Prognostic factors in Hungarian breast cancer patients.

BACKGROUND: Breast cancer is the most common cancer among women, with variable outcomes, justifying a continuous search for new parameters to predict accurate prognosis and indicate suitable adjuvant therapy for patients. MATERIALS AND METHODS: Fourty-four stage I-III breast cancer specimens were investigated immunohistochemically for the expression of cyclooxygenase-2 enzyme (COX-2), hormone receptors, tumor suppressor gene p53, oncogene HER2 and proliferation marker Ki-67. Additionally, twelve specimens were also investigated for the presence of the phosphorylated extracellular signal-regulated kinase (pERK). RESULTS: It was demonstrated that expressions of biological markers were related to each other (ER to p53 and Ki-67, COX-2 to ER, PgR, Ki-67 and p53, Ki-67 to p53 and PgR, p53 to PgR). CONCLUSION: Our data indicate that concomitant immunohistochemical evaluation of cyclooxygenase-2, hormone receptors, p53 and Ki-67 may be of clinical value in determining an accurate prognosis.

[Diagnostic value of 99mTc-methoxy-isobutyl-isonitril and 99mTc-methylene diphosphonate scintimammography in the preoperative evaluation of breast cancer]. / A 99mTc-metoxi-izobutil-izonitril- és 99mTc-metilén-difoszfonát-szcintimammográfiák diagnosztikus értéke az emlótumorok preoperatív vizsgálatában.

AIM: To compare and establish the value of 99mTc-MIBI (methoxyisobutiylisonitrile) and 99mTc-MDP (methylene diphosphonate) scintigraphy in patients with suspicion of breast cancer. PATIENTS AND METHODS: The study included 105 patients. All patients were evaluated before surgery by 99mTc-MIBI and 99mTc-MDP scintigraphy. Thoracic SPECT study (Multispect II, Siemens) was performed 10 min. after i.v. injection of 99mTc-MIBI and 2 hours after i.v. injection of 99mTc-MDP. Final diagnosis was achieved after operation by histology. RESULTS: 99mTc-MIBI scintigraphy showed a better sensitivity (87%) than the 99mTc-MDP scintigraphy (81%) and the results are similar in specificity and validity, too. CONCLUSIONS: The results suggest that 99mTc-MIBI scintigraphy is a useful method in the preoperative diagnosis of patients with suspicion of breast cancer.

[Manifestation of adult celiac disease during the puerperium]. / Szülést követóen manifesztálódó coeliakia.

The coeliac disease is a T cell mediated autoimmune enteropathy, presents in genetically susceptible person exposed to gluten. It can manifest in any age group but it is becoming more commonly diagnosed in adulthood. Very rarely it manifests during pregnancy or after childbirth, possibly due to hormonal and immunological changes. In authors' case a young female developed severe diarrhoea resulting in malabsorption following both of her pregnancies. On the first presentation the gluten sensitive enteropathy was not diagnosed despite detailed gastroenterological and endocrine workup. Following her first pregnancy she remained free of symptoms for years on a normal diet. After the birth of her second child her symptoms flared up and she was admitted to authors' department. The diagnosis of coeliac disease was confirmed by the histological finding from a small bowel biopsy. The coeliac specific serologic markers were also positive (antibodies to gliadin, endomysium and tissue transglutaminase). Significant improvement was achieved with supportive therapy and gluten-free diet. Despite the fact that authors' patient's symptoms were transient, the diagnosis of latent coeliac disease seems to be evident. Lifelong gluten-free diet is mandatory to prevent the late complications.

[Bile duct obstruction caused by neurofibroma in a patient with Recklinghausen's disease]. / Epeúti obstrukciót okozó neurofibroma Recklinghausen-kóros betegben.

INTRODUCTION: Neurofibromatosis type-I (von Recklinghausen's disease) is characterised by multiple cutan neurofibromas, cafe-au-lait spots, bone abnormalities and tumours of central and peripheral nerves. Gastrointestinal involvement occurs in 25 percent of all cases. CASE REPORT: The authors report a case of a 53-year-old man presenting with rare hepatobiliary complication. He complained of abdominal pain and he looked jaundiced. The abdominal ultrasound revealed cholestasis confirmed by the laboratory results. The endoscopic retrograd cholangiography showed nearly total obstruction in the middle part of common bile duct. Subsequently laparotomy and choledochoenterostomy was performed. Plexiform neurofibroma was found in the wall of common bile duct and several gastrointestinal stromal tumour seedings were identified on the serosal surface of the small intestine. Post surgery he remained symptom free and showed no sign of jaundice. CONCLUSION: The authors would like to draw attention to this extremely rare case, since only two similar cases appeared in the literature.