RESUMEN
PURPOSE: Many investigators have reported that aneuploidy detected by flow cytometry is a useful prognostic marker in patients with endometrial cancer. Laser scanning cytometry (LSC) is a technology similar to flow cytometry but is more feasible for clinical laboratory use. We evaluated the usefulness of DNA ploidy detected by LSC as a prognostic marker in patients with endometrial cancer and investigated genetic and epigenetic factors related to aneuploidy. EXPERIMENTAL DESIGN: Endometrial cancer specimens from 106 patients were evaluated. The methylation status of CDH13, Rassf1, SFRP1, SFRP2, SFRP4, SFRP5, p16, hMLH1, MGMT, APC, ATM, and WIF1 and mutations in the p53 and CDC4 genes were investigated. LSC was carried out to determine DNA ploidy. Fluorescence in situ hybridization was done with chromosome-specific centromeric probes to assess chromosomal instability. RESULTS: Univariate and multivariate analyses revealed that p53 mutation and lack of CDH13 hypermethylation associated positively with aneuploidy. Univariate analysis showed that aneuploidy, chromosomal instability, and lack of CDH13 hypermethylation as well as surgical stage were significantly predictive of death from endometrial cancer. Furthermore, multivariate analysis revealed that stage in combination with either DNA aneuploidy or lack of CDH13 hypermethylation was an independent prognostic factor. CONCLUSION: These results suggest that analysis of DNA ploidy and methylation status of CDH13 may help predict clinical outcome in patients with endometrial cancer. Prospective randomized trials are needed to confirm the validity of an individualized approach, including determination of tumor ploidy and methylation status of CDH13, to management of endometrial cancer patients.
Asunto(s)
Aneuploidia , Cadherinas/genética , Metilación de ADN , Neoplasias Endometriales/genética , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Biomarcadores de Tumor/genética , Femenino , Genes p53 , Humanos , Persona de Mediana Edad , Mutación , Reacción en Cadena de la Polimerasa , PronósticoRESUMEN
OBJECTIVE: This study examined the risk factors in the early rehabilitation therapy of critically ill patients with weakness acquired in an intensive care unit and the impact of this therapy on walking independence after discharge from the hospital. METHOD: Of the 764 consecutive patients transported to the study facilities by ambulance, newly admitted to the intensive care unit (ICU), and treated with rehabilitation during hospitalization, 88 were included in this study after eliminating those who met a detailed list of exclusion criteria. To retrospectively examine the rate of walking independence and the effect of differing durations of rehabilitation activity, the study patients were divided into two groups: those with ICU-acquired weakness (AW) and those without ICU-acquired weakness (non-ICU-AW) on discharge from the ICU. RESULTS: Analysis using the Kaplan-Meier estimator revealed that the non-ICU-AW group needed a markedly shorter period to achieve walking independence. In terms of the rehabilitation activities performed in the ICU, both in-bed exercises and the total duration of rehabilitation activity were significantly shorter in the ICU-AW group than in the non-ICU-AW group. CONCLUSION: The two groups were compared, and the amount of daily activity time significantly influenced the quality of patient outcome.
RESUMEN
A loss of the DNA copy number at chromosomal region 11q23-24 as detected by comparative genomic hybridization (CGH) is a marker of poor prognosis in patients with endometrial cancer. Malignant tumors display genetic instability, which is classified into two types: microsatellite instability (MIN) and chromosomal instability (CIN). In the present study, we examined whether there is a relation between loss of 11q23-24 and genetic instability in endometrial adenocarcinoma. Loss of 11q23-24 was detected in 4 of 70 endometrial cancers by fluorescence in situ hybridization (FISH), and DNA aneuploidy was detected by laser scanning cytometry (LSC) in 14 tumors. All tumors with 11q23-24 loss were aneuploid, and three of them were considered to have CIN. These findings suggest that 11q23-24 contains gene(s) necessary for normal chromosome replication and cell division.
Asunto(s)
Aneuploidia , Inestabilidad Cromosómica/genética , Cromosomas Humanos Par 11/genética , Neoplasias Endometriales/genética , Adulto , Anciano , Anciano de 80 o más Años , ADN de Neoplasias/genética , Neoplasias Endometriales/patología , Femenino , Humanos , Persona de Mediana Edad , PloidiasRESUMEN
A 28-year-old patient presented with severe intrauterine fetal growth retardation (IUGR) at 34 weeks' gestation. There was a prior history of a recurrent cutaneous ulcer on the left thigh. Serological tests for IgG anticardiolipin antibody were positive. A live premature male infant was delivered by an urgent cesarean section because of fetal distress. Histopathological examination revealed that the causes of the cutaneous ulcer and IUGR were thrombosis of the small blood vessels and placental infarction, respectively. Early diagnosis and proper treatment are important in the management of the antiphospholipid syndrome.