Classification of breast carcinomas according to gene expression profiles.

Breast carcinomas represent an important health problem. Understanding the development of breast cancer from precursor is critical for clinical treatment and prevention, however little is known about the molecular events involved in the progression to cancer. The advent of gene expression microarray technology provides a new powerful tool to assist in the determination of diagnosis, prognosis and treatment. In this paper, we present the recent DNA microarray studies that describe how gene expression profiling is being used to classify specimens of breast carcinomas based on molecular properties of the tumor and to identify gene expression patterns related to clinical outcome. In present, data are available that show that gene expression profiles can be used to distinguish cell type-specific gene clusters (stromal, epithelial, mesenchymal and proliferation status) and to classify breast tumors as basal-like, luminal-like, ERBB2 overexpressing and normal breast-like. Profiles associated with good prognosis and poor prognosis of young axillary node negative patients have been identified. The microarray technology will become in the near future a molecular complement to histopathology and immnuhistochemistry.

[Preliminary results for intraperitoneal chemotherapy in abdominal cancers]. / Date preliminare despre chimiohipertermia intraperitoneala (CHIP) în cancerele organelor intraabdominale.

The paper presents a review of the the last 20 years experience of some important oncologic and surgical centers all over the world on IntraPeritoneal Hyperthermic Chemotherapy (IPHC) applied by well known specialists in this domain: Sugarbaker P. (SUA), Takeshi S. (Japan, Elias D. (France), Deraco M. (Italy) and others. Then 20 cases of abdominal cancers with or without peritoneal metastases are presented, in which IPCH was applied using a Romanian apparatus of drainage - lavage with hyperthermic solutions of 5 Fluorouracil, alone or combined with cisplatin, over a 3 years period. The results are encouraging although the follow-up of this group is in progress.

[Preliminary data on post-pancreatectomy diabetes mellitus treated by islet-cell autotransplantation]. / Date preliminare despre tratamentul diabetului postpancreatectomie prin autotransplant de insule pancreatice.

The present study describes the first islet autotransplant program in Romania, and the first 3 cases of subtotal pancreatectomy for chronic pancreatitis combined with islet autotransplant. The primary objective was to pain relief by pancreatic resection, but also to preserve the endocrine function by islet autotransplant. Extensive distal pancreatectomy is effective in relieving pain, but should be limited to patients with small duct disease, in whom more conservative methods have failed, because of severe metabolic consequences. Islets were prepared by Liberase digestion of the excised pancreas, and infused unpurified into the portal vein in one case and in the omental pouch and peritoneum in two cases. All patients were relieved of pain, have achieved insulin independence, and positive C peptide levels, but one patient died of a acute bronchopneumonia 60 days post-transplantation. The mean islet yields were 2100 islet equivalents/Kg body weight. Islet autotransplantation can be considered a useful therapeutic option serving to prevent the occurrence of surgically-induced diabetes. The results have indicate that the omental pouch is a viable site for islet autotransplantation, that can accommodate a large tissue volume, is easy to access to implant, and the IBMIR (instant blood mediated inflammatory reaction) may be less severe.