Serum levels of circulating miRNA-21, miRNA-10b and miRNA-200c in triple-negative breast cancer patients.

INTRODUCTION: Breast cancer can be classified into five subtypes based on variations in the status of three hormonal receptors that are responsible for the cancer's heterogeneity: estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2). These classifications influence the choice of therapies (either neoadjuvant or adjuvant), and the range of prognoses, from good (luminal A subtype) to poor (triple-negative cancers). OBJECTIVE: The aim of the study was to compare the serum concentration of selected miRNAs (miRNA-21, miRNA-10b, and miRNA-200c) between in two groups of breast cancer patients with differing ER, PR, and HER2 statuses. MATERIALS AND METHODS: The study was performed on two groups of patients. One group (TNBC) consisted of patients with triple-negative cancer, and the other group (ER(+)/PR(+)) was comprised of patients with positive ER and PR receptors. RESULTS: The mean level of miRNA-200c was significantly higher in the ER(+)/PR(+) group than in the TNBC group (p < 0.05). No statistically significant difference was found between the two groups with regard to the mean levels of miRNA-21 or miRNA-10b. CONCLUSION: The level of miRNA-200c was lower in triple-negative patients when compared with the levels in the study's ER/PR positive group.

The clinical and histopathological factors in patients operated on for gastric GIST tumors with unclear diagnosis.

BACKGROUND: The preoperative radiological diagnosis of GIST is complicated by its varied macroscopic morphology. Moreover, the precision of preoperative histopathological diagnostics is reduced by the submucosal localization of the lesion. OBJECTIVES: The goal of the study was to perform a retrospective analysis of the clinical and histopathological factors seen in patients operated on for a stomach GIST tumor with unclear diagnosis. MATERIAL AND METHODS: Two groups of GIST patients treated in our department were compared with regard to their histopathological and clinical data. The first group (9 patients, group 1) comprised patients with a histopathological diagnosis for stomach GIST confirmed before the surgical procedure, while the second group (10 patients, group 2) comprised patients with no solid histopathological diagnosis before surgery. The following clinical and histopathological variables were analyzed in the study: age, gender, presence or absence of metastases, anatomical location of metastases, symptoms, tumor size, surgical mortality, tumor recurrence, treatment with imatinib, patient survival in months, histological subtype, mitotic index, cellular atypia, necrosis, tumor ulceration and Ki-67. The results were analyzed statistically. RESULTS: The mean survival time differed significantly between the two study groups: group 1 being 12 months and group 2 being 8 months. The lower survival time in group 2 was connected with the higher stage of the disease at the moment of diagnosis. CONCLUSIONS: Our findings suggest that GIST tumors with an unclear diagnosis are recognized at a late stage of the disease. The more advanced stage of the tumor probably results from faster tumor growth caused by higher proliferation activity. These GIST tumors are characterized by a lower survival rate due to the later stage of the disease at the time of diagnosis.

Long-term outcome of ATG vs. Basiliximab induction.

BACKGROUND: An evaluation of the long-term efficacy and incidence of adverse events after induction therapy with antithymocyte globulin (ATG) vs. Basiliximab in renal transplant patients. METHODS: Sixty recipients receiving ATG induction and a dual immunosuppression with Tacrolimus and steroids were compared retrospectively with 60 patients treated with Basiliximab. The following characteristics were evaluated: concomitant immunosuppression, recipient age, donor age, time on dialysis, cold ischemia time, year of transplantation and HLA mismatches. RESULTS: The 6-year patient survival in the ATG group was 91·7% compared to 85% in the Basiliximab group (not significant, n.s.). Graft survival at 6 years was 89·7% and. 83·6% in the ATG and the Basiliximab group (n.s.), respectively. Incidence of biopsy proven acute rejection episodes (33·3% vs. 26·7%) and delayed graft function (30% vs. 33·3%) were similar in both groups. Kidney function was not significantly different at 1 and 6 years. CMV infections were more prevalent in the ATG arm (22% vs. 5%; P = 0·05), and a significantly higher rate of haematological complications was observed following ATG induction. CONCLUSIONS: ATG induction was associated with an improved (but n.s.) trend in patient and graft survival. Patients induced with ATG had a higher rate of CMV infections and haematological complications.

Symptomatic lymphoceles after kidney transplantation - multivariate analysis of risk factors and outcome after laparoscopic fenestration.

Lymphocele formation is a common complication after kidney transplantation, and laparoscopic surgery has become a widely accepted treatment option. The aim of this retrospective study was to analyze the risk factors of lymphocele development and to assess the treatment outcome after laparoscopic fenestration. We analyzed 426 renal allograft recipients operated between 2002 and 2006 receiving triple immunosuppression with calcineurin inhibitors. The incidence of lymphocele was 9.9%, while 24 (5.6%) patients with symptomatic lymphoceles required laparoscopic surgery. Serum creatinine at diagnosis was significantly higher in patients with lymphoceles treated surgically (3.2 +/- 0.7 vs. 1.7 +/- 0.6 mg/dL; p < 0.001). After successful laparoscopic intervention, creatinine concentrations recovered until discharge and were comparable to other patients (1.6 +/- 0.5 vs. 1.5 +/- 0.5 mg/dL; p = NS). While we observed a significant association of lymphocele formation with diabetes, tacrolimus therapy, and acute rejection in univariate testing, only diabetes remained a significant factor after multivariate analysis. Laparoscopic fenestration proved to be a safe and efficient method without any associated mortality and a low recurrence rate of 8.3% (n = 2). We conclude that diabetes is an independent risk factor for lymphocele development, and laparoscopic fenestration should be the treatment of choice for larger and symptomatic lymphoceles, as it is safe and offers a low recurrence rate.

Serum levels of interleukin-1 receptor antagonist (IL-1ra) in thyroid cancer patients.

BACKGROUND AND AIMS: There is growing evidence that cytokines and their antagonists are important in the pathogenesis of various malignancies. While there are several reports on interleukin-1 receptor antagonist (IL-1ra) gene polymorphism and tissue expression, there is only little data available on the impact of IL-1ra serum levels. Therefore, we performed a prospective study, analyzing IL-1ra in thyroid cancer patients. MATERIALS AND METHODS: We measured preoperative IL-1ra serum levels of 52 consecutive patients with thyroid cancer, 15 with benign adenoma and 27 healthy volunteers. The final histological diagnosis revealed 21 patients with papillary and 8 patients with follicular carcinoma (FTC), while 12 cases of medullary and 11 cases of anaplastic carcinoma (ATC) were observed. RESULTS: Compared to the control group, serum concentrations of IL-1ra were significantly higher in ATC and FTC patients. Concerning gender differences, this effect reached significance only in women with ATC and FTC. Except for the stage IV disease in ATC, there was no correlation between IL-1ra levels and International Union Against Cancer staging. CONCLUSION: The findings of our study indicate that IL-1ra may play an important role in the development of ATC and FTC. Future efforts should focus on the possible application of IL-1ra as a biomarker for the above-mentioned thyroid malignancies.

Normocalcemic, subclinical, asymptomatic primary hyperparathyroidism in patients with goiter or papillary thyroid cancer--preliminary report. Normocalcemic primary hyperparathyroidism and thyroid pathology.

UNLABELLED: The aim of the prospective study was the evaluation of primary, subclinical, normocalcemic hyperparathyroidism (PHPT) incidence in patients, operated on because of non-toxic (NTG), toxic (TG) goiter and papillary thyroid cancer (PTC). MATERIAL AND METHODS: The study was performed in the group of 196 patients operated on NTG (115 patients), TG (43 patients) and PTC (38 patients). All patients had never been operated because of goiter. No patient had clinical symptoms of PHPT. Calcium concentration (Ca), phosphorus concentration (P) and alkaline phosphatase activity (ALP) in blood serum were measured in all patients a day before operation. When those parameters were out of range, parathormone concentration (PTH) in blood serum was measured. In the case of elevated PTH concentration PHPT was diagnosed. Furthermore, in order to exclude renal failure and insufficiency tests for creatinine and urea concentrations in blood serum and urinalysis were performed. RESULTS: There was no case of increased Ca concentration among 158 patients with benign goiter. The values of at least one measured parameters (P or ALP) were abnormal in 47 out of 158 patients with benign goiter (29.7%). Increased PTH concentration (mean 101.5 pg/ml) was in 16 of 47 patients (10.1% of 158 patients). Normocalcemic PHPT was diagnosed in 12 (10.4%) NTG patients and 4 (9.3%) TG patients. In patients with PTC hypercalcemia was not affirmed. In 7 (18.42%) cases of 38 PTC patients P concentration and ALP activity were abnormal. Increased PTH concentration (84.85 pg/ml) was found in one female with PTC with normal values of P and ALP. Incidence of PHPT was observed in 2.63% of PTC patients. CONCLUSIONS: 1. There was no significant difference of PHPT incidence between various type of goiter. 2. In our study coexistence of PTC and normocalcemic, asymptomatic PHPT is rare.

Angiopoietin 1 (Ang-1), angiopoietin 2 (Ang-2) and Tie-2 (a receptor tyrosine kinase) concentrations in peripheral blood of patients with thyroid cancers.

There are limited and conflicting studies investigating the role of the angiopoietin family in human thyroid cancer development and progression. We have investigated cytokines angiopoietin-1, -2 and their receptor (Tie-2), known to be involved in angiogenesis, in the serum of 52 thyroid cancer patients (21 cases of papillary cancers, PTC; 8 follicular cancers, FTC; 12 medullary cancers, MTC and 11 anaplastic cancers, ATC), using ELISA assays. The control consisted of 27 healthy volunteers. Statistically significant lower concentrations of Ang-1 were found in patients with thyroid cancers as compared with the control (p<0.003). The levels of Ang-2 and Tie-2 did not differ significantly between thyroid cancer patients and control. We have also compared the results of Ang-1, Ang-2, and Tie-2 determinations obtained in different histopathological subgroups of cancer patients. These results revealed lower Ang-1 concentrations in ATC (p<0.05), MTC (p<0.02), FTC (p<0.01) and in PTC patients (p<0.05) than control. We have also observed lower Ang-2 concentration in PTC patients (p<0.03) and Tie-2 in FTC patients (p<0.02 ) in comparison to controls. In conclusion, the Angs/Tie-2 system dysfunction may play an important role in thyroid cancerogenesis and decreased concentration of Ang-1 in serum can be a useful additional biomarker for the presence of thyroid cancers.

[Prospective study on incidence of primary hyperparathyroidism in patients with goiter]. / Prospektywna ocena czestosci wystepowania pierwotnej nadczynnosci przytarczyc u chorych z wolem guzowatym.

UNLABELLED: Primary hyperparathyroidismus (PHPT) may coexist with goitre. Measurement of calcium concentration in blood serum is recommended before goiter operation. However, because of subclinical PHPT with normocalcemia this screening is insufficient for diagnosis of all PHPT cases. THE AIM: of the study is prospective evaluation of PHPT incidence in patients operated because of goitre. MATERIAL AND METHODS: The study was performed in group of 158 patients (145 women, 13 men) operated because of non-toxic goitre --115 patients--(SNN) and toxic--43 patients--(SNT). Calcium concentration (Ca), phosphorus concentration (P) and alkaline phosphatase activity (ALP) have been measured in all patients a day before operation. When this parameters has been out of normal range, parathormone concentration (PTH) was measured. PHPT was diagnosed, when PTH has been higher then normal range. Following Ca, P, ALP and PTH measurement was performed 3 months after operation to confirm or exclude the diagnosis of PHPT RESULTS: Values of Ca, P and ALP was out of normal range in 47 (37 with SNN and 10 with SNT) of 158 patients (29,7%). Higher PTH concentration (average 101,5 pg/ml) was in 16 of 47 patients (10, 1% of 158 patients). There was no hypercalcemia in any patient with PHPT PHPT was diagnosed in 12 (10,4%) patients with SNN and 4 (9,3%) with SNT. 12 patients were applied to following screening 3 months after operation. Among this patients value of Ca, P and ALP out of normal range was ascertained in 8 patients (66,7%). In 4 patients was higher PTH concentration. Increased PTH concentration and CA, P ALP concentration in normal range was observed in 1 patient three months after operation. In 5 of 12 (41,7%) patients was confirmed remaining PHPT although operation (average PTH 87,1 pg/ml). CONCLUSIONS: Primary hyperparathyroidismus coexist with similar incidence in patients with SNN and SNT Standard PHPT screening is proper because of PHPT incidence in up to 10% thyroid operated patients.