNET removal can be problematic, particularly for the subsequent management, especially considering that even for lesions following the correct method, existing guidelines are sometimes unclear and not fully evidence-based .
|
[
"Roberta Elisa Rossi",
"Maria Terrin",
"Silvia Carrara",
"Roberta Maselli",
"Alexia Francesca Bertuzzi",
"Silvia Uccella",
"Andrea Gerardo Antonio Lania",
"Alessandro Zerbi",
"Cesare Hassan",
"Alessandro Repici"
] |
https://doi.org/10.3390/diagnostics14141484
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999996 |
PMC11276314_p37
|
PMC11276314
|
sec[3]/p[5]
|
4. Discussion
| 4.054688 |
biomedical
|
Study
|
[
0.99853515625,
0.0013637542724609375,
0.0001671314239501953
] |
[
0.99658203125,
0.000423431396484375,
0.002593994140625,
0.00022983551025390625
] |
Nevertheless, data from our case series, although limited by the small sample size and retrospective nature, seem reassuring, partially contrasting with some more alarming literature results, for both the completeness of resection and outcomes . In particular, in the study by Fine et al., out of 190 unsuspected rNETs subjected to attempted primary resection at index colonoscopy, 148 underwent standard polypectomy; the overall successful R0 resection rate was only 17% . Moreover, a Chinese study identified both the use of simple polypectomy and treatment during index colonoscopy as risk factors for incomplete resection in a cohort of patients with small (≤10 mm) rNETs; treatment in the early period was also a significant predisposing factor for inappropriate choice of polypectomy .
|
[
"Roberta Elisa Rossi",
"Maria Terrin",
"Silvia Carrara",
"Roberta Maselli",
"Alexia Francesca Bertuzzi",
"Silvia Uccella",
"Andrea Gerardo Antonio Lania",
"Alessandro Zerbi",
"Cesare Hassan",
"Alessandro Repici"
] |
https://doi.org/10.3390/diagnostics14141484
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999998 |
PMC11276314_p38
|
PMC11276314
|
sec[3]/p[6]
|
4. Discussion
| 3.265625 |
biomedical
|
Other
|
[
0.99658203125,
0.002727508544921875,
0.0005207061767578125
] |
[
0.2724609375,
0.68701171875,
0.035003662109375,
0.005237579345703125
] |
Since the prognosis of rNETs is usually attributed to the successful complete resection of the lesion, salvage therapies such as EMR, ESD, or transanal endoscopic microsurgery are suggested when complete resection is not achieved . A French study suggested systematically applying resection of the visible scar after an incomplete endoscopic resection .
|
[
"Roberta Elisa Rossi",
"Maria Terrin",
"Silvia Carrara",
"Roberta Maselli",
"Alexia Francesca Bertuzzi",
"Silvia Uccella",
"Andrea Gerardo Antonio Lania",
"Alessandro Zerbi",
"Cesare Hassan",
"Alessandro Repici"
] |
https://doi.org/10.3390/diagnostics14141484
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999998 |
PMC11276314_p39
|
PMC11276314
|
sec[3]/p[7]
|
4. Discussion
| 3.908203 |
biomedical
|
Study
|
[
0.998046875,
0.00145721435546875,
0.0004703998565673828
] |
[
0.93798828125,
0.0023899078369140625,
0.059173583984375,
0.0004410743713378906
] |
However, it is worth noting that for small G1 lesions, incomplete resection alone may not significantly impact the patient’s prognosis. In fact, in the same Chinese study, among 83 patients with incomplete resection, 18 underwent salvage treatment, while 65 refused it. However, patients who were only in follow-up showed no recurrence of the disease . Similar data also emerged from other case series comparing endoscopic treatment with surgical treatment, where surgical treatment guarantees almost zero rates of incomplete resection, but the overall prognosis does not appear to vary .
|
[
"Roberta Elisa Rossi",
"Maria Terrin",
"Silvia Carrara",
"Roberta Maselli",
"Alexia Francesca Bertuzzi",
"Silvia Uccella",
"Andrea Gerardo Antonio Lania",
"Alessandro Zerbi",
"Cesare Hassan",
"Alessandro Repici"
] |
https://doi.org/10.3390/diagnostics14141484
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999995 |
PMC11276314_p40
|
PMC11276314
|
sec[3]/p[8]
|
4. Discussion
| 3.828125 |
biomedical
|
Study
|
[
0.9990234375,
0.0005388259887695312,
0.0002663135528564453
] |
[
0.90966796875,
0.0047760009765625,
0.0848388671875,
0.0005702972412109375
] |
These results are certainly limited by the retrospective nature of the available studies, with subsequent short follow-up times, whereas in some series, the rare appearance of distant metastases occurred many years after the first endoscopic intervention . Furthermore, resection of small lesions with “simple” techniques makes margin assessment particularly difficult, thus increasing the rate of R1 or indefinite histopathological definitions .
|
[
"Roberta Elisa Rossi",
"Maria Terrin",
"Silvia Carrara",
"Roberta Maselli",
"Alexia Francesca Bertuzzi",
"Silvia Uccella",
"Andrea Gerardo Antonio Lania",
"Alessandro Zerbi",
"Cesare Hassan",
"Alessandro Repici"
] |
https://doi.org/10.3390/diagnostics14141484
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999996 |
PMC11276314_p41
|
PMC11276314
|
sec[3]/p[9]
|
4. Discussion
| 3.953125 |
biomedical
|
Review
|
[
0.96875,
0.0299835205078125,
0.0013055801391601562
] |
[
0.046966552734375,
0.1236572265625,
0.82421875,
0.005359649658203125
] |
For lesions <1 cm with R1 after correct endoscopic removal, current ENETS guidelines suggest a second endoscopic resection (or transanal minimally invasive surgery) in order to achieve R0 or, alternatively, a watch-and-wait approach if EUS, MRI, and repeat biopsies are negative (level of evidence 3 and grade of recommendation C) . However, as mentioned above, it is still unclear whether R1 accurately predicts the presence of residual tumor at the resection site and, even in that case, if the presence of residual tumor impacts the patient’s prognosis, posing the problem that further resection could result in overtreatment.
|
[
"Roberta Elisa Rossi",
"Maria Terrin",
"Silvia Carrara",
"Roberta Maselli",
"Alexia Francesca Bertuzzi",
"Silvia Uccella",
"Andrea Gerardo Antonio Lania",
"Alessandro Zerbi",
"Cesare Hassan",
"Alessandro Repici"
] |
https://doi.org/10.3390/diagnostics14141484
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999996 |
PMC11276314_p42
|
PMC11276314
|
sec[3]/p[10]
|
4. Discussion
| 4.070313 |
biomedical
|
Study
|
[
0.98583984375,
0.01377105712890625,
0.0003268718719482422
] |
[
0.99560546875,
0.0027599334716796875,
0.0007748603820800781,
0.00107574462890625
] |
In our cohort, despite the high number of R1/Rx resections, results are overall favorable for G1 lesions, without reported disease progression, and without the need for subsequent surgery. However, all the rNETs included in the current series were well differentiated, low- to moderate-grade tumors, which is in line with data from the literature , even though small lesions can also show a more aggressive behavior . In fact, in one case, surgery was required after endoscopic R1 resection, as the lesion was a G2 with evidence of lymph node metastases (so the need for surgery was not related to margin status).
|
[
"Roberta Elisa Rossi",
"Maria Terrin",
"Silvia Carrara",
"Roberta Maselli",
"Alexia Francesca Bertuzzi",
"Silvia Uccella",
"Andrea Gerardo Antonio Lania",
"Alessandro Zerbi",
"Cesare Hassan",
"Alessandro Repici"
] |
https://doi.org/10.3390/diagnostics14141484
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999998 |
PMC11276314_p43
|
PMC11276314
|
sec[3]/p[11]
|
4. Discussion
| 4.132813 |
biomedical
|
Study
|
[
0.99267578125,
0.007049560546875,
0.0002319812774658203
] |
[
0.99560546875,
0.0023651123046875,
0.0012121200561523438,
0.0006852149963378906
] |
Anyway, it is worth noting that in our cohort, among the 14 patients with a diagnosis of NET made after endoscopic resection, all of them underwent subsequent EUS evaluation after a median interval time of 6,5 months, which proved to be accurate in both the detection of recurrent disease (in one lesion after 14 months from resection, which was successfully re-treated with cap-EMR) and in the identification of lymph node metastases in a lesion that required subsequent surgery. Moreover, it might be reasonable to proceed with caution and apply all the available instruments to ensure a complete resection when needed, considering that, even if R1 is reported to have a generally good prognosis, the available studies are limited by the short follow-up time, and that a second endoscopic resection is a safe procedure, especially in comparison with surgical resection (also taking into account the delicate area of the rectum).
|
[
"Roberta Elisa Rossi",
"Maria Terrin",
"Silvia Carrara",
"Roberta Maselli",
"Alexia Francesca Bertuzzi",
"Silvia Uccella",
"Andrea Gerardo Antonio Lania",
"Alessandro Zerbi",
"Cesare Hassan",
"Alessandro Repici"
] |
https://doi.org/10.3390/diagnostics14141484
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999999 |
PMC11276314_p44
|
PMC11276314
|
sec[3]/p[12]
|
4. Discussion
| 3.835938 |
biomedical
|
Other
|
[
0.955078125,
0.0438232421875,
0.0012865066528320312
] |
[
0.035308837890625,
0.90625,
0.052642822265625,
0.005847930908203125
] |
Furthermore, rectal EUS, in comparison with EUS in other areas, is less invasive, as it requires simple preparation (enema) and does not require sedation. Therefore, even if the current guidelines do not encourage a wide use of rectal EUS , we believe that after balancing costs and benefits, rectal EUS should be performed after an incidental endoscopic resection of a rNET. The execution of a subsequent EUS represents a modality of surveillance, but also a complementary tool to the histology.
|
[
"Roberta Elisa Rossi",
"Maria Terrin",
"Silvia Carrara",
"Roberta Maselli",
"Alexia Francesca Bertuzzi",
"Silvia Uccella",
"Andrea Gerardo Antonio Lania",
"Alessandro Zerbi",
"Cesare Hassan",
"Alessandro Repici"
] |
https://doi.org/10.3390/diagnostics14141484
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999999 |
PMC11276314_p45
|
PMC11276314
|
sec[3]/p[13]
|
4. Discussion
| 3.888672 |
biomedical
|
Other
|
[
0.93701171875,
0.062103271484375,
0.0008578300476074219
] |
[
0.0704345703125,
0.9033203125,
0.00882720947265625,
0.017578125
] |
However, it is important to highlight that in clinical practice, distinguishing between the scar (scar tissue) and residual tumor after resection can be challenging. While the scar usually appears as a thickening of the mucosa and/or submucosa, with ill-defined borders and the presence of irregular hypo-echoes, the residual tumor has the same characteristics as the primary lesion, particularly with the presence of a defined lesion with vascularization.
|
[
"Roberta Elisa Rossi",
"Maria Terrin",
"Silvia Carrara",
"Roberta Maselli",
"Alexia Francesca Bertuzzi",
"Silvia Uccella",
"Andrea Gerardo Antonio Lania",
"Alessandro Zerbi",
"Cesare Hassan",
"Alessandro Repici"
] |
https://doi.org/10.3390/diagnostics14141484
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999999 |
PMC11276314_p46
|
PMC11276314
|
sec[3]/p[14]
|
4. Discussion
| 4.117188 |
biomedical
|
Study
|
[
0.99853515625,
0.0012493133544921875,
0.00020313262939453125
] |
[
0.99755859375,
0.0003867149353027344,
0.0016736984252929688,
0.00019180774688720703
] |
The limited use of MRI and functional imaging, which are currently considered necessary in follow-up by guidelines to complete the evaluation after R1 resection or if the resected lesion is G2-G3 or with additional risk factors (such as lympho-vascular invasion) , could be questioned. In our cohort, however, the use of these techniques was generally tailored to each single patient and reserved only for cases of suspected recurrence, and unfortunately, in some cases, data were missing (which is obviously a limitation due to the retrospective study design). It should be noted, however, that not only did previous guidelines not mention the routine use of these methods , but that even in the current ones, the strength of recommendations and quality of evidence are considered to be low . Moreover, in contrast to the work of O’Neill et al., which suggests that even small rNETs frequently present with metastases at diagnosis (which are detected by MRI and PET scan) , in our experience, not only were recurrences detected by EUS alone, but the frequency of lymph node metastases at diagnosis was also very low, and EUS was able to identify all of them, whereas during follow-up, neither MRI nor PET provided further relevant findings.
|
[
"Roberta Elisa Rossi",
"Maria Terrin",
"Silvia Carrara",
"Roberta Maselli",
"Alexia Francesca Bertuzzi",
"Silvia Uccella",
"Andrea Gerardo Antonio Lania",
"Alessandro Zerbi",
"Cesare Hassan",
"Alessandro Repici"
] |
https://doi.org/10.3390/diagnostics14141484
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999997 |
PMC11276314_p47
|
PMC11276314
|
sec[3]/p[15]
|
4. Discussion
| 3.179688 |
biomedical
|
Study
|
[
0.90234375,
0.09521484375,
0.0022373199462890625
] |
[
0.5244140625,
0.459228515625,
0.004390716552734375,
0.011932373046875
] |
Of course, the favorable outcomes of our cohort might be partially affected by the fact that our center is a referral center for both endoscopy and NEN management (with the availability of a dedicated multidisciplinary team), which is not a true representation of all clinical realities. In particular, the easy access to EUS performance by experts in the field represents, in our opinion, a key factor that is not everywhere available, which strengthens the importance of proper referral to tertiary centers for these specific tumors.
|
[
"Roberta Elisa Rossi",
"Maria Terrin",
"Silvia Carrara",
"Roberta Maselli",
"Alexia Francesca Bertuzzi",
"Silvia Uccella",
"Andrea Gerardo Antonio Lania",
"Alessandro Zerbi",
"Cesare Hassan",
"Alessandro Repici"
] |
https://doi.org/10.3390/diagnostics14141484
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999998 |
PMC11276314_p48
|
PMC11276314
|
sec[3]/p[16]
|
4. Discussion
| 2.798828 |
biomedical
|
Study
|
[
0.9892578125,
0.0101165771484375,
0.0006728172302246094
] |
[
0.89111328125,
0.1011962890625,
0.00206756591796875,
0.0054473876953125
] |
Finally, in our cohort, only one patient underwent ESD (an 8 mm tumor correctly suspected to be a rNET before endoscopic resection), so no observations can be made regarding this endoscopic technique. However, ESD has gained attention as a safe and effective procedure in rNETs .
|
[
"Roberta Elisa Rossi",
"Maria Terrin",
"Silvia Carrara",
"Roberta Maselli",
"Alexia Francesca Bertuzzi",
"Silvia Uccella",
"Andrea Gerardo Antonio Lania",
"Alessandro Zerbi",
"Cesare Hassan",
"Alessandro Repici"
] |
https://doi.org/10.3390/diagnostics14141484
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999996 |
PMC11276314_p49
|
PMC11276314
|
sec[4]/p[0]
|
5. Conclusions
| 3.183594 |
biomedical
|
Other
|
[
0.9853515625,
0.013641357421875,
0.0009255409240722656
] |
[
0.0264434814453125,
0.9619140625,
0.007537841796875,
0.004207611083984375
] |
When rNETs are improperly removed without prior imaging staging, caution should be exercised in the subsequent follow-up, as literature suggests that even small lesions may exhibit heterogeneous behavior, with local recurrence or nodal involvement .
|
[
"Roberta Elisa Rossi",
"Maria Terrin",
"Silvia Carrara",
"Roberta Maselli",
"Alexia Francesca Bertuzzi",
"Silvia Uccella",
"Andrea Gerardo Antonio Lania",
"Alessandro Zerbi",
"Cesare Hassan",
"Alessandro Repici"
] |
https://doi.org/10.3390/diagnostics14141484
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999997 |
PMC11276314_p50
|
PMC11276314
|
sec[4]/p[1]
|
5. Conclusions
| 4.023438 |
biomedical
|
Study
|
[
0.966796875,
0.032867431640625,
0.0005040168762207031
] |
[
0.96630859375,
0.0240325927734375,
0.006511688232421875,
0.0030574798583984375
] |
Data from our cohort seem to suggest that even if inappropriate resection has happened and positive or doubt margins are found on the histopathological piece, patients may be safely managed with early EUS evaluation, excluding eventual nodal involvement and ensuring subsequent endoscopic resection if recurrence or residue on the site of removal is found . Even if these efforts produce an uncertain impact on prognosis, it is worth doing it in consideration of the relatively safe and less invasive approach as compared to the low but existing risk of a lesion with aggressive behavior and the subsequent risk of undergoing surgery.
|
[
"Roberta Elisa Rossi",
"Maria Terrin",
"Silvia Carrara",
"Roberta Maselli",
"Alexia Francesca Bertuzzi",
"Silvia Uccella",
"Andrea Gerardo Antonio Lania",
"Alessandro Zerbi",
"Cesare Hassan",
"Alessandro Repici"
] |
https://doi.org/10.3390/diagnostics14141484
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999996 |
PMC11276314_p51
|
PMC11276314
|
sec[4]/p[2]
|
5. Conclusions
| 2.509766 |
biomedical
|
Other
|
[
0.99462890625,
0.0033245086669921875,
0.0019741058349609375
] |
[
0.1365966796875,
0.85595703125,
0.004058837890625,
0.003253936767578125
] |
A larger sample size is needed to draw more solid conclusions, although these preliminary results encourage the early referral to tertiary centers whenever a NET diagnosis is made. From a speculative point of view, efforts should be made to improve the prompt recognition of rNETs by endoscopists, and in this scenario, as a future perspective, AI might be of help.
|
[
"Roberta Elisa Rossi",
"Maria Terrin",
"Silvia Carrara",
"Roberta Maselli",
"Alexia Francesca Bertuzzi",
"Silvia Uccella",
"Andrea Gerardo Antonio Lania",
"Alessandro Zerbi",
"Cesare Hassan",
"Alessandro Repici"
] |
https://doi.org/10.3390/diagnostics14141484
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999997 |
PMC11276326_p0
|
PMC11276326
|
sec[0]/p[0]
|
1. Introduction
| 4.070313 |
biomedical
|
Study
|
[
0.99951171875,
0.00039577484130859375,
0.00018262863159179688
] |
[
0.51318359375,
0.117431640625,
0.3662109375,
0.0029582977294921875
] |
Li-Fraumeni syndrome (LFS) is a cancer predisposition syndrome caused by germline pathogenic variants (PVs) in the tumor suppressor gene TP53 . Approximately 90% of the carriers develop tumors by the time they reach 60 years of age . Adrenocortical carcinoma, sarcoma, brain cancer, and breast cancer are among the most common cancers in the phenotypic LFS tumor spectrum . Breast cancer (BC) is the most prevalent tumor type in women with LFS .
|
[
"Tatiana Strava Corrêa",
"Paula Fontes Asprino",
"Eduarda Sabá Cordeiro de Oliveira",
"Ana Carolina Rathsam Leite",
"Luiza Weis",
"Maria Isabel Achatz",
"Claudiner Pereira de Oliveira",
"Renata Lazari Sandoval",
"Romualdo Barroso-Sousa"
] |
https://doi.org/10.3390/genes15070928
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999996 |
PMC11276326_p1
|
PMC11276326
|
sec[0]/p[1]
|
1. Introduction
| 4.054688 |
biomedical
|
Study
|
[
0.99951171875,
0.0001481771469116211,
0.0002694129943847656
] |
[
0.99755859375,
0.0020847320556640625,
0.00039196014404296875,
0.00013518333435058594
] |
LFS is rare worldwide, affecting 1 in 5000–20,000 individuals , but its impact in Brazil is relevant because of a founder effect, which is responsible for the high prevalence of TP53 c.1010G>A (p.Arg337His or p.R337H) carriers . Studies of cohorts from the Southern region found a prevalence of 1 in 300 live births harboring the TP53 p.R337H variant .
|
[
"Tatiana Strava Corrêa",
"Paula Fontes Asprino",
"Eduarda Sabá Cordeiro de Oliveira",
"Ana Carolina Rathsam Leite",
"Luiza Weis",
"Maria Isabel Achatz",
"Claudiner Pereira de Oliveira",
"Renata Lazari Sandoval",
"Romualdo Barroso-Sousa"
] |
https://doi.org/10.3390/genes15070928
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999998 |
PMC11276326_p2
|
PMC11276326
|
sec[0]/p[2]
|
1. Introduction
| 3.435547 |
biomedical
|
Study
|
[
0.9990234375,
0.00021135807037353516,
0.0006213188171386719
] |
[
0.99365234375,
0.006000518798828125,
0.0003371238708496094,
0.00018584728240966797
] |
The prevalence of the TP53 p.R337H variant in BC cohorts in Brazil has been previously estimated to range from 0 to 12%, depending on the geographic region . Differences in the geographical distribution of this variant have increased interest in the determination of the frequency of p.R337H in the population of the Federal District of Brazil, a central area of the country, where families from different regions converge.
|
[
"Tatiana Strava Corrêa",
"Paula Fontes Asprino",
"Eduarda Sabá Cordeiro de Oliveira",
"Ana Carolina Rathsam Leite",
"Luiza Weis",
"Maria Isabel Achatz",
"Claudiner Pereira de Oliveira",
"Renata Lazari Sandoval",
"Romualdo Barroso-Sousa"
] |
https://doi.org/10.3390/genes15070928
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999995 |
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