Expression of netrin-1 in uterine serous carcinoma and its association with prognosis.

BACKGROUND/OBJECTIVES: At present, there are few biomarkers used to predict the prognosis of uterine serous carcinoma (USC). Netrin-1 may be a promising biomarker candidate. We investigated netrin-1 expression in USC tissues and healthy endometrial tissues to determine its relevance to disease prognosis. MATERIALS AND METHODS: Netrin-1 expression was examined in the tissues of 48 patients with USC and 30 patients with healthy benign endometrial tissues via immunohistochemistry. RESULTS: None of the healthy tissues were stained with netrin-1. In tumor tissues, the overall positivity rate of netrin-1 was 75%, detected as high expression in 17 patients (35%) and low in 19 (40%). Patients who had tumors with no netrin-1 expression (n = 12) had a median overall survival (OS) of 60.0 months (95% confidence interval [CI], 47-98), whereas patients who had tumors with low to strong netrin-1 expression (n = 33) had a lower median OS of 50 months, but the difference was not statistically significant (95% CI, 58-108; P = 0.531). Disease-free survival (DFS) was not statistically significant between the groups (95% CI, 67.7-115.9; P = 0.566). Patients with a tumor diameter ≥2 cm had higher netrin-1 expression than those with a tumor diameter of 2 cm (P = 0.027). We did not find any difference in overall and DFS when age, tumor stage, histology, tumor diameter, p53 status, lymphovascular space invasion, myometrial invasion, and lymph node metastasis were compared according to netrin-1 expression (P > 0.05). CONCLUSION: Netrin-1 was expressed in USC but not in healthy tissues. Its expression was not associated with OS or DFS.

The role of next-generation sequencing in the examination of signaling genes in Brca1/2-negative breast cancer cases.

INTRODUCTION: Breast cancer is the most prevalent malignancy in women worldwide. Although pathogenic variants in the BRCA1/2 genes are responsible for the majority of hereditary breast cancer cases, a substantial proportion of patients are negative for pathogenic variations in these genes. In cancers, the signal transduction pathways of the cell are usually affected first. Therefore, this study aimed to detect and classified genetic variations in non-BRCA signaling genes and investigate the underlying genetic causes of susceptibility to breast cancer. METHODS: Ninety-six patients without pathogenic variants in the BRCA1/2 genes who met the inclusion criteria were enrolled in the study, and 34 genes were analyzed using next-generation sequencing (NGS) for genetic analysis. RESULTS: Based on the ClinVar database or American College of Medical Genetics criteria, a total of 55 variants of 16 genes were detected in 43 (44.8%) of the 96 patients included in the study. The pathogenic variants were found in the TP53, CHEK2, and RET genes, whereas the likely pathogenic variants were found in the FGFR1, FGFR3, EGFR, and NOTCH1 genes. CONCLUSION: The examination of signaling genes in patients who met the established criteria for hereditary breast cancer but were negative for BRCA1/2 pathogenic variants provided additional information for approximately 8% of the families. The results of the present study suggest that NGS is a powerful tool for investigating the underlying genetic causes of occurrence and progression of breast cancer.

The efficiency of a mixed exercise program on quality of life and fatigue levels in patients with breast cancer.

OBJECTIVE: Exercise is a nonpharmacological supportive therapy which has been specifically identified to reduce postoperative complications or adverse events of cancer or treatments. Although there are few studies combining resistance and aerobic exercise in cancer survivors, exercise programs are very rare in different places in the literature. This study aims to investigate the effects of mixed-type exercise in different venues on weight, body mass index, fatigue, and quality of life in cancer survivors. METHODS: This is a descriptive, intervention study. Participants were included in the study, and the exercise process was between January and November 2019. The exercise group consisted of 32 patients who had just completed their breast cancer treatment and did not have distant metastases, and they applied a mixed exercise program including resistance at home and aerobic exercise in the fitness center for 12 weeks. The patients with breast cancer in the control group (30 patients) did not receive any exercise program. RESULTS: Subjective feelings of fatigue and decrease in concentration, motivation, and physical activity significantly decreased after exercise (p<0.001, p<0.001, p=0.006, p=0.008, and p<0.001, respectively) in the study group. The results also showed that physical health, general health status, and emotional and social health status significantly increased with the exercise program (p<0.001, p<0.001, p=0.004, and p=0.003, respectively). CONCLUSION: Our results show that a mixed (fitness center and home) 12-week exercise program provides an improvement in general health and reduces the side effects of the treatments and fatigue in patients with breast cancer. For a good prognostic process after medical treatment, exercise can be recommended in every accessible area.

The efficiency of a mixed exercise program on quality of life and fatigue levels in patients with breast cancer

SUMMARY OBJECTIVE: Exercise is a nonpharmacological supportive therapy which has been specifically identified to reduce postoperative complications or adverse events of cancer or treatments. Although there are few studies combining resistance and aerobic exercise in cancer survivors, exercise programs are very rare in different places in the literature. This study aims to investigate the effects of mixed-type exercise in different venues on weight, body mass index, fatigue, and quality of life in cancer survivors. METHODS: This is a descriptive, intervention study. Participants were included in the study, and the exercise process was between January and November 2019. The exercise group consisted of 32 patients who had just completed their breast cancer treatment and did not have distant metastases, and they applied a mixed exercise program including resistance at home and aerobic exercise in the fitness center for 12 weeks. The patients with breast cancer in the control group (30 patients) did not receive any exercise program. RESULTS: Subjective feelings of fatigue and decrease in concentration, motivation, and physical activity significantly decreased after exercise (p<0.001, p<0.001, p=0.006, p=0.008, and p<0.001, respectively) in the study group. The results also showed that physical health, general health status, and emotional and social health status significantly increased with the exercise program (p<0.001, p<0.001, p=0.004, and p=0.003, respectively). CONCLUSION: Our results show that a mixed (fitness center and home) 12-week exercise program provides an improvement in general health and reduces the side effects of the treatments and fatigue in patients with breast cancer. For a good prognostic process after medical treatment, exercise can be recommended in every accessible area.

TP53, EGFR and PIK3CA gene variations observed as prominent biomarkers in breast and lung cancer by plasma cell-free DNA genomic testing.

Use of plasma cell-free DNA genomic testing, also know as liquid biopsy, reveals information for early detection and monitoring of solid tumors. Our study reports the analysis of 113 lung and 18 breast cancer patients using commercially available platforms. Lung and breast cancer panel hotspot regions on the genes were investigated. There was a significant increase in isolation efficiency with very fresh blood samples of at least 15 millilitres which were processed in minutes. TP53 gene variations were detected in both types of tumors. Additionally, associations were found for EGFR variations in lung tumors and PIK3CA variations in breast tumors. Mutation assessment of these three genes are recommended as useful biomarkers for predictive studies, to follow up tumor growth and for personalized treatment. Mutations observed in this study warrant further investigation for follow up studies and may justify expression studies. However, in our subsequent studies, we intensify our tumor profiling strategy with other methods. However in terms of true personalized medicine,future plans would include repeating these studies with ctDNA size analysis and methylation analysis of the non-coding region in the individual tumors.

Radiation therapy for biliary tract tumors: the joint experience of three centers.

BACKGROUND/AIM: This study presents the joint experience of three centers in the treatment of patients with biliary tract tumors with radiation therapy (RT). MATERIALS AND METHODS: The records of 27 patients were retrospectively reviewed. All of the patients who had undergone surgical resection received postoperative adjuvant RT, whereas all of the patients who had not undergone a surgical resection received RT with palliative intent. Twenty patients with adequate performance status were treated with RT and chemotherapy, while the remaining seven patients were treated with RT alone. RESULTS: Follow-up ranged from 1 to 44 months. Local control was not achieved in 10 out of 11 patients who had received RT with palliative intent. Systemic failure was observed in eight patients at 5 to 16 months. Fifteen patients died due to disease-related causes at 1 to 22 months. At 2 years, overall survival was 33% and disease-free survival was 19%. A surgical resection with curative intent predicted improved local failure-free survival and improved disease-free survival. CONCLUSION: Since local recurrence is still the leading cause of failure following postoperative RT and the outcome following palliative RT is far from satisfactory, the indications, the target volume, and the doses for RT should be reconsidered.

Adipose-Derived Stem Cells Improve Survival of Random Pattern Cutaneous Flaps in Radiation Damaged Skin.

BACKGROUND: Tissue ischemia and necrosis following surgery after radiotherapy on the skin and subcutaneous tissue are well known to all reconstructive surgeons. Nevertheless, there has been no report so far on local effects of adipose-derived stem cells (ADSCs) on random flap survival elevated in an irradiated rat dorsum. In this experimental study, we aimed to identify the effect of adipose tissue-derived stem cell injection on random flap survival in irradiated tissues. METHODS: Adipose-derived stem cells were isolated from the groin region of Sprague-Dawley rats and expanded ex vivo for 3 passages. Animals were divided into 2: irradiated and nonirradiated and then again into ADSC injected and noninjected groups altogether 4 groups. After elevation of caudally based dorsal random skin flaps (10  cm long and 3  cm wide), Green fluorescent protein labeled ADSCs were then injected to the base of the pedicle. Radiotherapy was 20  Gy single dose applied during 8 weeks before surgery. At postoperative day 7, flap viability measurement and tissue harvest for histologic and immunocytochemical assessment were performed in all groups. RESULTS: We have observed increased flap viability in ADSCs injected irradiated group compared with control radiation group with small but not statistically significantly increase in vessel count per field. Mean survival rate of the flaps in groups A, B, C, and D were 40.46%, 60.07%, 40.90%, and 56.13%, respectively. There was a statistically significant vessel count difference between group B and group A and also with group D (P < 0.001). CONCLUSIONS: These findings suggest that ADSCs have a potential for enhancing the blood supply of random pattern skin flaps after radiation injury. This mechanism might be both neovascularization and vasodilation along with endothelial repair. Further studies are needed.