The effect of hormone receptor status on surgical margin in patients undergoing breast conserving surgery.

AIM: Our aim is to identify the subgroups of women undergoing breast conserving surgery (BCS) who are at high risk for positive surgical margins and who require a re-excision procedure and understand the characteristics of tumor and hormone receptors that will allow surgeons to remove larger margins. MATERIAL AND METHODS: One hundred twenty-nine patients with invasive carcinoma in breast who underwent BCS were included in the study. Women with a positive surgical margin (n = 61) required re-excision procedure. RESULTS: Patients with high grade breast cancer, negative hormone receptor status, high Ki-67 status, upper outer quadrant tumor, and associated ductal carcinoma were more likely to undergo tumor removal and re-excision. CONCLUSION: The pathological and clinical predictors described above that meet these criteria require the removal of larger margins for safety in order to minimize the rate of positive surgical margins. KEY WORDS: Estrogen Receptor, Hormone receptor status, Positive surgical margin.

Efficacy of PET-CT in the prediction of metastatic adrenal masses that are detected on follow-up of the patients with prior nonadrenal malignancy: A nationwide multicenter case-control study.

Metastasis is the second most common type of adrenal gland mass. In patients undergoing follow-up for nonadrenal malignancy, adrenalectomy is performed when metastasis to adrenal gland is suspected on the basis of positron emission tomography-computed tomography (PET-CT) imaging. This study investigated the efficacy of PET-CT in the discrimination of metastatic lesions from nonmetastatic lesions in the adrenal glands. In this multicentric study, data was collected from enrolled centers. Forty-one patients who underwent surgery for suspected adrenal metastases were evaluated retrospectively. The following data types were collected: demographic, primary tumor, maximum standardized uptake value of adrenal mass (a-SUVx) and detectability in computed tomography and/or magnetic resonance imaging, and specimen size and histopathology. Six patients were excluded due to unavailability of PET-CT reports and 4 for being primary adrenal malignancy. The rest were divided into 2 groups (metastatic: n = 17, 55% and nonmetastatic: n = 14, 45%) according to histopathology reports. There was no statistical difference between the analyzed values, except the a-SUVx (P < .05). The a-SUVx cutoff value was defined as 5.50 by receiver operating characteristic curves and compared with literature. There was no statistical difference when each group was divided as low and high (P > .05). It was found that PET-CT was able to discriminate metastatic lesions from primary benign lesions (P = .022). PET-CT can discriminate primary benign lesions and metastatic lesions by cutoff 5.5 value for a-SUVx.

Determination of modifications in rat liver due to phthalate uptake by SAM, RS, and ICP-OES.

The use of phthalates as plasticizers has been omnipresent, especially in cosmetics and food packaging, despite the proven effects on some organs of humans and animals. Therefore, alterations in living organisms due to phthalate exposure attract the attention of many scientists. Here, we demonstrate a mechanical and chemical investigation of the mentioned effects of di(2-ethylhexyl)phthalate (DEHP) and dibutyl phthalate (DBP) on rat liver by utilizing scanning acoustic microscopy (SAM), Raman spectroscopy (RS) and inductively coupled plasma optical emission spectrometry (ICP-OES) for the first time in the literature, as far as we know. The combined analysis gives insights into the degree of modification in the tissue components and which chemicals lead to these modifications. Our study shows that the acoustic impedance values of tissues of DEHP and DBP delivered mother rats are higher than those of tissues of the control mother rat, while the acoustic impedance values of tissues of offspring rats of DEHP and DBP delivered mother rats do not differ significantly from those of tissues of the control offspring rats of the control mother rat. Besides, RS analysis shows how the incorporation of DEHP into liver tissues changes the configuration and conformation of lipids and fatty acids. ICP-OES results show increased element levels within the tissues of DEHP and DBP delivered rats. Therefore, we can say that phthalates cause modifications within the liver. This study is a preliminary effort to investigate tissues with a mechano-chemical probe.

The effect of preoperative 18F-FDG PET on the surgical decision in early breast cancer: 5-Year follow-up.

OBJECTIVE: The diagnosis, treatment, and management of the breast cancer (BC) require a multidisciplinary approach. In newly diagnosed BC, fluorine-18-fluorodeoxyglucose positron emission tomography (18F-FDG PET) can detect extra-axillary regional nodal and distant lesions. SUBJECTS AND METHODS: Between 2010 and 2015, this study included 101 patients with early-stage BC who were examined with 18F-FDG PET before surgery. Patients were divided into two groups: Group 1 consisted of patients with suspected 18F-FDG uptake and Group 2 with the remaining 18F-FDG-negative patients. Differences between these groups were tested using the Pearson chi-square test, Fisher's exact test, Mann Whitney-U test, independent t-test and ROC analysis. They could be followed-up after 2015 for 5 years. All patients were then rediscussed either neoadjuvant therapy or surgery in the oncology board in 2020 with changing neoadjuvant criteria and oncoplastic surgery techniques. RESULTS: Fluorine-18-FDG PET was found to have a sensitivity of 77.8% and a specificity of 90.8% in detecting axillary lymph node metastasis. During the minimum 5-year follow-up, one patient had bone metastasis, 2 patients had a local recurrence, and 3 patients had metastatic lymph nodes in the axilla. In the re-evaluation of the same patients over 5 years, the decrease in mastectomy decision was remarkable (P-value 0.01). CONCLUSION: We observed that we could not achieve a significant difference in 5-year metastasis/recurrence between the groups. Moreover, due to 18F-FDG-PET high false positivity, it significantly extended the time to surgery (P-value 0.01). In early-stage BC, 18F-FDG PET demonstrated better performance in axillary lymph nodes metastases detection in comparison with other diagnostic imaging methods, even if SLNB remains the gold standard technique.

Identification of red blood cell membrane defects in a patient with hereditary spherocytosis using next­generation sequencing technology and matrix­assisted laser desorption/ionization time­of­flight mass spectrometry.

Hereditary spherocytosis (HS) is characterized by the morphological transformation of erythrocytes into a spherical shape due to a hereditary defect in cell membrane proteins (ghosts) associated with disruption of erythrocyte skeletal structures. Contrary to the literature, pores were detected in the erythrocytes of a patient with HS. The aim of the present study was to determine the affected proteins and genes that were responsible for the pores. Ghost isolation was performed to determine the proteins responsible for the pores observed on the erythrocytes of the patient. Erythrocyte membrane proteins were visualized using SDS­PAGE. Exome and matrix­assisted laser desorption/ionization time­of­flight mass spectrometry (MALDI TOF MS) analyses were used to identify the genes and proteins responsible for the observed defect. Quantitative protein assessments were performed using MALDI TOF MS. A difference was detected in the components of the erythrocyte membrane proteins. Band 3 and protein 4.2, which serve a particular role in membrane structure, decreased 4.573 and 4.106 fold, respectively. Through proteomic analyses, a non­synonymous exonic mutation region was identified in the Golgi membrane protein 1 (GOLM1) gene (Chr9 rs142242230). Sorting Intolerant From Tolerant and Polymorphism Phenotyping Scores, Likelihood Ratio Tests and MutationTaster revealed that the mutation was deleterious. The pores observed in the morphology of the erythrocytes may have developed due to the decrease in these proteins, which reside in the erythrocyte membrane structure. Furthermore, genetic profiling of the patient with HS and her family was conducted in the present study. Next­generation sequencing was used, and the genetic source of HS was identified as a GOLM1 gene mutation. The assessment of specific molecular defects is often not performed as the majority of mutations are unique to a family. However, molecular analyses should be performed in severe cases where prenatal diagnosis is required, or for unique HS phenotypes to aid scientific investigation.

iCELLigence real-time cell analysis system for examining the cytotoxicity of drugs to cancer cell lines.

The recently developed iCELLigence™ real-time cell analyzer (RTCA) can be used for the label-free real-time monitoring of cancer cell proliferation, viability, invasion and cytotoxicity. The RTCA system uses 16-well microtiter plates with a gold microelectrode biosensor array that measures impedance when cells adhere to the microelectrodes causing an alternating current. By measuring the electric field generated in this process, the RTCA system can be used for the analysis of cell proliferation, viability, morphology and migration. The present review aimed to summarize the working method of the RTCA system, in addition to discussing the research performed using the system for various applications, including cancer drug discovery via measuring cytotoxicity.