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1.
Eur Rev Med Pharmacol Sci ; 24(12): 6809-6817, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32633373

RESUMO

OBJECTIVE: To evaluate the possible involvement of PTK7 in the progression of human thyroid cancer and assess its potential effects on the proliferation and apoptosis of thyroid cancer. PATIENTS AND METHODS: Immunohistochemical (IHC) assays and clinical significance analysis were performed to explore the correlations between PTK7 expression and clinical characteristics of patients with thyroid cancer. Quantitative PCR assays and Immunoblot assays were performed to detect the expression of PTK7 in control or PTK7 shRNA plasmids transfected thyroid cancer cells. MTT assays were performed to detect the effects on the proliferation of thyroid cancer cells. Flow cytometry (FCM) assays were performed to assess the changes in cell apoptosis of thyroid cancer. Additionally, the effects of PTK7 on tumor growth were detected through in vivo tumor growth assays. RESULTS: PTK7 is highly expressed in human thyroid cancer tissues, and its expression levels are associated with the clinical characteristics, including TNM stage (p=0.015*), and intraglandular dissemination (p=0.024*) of patients with thyroid cancer. PTK7 ablation inhibits cell proliferation and stimulates cell apoptosis of thyroid cancer in vitro. Additionally, PTK7 contributes to tumor growth of thyroid cancer cells in mice. CONCLUSIONS: We demonstrated the involvement of PTK7in the progression of thyroid cancer, and therefore provided a novel and promising therapeutic target for thyroid cancer treatment.


Assuntos
Moléculas de Adesão Celular/genética , Receptores Proteína Tirosina Quinases/genética , Neoplasias da Glândula Tireoide/metabolismo , Apoptose , Moléculas de Adesão Celular/metabolismo , Proliferação de Células , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Receptores Proteína Tirosina Quinases/metabolismo , Neoplasias da Glândula Tireoide/patologia , Células Tumorais Cultivadas
2.
Eur Rev Med Pharmacol Sci ; 24(1): 434-443, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31957858

RESUMO

OBJECTIVE: By establishing osteoporosis (OP) model in rats, the specific regulatory effect of simvastatin on promoting the differentiation of mesenchymal stem cells (MSCs) into osteoblasts through the bone morphogenetic protein 2 (BMP-2)/Smads signaling pathway was investigated. MATERIALS AND METHODS: A total of 45 Sprague-Dawley rats were selected to establish the OP model by performing ovariectomy. The rats were divided into OP model group (OP group, n=15), 10-7 mmol/L simvastatin treatment group (SIM group, n=15), and normal control group (Control group, n=15). After the experimental period, the enzyme-linked immunosorbent assay (ELISA) was applied to observe the serum levels of tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), and IL-1. Reverse Transcription-Polymerase Chain Reaction (RT-PCR) was adopted to detect the contents of the differentiation-associated genes [runt-related transcription factor 2 (RUNX2) and Osterix (Osx)]. Later, the bone marrow MSCs (BMSCs) were selected and divided into Control group, 10-7 mol/L simvastatin group (SIM group), and osteoinduction medium group (OM group). Cell morphology in each group was observed. The Cell Counting Kit-8 (CCK-8) was performed to determine the proliferation activity of BMSCs. ELISA was performed to measure the level of alkaline phosphatase (ALP). RT-PCR was conducted to examine the levels of key differentiation-associated gene RUNX2 and those in BMP-2/Smads pathway. Moreover, the Western blotting was adopted to analyze the expressions of RUNX2 and genes in BMP-2/Smads pathway. RESULTS: The serum levels of TNF-α, IL-6, and IL-1 in OP group were remarkably higher than those in the Control group, and their levels in the SIM group were close to those in the Control group. The elevated messenger ribonucleic acid (mRNA) levels of the key differentiation-associated factors RUNX2, osteoprotegerin (OPG), osteopontin (OPN), and Osx were observed in the SIM group. In vitro cell culture revealed that the cells were in a favorable growth status in the SIM group and OM group, mostly manifesting in fusiform or spindle shape, and proliferated rapidly. In addition, the ALP level notably increased in the two groups compared with that in the Control group (p<0.05). Both SIM group and OM group had evidently higher mRNA expression levels of RUNX2, OPG, OPN, and Osx than those in the Control group (p<0.05), consistent with the expression trends of the genes in BMP-2/Smads pathway. The Western blotting indicated that the expression levels of RUNX2 and genes in BMP-2/Smads pathway in the SIM group were significantly higher than those in the Control group. CONCLUSIONS: Simvastatin can promote the differentiation of MSCs into osteoblasts in the OP rat model through the BMP-2/Smads signaling pathway.


Assuntos
Proteína Morfogenética Óssea 2/metabolismo , Hipolipemiantes/farmacologia , Osteogênese/efeitos dos fármacos , Osteoporose/tratamento farmacológico , Sinvastatina/farmacologia , Proteínas Smad/metabolismo , Animais , Proteína Morfogenética Óssea 2/genética , Diferenciação Celular/efeitos dos fármacos , Células Cultivadas , Modelos Animais de Doenças , Células-Tronco Mesenquimais/efeitos dos fármacos , Células-Tronco Mesenquimais/metabolismo , Osteoporose/metabolismo , Osteoporose/patologia , Ratos , Ratos Sprague-Dawley , Transdução de Sinais/efeitos dos fármacos , Proteínas Smad/genética
3.
Eur Rev Med Pharmacol Sci ; 23(16): 7073-7082, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31486509

RESUMO

OBJECTIVE: The aim of this study was to evaluate the effect of micro ribonucleic acid (miR)-26a on myocardial ischemia-reperfusion (I/R) injury in rats and to explore its potential mechanism. Our findings might help to provide references for clinical prevention and treatment of myocardial I/R. MATERIALS AND METHODS: A total of 60 male Sprague-Dawley (SD) rats were randomly divided into three groups using a random number table, including: Control group (n=20), I/R group (n=20) and I/R + miR-26a siRNA group (n=20). I/R model was established via recanalization after ligation of left anterior descending coronary artery (LAD). The model of miR-26a knockdown was established in rats of I/R + miR-26a siRNA group via tail intravenous injection of miR-26a siRNA. Ejection fraction (EF%) and fractional shortening (FS%) of rats in each group were detected via echocardiography. The infarction area of each group was detected via 2,3,5-triphenyltetrazolium chloride (TTC) assay. Subsequently, morphological changes in myocardial cells of each group were detected via hematoxylin-eosin (H&E) staining. Myocardial apoptosis level was measured via terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) assay. At the same time, the expression levels of pro-apoptotic proteins Bcl-2 associated X protein (Bax) and cleaved (C)-caspase3 in myocardial tissues of the three groups were determined using Western blotting. Finally, the effects of miR-26a knockdown on the expressions of glycogen synthase kinase (GSK)-3ß/ß-catenin signaling pathway-related proteins were detected via Western blotting and immunohistochemistry. RESULTS: The expression of miR-26a in myocardial tissues of I/R group increased significantly when compared with that in Control group (p<0.05). Knockdown of miR-26a significantly improved cardiac insufficiency caused by I/R, which also obviously increased both EF% and FS% in rats (p<0.05). In addition, knockdown of miR-26a significantly inhibited myocardial infarction caused by I/R injury, and reduced infarction area from (43.08±2.43) to (21.54±1.82) (p<0.05). The results of H&E staining revealed that in I/R + miR-26a siRNA group, myofilaments were arranged more orderly, the degree of degradation and necrosis was significantly lower, and cellular edema was significantly alleviated when compared with I/R group. Subsequent TUNEL staining demonstrated that rats in I/R + miR-26a siRNA group showed a remarkably lower level of myocardial apoptosis than I/R group (p<0.05). Meanwhile, the protein expression levels of Bax and C-caspase3 were remarkably declined in I/R + miR-26a siRNA group (p<0.05). Furthermore, the results of Western blotting showed that miR-26a siRNA could significantly reverse the inhibition of GSK-3ß/ß-catenin signaling pathway induced by I/R injury (p<0.05). CONCLUSIONS: Knockdown of miR-26a could significantly improve I/R-induced myocardial injury and promote cardiac function in rats. The possible underlying mechanism might be related to targeted regulation of miR-26a on GSK-3ß/ß-catenin signaling pathway. Therefore, miR-26a was expected to be a new therapeutic target for myocardial I/R injury.


Assuntos
Apoptose , Glicogênio Sintase Quinase 3 beta/metabolismo , MicroRNAs/metabolismo , Traumatismo por Reperfusão Miocárdica/metabolismo , Miocárdio/metabolismo , beta Catenina/metabolismo , Animais , Modelos Animais de Doenças , Ecocardiografia , Masculino , MicroRNAs/genética , Traumatismo por Reperfusão Miocárdica/diagnóstico por imagem , Miocárdio/patologia , Ratos , Ratos Sprague-Dawley , Transdução de Sinais
4.
Eur Rev Med Pharmacol Sci ; 21(24): 5548-5556, 2017 12.
Artigo em Inglês | MEDLINE | ID: mdl-29271985

RESUMO

OBJECTIVE: The oxidative stress-induced osteoblast apoptosis plays an important role in the pathological process of osteoporosis, but the roles of autophagy in oxidative stress and apoptosis of osteoblasts remain unclear. This study aimed to observe the role of autophagy in oxidative stress injury of osteoblasts and the relationship between autophagy and apoptosis. MATERIALS AND METHODS: Mc3T3-E1 cells were stimulated with different concentrations (0.1, 0.5, and 1 mM) of hydrogen peroxide. The cell viability was detected via cell counting kit 8 (CCK8) at different time points (0, 2, 6, 8, and 12 h), the apoptosis was detected via Western blotting and flow cytometry, and the autophagy was detected via macrophage-derived chemokine (MDC) and transmission electron microscope. The changes in expression of autophagy-associated protein, Beclin1, and LC3II/I ratio, were detected via Western blotting. Moreover, the intracellular reactive oxygen species (ROS) level and extracellular superoxide dismutase (SOD) level were observed using the autophagy regulators, rapamycin (Rap) and 3-methyladenine (3-MA), so as to clarify the interaction between autophagy and cellular oxidation. RESULTS: Hydrogen peroxide-induced apoptosis and autophagy of osteoblasts were in dose- and time-dependent manners; the hydrogen peroxide inhibitors could inhibit the autophagy level, and autophagy inhibitor (3-MA) could significantly enhance the hydrogen peroxide-induced ROS level and apoptosis rate in cells. Besides, Western blotting confirmed that the cleaved caspase-3 and cleaved poly adenosine diphosphate ribose polymerase (PARP) proteins were increased. The autophagy inducer (Rap) partially inhibited the hydrogen peroxide-induced oxidative stress and apoptosis. CONCLUSIONS: Autophagy inhibits the oxidative stress-mediated apoptosis of osteoblasts, which is a potential target for the osteoporosis treatment.


Assuntos
Apoptose , Autofagia , Osteoblastos/patologia , Estresse Oxidativo , Animais , Apoptose/efeitos dos fármacos , Linhagem Celular , Sobrevivência Celular , Peróxido de Hidrogênio/farmacologia , Camundongos , Osteoblastos/efeitos dos fármacos , Estresse Oxidativo/efeitos dos fármacos , Espécies Reativas de Oxigênio/metabolismo
5.
Eur J Surg Oncol ; 43(10): 1855-1861, 2017 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-28756019

RESUMO

BACKGROUND: Recent publications have suggested that human epidermal growth factor receptor 2 (HER2)-negative breast cancers with "weak" estrogen receptor (ER)/progesterone receptor (PR) expression levels by immunohistochemical (IHC) analysis were considered as the triple-negative (TN) subtype. This study aimed to evaluate the overall survival (OS), disease-free survival rates (DFS), and disease-specific survival (DSS) based on ER and PR expression levels into one of three groups, ER and PR <1%, ER and PR 1%-20%, and ER or PR >20% by hormone therapy. METHODS: Medical records of 3353 breast cancer patients treated from 2006 to 2013 were retrospectively reviewed. Tumor characteristics, type of treatment, OS, DFS and DSS were evaluated among the three patient groups. RESULTS: Regarding OS, there were significant differences according to the received hormone therapy in the different groups: ER and PR <1% (P = 0.972), ER and PR 1%-20% (P = 0.264), and ER or PR >20% (P = 0.014). Regarding DFS and DSS, there were also significant differences in the different groups: ER and PR <1% (P = 0.611, 0.766), ER and PR 1%-20% (P = 0.847, 0.629), and ER or PR >20% (P = 0.031, 0.002). CONCLUSIONS: In HER2 negative breast cancer patient with hormone therapy, ER and PR expression level of 1%-20% has similar survival outcome to the ER and PR expression level of <1% by IHC analysis.


Assuntos
Receptor ErbB-2/metabolismo , Receptores de Estrogênio/biossíntese , Receptores de Progesterona/biossíntese , Neoplasias de Mama Triplo Negativas/mortalidade , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores Tumorais/metabolismo , Intervalo Livre de Doença , Feminino , Seguimentos , Terapia de Reposição Hormonal/métodos , Humanos , Imuno-Histoquímica , Hibridização in Situ Fluorescente , Pessoa de Meia-Idade , Estudos Retrospectivos , Taxa de Sobrevida/tendências , Taiwan/epidemiologia , Neoplasias de Mama Triplo Negativas/tratamento farmacológico , Neoplasias de Mama Triplo Negativas/metabolismo , Adulto Jovem
6.
Ir J Med Sci ; 183(1): 71-5, 2014 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-23757214

RESUMO

AIMS: The aim of this study was to analyze the association between the status of estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor-2 (HER2) in breast cancer with neoadjuvant therapy by using tissue biopsy and surgical specimens. METHODS: This study included 78 patients with breast cancer, who presented to our hospital between June 1999 and June 2011, and were treated with neoadjuvant therapy and subsequent mastectomy or partial mastectomy. All clinicopathological data regarding pre-neoadjuvant biopsy and definitive surgical specimens were reviewed for accuracy. The status of ER, PR, and HER2 was determined by immunohistochemistry. RESULTS: Paired samples from 78 women (mean age 51.4 ± 11.7 years) were successfully analyzed. A switch in the status of ER was identified in 16 patients (20 %); PR, in 18 (23 %); and HER2, in 27 (35 %). There were no significant differences in the status of ER, PR, and HER2 between the primary tumor and the resected tumor after neoadjuvant therapy. Neoadjuvant therapy does not significantly influence the status of the steroid hormone receptors and the HER2 level in our study. CONCLUSIONS: Initial biopsy may be reliable for determining the appropriate adjuvant therapy, but final pathology are still needed to evaluate the prognosis and provided the alternative treatment when tumor recurrence. Further prospective study is needed to optimize the care available for breast cancer patients.


Assuntos
Biomarcadores Tumorais/metabolismo , Neoplasias da Mama/terapia , Carcinoma Ductal de Mama/terapia , Carcinoma Lobular/terapia , Receptor ErbB-2/metabolismo , Adulto , Idoso , Biópsia , Neoplasias da Mama/metabolismo , Neoplasias da Mama/patologia , Carcinoma Ductal de Mama/metabolismo , Carcinoma Ductal de Mama/patologia , Carcinoma Lobular/metabolismo , Carcinoma Lobular/patologia , Quimioterapia Adjuvante , Feminino , Humanos , Mastectomia , Pessoa de Meia-Idade , Terapia Neoadjuvante , Seleção de Pacientes , Valor Preditivo dos Testes , Receptores de Estrogênio/metabolismo , Receptores de Progesterona/metabolismo , Estudos Retrospectivos , Resultado do Tratamento
7.
Eur J Surg Oncol ; 40(2): 214-9, 2014 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-24316111

RESUMO

BACKGROUND: The role of surgery in the management of large hepatocellular carcinomas (HCCs) is controversial. Advanced age and comorbidities are taken into account when major surgery is considered. PURPOSE: To compare the outcomes of liver resection (LR) and transarterial chemoembolization (TACE) for resectable HCC in patients aged 70 years or older. PATIENTS AND MATERIALS: This study included 70 patients aged 70 years or older treated for large HCCs (≥5 cm) between January 2007 and December 2012: 37 underwent LR and 33 underwent TACE. The outcomes of these patients were retrospectively analyzed. Univariate and multivariate Cox proportional hazard models were established. Kaplan-Meier survival curves were generated, and survival data were compared using the log-rank test. RESULTS: Hospital stay was significantly longer in the LR group than in the TACE group (10 days vs 8.5 days; P = 0.003). Treatment-related complications were more frequent in the TACE group, but this difference was not statistically significant. LR was associated with a better disease-free survival rate, median survival rate and cumulative overall survival rate. CONCLUSION: Our results showed that LR could be a safe and effective treatment option for HCC tumors ≥5 cm in patiets aged 70 years or older.


Assuntos
Fatores Etários , Carcinoma Hepatocelular/cirurgia , Neoplasias Hepáticas/cirurgia , Idoso , Idoso de 80 Anos ou mais , Carcinoma Hepatocelular/patologia , Carcinoma Hepatocelular/terapia , Quimioembolização Terapêutica , Contraindicações , Intervalo Livre de Doença , Feminino , Hepatectomia , Humanos , Estimativa de Kaplan-Meier , Tempo de Internação , Neoplasias Hepáticas/patologia , Neoplasias Hepáticas/terapia , Masculino , Prognóstico , Modelos de Riscos Proporcionais , Estudos Retrospectivos , Taxa de Sobrevida , Resultado do Tratamento
8.
Clin Radiol ; 68(2): 139-47, 2013 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-22999524

RESUMO

AIM: To assess the utility of dual-source dual-energy computed tomography angiography (DSDECTA) in the diagnosis of active gastrointestinal bleeding (GIB). MATERIALS AND METHODS: From June 2010 to September 2011, 58 consecutive patients with clinical signs of active GIB underwent DSDECTA. Two radiologists, blinded to clinical data, interpreted images from DSDECTA independently, with discordant interpretation resolved by consensus. The standards of reference included digital subtraction angiography, endoscopy, surgery, or final pathology reports. Sensitivity, specificity, positive (PPV) and negative (NPV) predictive values, and accuracy of DSDECTA for detection of active GIB were evaluated. Receiver-operating characteristic (ROC) analysis was undertaken and the area under the curve (AUC) calculated. RESULTS: Active GIB source was identified in 39 of 58 patients (67.2%), all of which were confirmed by one or more reference standard. Negative DSDECTA results were obtained in 19 patients (32.8%). Of these, 15 patients did not require any further intervention and were discharged without incident. The overall sensitivity, specificity, PPV, NPV, and accuracy of DSDECTA was 88.6, 100, 100, 73.7, and 91.4%, respectively. The AUC was 0.935 ± 0.063. The dose reduction of a dual-phase DSDECTA protocol was approximately 30%, compared with that of a triple-phase protocol used in a previous study. CONCLUSION: DSDECTA can act as an accurate method for detection and localization of active GIB and has a relatively low radiation dose.


Assuntos
Angiografia/métodos , Hemorragia Gastrointestinal/diagnóstico por imagem , Imagem Radiográfica a Partir de Emissão de Duplo Fóton/métodos , Doença Aguda , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Feminino , Hemorragia Gastrointestinal/patologia , Hemorragia Gastrointestinal/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Variações Dependentes do Observador , Estudos Prospectivos , Curva ROC , Doses de Radiação , Interpretação de Imagem Radiográfica Assistida por Computador , Padrões de Referência , Reprodutibilidade dos Testes , Índice de Gravidade de Doença , Tomografia Computadorizada por Raios X/métodos , Adulto Jovem
9.
Transplant Proc ; 45(2): 580-4, 2013 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-23267792

RESUMO

Decoy receptor 3 (DcR3) blocks both Fas ligand- and LIGHT-induced pancreatic ß-cell damage in autoimmune diabetes. Heme oxygenase 1 (HO-1) possesses antiapoptotic, anti-inflammatory, and antioxidative effects that protect cells against various forms of attack by the immune system. Previously, we have demonstrated that transgenic islets overexpressing DcR3 or murine HO-1 (mHO-1) exhibit longer survival times than nontransgenic islets in syngeneic islet transplantation. In this study, we evaluated whether DcR3 and mHO-1 double-transgenic islets of NOD mice could provide better protective effects and achieve longer islet graft survival than DcR3 or mHO-1 single-transgenic islets after islet transplantation. We generated DcR3 and mHO-1 double-transgenic NOD mice that specifically overexpress DcR3 and HO-1 in islets. Seven hundred islets isolated from double-transgenic, single-transgenic, or nontransgenic NOD mice were syngeneically transplanted into the kidney capsules of newly diabetic female recipients. Unexpectedly, there was no significant difference in the survival time between double-transgenic or nontransgenic NOD islet grafts, and the survival times of double-transgenic NOD islet grafts were even shorter than those of DcR3 or mHO-1 single-transgenic islets. Our data indicate that transplantation of double-transgenic islets that coexpress HO-1 and DcR3 did not result in a better outcome. On the contrary, this strategy even caused an adverse effect in syngeneic islet transplantation.


Assuntos
Diabetes Mellitus Tipo 1/cirurgia , Sobrevivência de Enxerto , Heme Oxigenase-1/metabolismo , Transplante das Ilhotas Pancreáticas/efeitos adversos , Proteínas de Membrana/metabolismo , Membro 6b de Receptores do Fator de Necrose Tumoral/metabolismo , Animais , Diabetes Mellitus Tipo 1/enzimologia , Diabetes Mellitus Tipo 1/genética , Modelos Animais de Doenças , Feminino , Heme Oxigenase-1/genética , Proteínas de Membrana/genética , Camundongos , Camundongos Endogâmicos NOD , Camundongos Transgênicos , Membro 6b de Receptores do Fator de Necrose Tumoral/genética , Fatores de Tempo , Transplante Isogênico
10.
Eur J Surg Oncol ; 38(11): 1029-35, 2012 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-22959140

RESUMO

BACKGROUND: Surgical excision of papillary breast lesions with atypia diagnosed using core needle biopsy (CNB) has been accepted; however, the management of benign papillary lesions (without atypia) has been controversial. The purpose of this study was to evaluate the surgical outcome of nonmalignant papillary lesions diagnosed by ultrasound-guided 14-gauge CNB, and to establish clear guidelines on management of these lesions. METHODS: We retrospectively identified 268 nonmalignant papillary breast lesions, including 203 benign lesions and 65 atypical lesions, diagnosed by CNB and subsequently surgically excised in 250 women at our institution between July 2004 and October 2010. For each lesion, medical records and radiologic and pathologic reports were reviewed and coded. We compared the histological upgrade among the collected variables. RESULTS: On histological examination after surgical excision, 15.4% atypical papillary lesions and 5.9% benign lesions were upgraded to malignant, and 20.2% benign lesions were upgraded to atypical. Atypia (P = 0.015) was significantly associated with malignant upgrade at excision. No clinical or radiologic variable was helpful in predicting the possibility of histological upgrade of CNB-diagnosed nonmalignant papillary lesions. CONCLUSIONS: Nonmalignant papillary lesions diagnosed with CNB showed an unacceptable pathological upgrade rate after excision. Therefore, surgical excision should be performed for all papillary lesions of the breast for definitive diagnosis.


Assuntos
Biópsia com Agulha de Grande Calibre , Neoplasias da Mama/cirurgia , Carcinoma Papilar/cirurgia , Biópsia Guiada por Imagem , Papiloma/diagnóstico , Papiloma/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/patologia , Carcinoma Papilar/diagnóstico , Carcinoma Papilar/patologia , Feminino , Humanos , Pessoa de Meia-Idade , Adulto Jovem
11.
Surg Oncol ; 21(2): 119-23, 2012 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-21256735

RESUMO

Gastric cancer ranks the second leading cause of cancer-specific mortality worldwide. With a poor prognosis, 5-year survival rate of gastric cancer is less than 20%-25% in the USA, Europe, and China [1]. However, early gastric cancer(EGC) offers an excellent (over 90%) chance of cure based on surgical resection [2]. As the increasing detection of EGC, more treatment options have been developed both curatively and minimally invasively to maintain a good quality of life(QOL). One of the advanced therapeutic techniques is endoscopic dissection. Improvements in surgical treatment include minimizing lymph node dissection, reconstruction methods, laparoscopy-assisted surgery, and sentinel node navigation surgery(SNNS) [3]. With technological advances, even Natural Orifice Transluminal Endoscopy Surgery (NOTES) and robotic surgery are expected to represent the next revolution [4]. However, there still remains much dispute among these treatments, which arouses further clinical trials to verify. Update of the treatments, controversial indications, prognosis and current strategies for EGC are discussed in this review.


Assuntos
Gastroscopia/métodos , Laparoscopia/métodos , Neoplasias Gástricas/cirurgia , Terapia Combinada/métodos , Detecção Precoce de Câncer , Humanos , Excisão de Linfonodo/métodos , Metástase Linfática , Cirurgia Endoscópica por Orifício Natural/métodos , Tratamentos com Preservação do Órgão/métodos , Robótica , Biópsia de Linfonodo Sentinela , Neoplasias Gástricas/diagnóstico
12.
Ultraschall Med ; 33(5): 447-54, 2012 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-22161618

RESUMO

PURPOSE: We analysed the ultrasonographic (US) features of atypical ductal hyperplasia (ADH) of the breast diagnosed by US-guided core needle biopsy (CNB) with the aim of identifying factors that affect the underestimation of ADH. MATERIALS AND METHODS: A total of 134 ADH lesions sampled by US-guided CNB were reviewed retrospectively. All lesions were evaluated for pattern, size, lesion characteristics and margins, and the corresponding surgical outcome or imaging follow-up was obtained. Each patient's clinical and radiological features were analysed to identify factors involved in ADH underestimation. RESULTS: The prevalence of malignancy in each pattern of lesions following surgical excision was 32/81 (40%) for solid masses, 14/31 (45%) for ductal patterns, 5/17 (29%) for complex cystic lesions and 2/5 (40%) for architectural distortions. Based on the results of surgical and US follow-up, none of the category 3 lesions was proven to be a malignancy. Malignancy was found in 17 (21%) of the 80 BI-RADS (Breast Imaging Reporting and Data System) category 4a lesions, 20 (74%) of the 27 category 4b lesions, 12 (92%) of the 13 category 4c lesions, and four (100%) of the four category 5 lesions. Lesions with a higher US assessment category, lacking circumscribed margins, or a mammographic finding of suspected malignancy were all significantly associated with underestimation (p < 0.05 for each). CONCLUSION: US is useful in evaluating ADH lesions and in clarifying the indication for biopsy of these lesions. Familiarity with the frequency associated with malignancy for each feature will improve the utility of US in the work-up of these breast abnormalities.


Assuntos
Biópsia com Agulha de Grande Calibre/métodos , Interpretação de Imagem Assistida por Computador/métodos , Glândulas Mamárias Humanas/patologia , Ultrassonografia de Intervenção/métodos , Ultrassonografia Mamária/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Neoplasias da Mama/diagnóstico por imagem , Neoplasias da Mama/genética , Neoplasias da Mama/patologia , Calcinose , Diagnóstico Diferencial , Feminino , Doença da Mama Fibrocística/diagnóstico por imagem , Doença da Mama Fibrocística/patologia , Predisposição Genética para Doença , Humanos , Hiperplasia/diagnóstico por imagem , Hiperplasia/patologia , Pessoa de Meia-Idade , Estudos Retrospectivos , Sensibilidade e Especificidade
13.
Acta Chir Belg ; 111(4): 210-3, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-21954735

RESUMO

Tumours metastasising to the breast are very infrequent, with an incidence of 0.4-6.6% of all breast tumours. Occasionally a breast mass is the first indicator of a tumour arising elsewhere. Development of metastases to the breast from a lung cancer is very rare and the prognosis for such patients is poor. We present three patients who had metastases to the breast presenting clinically as the primary origin. It is important to distinguish a primary breast cancer from a metastasis, as different therapies are offered with considerably different outcomes.


Assuntos
Adenocarcinoma/patologia , Neoplasias da Mama/secundário , Neoplasias Pulmonares/patologia , Adenocarcinoma/tratamento farmacológico , Adulto , Idoso de 80 Anos ou mais , Carcinoma Mucoepidermoide/patologia , Feminino , Humanos , Neoplasias Pulmonares/tratamento farmacológico
14.
Eur J Surg Oncol ; 37(9): 758-64, 2011 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-21764539

RESUMO

AIMS: The purpose of the study was to explore factors predictive of breast cancer as diagnosed by excision biopsy in cases with a diagnosis of atypical ductal hyperplasia (ADH) on ultrasound-guided core needle biopsy (CNB). PATIENTS AND METHODS: We carried out diagnosis of breast lesions by ultrasound-guided CNB in a single hospital in Taiwan from November 2003 to October 2009. Patients who were diagnosed with ADH and subsequently underwent excision biopsy were included in this study (n = 124). RESULTS: Fifty-six of the 124 patients who were included (45.2%) had cancer, and the remaining 68 had benign lesions. By multivariate analysis of all clinical characteristics and on the basis of the imaging features in these cases, older patient age (≥50 y/o, OR: 3.910, p = 0.005), larger tumour size (≥15 mm, OR: 3.398, p = 0.013), and the presence of architectural distortion by mammography (OR: 10.7, p = 0.036) were found likely to be associated with breast cancer. CONCLUSIONS: Open biopsy is necessary in patients who were diagnosed with ADH on CNB. Older patients (≥50 y/o), with a larger tumour size (≥15 mm) and an abnormal mammography are especially likely to have breast cancer.


Assuntos
Biópsia por Agulha , Neoplasias da Mama/patologia , Mama/patologia , Lesões Pré-Cancerosas/patologia , Ultrassonografia de Intervenção , Adulto , Idoso , Idoso de 80 Anos ou mais , Biópsia , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/cirurgia , Feminino , Humanos , Hiperplasia , Pessoa de Meia-Idade , Lesões Pré-Cancerosas/diagnóstico
15.
Acta Chir Belg ; 111(2): 94-6, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-21618856

RESUMO

We report a rare case of breast cancer concomitant with progesterone-receptor-positive renal cell carcinoma. A 48-year-old woman was diagnosed as having infiltrating ductal carcinoma of the breast and underwent modified radical mastectomy. A synchronous retroperitoneal tumour was detected by sonography of the abdomen in a routine cancer staging. Initially, the tumour was diagnosed as a synchronous retroperitoneal metastasis by needle biopsy; further tests revealed that it was progesterone receptor-positive. The retroperitoneal tumour showed poor response to full courses of adjuvant chemotherapy for breast cancer. Subsequently, the patient underwent a radical operation that included nephrectomy. The final pathology confirmed a sarcomatoid renal cell carcinoma. The post-operative course was uneventful. The patient had no recurrence at the 1-year follow-up. In this report, accurate diagnosis and adequate treatment were discussed. An intra-abdominal tumour with progesterone receptor- (PR) positive features is usually considered to be metastatic in breast cancer patients. For breast cancer patients with a PR-positive retroperitoneal tumour, renal cell carcinoma should be differentiated from a metastatic lesion of breast cancer, even if PR-expression is rare in renal cell carcinoma. To the best of our knowledge, this is the first case of PR-positive expression in breast cancer concomitant with renal carcinoma. In clinical settings, it is challenging for the surgeon to make an accurate diagnosis and to provide prompt treatment in such cases.


Assuntos
Carcinoma de Células Renais/diagnóstico , Carcinoma de Células Renais/metabolismo , Neoplasias Renais/diagnóstico , Neoplasias Renais/metabolismo , Neoplasias Primárias Múltiplas/diagnóstico , Neoplasias Primárias Múltiplas/metabolismo , Receptores de Progesterona/metabolismo , Neoplasias Retroperitoneais/diagnóstico , Neoplasias Retroperitoneais/metabolismo , Neoplasias da Mama/patologia , Carcinoma de Células Renais/diagnóstico por imagem , Carcinoma de Células Renais/cirurgia , Feminino , Humanos , Neoplasias Renais/diagnóstico por imagem , Neoplasias Renais/cirurgia , Pessoa de Meia-Idade , Nefrectomia , Neoplasias Retroperitoneais/diagnóstico por imagem , Neoplasias Retroperitoneais/cirurgia , Tomografia Computadorizada por Raios X
17.
Z Gastroenterol ; 49(4): 449-51, 2011 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-21476181

RESUMO

Mucormycosis (zygomycosis) is a rare opportunistic fungal infection mainly affecting patients with diabetes mellitus, immunodeficiency, malignancies and solid organ transplant. We present a 55-year-old female with a mucormycosis infection primarily affecting the paranasal sinuses after liver transplantation. The patient presented with a one-week history of right-sided occipital headache and gradual loss of vision in the right eye just 6 months after liver transplantation. Imaging studies revealed a right-sided sphenoiditis with orbital apex involvement. The patient underwent endoscopic sinus surgery and the histology confirmed the diagnosis of mucormycosis. Aggressive surgical ablation of the infected parts, along with antifungal treatment and adjustment of her immunosuppressive maintenance resulted in a good outcome and long-term survival.


Assuntos
Transplante de Fígado/efeitos adversos , Mucormicose/etiologia , Mucormicose/terapia , Doenças dos Seios Paranasais/etiologia , Doenças dos Seios Paranasais/terapia , Sinusite/etiologia , Sinusite/terapia , Feminino , Humanos , Pessoa de Meia-Idade , Resultado do Tratamento
20.
Ultraschall Med ; 32 Suppl 1: S8-13, 2011 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-20603785

RESUMO

PURPOSE: The purpose of this retrospective study was to calculate the positive predictive value (PPV) of sonographic Breast Imaging Reporting and Data System (BI-RADS) categories 3, 4, and 5 in different age groups to investigate whether age influences the PPV of the BI-RADS category in breast ultrasound. MATERIALS AND METHODS: From our sonography-guided core biopsy database of breasts between 2006 and 2008, we identified 2817 BI-RADS category 3, 4, and 5 lesions with known pathological diagnosis in 2587 women, all of whom underwent the earlier breast assessment via ultrasound with a sonographic BI-RADS lexicon and later sonography-guided core biopsy. All lesions were classified into three age groups (< 45, 45 - 59, and > 59 years). The age-related PPVs of each BI-RADS category among three age groups were calculated on the basis of pathological diagnoses and were compared using a χ(2)-test. RESULTS: The overall PPV of each BI-RADS category was 2.2 % in category 3, 6.5 % in category 4a, 35.2 % in category 4b, 79.6 % in category 4c, and 99.6 % in category 5. The age-related PPVs of category 3 varied significantly among the three age groups (0.9 % versus 3.9 % versus 2.0 % p = 0.048), and notably, the age-related PPV in group 2 was higher than the others. Additionally, there was a significant positive association between the age-related PPVs and increasing age in categories 4a and 4b (4a, p < 0.0001 and 4b, p = 0.0139), but not in categories 4c and 5 (4c, p = 0.1853 and 5, p = 0.2871). CONCLUSION: The incidence of female breast cancer differs not only in different sonographic BI-RADS categories, but also in different age groups. Therefore, more attention should be paid to the special age group that we found for sonographic BI-RADS categories 3, 4a, and 4b.


Assuntos
Adenocarcinoma Mucinoso/diagnóstico por imagem , Adenocarcinoma Mucinoso/epidemiologia , Biópsia por Agulha/estatística & dados numéricos , Neoplasias da Mama/diagnóstico por imagem , Neoplasias da Mama/epidemiologia , Carcinoma Ductal/diagnóstico por imagem , Carcinoma Ductal/epidemiologia , Carcinoma Intraductal não Infiltrante/diagnóstico por imagem , Carcinoma Intraductal não Infiltrante/epidemiologia , Carcinoma Lobular/diagnóstico por imagem , Carcinoma Lobular/epidemiologia , Ultrassonografia de Intervenção/estatística & dados numéricos , Ultrassonografia Mamária/estatística & dados numéricos , Adenocarcinoma Mucinoso/classificação , Adenocarcinoma Mucinoso/patologia , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Cisto Mamário/classificação , Cisto Mamário/diagnóstico por imagem , Cisto Mamário/epidemiologia , Cisto Mamário/patologia , Neoplasias da Mama/classificação , Neoplasias da Mama/patologia , Carcinoma Ductal/classificação , Carcinoma Ductal/patologia , Carcinoma Intraductal não Infiltrante/classificação , Carcinoma Intraductal não Infiltrante/patologia , Carcinoma Lobular/classificação , Carcinoma Lobular/patologia , Comparação Transcultural , Estudos Transversais , Feminino , Fibroadenoma/classificação , Fibroadenoma/diagnóstico por imagem , Fibroadenoma/epidemiologia , Fibroadenoma/patologia , Humanos , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Projetos de Pesquisa/estatística & dados numéricos , Estudos Retrospectivos , Taiwan
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