BackgroundProstate cancer (PCa) is the most common male cancer in Europe and the US. The early diagnosis relies on prostate specific antigen (PSA) serum test, even if it showed clear limits. Among the new tests currently under study, one of the most promising is the prostate cancer gene 3 (PCA3), a non-coding mRNA whose level increases up to 100 times in PCa tissues when compared to normal tissues. With the present study we contribute to the validation of the clinical utility of the PCA3 test and to the evaluation of its prognostic potential.Methods407 Italian men, with two or more PCa risk factors and at least a previous negative biopsy, entering the Urology Unit of Regina Elena National Cancer Institute, were tested for PCA3, total PSA (tPSA) and free PSA (fPSA and f/tPSA) tests. Out of the 407 men enrolled, 195 were positive for PCa and 114 of them received an accurate staging with evaluation of the Gleason score (Gs). Then, the PCA3 score was correlated to biopsy outcome, and the diagnostic and prognostic utility were evaluated.ResultsOut of the 407 biopsies performed after the PCA3 test, 195 (48%) resulted positive for PCa; the PCA3 score was significantly higher in this population (p < 0.0001) differently to tPSA (p = 0.87). Moreover, the PCA3 test outperformed the f/tPSA (p = 0.01). The sensitivity (94.9) and specificity (60.1) of the PCA3 test showed a better balance for a threshold of 35 when compared to 20, even if the best result was achieved considering a cutoff of 51, with sensitivity and specificity of 82.1% and 79.3%, respectively. Finally, comparing values of the PCA3 test between two subgroups with increasing Gs (Gs ≤ 6 versus Gs ≥ 7) a significant association between PCA3 score and Gs was found (p = 0.02).ConclusionsThe PCA3 test showed the best diagnostic performance when compared to tPSA and f/tPSA, facilitating the selection of high-risk patients that may benefit from the execution of a saturation prostatic biopsy. Moreover, the PCA3 test showed a prognostic value, as higher PCA3 score values are associated to a greater tumor aggressiveness.
Gill et al 1 examined 2,043 cases of gastric cancer treated at a Canadian institution, and reported that Asian subjects, largely of Chinese descent, exhibited a hazard ratio lower than that of non-Asian subjects (0.89), but that this difference was not statistically significant. They also detected a greater benefit from curative surgery in Asians as compared with non-Asians.They concluded that, while their study may have been underpowered, ". . . even if we assume the lower limit of [the calculated 95%] CI to be the true effect, a 26% proportional reduction in mortality would only improve a 5-year survival estimate of 12% to 20%. . . ," which is ". . . insufficient to account for the great disparity with Asian survival rates, which remain three-fold higher than North American rates." Our prior study of 3,770 Southern Californian gastric cancer subjects had sufficient power to detect a 34% increased risk of dying among non-Asian subjects compared with Asian subjects of primarily of Japanese, Korean, and Vietnamese descent. This result is likewise insufficient to explain the great disparity between Japanese and US gastric cancer survival. 2 Given the complexity of comparisons of Eastern and Western gastric cancer survival, however, it should come as little surprise that one explanation is insufficient to resolve the current conundrum.It is clear that other issues bias in favor of improved Asian gastric cancer survival. For example, Japanese patients are more likely to be diagnosed with node-negative gastric cancer that can be cured with surgical resection. 3 Furthermore, studies comparing survival rates in gastric cancer subjects in the East and West are compromised by variability in diagnostic criteria for malignancy, because in Japan, gastric cancer is diagnosed on nuclear and structural criteria even when invasion is absent according to the Western viewpoint. 4 The tendency of Japanese pathologists to diagnose malignancy without evidence of invasion will increase Japanese gastric cancer cure rates. Also, studies comparing survival rates in patients from the East and West also are compromised by variability in surgical treatment, 3 with US patients being much less likely to undergo a D2-level dissection. The tendency of US subjects to have limited lymph nodes examined for malignancy produces stage migration (the Will Rogers effect) and may affect cure rates, both of which will decrease stage-stratified gastric cancer survival in the United States.Thus, while we agree with Gill et al that results from their study are insufficient to explain the entire disparity between Eastern and Western gastric cancer survival, it is important to realize that this conclusion should not be misinterpreted to imply that differences in tumor biology do not contribute to the disparate gastric cancer outcomes between the two regions.
BACKGROUNDIn the last decade, many researchers demonstrated the biological activities of native Bombyx mori silk sericin (SS), and its use is widespread in the cosmetic and biomedical field. However, SS is a polluting material from the silk fibroin textile industry. This paper aims to demonstrate that the industrial wastewater‐derived SS has many biological properties, and can be used as an eco‐friendly product for cosmetic/pharmaceutical purposes with an important impact on the circular economy.RESULTSWe focused on the SS derived from an ad hoc extraction process or industrial degumming wastewater. Both products were preserved with three different methods: lyophilization, spray‐drying and sterilization. All SS were characterized in terms of amino acid content, molecular weight, physical–chemical properties, morphology and size distribution; then we evaluated the biological properties, the cytocompatibility/cytoprotective profile, and the immunomodulatory abilities of SS. Free radical scavenging, anti‐tyrosinase, and anti‐elastase activities of waste SS were confirmed. Waste and standard SS were cytocompatible on human fibroblasts; all SS samples inhibited the proliferation of stimulated peripheral blood mononuclear cells in a dose‐dependent manner. Waste SS showed a significant effect on tumor necrosis factor α and interleukin 10 release.CONCLUSIONSThese results pave the way for using textile wastewater‐derived SS to obtain high‐value‐added products for cosmetic and/or pharmaceutical purposes. © 2020 Society of Chemical Industry
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