The analysis of the level of Treg lymphocytes in the blood of patients with endometrial cancer before and after the surgery — preliminary study

Introduction. The progression of cancer is a complex process involving host-tumour interactions taking place in cancer and in the cancer microenvironment. The tumour remodels the microenvironment into the suppressive profile by various mechanisms. One of the most important elements of this mechanism is the inducing of the infiltration of Treg lymphocytes into cancer and its microenvironment. The aim of the present study was to evaluate the alterations of the Treg cell population in the peripheral blood of patients before and after the surgical treatment for endometrial cancer. Material and methods. For the present study 24 patients with endometrial cancer were recruited. All the patients were treated surgically. The peripheral blood samples were collected from the endometrial cancer patients before operation and three days after the surgical procedure and evaluated using flow cytometry method. Results. CD25+ CD4+ FOXP3+ T cells were found in all the examined peripheral blood samples derived from the endometrial cancer patients in the days before and following applied surgery. We observed differences before and after the applied surgical procedure in patients treated for uterine cancer. The highest number of Treg cells in the peripheral blood was demonstrated before the surgical procedure; it diminished statistically significantly following the surgery. Conclusions. The decrease of the percentage of Treg cells in blood sera in patients following radical surgical treatment might be useful in measuring the radicalism of the treatment. The monitoring of the level of selective immune system suppression related to Treg cell blood serum levels during cancer therapy might support a decision to supplement the standard therapy with immunotherapy or to increase the degree of radicalism of the applied therapy.

An analysis of the influence of infection on overall survival rates, following modified posterior pelvic exenteration for advanced ovarian cancer

Objectives: The aim of our study was to determine the association between the appearance of infection after modified posterior pelvic exenteration (MPE) and the time to adjuvant chemotherapy (TTC), and to examine whether infection has any impact on clinical results by delaying the start of chemotherapy.Material and methods: Our retrospective study analyzed 77 patients who had undergone MPE followed by adjuvantchemotherapy. Postoperatively, either there was no residual tumor or, the residual tumor was less than 2.5 mm, in 76.7% of the study patients. Our study group was divided into two subgroups for comparison; the first group consisted of 41 patients with postoperative infections, and the second group of 36 patients had no infections. The infections of the first group were monitored during a 90-day postoperative period. Median TTC and overall survival rates (OS) were determined for those patients who developed an infection as well as for those who did not.Results: The expected 5-year survival rate was 0.40 (SD = 0.09) for those patients without infection and 0.17 (SD = 0.07) for those patients with infection. The survival curves of patients with infection and those without infection were significantly different statistically (p = 0.038). The median TTC differed significantly for those patients who developed infection compared with those patients who did not develop infection (37 days compared with 27.5 days respectively, p = 0.024); and patients without infection were statistically more likely to receive chemotherapy within 25 days following surgery than in the subsequent 25–42-day period compared with those patients who did develop infection (p = 0.048). No statistically significant differences were found between the two groups in relation to results following the initiation of chemotherapy during the first 42 days postoperatively (p = 0.445).Conclusions: The absence of postoperative infection was associated with better survival rates. Patients with infectionexperienced a longer time interval between surgery and the start of chemotherapy, without negative impact to theiroverall survival rates

The Potential Role of MT and Vimentin Immunoreactivity in the Remodeling of the Microenvironment of Parotid Adenocarcinoma

A tumor stimulates the remodeling of its microenvironment in order to control and accelerate its own growth and to initiate metastases. To create metastases the tumor cells must first acquire the ability to detach from the main tumor and to adhere to, invade, and degrade the adjacent extracellular matrix. The cells must then be able to enter the lumen of the vessels where they home the distant tissues and organs by forming secondary tumors. The acquisition of this phenotype is related to the phenomenon of epithelial-to-mesenchymal transition. On the molecular level, this process is typified by a change in the expression of epithelial markers and by the enhancement of the expression of mesenchymal markers like vimentin that are responsible for cell migration and invasion. Metallothioneins have been shown to help protect against apoptosis. The expression of MT by tumor cells plays an important and complex role not only because of its pro-proliferative, anti-apoptotic activity, but also because it inhibits the immune response. The aim of the present study was to evaluate the immunoreactivity of vimentin and MT in the salivary gland adenocarcinoma and its stroma in order to observe the phenomenon of stromal remodeling. The tissue samples of salivary gland adenocarcinomas and their stromas and the palatine tonsils which constituted the reference group were obtained during routine surgical procedures. The immunoreactivity of vimentin, metalothionein, CD56, CD57 antigens was evaluated by the immunohistochemistry method in 30 tissue samples of parotid adenocarcinoma. The patient’s consent was obtained in each case. A statistically significantly higher level of MT immunoreactivity was observed in the adenocarcinoma tissue slides than in either the stromal slides or the reference slides while no differences in MT immunoreactivity were detected when the stroma and reference tissue slides were compared. A statistically significantly higher vimentin immunoreactivity level was identified in the tumor microenvironment tissue slides than in the tumor tissue slides, and a statistically significantly higher level of vimentin immunoreactivity was identified in the tumor microenvironment slides than in the slides of the reference tissue, while no differences were identified between the adenocarcinoma tissue slides and the reference slides with respect to vimentin immunoreactivity. A statistically significantly higher number of CD56- and CD57-expressing cells were identified in the reference tissue slides than in either the adenocarcinoma or stromal slides. In conclusion, the stroma of salivary gland adenocarcinoma in this study has been characterized by remodeling. The remodeling is represented by the expression of both vimentin and MT and by a deficit of CD57- and CD58-expressing cell infiltration. This situation would seem to be the result of immune tolerance for the tumor developing within the tumor microenvironment. Furthermore, the presence of MT and vimentin immunoreactivity in the fibroblasts of the tumor stroma may constitute a marker of active tissue remodeling

The long-term outcomes in perimenopausal patients treated for cervical cancer

Introduction. In the coming decades, the population of adults 65 years of age and older will increase significantly. Younger patients between 30 and 40 years of age, who are diagnosed with cervical cancer, have a better prognosis than the older group. The second peak of incidence, involving patients between 60 and 70 years of age, correlates with a poorer prognosis. Material and methods. In our study, we included 360 patients between 40 and 60 years old operated on due to cervical cancer followed by radiochemotherapy. We divided these patients into two groups according to age. The first group was composed of premenopausal patients (aged between 40 and 50 years) and the second of postmenopausal patients (aged between 50 and 60 years), and long-term outcomes (overall survival rates OS) were analysed in both groups of patients. Results. We observed statistically significant differences in the long-term outcomes between the subgroups of patients treated surgically for cervical cancer, and it was better in the premenopausal group of patients. No statistically significant relationship between these two groups of patients as far as clinical features was observed. Conclusion. We found that postmenopausal patients may actually benefit more from having radical surgery. Proving this supports the case for distinguishing geriatric oncology from gynaecological oncology.

Side effects of postoperative radiotherapy in patient with laryngeal cancer receiving immunosuppressive drugs after renal transplant recipient

Radioterapia stanowi ważną opcję terapeutyczną w leczeniu raka krtani, zarówno jako leczenie uzupełniające, jak i leczenie radykalne, jednakże u chorych po przeszczepie nerki może być trudna do przeprowadzenia. Autorzy opisują przypadek 63-letniego mężczyzny, po przebytej operacji radykalnej krtani z powodu raka, skierowanego do uzupełniającej radioterapii. Na podstawie wyniku badania histopatologicznego ustalono stopień zaawansowania guza na T2N0M0. W wywiadzie 3 lata wcześniej u pacjenta przeprowadzono zabieg przeszczepienia nerki od zmarłego dawcy; od tamtej pory przyjmował leczenie immunosupresyjne. Po włączeniu radioterapii zaobserwowano nadmierny odczyn popromienny błony śluzowej jamy ustnej. Wysoki odczyn popromienny (15 pkt wg skali Dischae) utrzymywał się, pomimo 2-tygodniowej przerwy w napromienianiu i wymagał leczenia objawowego. Z powodu długiej przerwy w radioterapii, po konsylium lekarskim, podjęto decyzję o zakończeniu leczenia. Chory otrzymał łączną dawkę 26Gy z zaplanowanej dawki 60Gy. Aktualnie, półtora roku od zakończenia radioterapii, pacjent czuje się dobrze, jest pod stałą kontrolą nie stwierdza się nawrotu choroby.Radiotherapy is an important option for laryngeal cancer treatment, both as an adjuvant and a radical procedure; however, in patients after renal transplantation it may be difficult to carry out. The authors describe a case of a 63-year-old man with a history of radical surgery for cancer of the larynx, ordered to undergo adjuvant radiotherapy. In the postoperative histopathological examination the patient was diagnosed with cancer stage T2N0M0, and radical surgery was performed. As per anamnesis, three years earlier the patient underwent renal transplantation from a deceased donor; since then he received immunosuppressive therapy. After radiotherapy had been included, excessive post-radiative reaction was observed in the oral mucosa. High treatment toxicity (15 Dische score) persisted despite a two-week break in radiotherapy, and symptomatic treatment was necessary. Due to a long interruption of radiotherapy, after a medical consultation a decision was made to terminate the treatment; instead of the planned 60Gy, the patient received 26Gy. Currently, eighteen months after the radiotherapy, the patient is in good condition and the follow-up examinations have shown no evidence of recurrenc