Correlation between pre-therapeutic TPS and VEGF concentrations, in the serum of patients with cancer of the uterine cervix, and early effects of therapy

AimTo assess the relationship between pre-therapeutic serum TPS and VEGF levels and the results of treatment as measured immediately after completion of therapy.Materials/MethodsThe study included 146 women treated for cancer of the uterine cervix. Of these, 37 women were in stage I, 43 in stage II, 59 in stage III and 7 in stage IV of disease progression according to the FIGO classification. The ages of the patients ranged from 31 to 80 years. The dominant cancer observed was squamous cell carcinoma which accounted for more than 97% of cases. Samples were taken before commencement of treatment. Patients were treated by a combination of methods including radiochemotherapy, radical radiotherapy and palliative radiotherapy. The effects of therapy were graded after completion of irradiation according to generally accepted criteria. For tested criteria, ROC curves were drawn, determining cut-off points of 58 U/l for TPS and 500 pg/l for VEGF. For statistical calculations the U Mann-Whitney test was used.ResultsThe level of VEGF expression varied between groups of patients in certain stages of disease progression (stages 1 & 2 and stages 2 & 3). Statistically significant differences were found between group PR in stage 2 and a control group of healthy women. Entry levels of TPS rose with tumor advancement (in stages 2, 3 & 4) and were higher than in a group of healthy women. Detected differences were statistically significant.ConclusionsOnly pre-therapeutic TPS levels show definite differences between degrees of clinical advancement and also with early therapeutic effects. Comparatively higher levels of serum TPS were found in patients with the worst prognosis prior to treatment (group P) than in the control group. This difference is statistically significant. Pre-therapeutic VEGF levels showed statistically significant differences between early (I, II) and advanced (III) clinical stages of the tumor as well as some effects of therapy assessed immediately after completion of treatment (PR vs S)

Correlation between hepatocyte growth factor receptor and vascular endothelial growth factor-A in breast carcinoma.

The aim of the study was to evaluate the prognostic value of the vascular endothelial growth factor A (VEGF-A) and hepatocyte growth factor receptor (HGFR, c-met) expressions in homogenous group of breast cancer patients. Tumor samples were collected from 98 patients with invasive ductal breast carcinoma stage II treated with primary surgery. We have observed a strong correlation between VEGF-A and c-met. No correlations were found between VEGF-A or HGFR expressions and clinical parameters (tumor size, grade, axillary lymph node status, age), 5- and 10-years DFS or OS. Our study did not reveal any prognostic value of c-met or VEGF. In addition they are not useful to separate a patients' subgroup with poor prognosis. Unlike in other authors' studies, our patients' group is very homogenous which might tribute to obtained results

Tumour-infiltrating CD4 and CD8 T lymphocytes in breast cancer

Lymphocytes are cells circulating between the blood and tissues. It has been stated that a correlation exists between immune infiltrate and breast cancer. These tumours are infiltrated by T cells, B cells, natural killer cells and macrophages. The infiltrating T cells are of helper (CD4+) and cytotoxic (CD8+) phenotypes. Specific immunity mediated by cytolytic T lymphocytes is suspected of playing an anticancer role. It is widely known that regional lymph nodes are an important immunological defence or “barrier” against tumour expansion. Some authors have reported that in cancer patients natural killer (NK) cells and CD8+ T cells are diminished in regional lymph nodes, particularly those involved by the tumour.In the presented study the authors review current knowledge on this problem and the possibility of using successful immunotherapy with monoclonal antibodies for breast cancer

The value of the cytocins and the solubility of theirs receptors in the serum of the patients with the cervical cancer

The study encompassed 146 women with recognized invasive cervical cancer in 4 clinical stages. Patients underwent therapy in Oncologic Gynaecology Department of Wrocław Medical University in 2001 and 2002 years. The correlation between pretreatment serum level of proangiogenic and inflammation factors – VEGF, sTNF-R1, IL-6 and clinical stage or early effects of therapy were observed. The strong and statistically significant relationship between pretreatment serum level of IL-6 and sTNF-R1 and clinical stage with early effect of treatment were found. The statistically significant correlation between serum level of all investigated parameters and clinical stage of cervix cancer was noticed. VEGF wasn’t an independent prognostic factor in the study, but the prognostic value of IL-6 was demonstrated

Dysregulated Expression of Both the Costimulatory CD28 and Inhibitory CTLA-4 Molecules in PB T Cells of Advanced Cervical Cancer Patients Suggests Systemic Immunosuppression Related to Disease Progression

Cervical cancer (CC) occurs more frequently in women who are immunosuppressed, suggesting that both local and systemic immune abnormalities may be involved in the evolution of the disease. Costimulatory CD28 and inhibitory CTLA-4 molecules expressed in T cells play a key role in the balanced immune responses. There has been demonstrated a relation between CD28, CTLA-4, and IFN genes in susceptibility to CC, suggesting their importance in CC development. Therefore, we assessed the pattern of CD28 and CTLA-4 expression in T cells from PB of CC patients with advanced CC (stages III and IV according to FIGO) compared to controls. We also examined the ability of PBMCs to secrete IFN-gamma. We found lower frequencies of freshly isolated and ex vivo stimulated CD4 + CD28+ and CD8 + CD28+ T cells in CC patients than in controls. Loss of CD28 expression was more pronounced in the CD8+ T subset. Markedly increased proportions of CTLA-4+ T cells in CC patients before and after culture compared to controls were also observed. In addition, patients’ T cells exhibited abnormal kinetics of surface CTLA-4 expression, with the peak at 24 h of stimulation, which was in contrast to corresponding normal T cells, revealing maximum CTLA-4 expression at 72 h of stimulation. Of note, markedly higher IFN-gamma concentrations were shown in supernatants of stimulated PBMCs from CC patients. Conclusions: Our report shows the dysregulated CD28 and CTLA-4 expression in PB T cells of CC patients, which may lead to impaired function of these lymphocytes and systemic immunosuppression related to disease progression

Gestational trophoblastic disease: the role of surgery

Gestational trophoblastic disease (GTD) is a rare, potentially malignant condition, originating in the fetal tissue and developing inside maternal organism. Treatment of gestational trophoblastic neoplasia, a worse form of GTD, is based on chemotherapy administered as single- or multi-drug protocols, selected depending on the presence of significant risk factors, while in some clinical situations surgical treatment may play a significant role. In particular, surgery is resorted to in cases of persistent disease, developing as a result of primary or secondary chemoresistance of the original pathology. In such a setting, adjuvant surgery, e.g. hysterectomy or excision of a single pulmonary GTD focus, considerably improves expected remission rate. Standard procedure performed in patients with chemoresistant, residual form of GTD is hysterectomy. The second most frequently performed procedure in GTD is excision of a pulmonary metastasis. Furthermore, surgical intervention in an emergency setting (e.g. massive hemorrhage) is relatively frequent in GDT. Apart of hysterectomy, available surgical options include hemostatic suture of bleeding tissue, ligation of internal iliac arteries or interventional radiology aiming at selective embolization of uterine arteries. Therefore, surgery plays an important role in eradication of persistent and chemoresistant forms of GTD and may be life-saving in emergency situations.Ciążowa choroba trofoblastyczna (gestational trophoblastic disease, GTD) jest rzadką, czasem złośliwą chorobą wywodzącą się z tkanki płodowej, a powstającą w organizmie matczynym. Zasadnicze leczenie gorzej rokującej postaci tej choroby, zwanej ciążową trofoblastyczną neoplazją, oparte jest na chemioterapii stosowanej w postaci schematów mono- lub wielolekowych dobieranych w zależności od obecności istotnych czynników ryzyka, jednak w pewnych sytuacjach klinicznych istotną rolę odgrywa leczenie chirurgiczne. Stosuje się je w szczególności w przypadkach choroby przetrwałej rozwijającej się w wyniku pierwotnej lub wtórnej chemiooporności ogniska chorobowego. Zastosowanie wówczas chirurgii adiuwantowej, na ogół w postaci histerektomii lub resekcji pojedynczego ogniska GTN w płucach, znacznie poprawia szanse na uzyskanie remisji. Podstawowym zabiegiem operacyjnym wykonywanym u pacjentek z chemiooporną, przetrwałą postacią choroby trofoblastycznej jest usunięcie macicy. Drugi co do częstości wykonywania zabieg chirurgiczny w przypadku GTN stanowi usunięcie przerzutu do płuca poprzez jego resekcję. Również chirurgia interwencyjna w sytuacjach nagłych (np. masywnego krwotoku) ma relatywnie często miejsce w GTN. Do arsenału zabiegowego poza histerektomią zalicza się wówczas: hemostatyczne szycie krwawiącej tkanki, podwiązanie tętnic biodrowych wewnętrznych czy wreszcie wykorzystanie radiologii interwencyjnej w postaci angiograficznej selektywnej embolizacji tętnic macicznych. Chirurgia odgrywa zatem istotną rolę w eradykacji przetrwałych i chemioopornych postaci ciążowej choroby trofoblastycznej, a stosowana interwencyjnie ratuje życie chorej w stanach nagłych