60 research outputs found
Preliminary Experience With the Use of Electromagnetic Navigation for the Diagnosis of Peripheral Pulmonary Nodules and Enlarged Mediastinal Lymph Nodes
Electromagnetic navigation is a new technique that can be
used with bronchoscopy to obtain samples of small peripheral
nodular lesions and enlarged mediastinal lymph nodes. It is
very versatile in that it enables both transbronchial biopsies
and fine-needle aspiration to be performed. We describe
2 cases in which navigation with the superDimension/
Bronchus system combined with traditional diagnostic
techniques facilitated a definitive diagnosis by bronchoscopy.
Electromagnetic navigation can obviate the need for more
invasive diagnostic procedures such as surgery, thus saving
time and money and avoiding complications
Lesiones traqueales focales. A propósito de un caso
Presentamos un caso de carcinoma adenoide quístico de tráquea
demostrado mediante TC multidetector de 64 coronas, PET-TC, y co-
rrelación anatomopatológica, en un paciente con hemoptisis. En este
artículo revisamos el diagnóstico diferencial de las lesiones traqueales
únicas focales mediante tomografía computarizada (TC). Las técnicas
de imagen permitieron el diagnóstico e infravaloraron la invasión de la
pared traqueal en este caso, confi
rmada con posterioridad mediante el
estudio histológico. INGLÉS: We present a case of adenoid cystic tracheal carcinoma detected by computerized tomography (64-MDCT) with cyto-histological correlation in a patient with hemoptysis. In this article we review the differential diagnosis of solitary focal tracheal lesions as they appear in computerized tomography (CT). In this case, image methods suggested the diagnosis but underestimated the tracheal wall invasion, which was established by histologycal examination of the resected tumor
Decrease of apoptosis rate in patients with renal transplantation treated with mycophenolate mofetil
We conclude that treatment with MMF of kidney transplant patients does not affect the proliferative rate of cells of the allograft, but decreases the number of apoptotic cells in tubular epithelium
Ewing Family Tumors: Potential Prognostic Value of Reverse-Transcriptase Polymerase Chain Reaction Detection of Minimal Residual Disease in Peripheral Blood Samples
In more than 95% of patients, the Ewing family of tumors (ET) has chimeric
transcripts caused by fusion of the EWS gene to either FLI1 or ERG. The presence
of specific EWS-FLI1 or EWS-ERG transcripts in peripheral blood (PB) samples of
patients being treated for ET was prospectively evaluated, and these data were
correlated to their clinical status. The authors studied 113 PB samples from 28
patients with ET. Treatment included chemotherapy, radiotherapy, and surgical
excision of tumor after induction therapy. PB samples were taken prospectively at
least 2 weeks after resection of tumor. Nested reverse-transcriptase polymerase
chain reaction (RT-PCR) followed by Southern blot was performed in all samples.
Resected tumors were reviewed for the degree of response to chemotherapy and
volume. Seventy-seven PB samples from 28 patients had EWS-FLI1/ERG transcripts.
In 11 patients, PB samples became negative with treatment, and, in 5 of them, the
samples remained negative throughout the study. Samples taken during progression
were always positive and, in 4 patients, became positive before progression was
clinically evident. All patients with transcripts other than EWS-FLI1 type 1 (n =
3) died from tumor progression. This is a sensitive assay to monitor circulating
tumor cells in Ewing tumors. The preliminary data suggest that progression is
preceded by positive samples and may be related to specific transcript types
Diagnostic yield of electromagnetic navigation bronchoscopy is highly dependent on the presence of a Bronchus sign on CT imaging: results from a prospective study
Electromagnetic navigation bronchoscopy (ENB) has been developed as a
novel ancillary tool for the bronchoscopic diagnosis of pulmonary nodules.
Despite successful navigation in 90% of patients, ENB diagnostic yield does not
generally exceed 70%. We sought to determine whether the presence of a bronchus
sign on CT imaging conditions diagnostic yield of ENB and might account for the
discrepancy between successful navigation and diagnostic yield. METHODS: We
conducted a prospective, single-center study of ENB in 51 consecutive patients
with pulmonary nodules. ENB was chosen as the least invasive diagnostic technique
in patients with a high surgical risk, suspected metastatic disease, or
advanced-stage disease, or in those who demanded a preoperative diagnosis prior
to undergoing curative resection. We studied patient and technical variables that
might condition diagnostic yield, including size, cause, location, distance to
the pleural surface, and fluorodeoxyglucose uptake of a given nodule; the
presence of a bronchus sign on CT imaging; registration point divergence; and the
minimum distance from the tip of the locatable guide to the nodule measured
during the procedure. RESULTS: The diagnostic yield of ENB was 67% (34/51). The
sensitivity and specificity of ENB for malignancy in this study were 71% and
100%, respectively. ENB was diagnostic in 79% (30/38) patients with a bronchus
sign on CT imaging but only in 4/13 (31%) with no discernible bronchus sign.
Univariate analysis identified the bronchus sign (P = .005) and nodule size (P =
.04) as statistically significant variables conditioning yield, but on
multivariate analysis, only the bronchus sign remained significant (OR, 7.6; 95%
CI, 1.8-31.7). No procedure-related complications were observed. CONCLUSIONS: ENB
diagnostic yield is highly dependent on the presence of a bronchus sign on CT
imaging
Desarrollo de la técnica de FICTION como nueva herramienta para el diagnóstico precoz de cáncer de pulmón
El cáncer de pulmón es una de las causas de muerte más frecuentes en el mundo occidental. La supervivencia global de los pacientes no supera el 15% a los 5 años, debido principalmente a que la mayor parte de los casos se diagnostican en estadios avanzados. Además de la prevención primaria, mediante la reducción del consumo de tabaco, son necesarias nuevas tecnologías para el diagnóstico precoz de la enfermedad.
Estudios recientes han demostrado que el TAC helicoidal del tórax es efectivo en la detección de nódulos pulmonares malignos en estadios precoces. En la actualidad se está valorando su eficacia en series amplias de pacientes de alto riesgo.
Recientemente se ha desarrollado una nueva técnica de citogenética molecular, el FICTION (Fluorescence Immunophenotyping and Interphase Cytogenetics as a Tool for the Investigation of Neoplasms). Esta técnica permite el análisis simultáneo de marcadores inmunofenotípicos y alteraciones genéticas presentes en las células tumorales. El objetivo de nuestro proyecto es su puesta a punto para el estudio de muestras de esputo y lavado broncoalveolar de pacientes con cáncer de pulmón. El fin último es estudiar la posibilidad de que esta técnica pueda ser utilizada, junto con el TAC helicoidal, en programas de detección precoz de cáncer de pulmón, para pacientes de alto riesgo.
En este trabajo presentamos una revisión de la contribución de las distintas técnicas de citogenética al estudio del cáncer de pulmón y la metodología de trabajo que vamos a llevar a cabo en nuestro proyecto
Mitogen-Activated Protein Kinase Phosphatase-1 Is Overexpressed in Non-Small Cell Lung Cancer and Is an Independent Predictor of Outcome in Patients
An increase in the activity of the mitogen-activated protein kinases (MAPKs) has been correlated with a more malignant phenotype in several tumor models in vitro and in vivo. A key regulatory mechanism of the MAPKs [extracellular signal-regulated kinase (ERK); c-jun NH(2)-terminal kinase (JNK); and p38] is the dual specificity phosphatase CL100, also called MAPK phosphatase-1 (MKP-1). This study was designed to examine the involvement of CL100/MKP-1 and stress-related MAPKs in lung cancer.
EXPERIMENTAL DESIGN:
We assessed the expression of CL100/MKP-1 and the activation of the MAPKs in a panel of 18 human cell lines [1 primary normal bronchial epithelium, 8 non-small cell lung cancer (NSCLC), 7 small cell lung cancer (SCLC), and 2 carcinoids] and in 108 NSCLC surgical specimens.
RESULTS:
In the cell lines, CL100/MKP-1 expression was substantially higher in NSCLC than in SCLC. P-ERK, P-JNK, and P-p38 were activated in SCLC and NSCLC, but the degree of their activation was variable. Immunohistochemistry in NSCLC resection specimens showed high levels of CL100/MKP-1 and activation of the three MAPK compared with normal lung. In univariate analysis, no relationship was found among CL100/MKP-1 expression and P-ERK, P-JNK, or P-p38. Interestingly, high CL100/MKP-1 expression levels independently predicted improved survival in multivariate analysis. JNK activation associated with T(1-2) and early stage, whereas ERK activation correlated with late stages and higher T and N. Neither JNK nor ERK activation were independent prognostic factors when studied for patient survival.
CONCLUSIONS:
Our data indicate the relevance of MAPKs and CL100/MKP-1 in lung cancer and point at CL100/MKP-1 as a potential positive prognostic factor in NSCLC. Finally, our study supports the search of new molecular targets for lung cancer therapy within the MAPK signaling pathway
Solid pseudopapillary tumor of the pancreas (SPPT). Still an unsolved enigma
Solid pseudo-papillary tumor (SPPT) is a rare cystic tumor of
the pancreas (1-3% of exocrine tumors of the pancreas) which
shows an “enigmatic” behavior on the clinical and molecular pattern.
A retrospective analysis of the citological studies and resected
specimens of pancreatic cystic tumors from May 1996 to February
2010 was carried out. Three cases of SPPT were found,
which are the objective of this study. The diagnosis was established
upon occasional finding in the abdominal CT, in spite of sizing
between 3 and 6 cm of diameter. In the three cases the preoperative
diagnosis was confirmed by citology and specific
immunohistochemical staining. Cases 2 and 3 showed strong immunoreactivity
for Beta-Catenina and E-Cadherina staining. Radical
resection (R0) was carried out in the three cases. A young
male –21 years of age (case 1)- who had duodenal infiltration and
two lymph nodes metastases died of hepatic and peritoneal recurrence
20 months following surgery. The other two cases are free
of disease. The current review of the literature reports roughly
800 cases since the first report in 1959, and shows the enigmatic
character of this tumor regarding the cellular origin, molecular
pathways, prognostic factors and clinical behavior
Molecular features in a biphenotypic small cell sarcoma with neuroectodermal and muscle differentiation
We report a case of a 13-year-old girl with soft tissue sarcoma of the hand,
which showed muscle and neuroectodermal immunophenotypes. Molecular studies were
performed on RNA collected from fine-needle aspiration (FNA) cytology and
peripheral blood samples by nested reverse transcriptase-polymerase chain
reaction (RT-PCR) and Southern blot analysis. This biphenotypic tumor showed
simultaneous expression of EWS-FLI1 and PAX3-FKHR transcripts, specific of Ewing
family tumors and alveolar rhabdomyosarcoma, respectively. Although childhood
sarcomas with simultaneous muscle and neural differentiation have been described
to have EWS-FLI1 transcripts, there are no reports of tumors with both
transcripts. Cytological specimens are a good source of RNA for molecular
studie
Altered patterns of expression of members of the heterogeneous nuclear ribonucleoprotein (hnRNP) family in lung cancer
hnRNP A2/B1 has been suggested as a useful early detection marker for lung carcinoma. hnRNP A2/B1 is a member of a large family of heterogeneous nuclear ribonucleoproteins (hnRNP proteins) involved in a variety of functions, including regulation of transcription, mRNA metabolism, and translation. In lung cancer, we have evaluated the expression and cellular localization of several members of the hnRNP family, hnRNP A1, A2, B1, C1, C2 and K. 16 cell lines (SCLC and NSCLC) and biopsies from 32 lung cancer patients were analyzed. Our results suggest that, besides hnRNP A2/B1, the expression of other members of the hnRNP family is altered both in SCLC and NSCLC. In the biopsies, negative or low expression of the hnRNP proteins analyzed was observed in normal epithelial cells whereas lung cancer cells showed highly intense nuclear or cytoplasmic immunolocalization. In all the lung cancer cell lines, the mRNA for all the hnRNP proteins was detected. In general, higher levels of hnRNP mRNAs were found in SCLC as compared with NSCLC. Our results also suggest that the expression and processing of each hnRNP protein in lung cancer is independently regulated and is not exclusively related to proliferation status. In SCLC cell lines, hnRNP A1 protein expression correlated with that of Bcl-x(L). In the lung cancer cell lines, hnRNP K protein localization varied with the cellular confluence
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