Gene expression of circulating tumour cells in breast cancer patients

<p>Abstract</p> <p>Background</p> <p>The diagnostic tools to predict the prognosis in patients suffering from breast cancer (BC) need further improvements. New technological achievements like the gene profiling of circulating tumour cells (CTC) could help identify new prognostic markers in the clinical setting. Furthermore, gene expression patterns of CTC might provide important informations on the mechanisms of tumour cell metastasation.</p> <p>Materials and methods</p> <p>We performed realtime-PCR and multiplex-PCR analyses following immunomagnetic separation of CTC. Peripheral blood (PB) samples of 63 patients with breast cancer of various stages were analyzed and compared to a control group of 14 healthy individuals. After reverse-transcription, we performed multiplex PCR using primers for the genes <it>ga733.3, muc-1 </it>and <it>c-erbB2. Mammaglobin1, spdef </it>and <it>c-erbB2 </it>were analyzed applying realtime-PCR.</p> <p>Results</p> <p><it>ga733.2 </it>overexpression was found in 12.7% of breast cancer cases, <it>muc-1 </it>in 15.9%, <it>mgb1 </it>in 9.1% and <it>spdef </it>in 12.1%. In this study, <it>c-erbB2 </it>did not show any significant correlation to BC, possibly due to a highly ambient expression. Besides single gene analyses, gene profiles were additionally evaluated. Highly significant correlations to BC were found in single gene analyses of <it>ga733.2 </it>and <it>muc-1 </it>and in gene profile analyses of <it>ga733.3</it>*<it>muc-1 </it>and GA7 <it>ga733.3</it>*muc-1*<it>mgb1</it>*<it>spdef</it>.</p> <p>Conclusion</p> <p>Our study reveals that the single genes <it>ga733.3, muc-1 </it>and the gene profiles <it>ga733.3</it>*<it>muc-1 </it>and <it>ga733.3</it>*3<it>muc-1</it>*<it>mgb1</it>*<it>spdef </it>can serve as markers for the detection of CTC in BC. The multigene analyses found highly positive levels in BC patients. Our study indicates that not single gene analyses but subtle patterns of multiple genes lead to rising accuracy and low loss of specificity in detection of breast cancer cases.</p

Diabetic ketoacidosis

Diabetic ketoacidosis (DKA) is the most common acute hyperglycaemic emergency in people with diabetes mellitus. A diagnosis of DKA is confirmed when all of the three criteria are present — ‘D’, either elevated blood glucose levels or a family history of diabetes mellitus; ‘K’, the presence of high urinary or blood ketoacids; and ‘A’, a high anion gap metabolic acidosis. Early diagnosis and management are paramount to improve patient outcomes. The mainstays of treatment include restoration of circulating volume, insulin therapy, electrolyte replacement and treatment of any underlying precipitating event. Without optimal treatment, DKA remains a condition with appreciable, although largely preventable, morbidity and mortality. In this Primer, we discuss the epidemiology, pathogenesis, risk factors and diagnosis of DKA and provide practical recommendations for the management of DKA in adults and children