RESUMEN
BACKGROUND: Fifty tumor specimens from primarily untreated patients were analyzed to elucidate the involvement of the tumor suppressor gene PTEN/MMAC1 in the development of oral squamous cell cancer. METHODS: Eight microsatellite markers, spanning 10 cM of genomic DNA located centromeric, telomeric or intragenic of PTEN/MMAC1 were used for loss of heterozygosity (LOH) and breakpoint analysis. The microsatellite panel within or in close proximity (1 cM) to the 10q23.3 locus showed a LOH rate of 12%. Complete sequence analysis of the genes coding region was performed in all 10 cases that exhibited LOH in one of the eight microsatellite markers within or around the PTEN/MMAC1 gene. Comparative multiplex PCR reactions served to screen for homozygous deletions. RESULTS: There was no association between allelic loss of the gene, overall patient survival and recurrence-free survival. Sequencing did not reveal any mutation in the coding region of PTEN/MMAC1. Differential PCR analysis failed to detect any homozygous deletion. CONCLUSIONS: We conclude that PTEN/MMAC1 gene alterations do not play a key role in tumorigenesis of oral squamous cell cancers.
Asunto(s)
Carcinoma de Células Escamosas/genética , Genes Supresores de Tumor/fisiología , Mutación de Línea Germinal/genética , Neoplasias de la Boca/genética , Monoéster Fosfórico Hidrolasas/genética , Proteínas Supresoras de Tumor/genética , Adulto , Anciano , Anciano de 80 o más Años , Alelos , Centrómero/genética , Cromosomas Humanos Par 10/genética , Supervivencia sin Enfermedad , Femenino , Eliminación de Gen , Marcadores Genéticos/genética , Homocigoto , Humanos , Modelos Lineales , Pérdida de Heterocigocidad/genética , Masculino , Repeticiones de Microsatélite/genética , Persona de Mediana Edad , Recurrencia Local de Neoplasia/genética , Fosfohidrolasa PTEN , Reacción en Cadena de la Polimerasa , Análisis de Secuencia de ADN , Estadística como Asunto , Estadísticas no Paramétricas , Tasa de Supervivencia , Telómero/genéticaRESUMEN
Studies from six regions of Germany (Aachen (W1), Dresden (E1), Jena (E2), Marburg (W2), Munich (W3), and Stuttgart (C1)) have been compared to verify and assess the quality of healthcare using breast cancer as an example. All of the data collection was carried out in comprehensive cancer centres and is population-based, with the exception of C1. Classic prognostic factors and the initial treatment of 8661 women with breast cancer, diagnosed between 1996 and 1998, were examined. Primary therapy, breast conserving therapy (BCT), and the use of subsequent local radiation and/or systemic therapy (chemotherapy or hormonal therapy) were analysed. BCT was performed on 39.3-57.7% of patients. By pT-category, the proportion of BCT in the six regions were as follows: for pTis between 37.8 and 64.3%, for pT1 between 51.7 and 71.5%, for pT2 between 25.9 and 51.1%, for pT3 between 0 and 13.1% and for pT4 between 0 and 15.2%. Multivariate analyses, adjusted for age and biological factors, showed a significant influence of the treating hospital on the mastectomy rate. The use of radiotherapy after BCT (80%) was quite homogeneous in the six regions. The application of radiotherapy after mastectomy, however, varied between 10.4 and 32.2%. In all regions, for premenopausal patients, the use of adjuvant systemic therapy almost reflected the St. Gallen-Consensus recommendations. In contrast, post-menopausal women with positive lymph nodes were not always treated according to these standards. In all regions, age had an influence on the administration of treatment: elderly breast cancer patients received less BCT, less radiotherapy and less adjuvant therapy than recommended in the St. Gallen-Consensus. Feedback of the results was made available to each hospital, providing a comparative summary of patient care that could be used by the participating hospitals for self-assessment and quality-control.
Asunto(s)
Neoplasias de la Mama/terapia , Distribución por Edad , Anciano , Antineoplásicos/uso terapéutico , Neoplasias de la Mama/epidemiología , Neoplasias de la Mama/patología , Recolección de Datos , Femenino , Alemania/epidemiología , Humanos , Mastectomía/métodos , Persona de Mediana Edad , Análisis Multivariante , Garantía de la Calidad de Atención de Salud , Calidad de la Atención de SaludRESUMEN
BACKGROUND: The CHART-bronchus trial sponsored by the Medical Research Council showed an improvement in survival of 10% compared to conventional fractionation to 60 Gy when patients with inoperable non-small-cell lung cancer (NSCLC) were treated with CHART to 54 Gy. At present it is not known whether this survival advantage holds when the dose of conventional treatment is increased and whether CHART can be replaced by the more practicable CHARTWEEL (CHART-weekend less). PROTOCOL OF THE TRIAL: A randomized multicenter trial of definite radiotherapy in locally advanced inoperable NSCLC was designed (ARO 97-1, Arbeitsgemeinschaft Radioonkologie der Deutschen Krebsgesellschaft). Conventional fractionation to 66 Gy (5 weekly fractions of 2 Gy) is compared with CHARTWEEL to 60 Gy (15 weekly fractions of 1.5 Gy, Monday to Friday, interval between fractions > or = 6 hours, overall treatment time 2.5 weeks). The main endpoint of the trial is overall survival. It was calculated that an entry of 665 patients is needed to detect an improvement in 2-year survival of 10%, the actual time is estimated to be 5 years or less. The trial was activated on 1.9.1997.
Asunto(s)
Carcinoma de Pulmón de Células no Pequeñas/radioterapia , Neoplasias Pulmonares/radioterapia , Radioterapia/métodos , Adulto , Carcinoma de Pulmón de Células no Pequeñas/mortalidad , Carcinoma de Pulmón de Células no Pequeñas/patología , Humanos , Neoplasias Pulmonares/mortalidad , Neoplasias Pulmonares/patología , Estadificación de Neoplasias , Selección de Paciente , Dosificación Radioterapéutica , Tasa de Supervivencia , Factores de TiempoRESUMEN
The paper reports on the development of an evaluation system for mammography. It describes the background of programming and points out future development.
Asunto(s)
Mamografía , Sistemas de Información Radiológica , Humanos , Microcomputadores , Programas InformáticosRESUMEN
The prerequisites for the use of electronic data processing apparatuses in the laboratory diagnostics are explained and principal demands are formulated which are to be made to a laboratory organisation system supported by electronic data processing on the side of the clinic. The description of the project "LOL 2" practised at the Medical Academy Dresden deals above all with the demands of the laboratory, the establishment of findings referred to series and patients and their transmission to the requirer using the teleprinting technics. The first step of the practical use of this project is also used in the district hospitals Cottbus and Görlitz. The aim of this development is a comprehensive information system for the communication process between ward and laboratory.