Jerry Polesel

Adherence to a Cholesterol‐Lowering Diet and the Risk of Female Hormone‐Related Cancers: An Analysis From a Case–Control Study Network

ABSTRACTObjectiveWe investigated the association between a cholesterol‐lowering diet score and the risk of female hormone‐related cancers.DesignWe used data on 2108 breast, 367 endometrial, 869 ovarian cancer cases and corresponding controls from an Italian network of case–control studies.SettingHospital‐based.SampleBreast, endometrial, and ovarian cancer cases and controls.MethodsWe assessed the adherence to a cholesterol‐lowering diet using a score based on seven dietary components: high intake of non‐cellulosic polysaccharides, monounsaturated fatty acids, legumes, seeds/corn oil; low intake of saturated fatty acids, dietary cholesterol, and glycaemic index. We assigned one point for each component if the requirement was met; otherwise, we assigned zero. The overall score was calculated by summing up points over the seven components, ranging from 0 (null) to 7 (complete adherence).Main Outcome MeasuresOdds ratios (ORs) and 95% confidence intervals (CIs) were estimated through unconditional logistic regression models including terms for potential confounders.ResultsCompared to a low adherence to a cholesterol‐lowering diet (0–2 points), the ORs for a higher adherence (5–7 points) were 0.74 (95% CI: 0.60–0.92) for breast, 0.48 (95% CI: 0.30–0.77) for endometrial, and 0.77 (95% CI: 0.57–0.99) for ovarian cancer. The ORs for a 1‐point increment in the score were 0.87 (95% CI: 0.97–0.80), 0.80 (95% CI: 0.72–0.90), and 0.90 (95% CI: 0.84–0.97) for breast, endometrial, and ovarian cancers, respectively.ConclusionsA cholesterol‐lowering diet may favourably affect the risk of female hormone‐related cancers.

Plant-Based Diets and Ovarian Cancer Risk

Objective: To assess the relationship between adherence to various plant-based diets, as measured by overall, healthy, and unhealthy plant-based diet indices (PDI, hPDI, uPDI), and ovarian cancer risk. Methods: We obtained data on 1031 cases of ovarian cancer and 2411 controls from a case-control study conducted in Italy. PDI, hPDI, and uPDI were calculated using data from a validated food frequency questionnaire. We used logistic regression to calculate the odds ratios (ORs) and their corresponding 95% confidence intervals (CIs) of ovarian cancer for PDI, hPDI, and uPDI, adjusting for several possible confounders. Results: PDI and hPDI were inversely related to ovarian cancer risk (OR = 0.70 for the fourth compared to the first quartile, 95% CI: 0.55–0.89, and OR = 0.67, 95% CI: 0.53–0.84, respectively). On the other hand, a higher uPDI was related to a higher risk of ovarian cancer (OR = 1.78, 95% CI: 1.40–2.28). The estimates for a 5-point increment in the indices were 0.88 (95% CI: 0.81–0.95) for PDI, 0.90 (95% CI: 0.83–0.96) for hPDI, and 1.15 (95% CI: 1.07–1.23) for uPDI. Consistent associations for the three indices were observed across strata of age, family history of breast/ovarian cancer, educational level, parity, oral contraceptives use, and menopausal status. Conclusions: Plant-based diets favorably influence ovarian cancer risk; plant-based diets characterized by a high intake of unhealthy plant foods are linked to an increased risk. Promoting diets rich in healthy plant foods could support the reduction of ovarian cancer risk.

Probe-based confocal laser endomicroscopy intra-operative evaluation in ovarian cancer: definition of in vivo architectural patterns to determine resection strategies.

Probe-based confocal laser endomicroscopy (pCLE) is a novel real-time imaging technique that is potentially useful for accurately distinguishing between normal and cancerous tissues. The aim of this study was to describe the pCLE patterns of areas suggestive of tumors and evaluate the ability of the method to differentiate between normal and cancerous tissue during cytoreductive surgery for epithelial ovarian cancer. In vivo pCLE images and subsequent biopsies were acquired from various anatomical sites including the parietal and visceral peritoneum, ovaries, and omentum. Each endomicroscopic sequence was analyzed by highly experienced investigators using pCLE imaging for cancer diagnosis. Each pCLE sequence was compared with the histology of the corresponding specimens. We enrolled 18 women with International Federation of Gynecology and Obstetrics stage III/IV high-grade serous epithelial ovarian cancer referred for primary or interval debulking surgery. A total of 112 biopsies were obtained for histologic analysis. The pCLE images of normal tissue showed a regular distribution of stromal fibers and consistent cellular architecture, regardless of the anatomical region, with vascularized areas characterized by regular vessels. Conversely, the extravasation of fluorescein, used as a contrast agent, was a distinguishing feature of malignant nodules, which were easily recognized by leakage and are typical of tumor-associated vessels. The leakage often surrounded the dark clusters of neoplastic cells. A substantial agreement between pCLE and histology emerged (k = 0.66), whereas only a fair concordance between the surgeon's intra-operative assessment and histology was found (k = 0.30). Our results suggest that pCLE is a promising intra-operative technique to assist surgeons in accurately detecting peritoneal metastases in patients with advanced epithelial ovarian cancer, enhancing surgical radicality while avoiding unnecessary resection.