Gene profiling and circulating tumor cells as biomarker to prognostic of patients with locoregional breast cancer.

The gene profile of primary tumors, as well as the identification of circulating tumor cells (CTCs), can provide important prognostic and predictive information. In this study, our objective was to perform tumor gene profiling (TGP) in combination with CTC characterization in women with nonmetastatic breast cancer. Biological samples (from peripheral blood and tumors) from 167 patients diagnosed with stage I, II, and III mammary carcinoma, who were also referred for adjuvant/neoadjuvant chemotherapy, were assessed for the following parameters: (a) the presence of CTCs identified by the expression of CK-19 and c-erbB-2 in the peripheral blood mononuclear cell (PBMC) fraction by quantitative reverse transcription PCR (RT-PCR) and (b) the TGP, which was determined by analyzing the expression of 21 genes in paraffin-embedded tissue samples by quantitative multiplex RT-PCR with the Plexor® system. We observed a statistically significant correlation between the progression-free interval (PFI) and the clinical stage (p = 0.000701), the TGP score (p = 0.006538), and the presence of hormone receptors in the tumor (p = 0.0432). We observed no correlation between the PFI and the presence or absence of CK-19 or HER2 expression in the PBMC fraction prior to the start of treatment or in the two following readouts. Multivariate analysis revealed that only the TGP score significantly correlated with the PFI (p = 0.029247). The TGP is an important prognostic variable for patients with locoregional breast cancer. The presence of CTCs adds no prognostic value to the information already provided by the TGP.

Systemic chemotherapy interferes in homocysteine metabolism in breast cancer patients.

BACKGROUND: Hyperhomocysteinemia in breast cancer (BC) patients can be a risk factor for thromboembolic events. This study aimed to evaluate homocysteine and its cofators (folic acid and vitamin B12) concentrations and platelet count at diagnosis of BC, 3 and 6 months after the beginning of chemotherapy treatment and to correlate them with clinical data. METHODS: Thirty-five BC patients were included; blood samples were obtained by venipuncture. Plasmatic Hcy and cofactors concentrations were measured by competitive chemiluminescent enzyme immunoassay method. Platelet count was done using an automated analyzer. Statistical analysis was performed using the software SPSS. RESULTS: During chemotherapy, homocysteine (P = 0.032) and vitamin B12 (P < 0.001) concentrations increased, while folate and platelets decreased (P < 0.001). Among the clinical data, the menopausal status showed significant positive correlation (P = 0.022) with homocysteine concentration increase. CONCLUSIONS: Evaluation of homocysteine concentrations during chemotherapy is extremely important because their levels increase during chemotherapy treatment, thus increasing the risk of thromboembolism development.

Circulating tumor cell detection during chemotherapy in patients with breast cancer is not associated with plasma homocysteine levels.

Breast cancer remains the second most frequent type of cancer in the world and the first among women, and systemic chemotherapy is an adjuvant therapeutic modality that improves survival in a great part of patients. Women with breast cancer, however, frequently show a higher risk of thromboembolism, an event associated to hyperhomocysteinemia and the presence of circulating tumor cells (CTC). Our aim is to correlate the presence of CTCs, detected by the analysis of CK19 and c-erbB2 gene expressions, and the homocysteine plasma levels in the peripheral blood in patients with breast cancer undergoing chemotherapy. Epithelial marker expression (CK19 and c-erbB2) and homocysteine levels were analyzed in a mononuclear fraction of the peripheral blood and plasma, respectively, obtained from 35 patients diagnosed with breast cancer at diagnosis and throughout chemotherapy treatment. No significant relation between the CK19 and c-erbB2 expressions and hyperhomocysteinemia was observed at any moment of the evaluation throughout the chemotherapy treatment (3 and 6 months after the onset). Among clinical data, only menopausal status showed a statistically significant correlation with homocysteine concentration. Although differences in the expressions of the analyzed epithelial markers were detected at 3 and 6 months of chemotherapy treatment, no relation between plasma homocysteine variations and the CK19 and c-erbB2 gene expressions was found in patients under chemotherapy treatment at any moment of the evaluation, suggesting that chemotherapy affects the expressions of the studied genes independently.

Plasma levels of E-cadherin and MMP-13 in prostate cancer patients: correlation with PSA, testosterone and pathological parameters.

AIMS AND BACKGROUND: Prostate cancer is the most common malignant tumor in men. Serum prostate-specific antigen (PSA), Gleason score and clinical range at the time of diagnosis are important factors to predict prognosis and outcome after therapy but additional accurate and reliable biomarkers are still wanted. So far, few biomarkers of prostate cancer have been successfully implemented and are being used in clinical practice. However, modifications of E-cadherin and MMP-13 expression are likely to be involved in prostate cancer invasion and thus are potential biomarkers for prognosis. PATIENTS AND METHODS: We analyzed the concentrations of E-cadherin and MMP-13 in plasma of patients with prostate cancer at diagnosis and 3 and 6 months after the beginning of treatment and related these measures to free and total PSA and other clinical features. RESULTS: The concentration of E-cadherin was lower in patients with prostate cancer compared to the control group, but there was no difference in the concentration of MMP-13 between these two groups. During treatment, however, we found no significant differences between the concentrations of MMP-13 and E-cadherin, but we observed a significant positive correlation between total PSA and E-cadherin plasma concentration at the third month of treatment and between total testosterone and MMP-13 plasma concentration before the start of treatment. CONCLUSIONS: The results suggest that these parameters could be used both in the diagnosis and prognosis of prostate cancer.

Triagem sorológica e influência do conhecimento sobre a dengue em pacientes do ambulatório de especialidades do SUS / Serological screening and the influence of dengue awareness on patients from SUS specialty laboratory

INTRODUÇÃO: A dengue é causa de preocupação em países como o Brasil. OBJETIVO: Verificar a soropositividade dos pacientes do ambulatório de especialidades do Sistema Único de Saúde (SUS) para anticorpos antidengue, relacionando os resultados com os dados sociodemográficos. METODOLOGIA: Foram respondidos 184 questionários de avaliação sociodemográfica e de conhecimento sobre a transmissão da dengue. Foi utilizado o método de imunoensaio enzimático (ELISA) para pesquisar imunoglobulina da classe M (IgM) e da classe G (IgG) contra os vírus. RESULTADOS: Quinze por cento dos pacientes apresentaram IgG contra o vírus, sem a presença de IgM. CONCLUSÃO: Os pacientes demonstraram conhecimento sobre a doença e sua prevenção, independentemente da classe econômica. A infecção assintomática deve ser avaliada, principalmente nos casos de doença febril.

INTRODUCTION: Dengue is a public health problem in Brazil and worldwide. OBJECTIVE: To determine dengue seropositivity of patients from SUS specialty laboratory by correlating the results with socio-demographic data. METHODS: One hundred and eighty-four questionnaires on socio-demographic assessment and dengue transmission awareness were filled out. Enzyme linked immunosorbent assay (ELISA) method was performed for the detection of IgM and IgG antibodies against dengue virus. RESULTS: Fifteen percent of patients had IgG against dengue virus without the presence of IgM. CONCLUSION: All patients showed disease and prevention awareness regardless of their socio-economic background. The asymptomatic infection must be evaluated mainly in cases of disease with fever.