RESUMO
With regard to different types of malignancies, thymidine kinase 1 (TK1) is a useful prognostic marker in clinical oncology, both as a serum proliferation marker and in immunohistochemistry. The present study investigated the use of serum TK1 protein (STK1p) for the identification of multiple proliferating diseases linked to the risk of developing cancer, by following one patient during the period of 2003-2014. The patient presented with adenomatous polyps in the stomach in 2003, follicular cervicitis in 2007 and hyperplasia of the breast/fibrocystic breasts in 2010. The breast cysts increased from 4×5 mm in size in 2010 to 8×7 mm in size in 2013, and were assessed as a suspicious malignancy at the end of this period. In parallel, the STK1p values increased from 2.0 to 7.6 pM. Based on this information, a minimally invasive surgery using the Mammotome® Biopsy System was performed. Immunohistochemistry on the cyst tissue showed strong staining of TK1 in the ductal epithelial cells and thus confirmed the abnormal proliferation in the lesion. One week after the surgery, the STK1p value had decreased to almost normal values (1.6 pM), but then fluctuated above 2.0 pM for the next 7 months. After the surgery, the patient was re-examined and small foci with squamous cell hyperplasia and a suspected ulcerated cervix, as well as flat gastric erosive, were identified, but not treated; this may explain why the STK1 P-values did not return to within normal values. The patient is currently being followed up using STK1p analysis combined with imaging/pathology in order to begin therapeutic intervention as early as possible to avoid the risk of developing cancer. Overall, STK1p is useful in health screening to identify individuals at risk of developing premalignancy/malignancy.
RESUMO
BACKGROUND: The appropriateness of an individual's intra uterine growth is now considered an important determinant of both short and long term outcomes, yet currently used measures have several shortcomings. This study demonstrates a method of assessing appropriateness of intrauterine growth based on the estimation of each individual's optimal newborn dimensions from routinely available perinatal data. Appropriateness of growth can then be inferred from the ratio of the value of the observed dimension to that of the optimal dimension. METHODS: Fractional polynomial regression models including terms for non-pathological determinants of fetal size (gestational duration, fetal gender and maternal height, age and parity) were used to predict birth weight, birth length and head circumference from a population without any major risk factors for sub-optimal intra-uterine growth. This population was selected from a total population of all singleton, Caucasian births in Western Australia 1998-2002. Births were excluded if the pregnancy was exposed to factors known to influence fetal growth pathologically. The values predicted by these models were treated as the optimal values, given infant gender, gestational age, maternal height, parity, and age. RESULTS: The selected sample (N = 62,746) comprised 60.5% of the total Caucasian singleton birth cohort. Equations are presented that predict optimal birth weight, birth length and head circumference given gestational duration, fetal gender, maternal height, age and parity. The best fitting models explained 40.5% of variance for birth weight, 32.2% for birth length, and 25.2% for head circumference at birth. CONCLUSION: Proportion of optimal birth weight (length or head circumference) provides a method of assessing appropriateness of intrauterine growth that is less dependent on the health of the reference population or the quality of their morphometric data than is percentile position on a birth weight distribution.
