10 research outputs found
Estudio de la frecuencia, distribuciĂłn y rendimiento diagnĂłstico en las lesiones neoplĂĄsicas sincrĂłnicas del carcinoma colo-rectal
ABSTRACT
To analyse the frequency, characteristics and
diagnosis of synchronic neoplastic lesions in colorectal cancer.
A review was carried out of 384 colorectal
cancers, diagnosed through complete colonoscopy and
resected. The synchronic cancers and the characteristics of the
adenomas were determined: number, size, histological type,
dysplasia, as well as their localisation in the colon and with
respect to the carcinoma.
Twenty-eight synchronic cancers were found
(7.3% of the total); 8 developed tumours and 20 malignant
polyps. In 54.4% of the cases there was a synchronic adenoma.
In patients with synchronic lesions, 43% showed an advanced
adenoma. Twenty percent of the synchronic polyps found were
proximal to the splenic flexure; 41% were distal and 38% had
both localisations. Fifty-nine point one percent of the patients
had some adenoma proximal to the cancer, with criteria of
advanced adenoma in 13.9%. The distribution of the adenomas
was more uniformly spread in the cancers with a proximal
localisation (p = 0.038). Seventeen percent of the distal cancers
presented synchronic lesions with a proximal colon localisation
exclusively. Partial endoscopies would diagnose the distal
cancers, but would omit a synchronic adenoma in 42.3% of the
sigmoidoscopies and 40% of the short colonoscopies.
High rates of carcinoma and synchronic
adenomas were registered. We underline the high index of
advanced adenomas and the frequency of synchronic lesions
proximal to the cancer, which is why incomplete colonoscopies,
although allowing the diagnosis of the distal cancer, omit a high
percentage of synchronic adenomas, including advanced
lesions. All of this confirms the need to perform a complete pre-
, intra- and post operational colonoscopy in resectable
colorectal cancer
Synchronous neoplastic lesions in colorectal cancer. An analysis of possible risk factors favouring presentation
Aim: few data have been published regarding the causes of
synchronous lesions in patients with colorectal cancer. The aim of
our study was to identify potential factors that might be implicated
in the development of multicentric lesions, since this knowledge
could be useful for tailored follow-up once initial synchronous lesions
have been removed.
Methods: we retrospectively reviewed 382 colorectal cancer
cases diagnosed by total colonoscopy and histological study of
surgical specimens. We divided our population into 2 groups,
based on whether they had synchronous lesions or otherwise.
Several data related to personal and family history, habits, symptoms,
and tumor characteristics were assessed. Univariate and
multivariate statistical analyses were performed.
Results: 208 (54.5%) patients had synchronous adenomas
and 28 (7.3%) had synchronous cancer. A multivariate analysis
showed that the following parameters were consistently related
to the presence of multicentric lesions âmale gender: OR = 1.97;
CI = 1.13-3.45; p = 0.017; age â„ 59 years: OR = 2.57;
CI = 1.54-4.29; p < 0.001; personal history of colonic adenomas:
OR = 3.04; CI = 1.04-8.85; p = 0.042; and obstructive tumors:
OR = 0.48; CI = 0.27-0.85; p = 0.012.
Conclusion: our results show that several parameters that are
easy to measure could be considered risk factors for the development
of multicentric lesions. These factors need to be confirmed
with follow-up studies analyzing their role in patients with and
without metachronic lesions once all synchronous lesions have
been removed
AnĂĄlisis de la posible influencia de las lesiones sincrĂłnicas en el pronĂłstico del cĂĄncer colorrectal resecado
Aim: To analyze the relationship between synchronous lesions in
patients with colorectal cancer and their prognostic value.
Patients and methods: We have retrospectively reviewed 369 patients
with resected colorectal cancer. We compared the rate of apparently
curative surgery, progression and tumoral relapse, development of
extracolonic cancer and mortality between patients with and without
synchronous cancer. Afterwards, we analyzed the same parameters in
colorectal cancer with and without synchronous adenomas. Finally, we
repeated the analysis after stratification of cancers in 2 groups according
to pTNM staging: 0-I-II stage vs III-IV.
Results: We found synchronous adenomas in 54.7% of our patients
and synchronous cancers in 7.6%. Follow-up period of groups with and
without synchronous lesions were: 70.8 ± 22.9 and 67.2 ± 24.5 months (p
= 0.55) respectivelly. Synchronous cancers showed higher mortality:
35.7 vs. 14.4%: p = 0.006; OR = 3.31 (1.33-8.13), higher tumoral progression
: 39.3 vs. 19.1%: p = 0.011; OR = 2.75 (1.14-6.56) and higher
relapse rate: 10.7 vs. 3.5%: p = 0.096. Stratifying according to stage,
patients with stage 0-I-II and synchronous cancer showed worse prognosis:
mortality = 27.7 vs. 8.1%, p = 0.019; OR = 4.45 (1.2-15.1), tumoral
progression = 27.8 vs. 8.5%, p = 0.02; OR = 4.12 (1.14-14.19), and
extracolonic cancer = 16.7 vs. 6.4% p = 0.095. There were no statistical
differences between cases with and without synchronous adenomas.
Conclusions: Synchronous cancers showed worse prognosis after
resection, with higher rate of tumoral progression and mortality. This difference
is focused on the cases diagnosed in stage 0-I-II, not being found in
III-IV. The presence of synchronous adenomas doesnât influence prognosis
New cytogenetic prognostic markers in breast cancer
Abstract
BACKGROUND:
The aim of this study was to identify chromosomal imbalances in a series of invasive ductal carcinomas. In order to characterize the prognostic value of the chromosomal aberrations, we determined the association between genetic changes, overall survival, recurrences and some well-known prognostic and diagnostic parameters.
MATERIAL AND METHODS:
We included in this study 70 ductal invasive carcinomas diagnosed at the Hospital of Navarra during 1991-1994. We used the Comparative Genomic Hybridization Technique (CGH) for the molecular cytogenetic analysis of formalin-fixed, paraffin embedded specimens.
RESULTS:
We obtained successful results in 57 out of 70 cases (81.4%). The most frequent recurring findings were DNA gains on 8q, 17q, 1q, 20q, 11q and 6q and losses on 16q, Xp, Xq, 13q, 11q and 8p. In the survival study, gains on 1q and 11q13 were more frequent in patients with recurrence (41.3% vs. 18.5% and 50% vs. 23.7%). Loss of 16q appears as a prognostic factor of good outcome because of its association with good pathological prognostic features: 100% of tumors with this aberration showed overexpression of Bcl-2, and 75% of them were node negative. Besides, 46.7% of the positive cases for the expression of estrogen receptors also showed this imbalance.
CONCLUSIONS:
The CGH is a useful technique for the study of paraffin embedded tumors. Our results confirm that the cytogenetic aberrations of tumors could be considered as prognostic factors contributing to a better knowledge of tumor outcome
Estudio de las lesiones neoplĂĄsicas metacrĂłnicas en el carcinoma colorrectal
Fundamento.
Analizar la frecuencia y las caracterĂsticas de las lesiones neoplĂĄsicas metacrĂłnicas, carcinomas y adenomas, tras la resecciĂłn de un cĂĄncer colo-rectal (CCR).
Pacientes y métodos.
Revisamos 382 CCR operados y seguidos mediante colonoscopias completas en dos hospitales de nuestra comunidad. Analizamos las lesiones metacrĂłnicas registradas valorando su localizaciĂłn, momento del diagnĂłstico, histologĂa, nĂșmero y tamaño. Estudiamos la frecuencia de adenomas de apariciĂłn precoz (12 meses), comparando su tamaño con respecto al resto de lesiones.
Resultados.
La mediana de seguimiento fue de 48 meses (12-112), con 2,74±1,47 colonoscopias/caso. Diagnosticamos 7 cĂĄnceres metacrĂłnicos (1,8%), 4 de ellos en estadio I. La mediana de tiempo hasta su diagnĂłstico fue de 24 meses (13-54). Registramos adenomas metacrĂłnicos en 162 casos (42,4%), sin diferencias entre los dos hospitales: 42,1% vs. 43,8% (p=0,88). Un 6,3% de los pacientes presentaron adenomas avanzados. En 164 casos en que el primer control se efectuĂł a los 12 meses, la incidencia de adenomas fue del 24%. Los adenomas fueron mayoritariamente Ășnicos (60,8%) y menores de 5 mm (68,5%). En un 55,5% de los casos con pĂłlipos, alguno tenĂa una localizaciĂłn proximal. El diagnĂłstico se realizĂł en la 1ÂȘ exploraciĂłn (56,2%), 2ÂȘ (27,8%) Ăł 3ÂȘ (9%). La mediana de tiempo hasta el diagnĂłstico fue de 21 meses (12-112) para el adenoma simple y de 35 (12-112) para el avanzado.
Conclusiones.
Nuestro seguimiento permitiĂł aplicar un tratamiento teĂłricamente curativo en la mayorĂa de los carcinomas metacrĂłnicos diagnosticados. La alta incidencia de adenomas y su frecuente localizaciĂłn proximal hacen necesario un seguimiento con colonoscopias completas, que deberĂa iniciarse al año de la operaciĂłn y podrĂa pasar a ser menos estricto tras tres exploraciones consecutivas sin pĂłlipos
Genomic imbalances detected by comparative genomic hybridization are prognostic markers in invasive ductal breast carcinomas
AIMS:
The aim of this work is the study of the prognostic significance of the chromosomal aberrations described in a series of invasive ductal breast carcinomas.
METHODS AND RESULTS:
We analysed by comparative genomic hybridization a group of 70 formalin-fixed paraffin-embedded invasive ductal breast carcinomas. Aberrations showed a frequency similar to previous studies using frozen tumours. Interestingly, we identified gains involving 6q16-q24 more frequently than in other series. We analysed the association among the chromosomal imbalances, 11 histopathological factors, relapse rate and overall survival of patients. Associations showed 16q losses as a potential marker of good prognosis, as they were more frequent in node-negative (P=0.025) and in oestrogen-positive tumours (P < 0.001). Furthermore, 100% of bcl-2+ tumours presented this aberration compared with 29.3% in bcl-2- (P=0.014). 1q, 11q, 17q and 20q gains were associated with poor prognosis: 95% of cases with 1q gains were bigger than 20 mm (P=0.041). Tumours with 1q and 11q gains showed a higher relapse rate (P=0.063; P=0.066). Within the good prognosis group of lymph node-negative patients, 17q and 20q gains identify a subgroup with increased relapse rate (P=0.039).
CONCLUSIONS:
Chromosomal imbalances, together with histopathological factors, may help to predict outcome in breast cancer patients
Estudio de la frecuencia, distribuciĂłn y rendimiento diagnĂłstico en las lesiones neoplĂĄsicas sincrĂłnicas del carcinoma colo-rectal
ABSTRACT
To analyse the frequency, characteristics and
diagnosis of synchronic neoplastic lesions in colorectal cancer.
A review was carried out of 384 colorectal
cancers, diagnosed through complete colonoscopy and
resected. The synchronic cancers and the characteristics of the
adenomas were determined: number, size, histological type,
dysplasia, as well as their localisation in the colon and with
respect to the carcinoma.
Twenty-eight synchronic cancers were found
(7.3% of the total); 8 developed tumours and 20 malignant
polyps. In 54.4% of the cases there was a synchronic adenoma.
In patients with synchronic lesions, 43% showed an advanced
adenoma. Twenty percent of the synchronic polyps found were
proximal to the splenic flexure; 41% were distal and 38% had
both localisations. Fifty-nine point one percent of the patients
had some adenoma proximal to the cancer, with criteria of
advanced adenoma in 13.9%. The distribution of the adenomas
was more uniformly spread in the cancers with a proximal
localisation (p = 0.038). Seventeen percent of the distal cancers
presented synchronic lesions with a proximal colon localisation
exclusively. Partial endoscopies would diagnose the distal
cancers, but would omit a synchronic adenoma in 42.3% of the
sigmoidoscopies and 40% of the short colonoscopies.
High rates of carcinoma and synchronic
adenomas were registered. We underline the high index of
advanced adenomas and the frequency of synchronic lesions
proximal to the cancer, which is why incomplete colonoscopies,
although allowing the diagnosis of the distal cancer, omit a high
percentage of synchronic adenomas, including advanced
lesions. All of this confirms the need to perform a complete pre-
, intra- and post operational colonoscopy in resectable
colorectal cancer
Synchronous neoplastic lesions in colorectal cancer. An analysis of possible risk factors favouring presentation
Aim: few data have been published regarding the causes of
synchronous lesions in patients with colorectal cancer. The aim of
our study was to identify potential factors that might be implicated
in the development of multicentric lesions, since this knowledge
could be useful for tailored follow-up once initial synchronous lesions
have been removed.
Methods: we retrospectively reviewed 382 colorectal cancer
cases diagnosed by total colonoscopy and histological study of
surgical specimens. We divided our population into 2 groups,
based on whether they had synchronous lesions or otherwise.
Several data related to personal and family history, habits, symptoms,
and tumor characteristics were assessed. Univariate and
multivariate statistical analyses were performed.
Results: 208 (54.5%) patients had synchronous adenomas
and 28 (7.3%) had synchronous cancer. A multivariate analysis
showed that the following parameters were consistently related
to the presence of multicentric lesions âmale gender: OR = 1.97;
CI = 1.13-3.45; p = 0.017; age â„ 59 years: OR = 2.57;
CI = 1.54-4.29; p < 0.001; personal history of colonic adenomas:
OR = 3.04; CI = 1.04-8.85; p = 0.042; and obstructive tumors:
OR = 0.48; CI = 0.27-0.85; p = 0.012.
Conclusion: our results show that several parameters that are
easy to measure could be considered risk factors for the development
of multicentric lesions. These factors need to be confirmed
with follow-up studies analyzing their role in patients with and
without metachronic lesions once all synchronous lesions have
been removed
Incidencia y mortalidad por cĂĄncer en Navarra, 1998-2002. EvoluciĂłn en los Ășltimos 30 años
Entre 1998-2002 se registraron 16.952 nuevos casos de cĂĄncer en Navarra. En los hombres, los cĂĄnceres mĂĄs frecuentemente diagnosticados fueron, por este orden prĂłstata, pulmĂłn,
colon y recto, vejiga y estĂłmago, que sumaron el 63,2% de todos
los casos de cĂĄncer. En mujeres las localizaciones de mama,
colon y recto, cuerpo de Ăștero, estĂłmago y ovario sumaron el
57,6 % del total de los casos.
En el mismo periodo, 1998-2002, fallecieron por cĂĄncer
4.127 hombres y 2.470 mujeres. El 60 % de todas las muertes
producidas por tumores malignos en hombres se debieron a las
localizaciones de pulmĂłn, prĂłstata, colĂłn y recto, estĂłmago y
vejiga. En las mujeres las localizaciones de colon y recto, mama,
estĂłmago, pĂĄncreas y pulmĂłn, sumaron el 49% de las defunciones por cĂĄncer.
En los hombres de Navarra han aumentado las tasas de
incidencia del cåncer de próstata, riñón y linfoma no Hodgkin.
CĂĄnceres evitables, como los relacionados con el hĂĄbito de
fumar (pulmĂłn, cavidad oral y faringe o pĂĄncreas), continĂșan en
ascenso, y representan mayor riesgo global de morir por cĂĄncer
en el Ășltimo periodo estudiado que en las dĂ©cadas de los años
1970 y 1980. A partir de 1995 y hasta la actualidad, la mortalidad
por cĂĄncer pasĂł de ocupar el segundo lugar a ser la primera
causa de muerte entre los hombres de Navarra. El riesgo global
de muerte por cĂĄncer en hombres se ha igualado al primer
periodo estudiado 1975-77.
Entre las mujeres el riesgo global de muerte por cĂĄncer
descendiĂł un 25% entre 1975 y 2002, a costa fundamentalmente
del cĂĄncer de mama y de estĂłmago. Los tumores relacionados
con el hĂĄbito de fumar muestran incrementos tanto en la mortalidad como en la incidencia y emerge como un problema
importante de salud entre las mujeres de Navarra. Ha aumentado la incidencia de cĂĄncer de mama, en cambio en la mortalidad
se sitĂșa en cifras inferiores a las del primer periodo 1975-77. El
cĂĄncer invasivo de cĂ©rvix se mantiene en tasas muy bajas respecto a muchos paĂses europeos, incluida España.
En ambos sexos han aumentado el cĂĄncer colorrectal y el
melanoma mientras que continĂșa el descenso de la incidencia y
mortalidad por cĂĄncer de estĂłmago.Between 1998-2002, 16,952 new cases of cancer were
registered in Navarre. In men, the most frequently diagnosed
cancers were in the following order: prostate, lung, colon and
rectum, bladder and stomach, which accounted for 63.2%. In
women, the sites were breast, colon and rectum, corpus uteri,
stomach and ovary, which accounted for 57.6% of the cases.
In the same period, 1998-2002, 4,127 men and 2,470 women
died from cancer. Sixty percent of all deaths due to malign
tumours in men were due to cancer of the lung, prostate, colon
and rectum, stomach and bladder. In women this was due to
cancers of colon and rectum, breast, stomach, pancreas and
lung, which accounted for 49% of the cases.
In men in Navarre there has been an increase in the
incidence rates of cancer of the prostate, kidney and nonHodgkin lymphoma. Avoidable cancers such as those related to
smoking (lung, oral cavity and pharynx or pancreas) continue to
rise, and represent a greater global risk of dying from cancer in
the latest period studied than in the decades of the 1970s and
1980s. From 1995 up to the present, mortality due to cancer has
moved from occupying the second place to become the first
cause of death among men in Navarre. The global risk of death
due to cancer in men is now equal to the first period studied,
1975-1977.
Amongst women the global risk of death due to cancer fell
by 25% between 1975 and 2002, basically at the cost of breast
and stomach cancer. Tumours related to smoking increased
both in mortality and in incidence and appear as a significant
health problem amongst women in Navarre. Breast cancer has
increased in incidence, with lower mortality figures than those
of the first period 1975-1977. Invasive cancer of the cervix
remains at very low rates in comparison with many European
countries, including Spain.
In both sexes colorectal and skin cancer has increased,
while the incidence and mortality of stomach cancer continues
to fall
Multi-messenger Observations of a Binary Neutron Star Merger
International audienceOn 2017 August 17 a binary neutron star coalescence candidate (later designated GW170817) with merger time 12:41:04 UTC was observed through gravitational waves by the Advanced LIGO and Advanced Virgo detectors. The Fermi Gamma-ray Burst Monitor independently detected a gamma-ray burst (GRB 170817A) with a time delay of with respect to the merger time. From the gravitational-wave signal, the source was initially localized to a sky region of 31 deg(2) at a luminosity distance of Mpc and with component masses consistent with neutron stars. The component masses were later measured to be in the range 0.86 to 2.26 . An extensive observing campaign was launched across the electromagnetic spectrum leading to the discovery of a bright optical transient (SSS17a, now with the IAU identification of AT 2017gfo) in NGC 4993 (at ) less than 11 hours after the merger by the One-Meter, Two Hemisphere (1M2H) team using the 1 m Swope Telescope. The optical transient was independently detected by multiple teams within an hour. Subsequent observations targeted the object and its environment. Early ultraviolet observations revealed a blue transient that faded within 48 hours. Optical and infrared observations showed a redward evolution over âŒ10 days. Following early non-detections, X-ray and radio emission were discovered at the transientâs position and days, respectively, after the merger. Both the X-ray and radio emission likely arise from a physical process that is distinct from the one that generates the UV/optical/near-infrared emission. No ultra-high-energy gamma-rays and no neutrino candidates consistent with the source were found in follow-up searches. These observations support the hypothesis that GW170817 was produced by the merger of two neutron stars in NGC 4993 followed by a short gamma-ray burst (GRB 170817A) and a kilonova/macronova powered by the radioactive decay of r-process nuclei synthesized in the ejecta