Tumor-infiltrating regulatory T cells, CD8/Treg ratio, and cancer stem cells are correlated with lymph node metastasis in patients with early breast cancer.

BACKGROUND: Tumor-infiltrating lymphocytes are an important component of the tumor microenvironment (TME) in breast cancer. They have been linked with tumor pathogenesis in advanced stages. However, little is known about their contribution in early phases. In this study, we analyzed the infiltration of leukocytes and cancer stem cells (CSC) in tumors from patients with early breast cancer. METHODS: Samples of blood and tumor tissue from 30 patients with breast cancer were collected, and the number of dendritic cells (DC), T cells, and CSC were analyzed by flow cytometry. RESULTS: Tumor-infiltrating CD4 and CD8 T cells expressed higher levels of cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4) compared with peripheral T cells. Regulatory T cells (Treg) were enriched in tumors and overexpressed glucocorticoid-induced TNFR-related protein and CTLA-4. Tumor Treg had a positive correlation with the amount of myeloid DC (mDC) and disease progression. The CD8/Treg ratio was associated with lymph node metastasis and tumor stages. The main subset of DC in early breast tumors was mDC, while plasmacytoid DC were almost absent. CSC were present in most tumors with higher frequencies in patients with lymph node metastasis. CSC were also associated with the amount of tumor-infiltrating Treg. CONCLUSION: Early breast cancer has an inflammatory milieu characterized by mDC, Treg, and CSC infiltration. The frequencies of Treg, CSC and CD8/Treg ratio were associated with disease progression. The composition of leukocytes and the presence of CSC in early breast tumors should be considered for the development of new therapeutic approaches.

[Breast cancer and subsequent pregnancy. Infertility, death risk and survival]. / Cáncer de mama y embarazo subsiguiente. Infertilidad, riesgo de muerte y supervivencia.

BACKGROUND: The chemotherapy commonly used for the treatment of breast cancer affect the fertility and could cause premature ovarian failure. The subsequent pregnancy to the breast cancer therefore it is not habitual. OBJECTIVE: The purpose of this study was to identify the effects of the chemotherapy in the women reproductive life; to evaluate the frequency of the women that experienced a later pregnancy after treatment of cancer, as well as the effects of the subsequent pregnancy on the breast cancer. We report our experience in the 14 year period. MATERIAL AND METHOD: As retrospective design, of 14 cases with breast cancer and subsequent pregnancy, from March 1994 to June 2008; demographic variables, clinical presentation, histopathological data, diagnostic procedures, treatments and results of the pregnancy were identified. RESULTS: The mean (M +/- SD) age of gestational women was of 31.5 +/- 5.2 years; the 83.3% women received adyuvant chemotherapy with antraciclines; the patients with regional illness (> 4 N+) and advanced illness had an adverse presage; the systemic relapse and progression showed in 42.8% of the cases. The pregnancy to term was presented in half of the cases in the first two years and in a third part, later to the 2 years of having concluded the oncological treatment; of the fourteen patients with breast cancer presented a total of 16 pregnancies: 9 were of term, 3 of preterm and 4 abortions. CONCLUSIONS: The study founds are based on a series of cases, which do not suggest that the pregnancy after the diagnosis and treatment of breast cancer has some adverse effect in the patients survival, for what the patients can conceive later to the oncological treatment. However, in this study it was observed that the effect of the advanced stage and positive axillary ganglion (> 4) influence in the relapses.

Metástasis a pared abdominal por cáncer de vesícula biliar no sospechado después de colecistectomía laparoscópica: informe de dos casos / Abdminal wall metastasis non diagnosed after laparoscopic cholecystectomy for gallbladder carcinoma: report of two cases

La colecistectomía laparoscópica es actualmente el tratamiento de elección para la litiasis biliar sintomática. El hallazgo incidental de un cáncer no sospechado durante la colecistectomía laparoscópica y los implantes en la pared abdominal es un evento poco común que puede alterar la conducta biológica del tumor y empeorar su pronóstico. La frecuencia real de esta complicación no se conoce y sólo se han documentado casos aislados. Se deben examinar las piezas quirúrgicas y realizar estudios transoperatorios de cualquier zona sospechosa. En caso de encontrar un carcinoma de manera incidental, se recomienda reintervenir al paciente y realizar resección amplia de los puertos y del lecho vesicular con linfadenectomía en un intento de mejorar la posibilidad de curación. Presentamos dos casos de pacientes sometidas a colecistectomía laparoscópica quienes desarrollaron metástasis en los puertos por adenocarcinoma de vesícula biliar no sospechado y su evolución