ABSTRACT
INTRODUCTION: We report on the prognostic role of cross sectional area (CSA) enlargement and axonal damage in traumatic sural neuropathy (TSN). METHODS: Reference values were defined in 23 healthy subjects. 13patients with TSN underwent evaluation (Thessaloniki Hypesthesia Score (THS), ultrasound, electrophysiology). All patients were followed up with THS 6â¯months after initial evaluation. RESULTS: During initial evaluation, the 13 patients showed a mean THS of 2.6 (SD⯱â¯0.9). 7 patients showed pathological (pUS) and 6 normal CSA (nUS). 8 patients showed axonal affection (pCS) and 5 no axonal affection (nCS). During follow up, mean THS was 3.1 (SD⯱â¯0.9) in pUS, and 1.8 (SD⯱â¯0.7) in the nUS group (pâ¯<â¯0.001). Mean THS was 2.8 (SD⯱â¯0.7) in pCS, and 2.1 (SD⯱â¯0.9) in nCS group (pâ¯=â¯0.035). DISCUSSION: CSA enlargement, but not axonal loss, seems to have a negative prognostic role in patients with TSN.
Subject(s)
Peripheral Nerve Injuries/diagnostic imaging , Sural Nerve/diagnostic imaging , Ultrasonography/methods , Adult , Female , Humans , Male , Middle Aged , Muscle, Skeletal/diagnostic imaging , Muscle, Skeletal/innervation , Muscle, Skeletal/physiopathology , Neural Conduction , Peripheral Nerve Injuries/physiopathology , Predictive Value of Tests , Sural Nerve/injuries , Sural Nerve/physiopathology , Ultrasonography/standardsABSTRACT
PURPOSE: The objective of this study was to examine the association of EZH2 and paxillin expression and DNA ploidy status with pathological parameters of breast cancer, aiming to correlate tumor phenotype with its malignant behavior. METHODS: EZH2 and paxillin expression and DNA ploidy were evaluated in imprint smear samples obtained from 105 breast tumors after surgical removal. RESULTS: Increased expression of paxillin was associated with p53 expression (p=0.005), Ki-67 expression (p=0.018) and EZH2 expression (p<0.0001). EZH2 expression correlated with estrogen receptor (ER) and progesterone receptor (PR) status (p=0.01 and p=0.035, respectively), and expression of p53 and Ki-67 (p=0.007 and p<0.0001, respectively). Aneuploid tumors were significantly correlated with poor differentiation (p=0.000), stage of disease (p=0.000), size of the primary tumor (p=0.015), presence of nodal metastasis (p=0.001), ER status (p=0.008), cerbB2 status (p=0.012), and expression of Ki-67 (p=0.001) and EGFR (p=0.018). Multivariate analysis of ploidy results using paxillin and EZH2 expression as dependent variables revealed that aneuploid tumors were associated with disease stage and grade of differentiation, cerbB2 expression and EZH2 expression. CONCLUSION: Our results show that aneuploid tumors, EZH2 expression and paxillin expression correlate with more aggressive phenotype of breast cancer.
Subject(s)
Biomarkers, Tumor/analysis , Breast Neoplasms/chemistry , Breast Neoplasms/genetics , Carcinoma, Ductal, Breast/chemistry , Carcinoma, Ductal, Breast/genetics , Carcinoma, Lobular/chemistry , Carcinoma, Lobular/genetics , Paxillin/analysis , Ploidies , Polycomb Repressive Complex 2/analysis , Breast Neoplasms/pathology , Carcinoma, Ductal, Breast/pathology , Carcinoma, Lobular/pathology , Cell Differentiation , Chi-Square Distribution , Enhancer of Zeste Homolog 2 Protein , Female , Humans , Logistic Models , Lymphatic Metastasis , Multivariate Analysis , Neoplasm Grading , Neoplasm Staging , Phenotype , Prognosis , Risk Factors , Tumor BurdenABSTRACT
BACKGROUND: Aromatase Inhibitor (AI) induced arthralgia is one of the most frequent side effects in breast cancer hormonal therapy, which may become severe in some cases affecting patients' quality of life. The purpose of this study is to investigate alternative treatment of arthralgia, as current treatment options may often prove to be inadequate. MATERIAL-METHODS: According to Morales et al, AI-associated arthralgia syndrome is characterized by tenosynovial changes in MRI, including fluid in tendon sheaths and joints. Initially, furosemide (20 mg per two days) was prescribed by our team, in order to minimize peripheral edema in women receiving aromatase inhibitors. The data collected demonstrated that 16 out of 18 patients had benefited from the addition of a diuretic agent in their adjuvant AI treatment as far as AI induced arthralgia is concerned as well. In this retrospective study, data from 288 women receiving an AI for non-metastatic breast cancer are analyzed in order to define whether chronic diuretic therapy could affect the impact of arthralgia on those patients. RESULTS: 42/288 Patients were receiving chronic diuretic therapy for heart disease or hypertension (Group A), while 246/288 patients had never received any diuretic medication (Group B). At 43.03 months of mean follow up, in Group A arthralgia was developed in 3/42 patients (6.97%) as opposed to 39/246 patients in Group B (15.85%) -p value: 0.01. Other parameters that could affect the impact of arthralgia in both Groups are also analyzed and taken under consideration. CONCLUSION: Despite the low number of patients and the retrospective nature of the study, there was a clear trend to a lower incidence of arthralgia in patients receiving chronic diuretic therapy. We believe that based on this hypothesis generating study further research should be done to assess the value of diuretic agents in the treatment of AI-associated arthralgia.
