Papers by Maria Argenziano
Endoscopy, Jun 7, 2023
Position Statement * Although both ESGE and the Thieme Group adhere to a policy prohibiting publi... more Position Statement * Although both ESGE and the Thieme Group adhere to a policy prohibiting publications by Russian authors in Endoscopy at this time, an exception has been made to include Dr. Kriazhov owing to the fact that his significant contribution to this Position Statement was made before Russia's invasion of Ukraine.
Journal of Hepatology, Jun 1, 2023
SN Comprehensive Clinical Medicine, May 31, 2023
Gut, Jul 6, 2023
ObjectiveResidual or recurrent adenoma (RRA) after endoscopic mucosal resection (EMR) of large no... more ObjectiveResidual or recurrent adenoma (RRA) after endoscopic mucosal resection (EMR) of large non-pedunculated colorectal polyps (LNPCPs) of ≥20 mm is a major limitation. Data on outcomes of the endoscopic treatment of recurrence are scarce, and no evidence-based standard exists. We investigated the efficacy of endoscopic retreatment over time in a large prospective cohort.DesignOver 139 months, detailed morphological and histological data on consecutive RRA detected after EMR for single LNPCPs at one tertiary endoscopy centre were prospectively recorded during structured surveillance colonoscopy. Endoscopic retreatment was performed on cases with evidence of RRA and was performed predominantly using hot snare resection, cold avulsion forceps with adjuvant snare tip soft coagulation or a combination of the two.Results213 (14.6%) patients had RRA (168 (78.9%) at first surveillance and 45 (21.1%) thereafter). RRA was commonly 2.5–5.0 mm (48.0%) and unifocal (78.7%). Of 202 (94.8%) cases which had macroscopic evidence of RRA, 194 (96.0%) underwent successful endoscopic therapy and 161 (83.4%) had a subsequent follow-up colonoscopy. Of the latter, endoscopic therapy of recurrence was successful in 149 (92.5%) of 161 in the per-protocol analysis, and 149 (73.8%) of 202 in the intention-to-treat analysis, with a mean of 1.15 (SD 0.36) retreatment sessions. No adverse events were directly attributable to endoscopic therapy. Further RRA after endoscopic therapy was endoscopically treatable in most cases. Overall, only 9 (4.2%, 95% CI 2.2% to 7.8%) of 213 patients with RRA required surgery.Thus 159 (98.8%, 95% CI 95.1% to 99.8%) of 161 cases with initially successful endoscopic treatment of RRA and follow-up remained surgery-free for a median of 13 months (IQR 25.0) of follow-up.ConclusionsRRA after EMR of LNPCPs can be effectively treated using simple endoscopic techniques with long-term adenoma remission of >90%; only 16% required retreatment. Therefore, more technically complex, morbid and resource-intensive endoscopic or surgical techniques are required only in selected cases.Trial registration numbersNCT01368289andNCT02000141
International Journal of Molecular Sciences, Jun 5, 2021
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
Medicina-lithuania, Jun 15, 2023
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
Medicina
Background and Objectives: Hepatocellular carcinoma (HCC) is the leading cause of liver cancer wo... more Background and Objectives: Hepatocellular carcinoma (HCC) is the leading cause of liver cancer worldwide and has a high mortality rate. Its incidence has increased due to metabolic-associated liver disease (MAFLD) epidemics. Liver transplantation and surgery remain the most resolute measures. Despite the optimistic use of multi-kinase inhibitors, namely sorafenib, the co-existence of chronic liver disease made the response rate low in these patients. Immune checkpoint inhibitors (ICIs) have become a promising hope for certain advanced solid tumors and, also, for advanced HCC. Unfortunately, a large cohort of patients with HCC fail to respond to immunotherapy. Materials and Methods: We conducted a narrative search on the main medical databases for original articles, reviews, meta-analyses, randomized clinical trials, and case series using the following keywords and acronyms and their associations: hepatocellular carcinoma, immunotherapy, checkpoint inhibitors, gut microbiota, and fec...
Gut
ObjectiveResidual or recurrent adenoma (RRA) after endoscopic mucosal resection (EMR) of large no... more ObjectiveResidual or recurrent adenoma (RRA) after endoscopic mucosal resection (EMR) of large non-pedunculated colorectal polyps (LNPCPs) of ≥20 mm is a major limitation. Data on outcomes of the endoscopic treatment of recurrence are scarce, and no evidence-based standard exists. We investigated the efficacy of endoscopic retreatment over time in a large prospective cohort.DesignOver 139 months, detailed morphological and histological data on consecutive RRA detected after EMR for single LNPCPs at one tertiary endoscopy centre were prospectively recorded during structured surveillance colonoscopy. Endoscopic retreatment was performed on cases with evidence of RRA and was performed predominantly using hot snare resection, cold avulsion forceps with adjuvant snare tip soft coagulation or a combination of the two.Results213 (14.6%) patients had RRA (168 (78.9%) at first surveillance and 45 (21.1%) thereafter). RRA was commonly 2.5–5.0 mm (48.0%) and unifocal (78.7%). Of 202 (94.8%) ca...
Medicina
Liver cancer is very frequent, and hepatocellular carcinoma (HCC) accounts for the majority of li... more Liver cancer is very frequent, and hepatocellular carcinoma (HCC) accounts for the majority of liver cancer cases. Its growing incidence has been greatly affected by the increasing prevalence of metabolic-associated fatty liver disease (MAFLD). The latter is a new epidemic in our era. In fact, HCC is often generated from noncirrhotic liver and its treatment benefits from surgical and nonsurgical approaches, potentially bridged by transjugular intrahepatic portosystemic shunt (TIPS) use. TIPS use is an effective treatment for portal hypertension complications, but its application in patients with HCC and clinically significant portal hypertension (CSPH) remains controversial due to concerns about tumor rupture, dissemination, and increased toxicity. The technical feasibility and safety of TIPS use in HCC patients have been evaluated in several studies. Despite concerns about intraprocedural complications, retrospective studies have shown high success rates and low complication rates ...
SN Comprehensive Clinical Medicine
Hepatoma Research
Cholangiocarcinoma (CCA) is an extremely aggressive neoplasia, mostly because of diagnostic delay... more Cholangiocarcinoma (CCA) is an extremely aggressive neoplasia, mostly because of diagnostic delay and lack of effective therapies. CCA is typically surrounded by a peculiar microenvironment that includes abundant desmoplastic stroma and various cell types, which support and enhance CCA development. Among the tumor microenvironment (TME) cells, there are tumor infiltrating lymphocytes (TILs), such as CD8+ and CD4+ cells, Tregs, natural killers (NKs) and B lymphocytes. TILs contribute to an immunosuppressive microenvironment that leads to tumor immune escape. Dendritic cells (DCs) may lead to immunotolerance by maturation or antigen-presentation deficiency. Hepatic stellate cells (HSCs) are one of the major precursors of cancer-associated fibroblast (CAFs), which are distinguished in various subpopulations, each with different functions and interactions with other TME cells. CAFs can promote lymphangiogenesis, early lymph-node metastasis and proinflammatory environment, but they can a...
Journal of Clinical Medicine
Cholangiocarcinoma (CCA) is an aggressive neoplasia with an increasing incidence and mortality. I... more Cholangiocarcinoma (CCA) is an aggressive neoplasia with an increasing incidence and mortality. It is characterized by a strong desmoplastic stroma surrounding cancer cells. Cancer-associated fibroblasts (CAFs) are the main cell type of CCA stroma and they have an important role in modulating cancer microenvironments. CAFs originate from multiple lines of cells and mainly consist of fibroblasts and alpha-smooth muscle actin (α-SMA) positive myofibroblast-like cells. The continuous cross-talking between CCA cells and desmoplastic stroma is permitted by CAF biochemical signals, which modulate a number of pathways. Stromal cell-derived factor-1 expression increases CAF recruitment to the tumor reactive stroma and influences apoptotic pathways. The Bcl-2 family protein enhances susceptibility to CAF apoptosis and PDGFRβ induces fibroblast migration and stimulates tumor lymphangiogenesis. Many factors related to CAFs may influence CCA prognosis. For instance, a better prognosis is associ...
International Journal of Molecular Sciences, 2021
In nonalcoholic steatohepatitis animal models, an increased lipid droplet size in hepatocytes is ... more In nonalcoholic steatohepatitis animal models, an increased lipid droplet size in hepatocytes is associated with fibrogenesis. Hepatocytes with large droplet (Ld-MaS) or small droplet (Sd-MaS) macrovesicular steatosis may coexist in the human liver, but the factors associated with the predominance of one type over the other, including hepatic fibrogenic capacity, are unknown. In pre-ischemic liver biopsies from 225 consecutive liver transplant donors, we retrospectively counted hepatocytes with Ld-MaS and Sd-MaS and defined the predominant type of steatosis as involving ≥50% of steatotic hepatocytes. We analyzed a donor Patatin-like phospholipase domain-containing protein 3 (PNPLA3) rs738409 polymorphism, hepatic expression of proteins involved in lipid metabolism by RT-PCR, hepatic stellate cell (HSC) activation by α-SMA immunohistochemistry and, one year after transplantation, histological progression of fibrosis due to Hepatitis C Virus (HCV) recurrence. Seventy-four livers had n...
Endoscopy
Main recommendationsEndoscopic mucosal resection (EMR) is the standard of care for the complete r... more Main recommendationsEndoscopic mucosal resection (EMR) is the standard of care for the complete removal of large (≥ 10 mm) nonpedunculated colorectal polyps (LNPCPs). Increased detection of LNPCPs owing to screening colonoscopy, plus high observed rates of incomplete resection and need for surgery call for a standardized approach to training in EMR. 1 Trainees in EMR should have achieved basic competence in diagnostic colonoscopy, < 10-mm polypectomy, pedunculated polypectomy, and common methods of gastrointestinal endoscopic hemostasis. The role of formal training courses is emphasized. Training may then commence in vivo under the direct supervision of a trainer. 2 Endoscopy units training endoscopists in EMR should have specific processes in place to support and facilitate training. 3 A trained EMR practitioner should have mastered theoretical knowledge including how to assess an LNPCP for risk of submucosal invasion, how to interpret the potential difficulty of a particular EM...
International Journal of Molecular Sciences, 2021
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
Hepatoma Research, 2023
Cholangiocarcinoma (CCA) is an extremely aggressive neoplasia, mostly because of diagnostic delay... more Cholangiocarcinoma (CCA) is an extremely aggressive neoplasia, mostly because of diagnostic delay and lack of
effective therapies. CCA is typically surrounded by a peculiar microenvironment that includes abundant
desmoplastic stroma and various cell types, which support and enhance CCA development. Among the tumor
microenvironment (TME) cells, there are tumor infiltrating lymphocytes (TILs), such as CD8+
and CD4+
cells,
Tregs, natural killers (NKs) and B lymphocytes. TILs contribute to an immunosuppressive microenvironment that
leads to tumor immune escape. Dendritic cells (DCs) may lead to immunotolerance by maturation or antigenpresentation deficiency. Hepatic stellate cells (HSCs) are one of the major precursors of cancer-associated
fibroblast (CAFs), which are distinguished in various subpopulations, each with different functions and interactions
with other TME cells. CAFs can promote lymphangiogenesis, early lymph-node metastasis and proinflammatory
environment, but they can also provide a physical and chemical barrier to protect CCA. Tumor-associated
macrophages (TAMs) could be differentiated between two phenotypes, pro- and anti-inflammatory, and they may
sustain invasiveness and immunosuppression. Myeloid-derived suppressor cells (MDSCs) impair cytotoxic T
lymphocytes (CTLs) function, stimulating tumor proliferation and angiogenesis. Tumor-associated neutrophils
(TANs) function is influenced by the TME, leading to tumor-suppressing or tumor-promoting functions. This paper
aims to provide an overview of the CCA microenvironment cells, their role in tumor progression and possible
correlated diagnostic, therapeutic and prognostic implications.
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Papers by Maria Argenziano
effective therapies. CCA is typically surrounded by a peculiar microenvironment that includes abundant
desmoplastic stroma and various cell types, which support and enhance CCA development. Among the tumor
microenvironment (TME) cells, there are tumor infiltrating lymphocytes (TILs), such as CD8+
and CD4+
cells,
Tregs, natural killers (NKs) and B lymphocytes. TILs contribute to an immunosuppressive microenvironment that
leads to tumor immune escape. Dendritic cells (DCs) may lead to immunotolerance by maturation or antigenpresentation deficiency. Hepatic stellate cells (HSCs) are one of the major precursors of cancer-associated
fibroblast (CAFs), which are distinguished in various subpopulations, each with different functions and interactions
with other TME cells. CAFs can promote lymphangiogenesis, early lymph-node metastasis and proinflammatory
environment, but they can also provide a physical and chemical barrier to protect CCA. Tumor-associated
macrophages (TAMs) could be differentiated between two phenotypes, pro- and anti-inflammatory, and they may
sustain invasiveness and immunosuppression. Myeloid-derived suppressor cells (MDSCs) impair cytotoxic T
lymphocytes (CTLs) function, stimulating tumor proliferation and angiogenesis. Tumor-associated neutrophils
(TANs) function is influenced by the TME, leading to tumor-suppressing or tumor-promoting functions. This paper
aims to provide an overview of the CCA microenvironment cells, their role in tumor progression and possible
correlated diagnostic, therapeutic and prognostic implications.
effective therapies. CCA is typically surrounded by a peculiar microenvironment that includes abundant
desmoplastic stroma and various cell types, which support and enhance CCA development. Among the tumor
microenvironment (TME) cells, there are tumor infiltrating lymphocytes (TILs), such as CD8+
and CD4+
cells,
Tregs, natural killers (NKs) and B lymphocytes. TILs contribute to an immunosuppressive microenvironment that
leads to tumor immune escape. Dendritic cells (DCs) may lead to immunotolerance by maturation or antigenpresentation deficiency. Hepatic stellate cells (HSCs) are one of the major precursors of cancer-associated
fibroblast (CAFs), which are distinguished in various subpopulations, each with different functions and interactions
with other TME cells. CAFs can promote lymphangiogenesis, early lymph-node metastasis and proinflammatory
environment, but they can also provide a physical and chemical barrier to protect CCA. Tumor-associated
macrophages (TAMs) could be differentiated between two phenotypes, pro- and anti-inflammatory, and they may
sustain invasiveness and immunosuppression. Myeloid-derived suppressor cells (MDSCs) impair cytotoxic T
lymphocytes (CTLs) function, stimulating tumor proliferation and angiogenesis. Tumor-associated neutrophils
(TANs) function is influenced by the TME, leading to tumor-suppressing or tumor-promoting functions. This paper
aims to provide an overview of the CCA microenvironment cells, their role in tumor progression and possible
correlated diagnostic, therapeutic and prognostic implications.