Mide kanserinde reg1 alfa proteini sıklığı ve klinikopatolojik bulgularla ilişkisi

Giriş: Reg geni sadece pankreas B hücreleri için değil aynı zamanda gastrointestinal tractın epitelyal hücreleri için de bir büyüme faktörüdür. Gastrik epitelyal hücrelerde Reg1α proteinin trofik etkisi bilinmekle birlikte Reg1α proteininin mide karsinogenezinde rol alıp almadığı yeterince bilinmemektedir. Amaç: Bu çalışmada, mide kanserinde Reg1α protein sıklığının araştırılması ve Reg1α proteini ile klinikopatolojik özellikler arasında ilişki olup olmadığının ortaya konulması amaçlanmaktadır. Yöntem ve Gereçler: 102 mide kanseri hastası çalışmaya dahil edilmiştir. Sekonder malignitesi olan hastalar çalışma dışında bırakılmıştır. Tüm hastaların tümör piyeslerinde Reg1α proteini immunhistokimya yöntemi ile araştırılmıştır. Reg1α proteini pozitifliği ile klinikopatolojik özellikler arasındaki ilişki istatiksel olarak incelenmiştir. Sonuçlar: Hastaların yaş ortalaması 60,8±11,5 (31-83) dır. Toplam 102 hastanın 51 (50%)‘inde Reg1α protein pozitif bulunmuştur. Klinikopatolojik veriler incelendiğinde Reg1α pozitifliği ile seroza invazyonu arasında istatiksel olarak anlamlı ilişki gösterilmiştir (p: 0,042). Perinöral ve vasküler invazyonu olanlarda Reg1α proteini daha yüksek oranda gibi gözükse de sonuçlar istatistiksel olarak anlamlı düzeylere ulaşamamıştır. Sonuç olarak Reg1α proteini mide kanserinde anlamlı miktarda pozitiftir. Seroza invazyonu olan hastalarda daha yüksek oranda Reg1α protein pozitifliği, Reg1α proteininin tümorun agresif davranışı ile ilişkili olabileceği düşündürebilir. ABSTRACT Introduction: The Reg gene is known to be involved in the growth of not only pancreatic B-cells but also epithelial cells of the gastrointestinal tract and carsinoma of its lineage. Although regenerating gene (Reg) 1α protein has a trophic effect on gastric epithelial cells, it is unclear whether Reg1α protein and its receptor are involved in gastric carsinogenesis. Aim: In this study, we investigated the Reg1α protein in gastric cancers and assessed its relationship to clinicopathological factors. Material and Methods: One hundred-two patients with gastric cancer were included in this study. The patients who have the seconder malignancies were excluded. Gastric cancer pathologic specimens were examined using immunhistochemistry for Reg1α protein its relationship to clinicopathological parameters was analysed statistically. Results: The mean age of patients was 60,8±11,5 (31-83). Fifty-one (50%) patients of the 102 gastric cancer tissue samples were positive for Reg1α protein. The frequency of Reg1α protein was significiantly higher in patients with serosa invasion (p: 0,042). Reg1α protein had a high frequency in the patients with perineural and vascular invasion however these results were not important statistically. There were no relationship the Reg1α protein between other clinicopathological features and disease stage. Conclusion: Reg1α protein is expressed in a considerable number of gastric cancers. Increased Reg1α protein expression in gastric cancer with serosal invasion may related to aggressive tumor due to the relationship Reg1α protein and serosa invasion

Serum uric acid as a surrogate marker of favorable response to bevacizumab treatment in patients with metastatic colon cancer

WOS: 000385182500005PubMed ID: 26781472Bevacizumab is a monoclonal antibody which is a vascular endothelial growth factor inhibitor. It obscures vascularization of tumor tissue and damages intratumoral microcirculation. The damaged intratumoral microcirculation leads to tissue hypoxia and results in increase of uric acid level. The main aim of our study was to investigate the relationship between uric acid change and response to bevacizumab therapy. This study included a total of 158 patients with metastatic colorectal cancer who had received bevacizumab therapy. The number of male patients was 100 (63.3 %) while female patients number was 58 (37.7 %). The median age was 61 (29-83). There was relationship between increase of uric acid level of third month uric acid level and stable disease (p < 0.001). There was a significant overall survival increased in the group with increased uric acid level (p < 0.001). The decline of CEA level was related to uric acid level (p < 0.022). In conclusion, this study is the first showing significant increases of serum uric acid in patients with metastatic colorectal cancer who favorably responded to chemotherapy with bevacizumab. But further studies are justified to test whether monitoring uric acid levels might predict clinical outcomes of patients with metastatic colorectal cancer

Hemophagocytic Syndrome Associated with Immune Reconstitution Inflammatory Syndrome in a Patient with AIDS Related Burkitt’s Leukemia/Lymphoma

Highly active antiretroviral therapy (HAART) has markedly decreased human immunodeficiency virus- (HIV-) related mortality and the incidence of opportunistic infections. The dramatic reduction in HIV-1 RNA and increase in CD4 lymphocyte count mean a recovery in immune function. This restoration in immune function may be associated with paradoxical deterioration in subclinical opportunistic infections in some patients, a condition called immune reconstitution inflammatory syndrome (IRIS). IRIS, a “paradoxical” inflammatory response to either previously treated or subclinical infections or noninfectious diseases, can manifest during the restoration phase of immunity hemophagocytic syndrome (HS) which is a very rare complication in patients with acquired immune deficiency syndrome (AIDS). We describe a case of hemophagocytic syndrome associated with IRIS in a patient with AIDS related Burkitt’s leukemia/lymphoma (BL). IRIS was probably the cause of hemophagocytosis for our patient. Zoster infection may facilitate to IRIS. With the increasing number of people with HIV infection and the accompanying use of HAART, much more clinical manifestations of IRIS will be experienced especially in patients given high dose chemotherapy, just like in our case

Efficacy of subsequent treatments in patients with hormone-positive advanced breast cancer who had disease progression under CDK 4/6 inhibitor therapy.

Background There is no standard treatment recommended at category 1 level in international guidelines for subsequent therapy after cyclin-dependent kinase 4/6 inhibitor (CDK4/6) based therapy. We aimed to evaluate which subsequent treatment oncologists prefer in patients with disease progression under CDKi. In addition, we aimed to show the effectiveness of systemic treatments after CDKi and whether there is a survival difference between hormonal treatments (monotherapy vs. mTOR-based). Methods A total of 609 patients from 53 centers were included in the study. Progression-free-survivals (PFS) of subsequent treatments (chemotherapy (CT, n:434) or endocrine therapy (ET, n:175)) after CDKi were calculated. Patients were evaluated in three groups as those who received CDKi in first-line (group A, n:202), second-line (group B, n: 153) and >= 3rd-line (group C, n: 254). PFS was compared according to the use of ET and CT. In addition, ET was compared as monotherapy versus everolimus-based combination therapy. Results The median duration of CDKi in the ET arms of Group A, B, and C was 17.0, 11.0, and 8.5 months in respectively; it was 9.0, 7.0, and 5.0 months in the CT arm. Median PFS after CDKi was 9.5 (5.0-14.0) months in the ET arm of group A, and 5.3 (3.9-6.8) months in the CT arm (p = 0.073). It was 6.7 (5.8-7.7) months in the ET arm of group B, and 5.7 (4.6-6.7) months in the CT arm (p = 0.311). It was 5.3 (2.5-8.0) months in the ET arm of group C and 4.0 (3.5-4.6) months in the CT arm (p = 0.434). Patients who received ET after CDKi were compared as those who received everolimus-based combination therapy versus those who received monotherapy ET: the median PFS in group A, B, and C was 11.0 vs. 5.9 (p = 0.047), 6.7 vs. 5.0 (p = 0.164), 6.7 vs. 3.9 (p = 0.763) months. Conclusion Physicians preferred CT rather than ET in patients with early progression under CDKi. It has been shown that subsequent ET after CDKi can be as effective as CT. It was also observed that better PFS could be achieved with the subsequent everolimus-based treatments after first-line CDKi compared to monotherapy ET