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Background: Breast cancer is one of the most common malignant forms of neoplasia worldwide; programmed death protein 1 (PD-1), an inhibitory receptor of T lymphocytes, and its ligand programmed death ligand 1 (PD-L1), play an important role in the ability of tumor cells to evade the host's immune system. Methods: We conducted a descriptive, observational study using retrospective data and an open evaluation using immunohistochemistry to determine the general prevalence of PD-L1 expression in 63 women with breast cancer who underwent a modified radical mastectomy, or quadrantectomy, with axillary lymph node removal. Results: The prevalence of PD-L1 expression was 32% in patients with breast cancer treated with radical mastectomy. PD-L1 expression was higher in patients with large tumor size (19% for pT1, 37% for pT2, 50% for pT3, and 100% for pT4), metastasis in regional lymph nodes (25% for N0, 38% for N1, 75% for pN2, and 38% for pN3), and higher histological grade carcinoma (0% for grade 1, 23% for grade 2, and 50% for grade 3). Conclusions: These findings suggest that PD-L1 expression is heterogeneous in breast cancer tumors and that its expression varies highly in tumor regions over time. The evaluation of PD-L1 expression is significant, because of the therapeutical implications that could improve the outcomes and prognosis of these patients.
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Background: In Mexico, about 30% of renal cancer patients are diagnosed in a metastatic state. Despite the recent advances in the treatment of cancer, metastatic renal cancer is still an incurable illness. Thus, identifying prognostic factors helps improve prognosis accuracy and survival prediction for patients. Methods: In this study, we retrospectively analyzed 26 patients with histological diagnosis of renal cell carcinoma, including clear cell and other subtypes in stage IV (metastatic), recurrent or unresectable disease. We performed a multivariate analysis of overall survival regarding the congruity between prognostic scales. Results: Our results showed a significant difference in favor of patients with congruity between scales for progression-free survival (18.9 vs. 3.1 months; P = 0.048) and a tendency towards better overall survival in patients with the congruity of both scales compared to the discordant patients (112 vs. 32 months; P = 0.99). Conclusion: This study highlights the discordance between Memorial Sloan-Kettering Cancer Center and International Metastatic Renal Cell Carcinoma Database Consortium scales, which was associated with worse prognosis with a significant difference in progression-free survival but not in overall survival.
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BACKGROUND: To date, the prognostic value of laterality for testicular germ cell tumors remains unknown. Herein, we describe this prognostic factor in the Mexican population. METHODS: A retrospective single-center study that included 37 patients with primary testicular germ cell tumors was conducted. Primary outcome was recurrence-free survival (RFS) at 2 years. Secondary outcomes were RFS by histology, progression-free survival by laterality, and 2-year overall survival. RESULTS: Thirty-seven patients were included, of which five showed relapses. By laterality, the 2-year RFS rate was 100% for left tumors and 77.3% for right tumors, with a trend toward statistical significance (P = 0.058). By histology, the RFS rate was higher for seminomas than non-seminomas (89% vs. 83%, respectively) without this difference being statistically significant. Progression-free survival was higher for right tumors than left tumors (91% vs. 80%, respectively) but without reaching statistical significance. The overall survival rate for the entire cohort was 94.5%. CONCLUSIONS: Our study shows that patients with primary germ cell tumors of the right testicle have a higher risk of recurrence than those with primary germ cell tumors of the left testicle, with a trend toward statistical significance.
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Resumen La enfermedad celíaca (EC) es un padecimiento sistémico con base inmunológica caracterizado por la intolerancia al gluten. La prevalencia mundial se ha reportado aproximadamente en 1%. El diagnóstico depende de la sintomatología, pruebas serológicas y resultado de la biopsia de intestino delgado. El cuadro clínico típico se caracteriza por diarrea, malabsorción y pérdida de peso. La enfermedad celiaca fue clásicamente descrita como una enfermedad de presentación en la infancia, sin embargo, su diagnóstico en la etapa adulta se ha vuelto más común. Existe una transición en la presentación de esta entidad, desde pacientes con síntomas típicos hasta pacientes asintomáticos. La identificación de estos últimos ha sido posible por la detección de anticuerpos séricos y los hallazgos de biopsias de intestino realizadas por otro motivo. Se presenta el caso de un hombre de 57 años de edad que acude al servicio de urgencias por síntomas gastrointestinales y clínica neuropática. A la exploración física destacó la presencia de los signos de Chvostek y Trousseau. Se solicitaron estudios de laboratorio generales en los que destacó la presencia de hipocalcemia, por lo que requirió manejo con infusión de calcio intravenoso. Se complementó el abordaje con estudios que sugirieron malabsorción. Se realizó panendoscopía y colonoscopia con toma de biopsias, en las que se reportaron hallazgos sugestivos de enfermedad celiaca Marsh 3B. Finalmente, se solicitaron anticuerpos antitransglutaminasa, los cuales se reportaron postivos. Fue así que se integró el diagnóstico de EC. Se inició manejo con dieta libre de gluten con posterior mejoría.
Abstract Celiac disease (CD) is a systemic process with an immunological basis characterized by gluten intolerance. The worldwide prevalence that has been reported is of approximately 1%. The diagnosis depends on the symptomatology, serological tests and the results of a small bowel biopsy. The typical clinical presentation is characterized by diarrhea, malabsorption and weight loss. Reports describe that the celiac disease is typically found in childhood, however, its diagnosis in adulthood has become a lot more common. A transition exists in the presentation of this nosological entity, from patients with typical symptoms to patients with an asymptomatic type. The identification of the latter has been possible with the detection of serum antibodies and the findings of bowel biopsies performed for other reasons. We present the case of a 57-year old male patient who arrived to the emergency room due to gastrointestinal and neuropathic symptoms. The physical examination highlighted the presence of Chvostek and Trousseau signs. General laboratory studies were requested, and hypocalcemia was identified; hence, a treatment with intravenous calcium infusion was required. The approach was complemented with other studies that suggested malabsorption. A panendoscopy and a colonoscopy with biopsies were performed. The findings suggested a Marsh 3B celiac disease. Finally, antitransglutaminase antibodies were requested and were reported as positive; therefore, a celiac disease diagnosis was made. The treatment started with a gluten-free diet, showing a subsecuent improvement.
