Indirect costs associated with glioblastoma: Experience at one hospital. / Costes indirectos asociados al glioblastoma. Experiencia en un centro.

INTRODUCTION: Glioblastoma is the most common primary brain tumour. Despite advances in treatment, its prognosis remains dismal, with a mean survival time of about 14 months. Many articles have addressed direct costs, those associated with the diagnosis and treatment of the disease. Indirect costs, those associated with loss of productivity due to the disease, have seldom been described. MATERIAL AND METHOD: We conducted a retrospective study in patients diagnosed with glioblastoma at Hospital Universitario Donostia between January 1, 2010 and December 31, 2013. We collected demographics, data regarding the treatment received, and survival times. We calculated the indirect costs with the human capital approach, adjusting the mean salaries of comparable individuals by sex and age and obtaining mortality data for the general population from the Spanish National Statistics Institute. Past salaries were updated to 2015 euros according to the annual inflation rate and we applied a discount of 3.5% compounded yearly to future salaries. RESULTS: We reviewed the records of 99 patients: 46 women (mean age 63.53) and 53 men (mean age 59.94); 29 patients underwent a biopsy and the remaining 70 underwent excisional surgery. Mean survival was 18.092 months for the whole series. The total indirect cost for the series was €11 080 762 (2015). Mean indirect cost per patient was €111 926 (2015). DISCUSSION: Although glioblastoma is a relatively uncommon type of tumour, accounting for only 4% of all cancers, its poor prognosis and potential sequelae generate disproportionately large morbidity and mortality rates which translate to high indirect costs. Clinicians should be aware of the societal impact of glioblastoma and indirect costs should be taken into account when cost effectiveness studies are performed to better illustrate the overall consequences of this disease.

[Unusual presentation of juvenile idiopathic arthritis and autoimmune hepatitis]. / Infrecuente presentación de artritis idiopática juvenil y hepatitis autoinmune.

The coexistence of autoimmune hepatitis and juvenile idiopathic arthritis is very rare. This is the case of an 18 month old female patient whose first sign of disease was torticollis due to an underlying atlanto-axial subluxation. Three months later, bilateral knee arthritis developed and she was diagnosed with Juvenile Idiopathic Arthritis. Throughout the disease a persistent elevation of liver enzymes was noted, combined with positive antinuclear antibodies and hypergammaglobulinemia, reaching the diagnosis of concomitant autoimmune hepatitis.

Home enteral nutrition in Spain; NADYA registry 2011-2012.

OBJECTIVE: To describe the results of the home enteral nutrition (HEN) registry of the NADYA-SENPE group in 2011 and 2012. MATERIAL AND METHODS: We retrieved the data of the patients recorded from January 1st 2011 to December 31st 2012. RESULTS: There were 3021 patients in the registry during the period from 29 hospitals, which gives 65.39 per million inhabitants. 97.95% were adults, 51.4% male. Mean age was 67.64 ± 19.1, median age was 72 years for adults and 7 months for children. Median duration with HEN was 351 days and for 97.5% was their first event with HEN. Most patients had HEN because of neurological disease (57.8%). Access route was nasogastric tube for 43.5% and gastrostomy for 33.5%. Most patients had limited activity level and, concerning autonomy, 54.8% needed total help. Nutritional formula was supplied from chemist's office to 73.8% of patients and disposables, when necessary, was supplied from hospitals to 53.8% of patients. HEN was finished for 1,031 patients (34.1%) during the period of study, 56.6% due to decease and 22.2% due to recovery of oral intake. CONCLUSIONS: Data from NADYA-SENPE registry must be explained cautiously because it is a non-compulsory registry. In spite of the change in the methodology of the registry in 2010, tendencies regarding HEN have been maintained, other than oral route.

Objetivos: Describir los resultados del registro de nutrición enteral domiciliaria (NED) del grupo NADYASENPE de los años 2011 y 12. Material y métodos: Se recopilaron los datos introducidos en el registro desde el 1 de enero de 2011 al 31 de diciembre de 2012. Resultados: Hubo 3021 pacientes en el registro durante el periodo, procedentes de 29 hospitales, lo que da una prevalencia de 65,39 casos por millón de habitantes. 97.95% fueron adultos, 51,4% varones. La edad media fue 67,64 ± 19,1 años y la mediana 72 años para los adultos y 7 meses para los niños. La duración media de la NED fue 351 días y para el 97,5% fue el primer episodio con NED. La mayoría de pacientes tenían NED por una enfermedad neurológica (57,8%). La vía de acceso fue sonda nasogástrica para el 43,5% y gastrostomía para el 33,5%. La mayoría de pacientes tuvieron un nivel de actividad física limitado y, respecto a la autonomía, 54,8% necesitaba ayuda total. La fórmula de nutrición se suministró desde las oficinas de farmacia para el 73,8% y los fungibles, cuando fueron necesarios, desde los hospitales para el 53,8%. La NED se suspendió en 1.031 pacientes (34,1%) durante el periodo de estudio, 56,6% debido a fallecimiento y 22,2% debido a recuperación de la vía oral. Conclusiones: Los datos del registro NADYA-SENPE deben ser interpretados con precaución ya que se trata de un registro voluntario. A pesar del cambio de metodología del registro en 2010, las tendencias en NED se han mantenido, salvo la importancia cuantitativa de la vía oral.

Multiprotein deposits in neurodegenerative disorders: our experience in the tissue brain bank of Navarra.

The prevalence of neurodegenerative disorders increases dramatically with advancing age. Although in recent decades the study of many neurodegenerative disorders has evolved greatly, the concept of neurodegeneration still remains elusive. Although neurodegenerative disorders are classified according to the major components of protein deposits, coexpression of several abnormal proteins in the brain tissue is more common than that was previously thought. The aim of this report is to describe the type of protein deposits found in brains with neuropathological diagnosis of neurodegenerative disease. The report shows the experience obtained in the Brain Bank of Navarra (Spain). The target population for this retrospective descriptive study comprised 178 brains autopsied in the "Hospital of Navarra" in Pamplona between 1994 and 2004 and 201 brains donated to the Brain Bank of Pamplona between 2004 and 2009. The diagnosis of the 201 brains from the Brain Bank was 62 (30.8%) Alzheimer's disease (AD), 43 (21.3%) multiprotein deposit, 31 (15.4%) α-synucleinopathies, 31 (15.4%) frontotemporal lobar degeneration (FTLD), 17 (8.4%) tauopathies, 9 (4.4%) prion disease, 6 (2.9%) vascular dementia (VD), and 2 (0.9%) Huntington's disease. Among the 43 cases with multiprotein deposits, we found 35 brains with deposits of 3 proteins (tau, ß-amyloid, and α-synuclein). In these two series of brains, the high incidence of deposition of multiple proteins in neurodegenerative disorders is shown. Our results are in agreement with previous findings showing that tau, ß-amyloid, and α-synuclein are the proteins most frequently deposited together.

Papel de la difusión en la evaluación de los meningiomas: correlación radiopatológica / The role of diffusion-weighted imaging in the evaluation of meningiomas: radio-pathologic correlation

Objetivo: Estudiar el comportamiento de los meningiomas en secuencias de difusión y su correlación histopatológica. Material y métodos: Se incluyeron prospectivamente pacientes operados de meningiomas durante 2 años en nuestro hospital. Se estudiaron 30 meningiomas en 28 pacientes entre 31 y 85 años. Todos los pacientes fueron estudiados en una unidad de resonancia magnética de 1,5T antes de la intervención, incluyendo imágenes potenciadas en difusión (IPD). La intensidad de señal se valoró en imágenes potenciadas en T2, IPD (b=1.000) y mapas del coeficiente de difusión aparente (CDA), dentro del tumor y en la sustancia blanca parietal como referencia. En el estudio histopatológico se analizaron la celularidad, el índice de proliferación, el grado histológico y la invasión cerebral. Resultados: De los 30 meningiomas, 22 fueron grado I de la Organización Mundial de la Salud y 8 atípicos o grado II. El valor medio del CDA fue 89.19±13,95×10–3mm2/s. En el grupo de meningiomas atípicos fue de 82±13,69×10–3mm2/s, y en el grupo de típicos de 92,21±13,21×10–3mm2/s. No se encontraron diferencias estadísticamente significativas entre los 2 grupos. Dos subtipos de meningiomas típicos, los secretores y el angiomatoso, presentaron los valores más altos en los mapas CDA. En el análisis histológico se observó una asociación significativa entre la celularidad tumoral y la señal en el mapa CDA. Conclusión: Los meningiomas presentan una restricción moderada de la difusión. La señal en el mapa CDA se asocia con la celularidad tumoral pero no se ha demostrado su utilidad para predecir el grado histológico (AU)

Objectives: To describe the ultrasonographic findings in liver abscesses after the administration of a second generation agent. To perform the differential diagnosis of liver abscesses with other focal liver lesions. Material and methods: We evaluated 28 liver abscesses in 5 patients before and after the administration of SonoVue. We also evaluated liver lesions in six patients in whom the differential diagnosis with liver abscess was considered in the baseline ultrasonographic examination. Results: A typical enhancement pattern consisting of peripheral ring enhancement in the arterial phase and absence of central enhancement was observed in 21 (75%) abscesses. In another 6 (21.4%) abscesses, arterial enhancement was seen in large areas of the lesion, while other areas showed no uptake. One case (3.6%) had a multiseptated pattern of enhancement. Segmental hepatic enhancement was observed in 6 abscesses. In the liver lesions in which the differential diagnosis with abscess was carried out, 5 of the 6 showed no enhancement in any phase. The other lesion, a cystic metastasis, had irregular peripheral enhancement in the arterial phase. None of these lesions had segmental hepatic enhancement in the arterial phase. Conclusions: Contrast administration improves the performance of ultrasonography in the diagnosis of liver abscesses. There are three patterns of enhancement and these correlate well with the findings at CT and MRI. Contrast-enhanced ultrasonography is very useful for defining the internal architecture of the abscess, which is important for choosing the type of treatment. Contrast-enhanced ultrasonography also enables the differential diagnosis with other focal liver lesions (AU)

[The role of diffusion-weighted imaging in the evaluation of meningiomas: radio-pathologic correlation]. / Papel de la difusión en la evaluación de los meningiomas: correlación radiopatológica.

OBJECTIVE: To study the behavior of meningiomas in diffusion-weighted sequences and the correlation of these findings with the histological findings. MATERIAL AND METHODS: We prospectively included all patients operated on for meningiomas at our hospital during two years. We studied 30 meningiomas in 28 patients aged 31 to 85 years old. All patients underwent MRI prior to surgery, including diffusion-weighted sequences, in a 1.5 T scanner. We evaluated the signal intensity in T2-weighted images, diffusion-weighted images (b=1,000), and apparent diffusion coefficient (ADC) maps within the tumor and in the parietal white matter as a reference. In the histological study, cellularity, proliferation index, histological grade, and cerebral invasion were evaluated. RESULTS: Of the 30 meningiomas, 22 were World Health Organization (WHO) grade I and 8 were atypical or WHO grade II. The overall mean value of the ADC was 89.19+/-13.95x10(-3) mm2/s; the mean ADC value was 82+/-13.69x10(-3) mm2/s in the atypical group and 92.21+/-13.21x10(-3) mm2/s in the typical group. No statistically significant differences were found between the 2 groups. Two subtypes of typical meningiomas, secretory and angiomatous meningiomas, had the highest values in the ADC maps. In the histological analysis, there was a significant association between tumor cellularity and the signal in the ADC map. CONCLUSION: Meningiomas show moderately restricted diffusion. The signal on the ADC map is associated with tumor cellularity but we have not demonstrated its usefulness for predicting the histological grade.

Danon disease: a novel Lamp-2 gene mutation in a family with four affected members.

This is a report of a family with four members affected with Danon disease and variable clinical presentations, including cardiomyopathy, skeletal muscle pathology, and hepatopathy. Analysis by electron microscopy of the quadriceps muscle from the proband and his brother showed abnormal mitochondria, and immunohistochemistry revealed no expression of LAMP-2 protein. This defect is due to a yet undescribed mutation located at the second nucleotide in the intron 8 of the Lamp-2 gene (c.1093+2 T>A) that generated exon 8 skipping confirmed at RNA level in the proband.

A patient with MV2 subtype of sporadic Creutzfeldt-Jakob disease and atypical clinical presentation.

We report the case of a 71-year-old woman with progressive dementia over the course of 4 years, characterized by prominent pyramidal signs and by the lack of ataxia and other cerebellar signs. Creutzfeldt-Jakob disease (CJD) was not suspected during the patient's life. Autopsy brain tissue showed severe spongiform encephalopathy with kuru-like, but not florid, plaques in neocortex and cerebellum. Massive synaptic diffuse and plaque-like PrP(Sc) deposition was found in the cerebral cortex, striatum, cerebellum and brainstem. Genetic analysis revealed no PRNP gene mutations and methionine/valine heterozygosity (MV) at codon 129. The pathogenic scrapie prion protein (PrP(Sc)) pattern detected by Western blot was Type 2. However, this pattern showed a single unglycosylated band in contrast to the doublet described for MV2 subtype of sCJD with kuru plaques. In summary, this is an autopsy case report of a particular presentation of MV2 subtype of sCJD.

Propuesta de formación de equipo de terapia intravenosa / Proposal for the formation on an intravenous therapy team

Actualmente la medicina está logrando, no solo que los enfermos vivan más años, sino que tengan una mejor calidad de vida, a ser posible dentro del ámbito familiar. Esto entraña un estudio serio de la situación. Muchos de los pacientes podrán recibir tratamiento endovenoso ambulatorio siempre que se cuente con un sistema fiable de administración del mismo, que dé seguridad y confort al enfermo, y facilidad a los profesionales que lo administran

çat the present time, the medical profession is succeeding not only in helping the sick live longer but to have a higher quality of life, if possible inside their family environment. This requires a serious study regarding this situation. MAny patients can receive intravenous treatment in outpatient clinics whenever these have a trustworthy system to administer intravenous pharmaceuticals, a system which provides safety and comfort to the patient and ease to the professionals which administer it

[Metanephric stromal tumor: report of two cases and bibliographic review]. / Tumor del estroma metanéfrico: presentación de dos casos en adultos y revisión de la literatura.

OBJECTIVE: Metanephric Stromal Tumors (MST) are pediatric renal neoplasms not very common in adults. This study revises its classification, incidence and evolution and also some specific characteristics of the cases diagnosed in adults. METHODS: We present two cases of MST diagnosed in adults of 72 and 77 years old respectively. Abdominal pain due to a more than 4 Kg. mass was the initial presentation in both cases. The tumors were completely resected. Four and ten years after excision patients are alive without disease. RESULTS: Characteristic histologic features include a proliferation of fusocellular cells with alternating cellularity that imparts a nodular appearance and onion-skin cuffing around entrapped renal tubules or vascular structures. No mitoses or atypia was found but extensive necrosis and fibrosis were present. A majority of stromal cells were vimentine and CD-34 positive. Stains for CK and EMA highlighted entrapped native tubules. Both cases were previously classified as mesoblastic nephromas. According to the 2002 ONS classification of tumours of the urinary system, they have been revised and re-classified as MST CONCLUSION: MST are pediatric benign tumors exceptionally diagnosed in adults. Metanephric stromal tumors are divided into 3 categories based on the presence of epithelial cells, stroma and epithelial cells plus stromal. Complete excision is the treatment of choice and the prognosis is excellent.

[Proposal for the formation of an intravenous therapy team]. / Propuesta de formación de equipo terapia intravenosa.

At the present time, the medical profession is succeeding not only in helping the sick live longer but to have a higher quality of life, if possible inside their family environment. This requires a serious study regarding this situation. Many patients can receive intravenous treatment in outpatient clinics whenever these have a trustworthy system to administer intravenous pharmaceuticals, a system which provides safety and comfort to the patient and ease to the professionals which administer it.

Self-awareness after acquired brain injury--predictors and rehabilitation.

OBJECTIVE: To investigate the factors contributing to deficit in self-awareness following acquired brain injury and to study change in self-awareness during a group support program. METHODS: Sixty-two patients (mean age: 35.4 +/- 15.3 years) attending our Service (295 +/- 525 days after injury) were included in the study (41 of them had sustained a head injury). Thirty-six patients were admitted to a multidisciplinary rehabilitation program including a group support program designed to improve self-awareness deficits. All patients were assessed with the Patient Competency Rating Scale as a measure of self-awareness and with a broad range of neuropsychological tests, checklists of psychopathological symptoms, and several functional scales. RESULTS: Thirty patients showed high levels of self-awareness while 32 showed impaired self-awareness. Patients with appropriate perception of their deficits showed less psychopathological symptoms, better neuropsychological function and higher functional independence than those with impaired SA (Student's t test, p < 0.05). Both groups improved, but with different patterns, after rehabilitation (MANOVA, p < 0.05). Multiple regression analysis revealed that cognitive status was predictive of level of self-awareness. CONCLUSION: The level of self-awareness after acquired brain injury is a useful prognostic index of the neuropsychological, psychopathological and functional status of the patient. We recommend the evaluation of this symptom after acquired brain injury due to its clinical relevance.

[Intelligence and prognosis in severe traumatic brain injury: a neuropsychological study with the Wechsler adult intelligence scale (WAIS-III)]. / Pronóstico e inteligencia en los traumatismos craneoencefálicos graves: estudio neuropsicológico mediante el test de inteligencia de Wechsler para adultos (WAIS-III).

OBJECTIVE: To evaluate the utility of the Wechsler adult intelligence scale III (WAIS-III) as a measure of intelligence after severe brain injury, and to elucidate prognostic factors associated with intelligence coefficients (IQs). METHODS: Forty-six patients (age: 27.4 +/- 12.8 years) attending our service after a severe head injury were included in our study (chronicity: 315.3 +/- 330 days after injury). All patients were assessed with the WAIS-III. WAIS-III IQs were correlated (Pearson and Spearman) with clinical and demographic data. A significance level of p < 0.05 was used in all comparisons. IQs between 1 and 2 standard deviation (SD) below normative data were considered "mild abnormal" while indexes below 2 SD were considered "abnormal". RESULTS: Only eleven patients (25 %) showed normal total IQ with predominance of manipulative (77.7 %) compared to verbal (64.5 %) impairment. Thirty-eight patients (95 %) had difficulties in speed processing, thirty-six (85.6 %) had problems with working-memory, twenty-five (62.5 %) showed impairments in perceptual organization, and twenty-six (62 %) had verbal comprehension deficits. WAIS-III IQs showed significant correlations with length of coma and posttraumatic amnesia duration (p < 0.05). CONCLUSIONS: The WAIS-III is a valid and sensible tool to detect cognitive deficits associated with brain injury. Almost all patients with severe brain injury show abnormal IQs with a slow processing speed as predominant symptom. Length of coma and posttraumatic amnesia seems to be the most relevant parameter related to intelligence in severe brain-injured patients.

[Intelligence, memory and malingering: correlation between scales]. / Inteligencia, memoria y simulación: correlaciones entre instrumentos de medida.

OBJECTIVES: To validate the test of memory malingering (TOMM), and to study the influence of intelligence and memory on its performance in brain injury patients. PATIENTS AND METHODS: A total of 30 patients with traumatic head injury were included in the study. All patients were assessed with the Complutense verbal learning test, the Visual Reproduction subtest of the Wechsler memory scale-revised, the Boston naming test, two fluency tests (FAS, and animals), the Wechsler adult intelligence test-III, and with the TOMM. Cognitive results below 1 standard deviation (SD) from normative data were considered 'abnormal'. A parametric correlation between TOMM scores and cognitive tests was used to detect whether memory and intelligence were affecting TOMM performance. Statistical significance was set up at p<0.05. RESULTS: Between 46.1% (Boston) and 81.4% (WAIS-III performance IQ) of the sample presented cognitive deficits. Up to 83.3% of the patients scored above the cutoff point suggestive of malingering in the TOMM (45/50). Significance correlations were found between TOMM scores and memory or intelligence indexes. DISCUSSION: The TOMM is a useful tool to detect malingering in head injured patients. Effects of low intelligence coefficients, as well as memory deficits should be considered in clinical practice when evaluating patients with TOMM scores suggestive of malingering.

[Anoxic encephalopathy. Clinical description, prognosis and neuroimaging]. / Encefalopatía anóxica. Descripción clínica, pronóstico y neuroimagen.

OBJECTIVES: To describe the clinical profile (neuropsychological, psychopathological, functional and neuroimaging), as well as the evolution of patients with anoxic encephalopathy. PATIENTS AND METHODS: Nine patients with anoxic encephalopathy attending our Service were included in the study. All patients were assessed with a broad range of neuropsychological tests, checklists of psychopathological symptoms, and several functional scales. A CT/MRI or a positron emission tomography (PET) were performed in five patients. Five patients were admitted to a multidisciplinary rehabilitation program. RESULTS: All patients showed problems in orientation, executive functions, verbal learning an immediate and long-term verbal memory, in association with diffuse cognitive changes in other functions. Psychopathologically, all patients showed apathy-indifference, and eight subjects showed anosognosia. All subjects have an important dependence in daily activities. CT/MRI were normal or showed subcortical changes whereas the PET showed a predominantly cortical hypometabolism with specific patterns. There were no significant improvements after rehabilitation in treated patients. CONCLUSION: In the absence of a unique clinical profile, our patients with anoxic encephalopathy showed similarities in their symptoms (diffuse cognitive deficits with predominance of amnesic and executive impairments; presence of apathy and anosognosia; complete functional dependence; and poor response to the rehabilitation). Functional neuroimaging could be a useful tool for a better understanding of these encephalopathies.

Banco de tejidos neurológicos destinados a la investigación en neurociencias. Una realidad en Navarra / Neurological tissue bank for research in neuroscience. A reality in Navarre

No disponible

[Primary low-grade non-Hodgkin's B lymphoma mimicking meningioma]. / Linfoma dural primario no Hodgkin B de bajo grado simulando un meningioma.

Primary dural lymphomas are rare. Usually they present themselves as diffuse lesions and are infrequently well-delimited. We present a 44 year old male, who was admitted into our Centre after a generalised seizure. Neuroimage studies (CT scan, MRI and angiography) were performed, demonstrating a right hemispheric well-delimited extra-axial mass, being diagnosed initially as meningioma. The patient underwent surgery with radical scission of the mass and dural margins. Histopathological diagnosis was Non-Hodgkin B-Cell lymphoma (marginal B-Cell lymphoma), which nowadays is considered as MALT lymphoma (Mucosa Associated Lymphoid Tissue). Studies directed to establish tumour extension didn't demonstrate the existence of another lesions in the organism.

Linfoma dural primario no Hodgkin B de bajo grado simulando un meningioma / Primary dural low grade non-Hodgkin B cell-lymphoma mimicking meningioma

Los linfomas meníngeos primarios son muy poco frecuentes, presentándose como lesiones difusas y siendo muy infrecuentes las masas bien delimitadas. Presentamos el caso de un paciente varón de 44 años de edad, que ingresa de Urgencias por presentar una crisis convulsiva generalizada. Se realizaron estudios de neuroimagen consistentes en TC, RNM y angiografía cerebral, que demostraron la presencia de una tumoración extraaxial bien delimitada en convexidad derecha, siendo el diagnóstico sospechado meningioma y siendo intervenido quirúrgicamente, con resección completa de la lesión y márgenes durales. El diagnóstico histopatológico correspondió a un linfoma B no Hodgkin de bajo grado (linfoma de células de zona marginal), actualmente considerado como linfoma MALT (Mucosa Associated Lymphoid Tissue). Los estudios destinados a establecer una extensión tumoral no demostraron la existencia de otras lesiones en el organismo (AU)

[New cytogenetic prognostic markers in breast cancer]. / Identificación de nuevos marcadores citogenéticos con valor pronóstico en cáncer de mama.

BACKGROUND: The aim of this study was to identify chromosomal imbalances in a series of invasive ductal carcinomas. In order to characterize the prognostic value of the chromosomal aberrations, we determined the association between genetic changes, overall survival, recurrences and some well-known prognostic and diagnostic parameters. MATERIAL AND METHODS: We included in this study 70 ductal invasive carcinomas diagnosed at the Hospital of Navarra during 1991-1994. We used the Comparative Genomic Hybridization Technique (CGH) for the molecular cytogenetic analysis of formalin-fixed, paraffin embedded specimens. RESULTS: We obtained successful results in 57 out of 70 cases (81.4%). The most frequent recurring findings were DNA gains on 8q, 17q, 1q, 20q, 11q and 6q and losses on 16q, Xp, Xq, 13q, 11q and 8p. In the survival study, gains on 1q and 11q13 were more frequent in patients with recurrence (41.3% vs. 18.5% and 50% vs. 23.7%). Loss of 16q appears as a prognostic factor of good outcome because of its association with good pathological prognostic features: 100% of tumors with this aberration showed overexpression of Bcl-2, and 75% of them were node negative. Besides, 46.7% of the positive cases for the expression of estrogen receptors also showed this imbalance. CONCLUSIONS: The CGH is a useful technique for the study of paraffin embedded tumors. Our results confirm that the cytogenetic aberrations of tumors could be considered as prognostic factors contributing to a better knowledge of tumor outcome.