Pathologic Lymph Node Regression After Neoadjuvant Chemotherapy Predicts Recurrence and Survival in Esophageal Adenocarcinoma: A Multicenter Study in the United Kingdom.

PURPOSE: There is limited evidence regarding the prognostic effects of pathologic lymph node (LN) regression after neoadjuvant chemotherapy for esophageal adenocarcinoma, and a definition of LN response is lacking. This study aimed to evaluate how LN regression influences survival after surgery for esophageal adenocarcinoma. METHODS: Multicenter cohort study of patients with esophageal adenocarcinoma treated with neoadjuvant chemotherapy followed by surgical resection at five high-volume centers in the United Kingdom. LNs retrieved at esophagectomy were examined for chemotherapy response and given a LN regression score (LNRS)-LNRS 1, complete response; 2, <10% residual tumor; 3, 10%-50% residual tumor; 4, >50% residual tumor; and 5, no response. Survival analysis was performed using Cox regression adjusting for confounders including primary tumor regression. The discriminatory ability of different LN response classifications to predict survival was evaluated using Akaike information criterion and Harrell C-index. RESULTS: In total, 17,930 LNs from 763 patients were examined. LN response classified as complete LN response (LNRS 1 ≥1 LN, no residual tumor in any LN; n = 62, 8.1%), partial LN response (LNRS 1-3 ≥1 LN, residual tumor ≥1 LN; n = 155, 20.3%), poor/no LN response (LNRS 4-5; n = 303, 39.7%), or LN negative (no tumor/regression; n = 243, 31.8%) demonstrated superior discriminatory ability. Mortality was reduced in patients with complete LN response (hazard ratio [HR], 0.35; 95% CI, 0.22 to 0.56), partial LN response (HR, 0.72; 95% CI, 0.57 to 0.93) or negative LNs (HR, 0.32; 95% CI, 0.25 to 0.42) compared with those with poor/no LN response. Primary tumor regression and LN regression were discordant in 165 patients (21.9%). CONCLUSION: Pathologic LN regression after neoadjuvant chemotherapy was a strong prognostic factor and provides important information beyond pathologic TNM staging and primary tumor regression grading. LN regression should be included as standard in the pathologic reporting of esophagectomy specimens.

ETS1, nucleolar and non-nucleolar TERT expression in nevus to melanoma progression.

TERT (telomerase reverse transcriptase) is the catalytic component of telomerase. TERT shows little expression in normal somatic cells but is commonly re-expressed in cancers, facilitating immortalization. Recently-discovered TERT promoter mutations create binding sites for ETS-family transcription factors to upregulate TERT. ETS1 is reported to be important for TERT upregulation in melanoma. However it is unclear when in melanoma progression TERT and ETS1 proteins are expressed. To elucidate this question, ETS1 and TERT immunohistochemistry were performed on a panel of benign (n=27) and dysplastic nevi (n=34), radial growth phase (n=29), vertical growth phase (n=25) and metastatic melanomas (n=27). Lesions were scored by percentage of positive cells. ETS1 was readily detectable in all lesions, but not in normal melanocytes. TERT was located in either the nucleolus, the nucleoplasm (non-nucleolar) or both. Non-nucleolar TERT increased in prevalence with progression, from 19% of benign nevi to 78% of metastases. It did not however correlate with cell proliferation (Ki-67 immunostaining), nor differ significantly in prevalence between primary melanomas with or without a TERT promoter mutation. These results demonstrate that ETS1 is expressed very early in melanoma progression, and interestingly only non-nucleolar TERT correlates clearly in prevalence with melanoma progression. It can be acquired at various stages and by mechanisms other than promoter mutations.

Antimicrobial salicylaldehyde Schiff bases: synthesis, characterization and evaluation.

As the pathogens soon develop resistance to the existing antibiotics, the demand for new and more effective anti-microbial agents is a continuous phenomenon. In this paper we are reporting synthesis and spectral data of eight Schiff bases of salicylaldehyde with different amines, and evaluation of their anti-microbial activities against different bacterial strains. The bases were synthesized by reflux method, and their structures were determined based FT-IR, (1)H-NMR, (13)C-NMR and Mass spectrometric data. The Schiff bases synthesized included 2-{[(Z)-(2-hydroxyphenyl) methylidene] amino}benzoicacid (SB1), 4-{[(Z)-(2-hydroxyphenyl) methylidene] amino} benzoic acid (SB2),2-[(naphthalene-2-ylimino)methyl] phenol(SB3),2-2'-[benzene-1,4-diylbis(nitrilomethylylidene)]diphenol (SB4), 2-2'-[benzene-1,2-diylbis (nitrile-(E)-methylylidene)]diphenol (SB5), 2-[(2-phenylhydrazineylidene)methyl]phenol (SB6), 2-2'-[ethene-1,2-diylbis(iminomethanediyl)]diphenol (SB7) and 2-[(Z)-(phenylimino)methyl]phenol (SB8). The anti-microbial activities of synthesized Schiff bases were determined in terms of zones of inhibition and minimum inhibitory concentrations (MICs). All the bases showed moderate to good activities against all the tested microorganisms. The MICs of most compounds were 100-200ßg/mL against different microorganisms. However, it was 50ßg/mL for SB1 against P. aeruginosa (1), SB3 against P. aurantiaca, P. aeruginosa (1), E. coli (2), S. typhi (2) and C. freundii, SB4against E. coli (2), S. typhi (1) and S. maltophilia, SB5 against K. pneumoniae and S. typhi (2), SB6 against P. aeruginosa (3) and C. freundii, SB7 against E. cloacae and A. lipoferum, and SB8 against E. coli (2). Considerably active bases may prove to be potential candidates for future antibiotic drugs.