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1.
Artigo em Inglês | MEDLINE | ID: mdl-39355199

RESUMO

Background: Trastuzumab is commonly utilized in the management of metastatic HER2-positive breast cancer. Our main goal was to examine the clinical outcomes and immune markers of patients who received trastuzumab and chemotherapy treatment. Methods: Between 1995 and 2012, a total of 98 patients diagnosed with metastatic HER2-positive breast cancer were retrospectively analyzed at Ege University Hospital and Tepecik Training and Research Hospital. The clinicopathological characteristics and clinical outcomes of the patients were assessed, and the associations between response rates, survival and the immune profiles of tumor infiltrating lymphocytes were statistically evaluated. Results: The average age of patients at the time of diagnosis was 50.1±10.3 (ranging from 30 to 79) years. The mean follow-up period for all patients was 97.9±53.8 months. Among the patients, complete response was observed in 24.5%, partial response in 61.2%, and stable disease in 8.2% of cases. The average progression-free survival was 50.3±26.9 months (ranging from 1 to 163 months), and the average overall survival was 88.8±59.4 months (ranging from 12 to 272 months). After analyzing all cases, it was found that patients who were younger (p=0.006), exhibited higher CD3-positivity (p=0.041), presented with higher FOXP3-positivity (p=0.025), showed complete or at least partial response to treatment (p=0.008), and experienced a long-term response to trastuzumab (and chemotherapy) treatment had longer survival (p=0.001). Conclusion: Patients with HER2-positive breast cancer, who initially respond positively to palliative trastuzumab and chemotherapy treatment, can achieve long-term tumor remission lasting for several years.

2.
Healthcare (Basel) ; 12(16)2024 Aug 22.
Artigo em Inglês | MEDLINE | ID: mdl-39201236

RESUMO

The aim of this study was to quantify the multivariate relationships between clinical, cognitive performance, executive functioning, and psychological outcomes in women with fibromyalgia (FMS) using network analyses. Demographic (age, height, weight), clinical (pain history, pain intensity, and related disability), neurocognitive (D2 Attention test, Rey-Osterrieth Complex Figure for visual perception, "Digits D/R/I" tests of the WAIS-IV battery for working memory, the 5-Digit Test for mental inhibition, the Symbol Search for processing speed and the Zoo Test for planning/decision making) and psychological (depressive symptoms, anxiety levels, sleep quality, pain hypervigilance) variables were collected in 129 women with FMS and 111 healthy women. Network analyses were conducted separately for each group to quantify the adjusted correlations between the modeled variables and to assess their centrality indices (i.e., connectivity with other symptoms in the network and their importance in the network). The network identified 74 associations in FMS women and 46 associations in controls with small differences. The strongest correlations in both groups were found between different attention variables: d2_CON with d2_C, d2_O with d_2TR, and d2_CON with d2_TA. The most central variables were d2_TA, d2_C, and d2_CON (highest strength centrality in both groups) and anxiety levels and pain hypervigilance (highest harmonic centrality in FMS women). The strength centrality of the network was stable for women with FMS (CScor0.7: 0.68) but not for healthy women (CScor0.7: 0.28). This study found that attention variables are most relevant within a neurocognitive network and that psychological variables are most important for the treatment of women with FMS. The clinical implications of the current findings, such as the development of treatments targeting these variables, are discussed.

3.
Bratisl Lek Listy ; 125(8): 463-467, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38989745

RESUMO

AIMS: Individuals with a higher De Ritis ratio (aspartate transaminase/alanine transaminase) and neutrophil-to-lymphocyte ratio (NLR) have an inferior survival in varied malignancies. To our knowledge, the prognostic potential of the De Ritis ratio and NLR to predict the survival in nonmetastatic glioblastoma multiforme (GBM) patients remains unclear. In this study, we aimed to explore the prognostic power of the De Ritis ratio and NLR in patients with nonmetastatic glioblastoma multiforme. METHODS: Data of 262 patients with glioblastoma multiforme have been retrospectively analyzed. Their age, gender, tumor characteristics, AST/ALT ratio, NLR and hemogram values, including age at diagnosis and date of diagnosis were recorded. RESULTS: The median survival time of the study group was 21 months (95% CI: 19‒23 months). The first-year and second-year survival rates were 73.0% and 40.5%, respectively. The univariate analysis revealed that the correlation of survival with age, gender, left/right location of tumor, mean platelet volume and De Ritis ratio did not reach the level of significance. The univariate analysis of the prognostic potential of NLR indicated that a 1-unit increase in NLR value translates to a 1.05 times higher risk of death (95% CI: 1.01‒1.09). CONCLUSION: The results of this study lead to the observation that NLR value can serve as an effective prognostic marker in predicting the outcomes of patients with glioblastoma multiforme. It can be positioned as an easily accessible and cost-effective biomarker for establishing appropriate therapeutic strategies (Tab. 2, Fig. 1, Ref. 20).


Assuntos
Neoplasias Encefálicas , Glioblastoma , Linfócitos , Neutrófilos , Humanos , Glioblastoma/sangue , Glioblastoma/mortalidade , Glioblastoma/diagnóstico , Glioblastoma/patologia , Masculino , Feminino , Prognóstico , Pessoa de Meia-Idade , Estudos Retrospectivos , Neoplasias Encefálicas/sangue , Neoplasias Encefálicas/mortalidade , Neoplasias Encefálicas/diagnóstico , Adulto , Linfócitos/patologia , Idoso , Alanina Transaminase/sangue , Aspartato Aminotransferases/sangue , Taxa de Sobrevida , Contagem de Linfócitos , Contagem de Leucócitos , Adulto Jovem
4.
Breast Cancer ; 31(5): 807-814, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-38758305

RESUMO

BACKGROUND: This article aims to examine how psychological resilience influences the interplay between quality of life and post-traumatic growth among breast cancer patients receiving follow-up care and treatment in Türkiye. METHODS: The study involved 119 female individuals diagnosed with breast cancer who visited the Oncology outpatient clinic at a state hospital in Türkiye from January to September 2023. Data were gathered through the administration of a survey form and the utilization of several assessment tools, including the Adult Life Quality Scale in Cancer Survivors (QLACS), the Brief Resilience Scale (BRS), and the Post-traumatic Growth Inventory (PTGI). Data analysis was carried out using SPSS 25 software. RESULTS: The participants demonstrated an inverse correlation between Post-Traumatic Growth (PTG) and two QLACS sub-dimensions, namely recurrence and family concern. Conversely, a positive association was identified between PTG and the advantages of dealing with cancer. Furthermore, a statistically significant positive association was established between BRS and all QLACS sub-dimensions, except for family concern and appearance. However, it was determined that psychological resilience did not act as a moderator in the relationship between PTG and QLACS. CONCLUSION: It is important to enhance psychological resilience in women who have survived cancer at all stages of the cancer journey, including the years after treatment, to have a positive impact on post-traumatic growth and quality of life.


Assuntos
Neoplasias da Mama , Sobreviventes de Câncer , Crescimento Psicológico Pós-Traumático , Qualidade de Vida , Resiliência Psicológica , Humanos , Feminino , Neoplasias da Mama/psicologia , Neoplasias da Mama/terapia , Pessoa de Meia-Idade , Adulto , Sobreviventes de Câncer/psicologia , Idoso , Inquéritos e Questionários
5.
Pol J Pathol ; 74(1): 18-28, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37306349

RESUMO

The aim of this study is to make a differential diagnosis and prognosis of the ampullary adenocarcinoma subtypes. We also investigated the role of prognostic markers PD-1 and PD-L1, and epidermal growth factor receptor (EGFR). Local or locally advanced stage ampullary adenocarcinoma patients who had undergone pancreaticoduodenectomy at the time of diagnosis were included. MUC1, MUC2, MUC5AC, CDX2, CK7, CK20, PD-1, and PDL-1 were analysed immunohistochemically, and EGFR was analysed by real-time polymerase chain reaction. According to histopathological and immunohistochemical evaluation, we found 27 patients as pancreatobiliary type and 56 patients as intestinal type adenocarcinoma. The median survival of patients with intestinal and pancreatobiliary type adenocarcinoma was 23 months and 76 months ( p = 0.201), respectively. When the survival of PD1-positive ( n = 23) and PD-L1-positive ( n = 18) patients were compared with the patients with negative staining ( n = 60, n = 65), no significant difference was found. Epidermal growth factor receptor mutation was detected in a total of 6 patients, and 5 of these 6 mutations were shown in intestinal type tumours and one in a pancreatobiliary type tumour. A significant difference was determined in terms of overall survival for the patients with EGFR mutations compared to those without ( p = 0.008). In conclusion, we could reveal the prognostic significance of EGFR mutation, which is also a target molecule.


Assuntos
Adenocarcinoma , Antígeno B7-H1 , Humanos , Prognóstico , Receptor de Morte Celular Programada 1 , Adenocarcinoma/genética , Adenocarcinoma/cirurgia , Receptores ErbB/genética , Neoplasias Pancreáticas
6.
Pain Med ; 24(3): 275-284, 2023 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-35961027

RESUMO

OBJECTIVE: Current evidence suggests that fibromyalgia syndrome (FMS) involves complex underlying mechanisms. This study aimed to quantify the multivariate relationships between clinical, psychophysical, and psychological outcomes in women with FMS by using network analysis to understand the psychobiological mechanisms driving FMS and generating new research questions for improving treatment strategies. METHODS: Demographic (age, height, weight), clinical (pain history, pain intensity at rest and during daily living activities), psychophysical (widespread pressure pain thresholds [PPT]), sensory-related (PainDETECT, S-LANSS, Central Sensitization Inventory [CSI]) and psychological (depressive and anxiety levels) variables were collected in 126 women with FMS. Network analysis was conducted to quantify the adjusted correlations between the modeled variables and to assess their centrality indices (i.e., the connectivity with other symptoms in the network and the importance in the system modelled as network). RESULTS: The network showed several local associations between psychophysical and clinical sensory-related variables. Multiple positive correlations between PPTs were observed, being the strongest weight between PPTs on the knee and tibialis anterior muscle (ρ: 0.33). PainDETECT was associated with LANSS (ρ: 0.45) and CSI (ρ: 0.24), whereas CSI was associated with HADS-A (ρ: 0.28). The most central variables were PPTs over the tibialis anterior (the highest Strength centrality) and CSI (the highest Closeness and Betweenness centrality). CONCLUSION: Our findings support a model where clinical sensory-related, psychological, and psycho-physical variables are connected, albeit in separate clusters, reflecting a nociplastic condition with a relevant role of sensitization. Clinical implications of the findings, such as developing treatments targeting these mechanisms, are discussed.


Assuntos
Fibromialgia , Humanos , Feminino , Fibromialgia/psicologia , Limiar da Dor , Medição da Dor , Sensibilização do Sistema Nervoso Central , Músculo Esquelético
7.
Eur J Breast Health ; 18(4): 336-342, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-36248749

RESUMO

Objective: Breast cancer is the most common cancer among women worldwide. Neutrophil gelatinase-associated lipocalin (NGAL) has important roles in immunity, cell proliferation, and carcinogenesis. Kidney injury molecule-1 (KIM-1) is a transmembrane glycoprotein also known as hepatitis A virus cellular receptor 1 and T-cell immunoglobulin and mucin, has restricted expression in immune cells and healthy epithelial cells, but it is up-regulated in several human cancers. The aim of this study was to determine the prognostic values of NGAL and KIM-1 expression in tumor cells and to detect the presence of NGAL-positive neutrophils (PNL) in the tumor microenvironment. Materials and Methods: The expression of NGAL and KIM-1 protein were assessed by immunohistochemical staining in tissue specimens from 412 primary breast cancer cases. Results: In this series, the mean age of the patients was 55.6±12.4 years. In 218 (52.9%) cases, there was NGAL expression in tumor cells. In 104 (25.2%) cases there was KIM-1 expression in tumor cells. NGAL-positive inflammatory cells were seen in tumors of 45 (10.9%) cases. There was no significant relationship between NGAL-positive PNL presence in the tumor microenvironment and other clinicopathological features. However, there was a significant association between the presence of in situ carcinomas and NGAL expression (p = 0.008) and KIM-1 expression (p = 0.020) in tumor cells. Conclusion: This study has demonstrated positivity of NGAL and KIM-1 in breast cancer cells. Considering the development of anti-KIM-1 therapies, the presence of KIM-1 expression may be a new treatment option in breast cancer, especially in in situ component-rich tumors. These findings should be confirmed in larger series.

8.
Diagnostics (Basel) ; 12(8)2022 Jul 30.
Artigo em Inglês | MEDLINE | ID: mdl-36010196

RESUMO

The aim of this study was to assess potential associations between sensory, cognitive, health-related, and physical variables in women with fibromyalgia syndrome (FMS) using a network analysis for better understanding the complexity of psycho-biological mechanisms. Demographic, clinical, pressure pain threshold (PPT), health-related, physical, and psychological/cognitive variables were collected in 126 women with FMS. A network analysis was conducted to quantify the adjusted correlations between the modeled variables and to assess the centrality indices (i.e., the degree of connection with other symptoms in the network and the importance in the system modeled as a network. This model showed several local associations between the variables. Multiple positive correlations between PPTs were observed, being the strongest weight between PPTs over the knee and tibialis anterior (ρ: 0.28). Catastrophism was associated with higher hypervigilance (ρ: 0.23) and lower health-related EuroQol-5D (ρ: −0.24). The most central variables were PPT over the tibialis anterior (the highest strength centrality), hand grip (the highest harmonic centrality) and Time Up and Go (the highest betweenness centrality). This study, applying network analysis to understand the complex mechanisms of women with FMS, supports a model where sensory-related, psychological/cognitive, health-related, and physical variables are connected. Implications of the current findings, e.g., developing treatments targeting these mechanisms, are discussed.

9.
Tomography ; 8(4): 1726-1734, 2022 07 04.
Artigo em Inglês | MEDLINE | ID: mdl-35894010

RESUMO

We aimed to investigate clinical and ultrasound signs of shoulder overuse injuries in professional bullfighters; side-to-side differences (dominant vs. non-dominant); and to determine potential differences according to bullfighters' categories. An observational cross-sectional study was conducted. Thirty professional and active bullfighters were assessed. A bilateral ultrasound assessment of the subacromial bursa, long biceps head tendon (LHBT), and rotator cuff was performed to determine the presence of bursitis, subluxation, partial or total tendon rupture, tenosynovitis, or calcification. Supraspinatus tendon thickness was measured. Finally, a battery of clinical orthopedic tests (Yergason, Jobe, infraspinatus, Gerber, and bursa tests) were also performed. Most identified ultrasound findings were located in the dominant side, being the presence of bursitis (n = 9; 30%), LHBT tenosynovitis (n = 8; 26.7%), and subscapularis tendon calcification (n = 5; 16.7%) the most prevalent. No side-to-side or between-categories differences were found for supraspinatus tendon thickness (all, p > 0.05). The most frequent positive signs were the infraspinatus test (40.0%), Gerber lift-off test (33.3%), and bursitis, Jobe, and Yergason tests (all, 26.7%). Ultrasound signs were commonly found at LHBT, subacromial bursa, and rotator cuff in professional bullfighters without difference between categories and sides. No side-to-side or between-categories differences were found. Positive clinical test signs suggestive of bursitis, LHBT, and rotator cuff tendinopathy were frequently observed.


Assuntos
Bursite , Calcinose , Lesões do Manguito Rotador , Lesões do Ombro , Tenossinovite , Bursite/diagnóstico por imagem , Bursite/epidemiologia , Estudos Transversais , Humanos , Prevalência , Lesões do Manguito Rotador/diagnóstico por imagem , Lesões do Manguito Rotador/epidemiologia , Ombro/diagnóstico por imagem , Lesões do Ombro/diagnóstico por imagem , Lesões do Ombro/epidemiologia , Ultrassonografia
10.
Biomedicines ; 10(5)2022 May 20.
Artigo em Inglês | MEDLINE | ID: mdl-35625923

RESUMO

We aimed to explore a path model identified using a structural equation model (SEM) which best explains the multivariate contributions of sensitization, sensitivity, and emotional variables to clinical severity in women with FMS. Pain features, the Central Sensitization Inventory (CSI), painDETECT, S-LANSS, the Hospital Anxiety and Depression Scale (HADS), the Pittsburgh Sleep Quality Index (PSQI), the Pain Catastrophizing Scale (PCS), the Pain Vigilance and Awareness Questionnaire (PVAQ), the 11-item Tampa Scale for Kinesiophobia (TSK-11), and pressure pain thresholds (PPTs) were collected from 113 women with FMS. Four latent variables were created: severity (clinical pain features), sensitivity (PPTs), sensitization (S-LANSS, CSI, painDETECT), and distress (HADS-A, HADS-D, PCS, PVAQ, TSK-11). Data fit for the measurement model were considered excellent (RMSEA = 0.043, CFI = 0.966, SRMR = 0.067, and NNFI = 0.960). Distress had a significant relationship with the mediators of sleep (ß = 0.452, p = 0.031) and sensitization (ß = 0.618, p = 0.001). The only mediator with a significant effect (ß = 1.113, p < 0.001) on severity was sensitization. A significant indirect effect of sensitization (ß = 0.687, p = 0.001) that explained the relationship between distress and severity was also identified. The proposed model suggests that distress and sensitization, together with poor sleep, have a complex mediating effect on severity in women with FMS. The identified path model can be leveraged in clinical trials investigating treatment approaches for FMS.

11.
Artigo em Inglês | MEDLINE | ID: mdl-35457550

RESUMO

A better understanding of the connection between factors associated with pain sensitivity and related disability in people with fibromyalgia syndrome may assist therapists in optimizing therapeutic programs. The current study applied mathematical modeling to analyze relationships between pain-related, psychological, psychophysical, health-related, and cognitive variables with sensitization symptom and related disability by using Bayesian Linear Regressions (BLR) in women with fibromyalgia syndrome (FMS). The novelty of the present work was to transfer a mathematical background to a complex pain condition with widespread symptoms. Demographic, clinical, psychological, psychophysical, health-related, cognitive, sensory-related, and related-disability variables were collected in 126 women with FMS. The first BLR model revealed that age, pain intensity at rest (mean-worst pain), years with pain (history of pain), and anxiety levels have significant correlations with the presence of sensitization-associated symptoms. The second BLR showed that lower health-related quality of life and higher pain intensity at rest (mean-worst pain) and pain intensity with daily activities were significantly correlated with related disability. These results support an application of mathematical modeling for identifying different interactions between a sensory (i.e., Central Sensitization Score) and a functional (i.e., Fibromyalgia Impact Questionnaire) aspect in women with FMS.


Assuntos
Fibromialgia , Teorema de Bayes , Feminino , Fibromialgia/psicologia , Humanos , Modelos Lineares , Masculino , Dor/psicologia , Qualidade de Vida
12.
Eur Geriatr Med ; 13(4): 795-803, 2022 08.
Artigo em Inglês | MEDLINE | ID: mdl-35277853

RESUMO

AIM: Sarcopenia is a progressive and generalized syndrome that can be linked to many causes such as cancers, and is caused by a quantitative and qualitative disorder (loss of muscle strength and/or physical performance) of skeletal muscle mass. Although sarcopenia has some hypothetical explanation in clinical practice, the mechanisms underlying this condition have not been clearly differentiated in patients with cancer. We aimed to investigate the relationship between irisin, FGF21 and CRP in detecting sarcopenia in colorectal cancer patients. MATERIAL AND METHODS: Current prospectively study included non-metastatic newly diagnosed colorectal cancer patients. Patients were divided into 2 groups of 25 people, those with and without sarcopenia. Body composition measurements by examined by BIA. To measure the level of iris and FGF21 from patients, blood samples were taken into the biochemistry tube and their levels were measured. RESULTS: The median age of the patients included in the study was 60 years (range: 21-81), 68% were men. It was found that there was a significant relationship between sarcopenia and gender and BMI measurement. When Spearman correlation analysis was performed between skeletal muscle mass index and FGF21, irisin and CRP, there was a positive correlation between skeletal muscle mass index and irisin and FGF21, while there was a negative correlation between skeletal muscle mass index and CRP. [respectively: (r: 0.282, p: 0.048), (r: 0.564, p: < 0.001) and (r: - 0.360, p: 0.010)]. Similar results were found between hand-grip strength and FGF21, irisin and CRP. [respectively: (r: 0.342, p: 0.015), (r: 0.290, p: 0.041) and (r: - 0.476, p < 0.001)]. When sarcopenia was treated as the dependent variable in the logistic regression analysis, and FGF21, irisin, CRP, gender and BMI were treated as the independent variables, irisin and CRP levels were determined as independent predictors. CONCLUSION: This study was revealed that there is a negative relationship between sarcopenia and irisin and FGF-21 in operated non-metastatic colorectal cancer patients and there may be a relationship between sarcopenia and inflammation. It suggests that these biomarkers may play a role in the pathophysiology of sarcopenia. However, our results need to be validated in different types of cancer and with more patients.


Assuntos
Neoplasias Colorretais , Sarcopenia , Idoso , Idoso de 80 Anos ou mais , Neoplasias Colorretais/complicações , Neoplasias Colorretais/diagnóstico , Feminino , Fatores de Crescimento de Fibroblastos , Fibronectinas , Humanos , Masculino , Sarcopenia/diagnóstico
13.
Sisli Etfal Hastan Tip Bul ; 55(4): 503-509, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-35317367

RESUMO

Objectives: Neuroendocrine breast carcinoma (NEBC) is a rare subgroup of breast cancer, which makes up 2-5% of all invasive breast cancers. The aim of this retrospective analysis is to present and analyze our own data of primary NEBCs. Methods: We retrospectively analyzed clinical, pathological, and radiological characteristics of 36 patients diagnosed with neuroendocrine differentiated breast cancer between 2008 and 2019 compared to that of 925 patients with invasive ductal carcinoma (IDC/NOS) along with a literature review. Results: In this study, 36 patients with neuroendocrine differentiated breast carcinoma and 961 patients with (IDC/NOS), as the comparison group, were identified between 2008 and 2019. In NEBC patients, seven were premenopausal and 29 postmenopausal. Patients whose ultrasound (USG), magnetic resonance, and mammographic (MMG) images available in our hospital, high-density masses were detected in the MMG with irregular (77%), microlobulated (80%) and spiculated margins (63%), unaccompanied by asymmetry and structural distortion. Calcifications were less common than invasive breast cancer, present only in four patients (17%). When NEBC were compared to ductal carcinomas (n=925), NEBC were more often human epidermal growth factor receptor 2 negative (p=0.039), estrogen receptor positive (p=0.05), progesterone receptor positive (0.03), and the NEBC patients were older (p=0.02). Age, grade, metastatic status, lymph node number, and molecular type were identified as prognostic factors that significantly affect survival in both groups (p<0.05). Conclusion: NEBC is a subtype that is both histopathologically and radiologically distinct from other breast cancer subtypes, and neuroendocrine differentiation may be an important predictive marker in the future.

14.
J BUON ; 25(2): 675-680, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32521852

RESUMO

PURPOSE: Galectin-1 is a lectin involved in the carcinogenesis of many cancers. In the present study, we aimed to investigate the importance of galectin-1 in breast cancer carcinogenesis and its relationship with tumor development. METHODS: Patients who were diagnosed with new breast cancer and a healthy volunteer population were included in the study. Preoperative and postoperative (1 month following visit at the medical oncology outpatient clinic) serum samples were collected from breast cancer patients and the healthy volunteer control group. RESULTS: There was no statistically significant difference between patients' age, height, weight and body mass index (BMI) (p>0.05). The mean galectin-1 value of the preoperative group was 2.16±0.69 ng/ml, in the postoperative group; 1.75±0.31 ng/ml, and the healthy control group 1.64±0.40 ng/ml. A comparison of mean galectin-1 values between the groups showed that the highest galectin-1 level was found in the preoperative patients. When the mean serum galectin-1 levels of preoperative and postoperative patients were compared, a statistically significant difference was found between the two groups (p<0.001). Furthermore, a comparison of the control group and preoperative patients also revealed a statistically significant difference between the groups (p<0.001). When the control group and postoperative patients were compared, no statistically significant difference was found between them (p=0.16). CONCLUSION: Serum galectin-1 levels were higher in breast cancer patients than in the healthy control group. In addition, postoperative galectin-1 levels of breast cancer patients tended to decrease. This suggests that serum galectin-1 levels are important in breast carcinogenesis and positively correlated with the presence of tumors.


Assuntos
Neoplasias da Mama/sangue , Galectina 1/metabolismo , Estudos de Casos e Controles , Feminino , Humanos , Pessoa de Meia-Idade
15.
J BUON ; 25(2): 1063-1069, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32521907

RESUMO

PURPOSE: We aimed to investigate the prognostic significance of neutrophil/lymphocyte ratio (NLR), an indirect indicator for the immune response and AST/ALT ratio (De Ritis), liver enzymes that are commonly used in various clinical fields, in patients with advanced-stage pancreatic cancer. METHODS: NLR and De Ritis of the patients with diagnosis of locally advanced and metastatic pancreatic cancer between the 2010-2017 were evaluated retrospectively. All patients were divided into two groups as high and low according to NLR and De Ritis cut-off values which were 2.4 and 0.75, respectively. RESULTS: A total of 191 patients were evaluated. The mean overall survival (OS) in patients with NLR<2.4 at the time of diagnosis was 10±0.8 months, while it was 4±0.49 months in patients with NLR>2.4 (p<0.0001). The mean OS of the patients with a De Ritis <0.75 was 8±1.2 months, whereas the survival of those with De Ritis >0.75 was 6±0.74 months (p=0.024). The mean progression free survival (PFS) in patients with NLR<2.4 and De Ritis <0.75 at diagnosis were 5±0.76 months and 6±0.87 months respectively, whilst it was 3±0.37 months in patients with NLR>2.4 (p=0.017) and 4±0.3 months in patients with De Ritis >0.75 (p=0.14). CONCLUSIONS: The NLR and De Ritis are associated with prognosis in many cancers and have been found to be associated with survival outcome in advanced-stage pancreatic cancer patients.


Assuntos
Linfócitos/metabolismo , Neutrófilos/metabolismo , Neoplasias Pancreáticas/sangue , Feminino , Humanos , Masculino , Neoplasias Pancreáticas/mortalidade , Neoplasias Pancreáticas/patologia , Prognóstico , Intervalo Livre de Progressão , Análise de Sobrevida
16.
Indian J Cancer ; 57(2): 158-163, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32445318

RESUMO

BACKGROUND: Adjuvant treatment is necessary in pancreatic cancer patients, but the optimal approach is not clear yet. Our aim was to explore the effectiveness of adjuvant treatment modalities in patients with operated pancreatic cancer. METHODS: There were five groups of patients operated for primary pancreas adenocarcinoma. The first two groups included patients who were treated with only adjuvant chemotherapy or radiotherapy. The patients in third group had received combination chemotherapy and radiotherapy either sequentially or concomitantly. The fourth group was composed of patients who were treated with adjuvant chemotherapy after concurrent chemoradiotherapy, whereas the patients in the fifth group were only observed after surgery without any adjuvant treatment. RESULTS: There were 83 operated pancreatic cancer patients available for analysis. Median age of the patients was 63 years (range, 40-82 years). There were 55 patients who had local disease recurrence (n = 14) or metastasis (n = 41) during or after adjuvant treatment. The median overall survival for all patients was 14 months. When we compared the median survival of patients who had any adjuvant treatment with the patients treated without any adjuvant therapy, we found a significant statistical difference between the groups (32.4 vs 6.5 months; P = 0.000). In addition, survival of each treatment group was also compared with each other but we did not find any significant statistical difference. CONCLUSIONS: Our result suggests that any adjuvant therapy in the treatment of pancreatic cancer patients is important. However, we could not find any superiority between adjuvant treatment modalities.


Assuntos
Quimioterapia Adjuvante/métodos , Neoplasias Pancreáticas/tratamento farmacológico , Neoplasias Pancreáticas/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Pancreáticas
17.
Support Care Cancer ; 28(8): 3965-3977, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32335732

RESUMO

INTRODUCTION: Although the chemotherapy-induced sarcopenia has some explanatory presence in clinical practice, the mechanisms underlying this phenomenon have not been clearly distinguished in patients with cancer. Therefore, we aimed with this study to investigate the role of inflammation by examining the inflammatory markers in the physiopathology of adjuvant chemotherapy-induced sarcopenia in patients with gastrointestinal tract cancer. MATERIAL AND METHOD: To detect the presence of sarcopenia, patients' body composition measurements were assessed using the BIA, and their muscular strength was assessed with a handgrip dynamometer in both pre- and post-adjuvant chemotherapy. At the same time, we examined the baseline and post-adjuvant chemotherapy anthropometric measurements and inflammatory markers in serum (Hs-CRP, IL8, and TNF-α). Patients were divided in three groups. Group 1 consisted of patients who presented post-treatment sarcopenia although they did not have it prior to the treatment, group 2 included the patients who had no pre- or post-treatment sarcopenia, and group 3 was comprised of patients who presented pre-treatment sarcopenia. Each group included 30 patients. RESULTS: A total of 90 patients were included in the study. Fifty-one of them were female patients. Median age was 60.5 (range 27-83). The patients consisted of cases with colorectal and gastric cancers. In group 1, Wilcoxon signed-rank test revealed a significant difference between scores of IL-8 (pg/mL), TNF-α (pg/mL) and Hs-CRP (mg/dL) given for the post-chemotherapy compared with the pre-chemotherapy ((Z 3.61, p < 0.001), (Z 3.254, p = 0.001), (Z 3.319, p = 0.001)). The post-chemotherapy median scores of IL-8 (pg/mL), TNF-α (pg/mL), and Hs-CRP were 76.31, 7.34, and 1.55, respectively, which remained on the levels of 12.25, 1.6, and 0.51 for the pre-chemotherapy. For group 2, a Wilcoxon signed-rank test indicated no significant difference between scores of the same markers given for the post-chemotherapy compared with the pre-chemotherapy. In all patients (including groups 1, 2, and 3), a comparison of the patients with pre-treatment sarcopenia (n = 30) and non-sarcopenic patients (n = 60) in terms of baseline IL-8, TNF-α, and Hs-CRP mean levels, IL-8 and Hs-CRP were found to be statistically different (146.02 (SD 311.96) vs. 47.24 (SD 66.3) (p = 0.009), 3.91 (SD 4.26) vs. 0.75 (SD 1.08) (p < 0.001), respectively). CONCLUSIONS: The present prospective observational study suggested an association of chemotherapy-induced sarcopenia with inflammatory markers Hs-CRP, IL8, and TNF-α. Inflammation may play a role in chemotherapy-induced sarcopenia in newly diagnosed non-metastatic patients.


Assuntos
Mediadores da Inflamação/sangue , Inflamação/sangue , Sarcopenia/sangue , Sarcopenia/induzido quimicamente , Adulto , Idoso , Idoso de 80 Anos ou mais , Composição Corporal , Proteína C-Reativa/metabolismo , Quimioterapia Adjuvante/efeitos adversos , Neoplasias Colorretais/sangue , Neoplasias Colorretais/tratamento farmacológico , Neoplasias Colorretais/patologia , Feminino , Humanos , Inflamação/patologia , Interleucina-8/sangue , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Sarcopenia/diagnóstico , Sarcopenia/patologia , Neoplasias Gástricas/sangue , Neoplasias Gástricas/tratamento farmacológico , Neoplasias Gástricas/patologia , Fator de Necrose Tumoral alfa/sangue
18.
Support Care Cancer ; 28(2): 837-843, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31161438

RESUMO

INTRODUCTION: Sarcopenia is defined as the loss of muscle mass and muscular functioning. Although sarcopenia prevalence is highly variable in the literature, pre-chemotherapy sarcopenia prevalence was not well studied in newly diagnosed cancer patients. In this context, the present study aims to determine the prevalence of sarcopenia and its related factors in this population. MATERIAL AND METHODS: Prospectively, newly diagnosed cancer patients were evaluated for body composition measurement and muscle strength by employing the bioelectric impedance analysis method and handgrip dynamometer tool. RESULTS: A total of 461 patients were included in the study. The median age of patients was 59 years (range 18-83) and 258 patients (56%) were women. Sarcopenia was present in 77 patients (16.7%) and was at significantly higher frequencies in men (p = 0.015), advanced age (≥ 65 years, p = 0.014), lower body mass index (BMI < 25, p = < 0.001), and poor performance status (ECOG status > 0, p = 0.026). In multivariate analyses, advanced age (over 65 years), gender (men), and lower body mass index (BMI < 25) were significantly associated with sarcopenia (p values 0.033, < 0.001, and < 0.001, respectively). CONCLUSIONS: Our study is the first prevalence study conducted with bioelectric impedance analysis on Turkish cancer patients and sarcopenia was detected to be notably prevalent among our patients with newly diagnosed cancer. Given the likely negative outcomes of sarcopenia reported in the literature (treatment failure, increased complications, and impaired survival), it is important to know the presence of sarcopenia before treatment and take preventive precautions.


Assuntos
Neoplasias/complicações , Sarcopenia/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência
19.
Support Care Cancer ; 28(6): 2899-2910, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31758325

RESUMO

BACKGROUND: Sarcopenia is associated with physical disability, increased post-operative complications, poorer tolerance to chemotherapy, and reduced survival outcome. However, little is known about the changes in body composition during chemotherapy treatment. We aimed to determine whether adjuvant or palliative chemotherapy causes the development of sarcopenia in newly diagnosed cancer patients and to reveal the relationship of sarcopenia with the duration of chemotherapy. METHODS: The study included newly diagnosed cancer patients who underwent curative surgery for primary tumor and also cancer patients who were metastatic at diagnosis. Body composition and handgrip strength were assessed by bio-electric impedance analysis (BIA) and handgrip dynamometer tools, respectively. Measurement tests were performed prior to chemotherapy, in the third and sixth months of chemotherapy. RESULTS: The median age of a total of 276 patients was 57.5 years (range 18-83), and majority of them (55.8%) were women. Among the pre-chemotherapy factors that could be associated with sarcopenia, male gender ≥ 65 years of age, body mass index (BMI) < 25, and nutritional risk screening 2002 score < 3 were found to be positively associated with sarcopenia (p < 0.001, p = 0.036, p < 0.001, and p < 0.001, respectively). In the multivariate analysis, male gender (p < 0.001) and BMI < 25 (p = 0.047) were found to be significant. Of 276 patients, 14.5% were sarcopenic prior to chemotherapy. After chemotherapy, 21.4% of them were sarcopenic at the end of the third month and 23.9% were sarcopenic at the end of the sixth month. CONCLUSION: The incidence of sarcopenia was found to be increased with chemotherapy itself and its duration in both non-metastatic and metastatic cancer patients which has to be evaluated in detail in disease-specific prospective and randomized studies.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Neoplasias/tratamento farmacológico , Neoplasias/epidemiologia , Sarcopenia/induzido quimicamente , Sarcopenia/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Composição Corporal/efeitos dos fármacos , Índice de Massa Corporal , Feminino , Força da Mão/fisiologia , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Neoplasias/diagnóstico , Estudos Prospectivos , Fatores de Tempo , Turquia/epidemiologia , Adulto Jovem
20.
J BUON ; 24(4): 1549-1554, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31646807

RESUMO

PURPOSE: Mesothelin is a cell surface glycoprotein which is highly expressed in various types of epithelial cancers. Its expression level is associated with poor prognosis in many cancer types. The aim this study was to evaluate the association of the level of mesothelin expression with clinicopathological characteristics and its prognostic significance in patients with advanced serous ovarian cancer (SOC). METHODS: Tissue blocks from a total 42 patients with advanced SOC treated at the medical oncology clinic of Izmir Katip Celebi University Ataturk Training and Research Hospital between 2006 and 2013 were evaluated. Immunohistochemical staining for mesothelin was performed. Clinical characteristics, optimal or suboptimal operation, response to platinum-based chemotherapy, and overall survival (OS) were analyzed. RESULTS: The cut-off value of 45 for mesothelin H-score determined by ROC analysis predicted survival with 86% sensitivity and 75% specificity (p=0.020). We found a notable negative correlation between mesothelin H-score and OS (r = -0.570, p=0.0001). The median OS was 67 months (95%CI, 36.114 to 97.886) in the low-staining mesothelin H-score group and 27 months (95%CI, 22.238 to 31.762) in the high-staining mesothelin H-score group (p=0.002). Univariate analysis showed that the clinical stage IV disease (p=0.023), platinum chemoresistance (p=0.001), higher mesothelin H-score (p=0.002), and suboptimal surgery (p=0.024) were associated with worse OS. In the multivariate Cox regression model, mesothelin H-score (B=1.15, 95%CI=1.016 to 9.850, p=0.047) and the status of platinum sensitivity (B=-.916, 95%CI=.185 to -.864, p=0.020 were statistically significant predictors for OS. CONCLUSION: These results indicated that high mesothelin H-scores were significantly associated with poor prognosis in patients with advanced SOC.


Assuntos
Carcinoma Epitelial do Ovário/tratamento farmacológico , Cistadenocarcinoma Seroso/tratamento farmacológico , Proteínas Ligadas por GPI/genética , Neoplasias Epiteliais e Glandulares/tratamento farmacológico , Adulto , Idoso , Idoso de 80 Anos ou mais , Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Biomarcadores Tumorais/genética , Carcinoma Epitelial do Ovário/genética , Carcinoma Epitelial do Ovário/patologia , Cistadenocarcinoma Seroso/genética , Cistadenocarcinoma Seroso/patologia , Intervalo Livre de Doença , Tratamento Farmacológico , Feminino , Regulação Neoplásica da Expressão Gênica/efeitos dos fármacos , Humanos , Mesotelina , Pessoa de Meia-Idade , Neoplasias Epiteliais e Glandulares/genética , Neoplasias Epiteliais e Glandulares/patologia , Platina/administração & dosagem , Prognóstico
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