Usefulness of COL11A1 as a Prognostic Marker of Tumor Infiltration.

BACKGROUND: Determining the infiltration of carcinomas is essential for the proper follow-up and treatment of cancer patients. However, it continues to be a diagnostic challenge for pathologists in multiple types of tumors. In previous studies (carried out in surgical specimens), the protein COL11A1 has been postulated as an infiltration marker mainly expressed in the extracellular matrix (ECM). We hypothesized that a differential expression of COL11A1 may exist in the peritumoral stroma of tumors that have acquired infiltrating properties and that it may be detected in the small biopsies usually available in normal clinical practice. MATERIAL AND METHODS: In our study, we performed immunohistochemical staining in more than 350 invasive and noninvasive small samples obtained via core needle biopsy (CNB), colonoscopy, or transurethral resection of bladder tumor (TURBT) of breast, colorectal, bladder, and ovarian cancer. RESULTS: Our results revealed that COL11A1 immunostaining had a sensitivity to classify the samples into infiltrative vs. noninfiltrative tumors of 94% (breast), 97% (colorectal), >90% (bladder), and 74% (ovarian); and a specificity of 97% (breast), 100% (colorectal), and >90% (bladder). In ovarian cancer, the negative predictive value (0.59) did not present improvement over the usual histopathological markers. In all samples tested, the cumulative sensitivity was 86% and the specificity 96% (p < 0.0001). CONCLUSIONS: COL11A1-positive immunostaining in small biopsies of breast, colon, bladder and ovarian cancer is an accurate predictive marker of tumor infiltration that can be easily implemented in daily clinical practice.

Gb3/cd77 Is a Predictive Marker and Promising Therapeutic Target for Head and Neck Cancer.

Head and neck squamous cell carcinoma is the sixth leading cancer in the world. This cancer is difficult to treat and is characterized by recurrences that are often fatal. This cancer is generally removed surgically, but it often regrows from the edges of the lesion from where most recurrences reappear. In this study, we have investigated if the expression of GB3 in human cell lines, tissues from patient biopsies, and a murine animal model could be used as an early and determinant marker of HNC. We found that in all the investigated systems, this marker appears in neoplastic cells from the very early stages of their malignant transformation. Our conclusions support the hypothesis that GB3 is a reliable and independent target for HNC identification and selective delivery of treatments. Furthermore, we show that the level of expression of this marker correlates with the degree of malignancy of the tumor. These studies suggest that GB3 may provide the basis for the early identification and new targeted therapies for head and neck cancer.

Mortality risk scales in esophagectomy for cancer: their usefulness in preoperative patient selection.

BACKGROUND/AIMS: To improve esophagectomy outcome, preoperative identification of high-risk patients should allow the surgical approach to be modified or alternative treatment methods to be employed. METHODOLOGY: Preoperative risk assessment of 114 patients with resected esophageal cancer. One half of the cases affected the middle third of the esophagus. The tumor stage was III (33.3%) or IV (29.8%). The combined thoracoabdominal approach was the preferred route for resection (88.6%). We analyzed the influence of different variables (epidemiological, clinicopathological and surgical) affecting postoperative mortality. RESULTS: Sixty-six (57.9%) patients developed postoperative complications, mainly pulmonary. The mortality rate was 12.3% (14 patients). Multivariate analysis of preoperative variables found significant association between postoperative death and previous neoplasm (p=0.01), liver cirrhosis (p=0.001), abnormal functional respiratory test (p=0.01) and low serum cholesterol (p=0.005) and albumin (p=0.01). Using those variables, we created a composite scoring system that provides a separation of patients into three postoperative death risk groups. If this knowledge was used, we could avoid 50% of postoperative mortality via improved patient selection. CONCLUSIONS: The development of risk scales based on preoperative mortality risk factors may be useful in the selection and preparation of patients suitable for esophageal resection in order to diminish postoperative mortality.