Radiopharmaceuticals for SPECT Cancer Detection

The purpose of the study was to assess the efficacy of single photon emission computed tomography (SPECT) with {199}Tl and {99}mTc-MIBI in the detection of breast, laryngeal and hypopharyngeal cancers. A total of 220 patients were included into the study: 120 patients with breast lesions (100 patients with breast cancer and 20 patients with benign breast tumors) and 100 patients with laryngeal/hypopharyngeal diseases (80 patients with laryngeal/hypopharyngeal cancer and 20 patients with benign laryngeal/hypopharyngeal lesions). No abnormal {199}Tl uptake was seen in all patients with benign breast and laryngeal lesions, indicating a 100% specificity of {199}Tl SPECT. In the breast cancer patients, the increased {199}Tl uptake in the breast was visualized in 94.8% patients, {99m}Tc-MIBI-in 93.4% patients. The increased {199}Tl uptake in axillary lymph nodes was detected in 60% patients, and {99m}Tc-MIBI-in 93.1% patients. In patients with laryngeal/hypopharyngeal cancer, the sensitivity of SPECT with {199}Tl and {99m}Tc-MIBI was 95%. The {199}Tl SPECT sensitivity in identification of regional lymph node metastases in the patients with laryngeal/hypopharyngeal cancer was 75% and the {99m}Tc-MIBI SPECT sensitivity was 17%. The data obtained showed that SPECT with {199}Tl and {99m}Tc-MIBI can be used as one of the additional imaging methods in detection of tumors

ВЛИЯНИЕ ТРАНСКРИПЦИОННЫХ ФАКТОРОВ, VEGF И ПРОТЕИНАЗ НА прогрессирование РАКА ПОЧКИ

Introduction. The efficacy of anticancer treatment depends on biological factors of tumor.The aim of the study was to determine the activity of proteasomes and calpains and to  reveal their association with VEGF, HIF-1α and NF-κΒ expressions in normal, primary and metastatic renal cell carcinoma (RCC) tissues.Methods. Ninety-three patients with renal cell carcinoma were included into the study. The expression levels of transcription factor and VEGF were measured using ELISA kits. The  levels of proteasome subunits were measured by Western Blotting. Proteasome and calpain  activities were determined using specific fluorogenic  substrates.Results. We revealed inactivation of proteolysis in patients with kidney cancer. Disease advance was associated with a significant depression of cellular proteolysis and increase in  transcription and growth factor levels in primary kidney cancer tissues. The proteolysis  activation was found in metastatic tissues.Conclusions. Our results suggest that NF-κΒ, HIF-1α and VEGF transcription factors and intracellular proteolytic systems are involved in kidney cancer progression.Введение. Эффективность противоракового лечения зависит от биологических факторов опухоли.Цель исследования – определить активность протеасом и кальпаинов и выявить их связь с содержанием  VEGF, HIF-1α и NF-κΒ в опухолевых, неизмененных и метастатических тканях карциномы почек (RCC).Материал и методы. В исследование были включены 93 пациента с почечно-клеточным раком. Содержание  транскрипционных факторов и VEGF определяли методом ИФА. Количественный состав протеасом исследовали  методом Вестерн-блоттинг. Активность протеасомы и кальпаина определяли с использованием специфического флюорогенного субстрата.Результаты. Выявлена инактивация протеолиза у пациентов с раком почки. Прогрессирование заболевания  было связано со значительным снижением уровня клеточного протеолиза и ростом содержания  транскрипционных и ростовых факторов в тканях первичной опухоли. Активация протеолиза была обнаружена в метастатических тканях.Выводы. В результате проведенного исследования показано, что факторы транскрипции NF-κΒ, HIF-1α, VEGF и внутриклеточные протеолитические системы участвуют в прогрессировании рака почки

ОТДАЛЕНЫЕ РЕЗУЛЬТАТЫ КОМПЛЕКСНОГО ЛЕЧЕНИЯ БОЛЬНЫХ РАКОМ МОЛОЧНОЙ ЖЕЛЕЗЫ С ИСПОЛЬЗОВАНИЕМ РАЗЛИЧНОГО ОБЪЕМА АДЪЮВАНТНОЙ ЛУЧЕВОЙ ТЕРАПИИ

The study included 103 patients with stage T1–3N0–3M0 breast cancer who received multimodality treatment including neo- and adjuvant chemotherapy according to CMF and CAF schedules, hormonal therapy, radical mastectomy and adjuvant radiation therapy. All patients were divided into two groups depending on the volume of postoperative radiation therapy. Group I patients (n=48) received 40–44 Gy external radiation therapy to the areas of potential regional spread. Group II patients (n-55) additionally received radiation therapy delivered to postoperative scar area at a total dose of 38–44 isoGy. The  comparative analysis of long-term results showed a significant decrease in the rate of local recurrences and increase in the 5-year recurrence-free and overall survival rates in the group of breast cancer patients who received adjuvant radiation therapy to the areas of potential regional spread and postoperative scar. In order to plan adequate radiotherapyand to minimize local radiation-induced reactions, it is necessary to consider clinical and morphological prognostic factors.В исследовании представлены результаты комплексного лечения 103 больных РМЖ стадии T1–3N0–3M0 c использованием нео- и адъювантной химиотерапии по схемам CMF, CAF и/или гормонотерапии, радикальной мастэктомии и адъювантной лучевой терапии. В зависимости от объема послеоперационной лучевой терапии больные были распределены на две группы: в I группе (n=48) проводилась дистанционная лучевая терапия (ДЛТ) на зоны регионарного лимфооттока в стандартном режиме СОД 40–44 Гр; во II группе (n-55) дополнительно проводилось облучение области послеоперационного рубца СОД 38–44 изоГр. Сравнительный анализ отдаленных результатов показал  значимое снижение числа местных рецидивов, а также повышение показателей  пятилетней безрецидивной и общей выживаемости в группе больных РМЖ, получавших адъювантную лучевую терапию на зоны регионарного лимфооттока и область послеоперационного рубца. Для планирования адекватного облучения и минимизации местных лучевых реакций нормальных тканей необходимо учитывать клинико-морфологические факторы прогноза заболевания

Clinicopathological features of nonspecific invasive breast cancer according to its molecular subtypes

The aim of the present study was to investigate the clinical and morphological features of nonspecific invasive breast cancer according to its molecular subtypes. Materials and Methods: 163 women with nonspecific invasive breast cancer (T1–4N0–3M0) were included in the present study. Luminal A type of breast cancer was detected in 101 women, luminal B type — in 23 women, overexpression of HER2/neu was identified in 14 women and triple-negative cancer — in 25 women. Results: The study revealed that various molecular subtypes of breast cancer differ in the morphological structure, the expression characteristics of the primary tumor and the rate of lymphogenous and hematogenous metastasis. Lymphogenous metastases were more frequently (in 71%) detected in HER2/neu overexpressing breast cancer than in luminal A (41%), luminal B (39%) and triple-negative tumors (40%). Hematogenous metastasis did not depend on the morphological structure of carcinoma infiltrative component, the state of tumor stroma as well as the proliferative activity in all the investigated groups. Conclusion: The revealed clinicopathological characteristics of different molecular subtypes of invasive breast cancer allow to predict the possible outcome of the disease and select personalized treatment strategy for patients more reasonably

ЛУЧЕВАЯ ТЕРАПИЯ РАКА МОЛОЧНОЙ ЖЕЛЕЗЫ С УЧЕТОМ ФАКТОРОВ ПРОГНОЗА

This review about the application of radiotherapy in breast cancer patients after radical mastectomy. Emphasizes the need for a differentiated approach to radiation therapy, which should be based on the definition of clinical morphological factors that determine the risk of loco-regional recurrence of breast cancer.Обзор посвящен применению послеоперационной лучевой терапии у больных раком молочной железы после выполнения радикальной мастэктомии. Подчеркивается необходимость дифференцированного подхода к лучевой терапии, который должен базироваться на оценке клинико-морфологических факторов, определяющих риск развития локо-регионарного рецидива РМЖ

АССОЦИАЦИЯ СОЧЕТАНИЯ АБЕРРАЦИЙ ЧИСЛА КОПИЙ ГЕНОВ WNT-СИГНАЛИНГА И АМПЛИФИКАЦИЙ ГЕНОВ СТВОЛОВОСТИ В ОПУХОЛИ МОЛОЧНОЙ ЖЕЛЕЗЫ С МЕТАСТАЗИРОВАНИЕМ

We studied the association between the presence of 2 or more stemness gene amplifications as well as copy number aberrations (CNAs) of WNT signaling genes in residual breast tumor and metastasis. WNT pathway genes associated with metastasis were identified.Material and Methods. The study included 30 patients with breast cancer, who had 2 or more stemness gene amplifications in the residual tumor after neoadjuvant chemotherapy. Fifteen of the thirty patients developed hematogenous metastases; they constituted a group with metastases, the remaining 15 patients entered the second group without metastases. The tumor DNA was examined using a CytoScanHD Array microarray (Affymetrix, USA).Results. By subtracting amplification and deletion frequencies in 852 cytobands between groups with metastases and without metastases, 21 cytobands were identified with the largest difference in deletion and amplification frequencies. They contain 19/150 of WNT genes (12 activators: SKP1, WNT8A, MAPK9, CCND3, FZD9, WNT8B, CCND1, PLCB2, PRKCB, FZD2, WNT3, WNT9B and 7 negative regulators: GSK3B, APC, CSNK2B, SFRP5, BTRC, TCF7L2, CSNK2A2). A point system was developed: when amplifying WNT-signaling activators or deletion of negative regulators, one point was added to the total score, and vice versa when deleting WNT-signaling activators or amplification of negative regulators, one point was taken from the total amount. It was shown that 93% (14/15) of patients with metastases had a total score higher than 0, while 93% (14/15) of patients without metastases had a total score of zero or less than zero. The differences between the groups were statistically significant according to the two-sided Fisher test with a high level of confidence probability (p=0.000003) and the log-rank test (p=0.00004) when assessing non-metastatic survival by the Kaplan-Mayer method.Conclusion. Nineteen WNT signaling genes were identified. Copy number aberrations of these genes in combination with stemness gene amplifications in residual tumors were associated with metastasis. A new highly effective prognostic factor for breast cancer was identified. Введение. Изучена ассоциация с гематогенным метастазированием наличия 2 и более амплификаций генов стволовости и CNA (Copy Number Aberration) локусов генов WNT-сигнального пути в остаточной резидуальной опухоли молочной железы. Идентифицированы гены WNT-pathway, ассоциированные с метастазированием.Материал и методы. В исследование были включены 30 больных раком молочной железы, в резидуальной опухоли которых после неоадъювантной химиотерапии были 2 и более амплификации генов стволовости. У 15 из 30 больных развились гематогенные метастазы, они составили группу с метастазами, во вторую группу без метастазов вошли остальные 15 пациентов. ДНК опухоли была исследована при помощи микроматрицы CytoScanHD Array (Affymetrix, USA).Результаты. Путем вычитания частот амплификаций и делеций по 852 цитобендам между группами с метастазами и без метастазов был установлен 21 цитобенд с наибольшей разницей частот делеций и амплификаций. В них находятся 19 из 150 генов WNT (14 активаторов: SKP1, WNT8A, MAPK9, CCND3, FZD9, WNT8B, CCND1, PLCB2, PRKCB, FZD2, WNT3, WNT9B и 7 негативных регуляторов: GSK3B, APC, CSNK2B, SFRP5, BTRC, TCF7L2, CSNK2A2). Была разработана балльная система, при амплификации активаторов WNT-сигналинга или делеции негативных регуляторов к общей сумме баллов прибавлялся один балл, и, наоборот, при делеции активаторов WNT-сигналинга или амплификации негативных регуляторов от общей суммы отнимался один балл. Показано, что 93 % (14/15) больных с метастазами имеют суммарный балл больше 0, в то время как 93 % (14/15) больных без метастазов имеют суммарный балл, равный нулю или меньше нуля. Различия между группами статистически значимы по двустороннему критерию Фишера с высоким уровнем доверительной вероятности (р=0,000003) и по лог-ранговому тесту (р=0,00004) при оценке безметастатической выживаемости по методу Каплана – Майера.Заключение. Были идентифицированы 19 генов WNT-сигналинга, CNA которых в резидуальной опухоли, совместно с амплификациями генов стволовости ассоциированы с метастазированием и могут использоваться в качестве прогностического фактора.

ROLE OF TRANSFORMING GROWTH FACTOR RECEPTOR B I TYPE (TGF-BRI) IN THE PROGRESSION OF THE LUMINAL BREAST CANCER SUBTYPE

Introduction. The crosstalk between the estrogen and growth factor receptors signaling may play an important role in the resistance to endocrine therapy. The aim of the study was to examine the relationship between the protein and receptor gene expression of transforming growth factor β type I (TGF-βRI) and its polymorphism with progression of luminal breast cancer patients treated by adjuvant tamoxifen. Material and methods.  The study included 105 patients with luminal breast cancer (T1-3N0–3M0), who had received adjuvant tamoxifen  at a dose of 20 mg/day for at least 5 years. Patients who developed distant metastasis or recurrence after tamoxifen therapy were defined as tamoxifen resistance (TR) group, while distant metastasis-free patients were analyzed as tamoxifen sensitive (TS) group. TGF-βRI expression level was evaluated using immunohistochemistry. TGF-BRI gene expression and genotypes for rs334354 SNP were detected by a Real-time PCR. Results. We found high TGF-βRI gene expression in patients with luminal A subtype compared with luminal B breast cancer (p=0.050). The Int7G24AA and Int7G24A mutant carriers were more prevalent in luminal A breast cancer patients (p=0.019 and p=0.007, respectively). TGF-βRI protein expression level was significantly higher in the tamoxifen sensitive group compared to tamoxifen resistance breast cancer patients regardless of molecular subtypes (p=0.043). There was a trend for a tamoxifen sensitivity among luminal B breast cancer patients with a high TGF-βRI protein expression (p=0.090). Conclusion. TGF-βRI protein expression level can be a potential molecular marker of tamoxifen resistance in luminal breast cancer patients