C-reactive protein as a diagnostic and prognostic factor of endometrial cancer.

Endometrial cancer (EC) is the sixth most commonly occurring cancer in women and its morbidity and mortality are continuously increasing. Considering experience with different types of cancers, C-reactive protein (CRP) appears to be a promising diagnostic and prognostic factor. Aiming to investigate its potential in view of EC authors of this paper reviewed databases for metanalysis, randomized controlled trials and review articles. Studies indicate CRP > 3.33 mg/l correlates with the EC incidence with HR = 2.29 (p < 0.05). Moreover, High-sensitivity CRP assay allows to detect CRP in very low concentrations and distinguish patients with endometriosis, soft tissue sarcomas and possibly EC. Perioperational CRP, as well as its changes are independent prognostic factors for EC. However, CRP-to-albumin ratio as well as Glasgow Prognostic Score (GPS) have greater prognostic value that CRP alone. Additionally, CRP is possibly a mediator of carcinogenesis and cancer progression through activation of inter alia FcgRs/MAPK/ERK, FcgRs/IL-6/AKT/STAT3 and FcgRs/NF-κB/NLRP3 pathways.

Evaluation of multiple transcriptomic gene risk signatures in male breast cancer.

Male breast cancer (BCa) is a rare disease accounting for less than 1% of all breast cancers and 1% of all cancers in males. The clinical management is largely extrapolated from female BCa. Several multigene assays are increasingly used to guide clinical treatment decisions in female BCa, however, there are limited data on the utility of these tests in male BCa. Here we present the gene expression results of 381 M0, ER+ve, HER2-ve male BCa patients enrolled in the Part 1 (retrospective analysis) of the International Male Breast Cancer Program. Using a custom NanoString™ panel comprised of the genes from the commercial risk tests Prosigna®, OncotypeDX®, and MammaPrint®, risk scores and intrinsic subtyping data were generated to recapitulate the commercial tests as described by us previously. We also examined the prognostic value of other risk scores such as the Genomic Grade Index (GGI), IHC4-mRNA and our prognostic 95-gene signature. In this sample set of male BCa, we demonstrated prognostic utility on univariate analysis. Across all signatures, patients whose samples were identified as low-risk experienced better outcomes than intermediate-risk, with those classed as high risk experiencing the poorest outcomes. As seen with female BCa, the concordance between tests was poor, with C-index values ranging from 40.3% to 78.2% and Kappa values ranging from 0.17 to 0.58. To our knowledge, this is the largest study of male breast cancers assayed to generate risk scores of the current commercial and academic risk tests demonstrating comparable clinical utility to female BCa.

Predictive value of HPV DNA in lymph nodes in surgically treated cervical carcinoma patients--a prospective study.

OBJECTIVE: High-risk types of HPV are etiological factors in cervical cancer. Lymph node involvement in cervical cancer patients reduces 5-year survival rates by 25-60%. However, the influence on survival of HPV DNA positivity in histopathologically negative lymph nodes remains unresolved. METHODS: The study included 116 of 148 patients who underwent Piver type III radical hysterectomy and pelvic lymphadenectomy and who showed HPV DNA positivity in the primary lesion. Lymph node tissues were tested for the presence of HPV DNA, using a PCR technique. RESULTS: We found the presence of HPV DNA sequences in lymph nodes dissected intraoperatively in 81 (69.83%) cases. In analysis, we compared patients from 3 groups: HPV- and metastatic-negative (LN HPV-M-); HPV-positive metastatic-negative (LN HPV+M-); and metastatic-positive (LN M+). We discovered that survival in groups LN M+ and LN HPV+M- did not differ statistically (p=0.37). However, the survival periods in these two groups differed when compared with LN HPV-M- patients (p<0.001). Using Cox's proportional hazards model, we found that the presence of lymph node HPV DNA, and FIGO stage, and primary lesion volume were independent parameters correlating with survival and mortality risk. CONCLUSION: We conclude that the presence of HPV DNA in lymph nodes is an early sign of metastasis and should be treated as such in prognostic outlook and planning the therapeutic strategy.

[Efficacy and feasibility evaluation in long term pamidronate treatment of bone metastases]. / Ocena skutecznosci i tolerancji dlugotrwalego leczenia pamidronianem przerzutów do kosci.

UNLABELLED: The aim of our study was to evaluate the efficacy and feasibility of long-term pamidronate treatment. MATERIAL AND METHODS: Thirty-six patients (pts) undergoing long-term (> 9 months) pamidronate treatment for bone metastases of breast cancer (30 pts), prostate cancer (3), multiple myeloma (2) and renal carcinoma (1) were retrospectively analyzed. The indication for pamidronate treatment were appearance of bone metastases (21 pts), progression of bone lesions (13) or intolerance of clodronate (2). Pamidronate was administered as an intravenous infusion, most commonly at a dose of 90 mg monthly. Skeletal complications including pathologic fractures, the need for palliative radiotherapy or bone surgery, spinal cord compression and hypercalcemia as well as occurrence of new bone or visceral lesions were assessed. The use of analgesics and subjective bone pain relief were used to evaluate the analgetic effect of pamidronate therapy. Adverse events of pamidronate treatment were noted. RESULTS: Patients received a median of 15 pamidronate infusions (range 9-35). Complete pain control was observed in 7 pts (19%), partial in 21 (58%) and stabilization in 8 (22%). Mean time to maximal effect was 5 months (range 0-17). There were 5 cases (14%) of fever and 6 cases (17%) of flu-like syndrome after pamidronate administration. New bone lesions appeared in 16 pts (44%) after a median of 12 months (range 1-28). Other skeletal complications included pathologic fractures (9 pts, 25%) and hypercalcemia (2 pts, 5.6%); 13 pts (36%) required radiotherapy. Symptomatic progression occurred in 27 pts (75%), with a median progression-free time of 14 months (range 5-35) from the beginning of pamidronate treatment. CONCLUSIONS: Long-term treatment with pamidronate in patients with bone metastases is well tolerated and effective in decreasing bone pain, thus maintaining considerably high quality of life.