RESUMO
OBJECTIVE: To investigate the expression of oncoprotein c-erbB2 in primary breast cancer and to analyze its relation to its prognosis. METHODS: Immunohistochemical staining for c-erbB2 was performed on paraffin-embedded specimens of primary breast cancer from 284 patients, and the relation to its prognosis was statistically analyzed. RESULTS: Positive expression rate of c-erbB2 was 26.8% (76/284) in 284 primary breast cancer patients. Expression of c-erbB2 was positively correlated with the status of lymph node metastasis (P = 0.003). Univariate analysis indicated that c-erbB2 expression is a significant prognostic factor for the disease-free survival (DFS) (P = 0.024) and overall survival (OS) (P = 0.002), while multivariate analysis demonstrated that c-erbB2 is an independent prognostic factor for OS (P = 0.023). Moreover, tumors with c-erbB2 positive expression are more tend to metastasis to other viscera than those with c-erbB2 negative. c-erbB2 expression has different prognostic values for patients with different status of estrogen receptor (ER) and lymph node metastasis. CONCLUSION: c-erbB2 expression is an independent prognostic factor for total survival time in primary breast cancer patients, and its prognostic values are different according to the different ER status and lymph node metastasis.
Assuntos
Neoplasias da Mama , Carcinoma Ductal de Mama , Receptor ErbB-2/metabolismo , Adulto , Idoso , Neoplasias da Mama/metabolismo , Neoplasias da Mama/patologia , Neoplasias da Mama/terapia , Carcinoma Ductal de Mama/metabolismo , Carcinoma Ductal de Mama/patologia , Carcinoma Ductal de Mama/terapia , Quimioterapia Adjuvante , Intervalo Livre de Doença , Feminino , Seguimentos , Humanos , Metástase Linfática , Mastectomia Radical , Pessoa de Meia-Idade , Prognóstico , Modelos de Riscos Proporcionais , Radioterapia Adjuvante , Receptores de Estrogênio/metabolismo , Taxa de SobrevidaRESUMO
The purpose of this study was to investigate the effect of different concentrations of desflurane on jugular bulb gases and jugular bulb pressure (JBP) and to determine an optimal concentration of desflurane in neurosurgical patients with supratentorial tumor. Twenty-two patients were anesthetized with desflurane in oxygen. Radial arterial and jugular bulb catheters were inserted for blood gas sampling and direct blood pressure measurement after anesthesia. Mean arterial blood pressure (MAP), heart rate (HR), and JBP were monitored continuously. Arterial and jugular bulb blood gases were measured at 0.7 minimum alveolar contraction (MAC) (4.2%), 1.0 MAC (6%), and 1.3 MAC (7.8%) of desflurane randomly after a 30-minute stabilization period, respectively. Jugular bulb oxygen saturation (S(J)O2) significantly increased and cerebral arteriojugular difference of oxygen content (A(J)DO2) and oxygen extraction ratio (O2ER) significantly decreased from 0.7 MAC to 1.0 MAC of desflurane, but there was no further increase in S(J)O2 nor further decreases in A(J)DO2 and O2ER at 1.3 MAC compared with 1.0 MAC desflurane. There was a significant dose-related decrease in MAP from 0.7 MAC to 1.3 MAC of desflurane, but JBP did not change significantly. No significant change in hour was observed in the study. It is concluded that 1.0 MAC is a suitable concentration of desflurane in neurosurgery with an improved balance between cerebral oxygen supply and demand.