Prognostic impact of progesterone receptor expression in HER2-negative luminal B breast cancer

Aim: The new classification of breast cancer is based on microarray studies. Within the estrogen receptor (ER) positive breast carcinoma subtype further subgroups could be identified. In the present study, we analyzed the Her2 negative, highly proliferative subgroup (Luminal B1-like, LUMB1) with emphasis on their clinicopathological characteristics and progesterone receptor (PR) expression. Patients and methods: Our retrospective study concerned the period between 2000 and 2010. 158 patients were selected with ER positive, Her2 negative, Ki67>15% breast cancer. The pathological and clinical data were collected and analyzed. Age, tumor grade and stage, ER, PR, Her2 and Ki67 expression were recorded. The clinicopathological variables were correlated to PR expression. Results: The mean age of the patients was 57.5 (28-75) years. The ratio of patients younger than 40, was 8.86%. Shorter metastasis-free survival was observed in this young age group (P=0.044). The majority of our cases belonged to the pT1-pT2 stages (41.28% and 44.95%, respectively) whereas pT3 and T4 stage was detected in 5.50% and 8.25% of the cases, respectively. Almost half of the cases had no axillary lymph node metastasis (pN0: 48.91%), 1-3 lymph node metastases were detected in 38.04% (pN1), 4-10 metastatic lymph nodes were identified in 9.78% (pN2) and pN3 stage was found in 3.26% of the cases. Most commonly the tumors were either grade 2 or 3 (44.16% and 45%, respectively). The median value of Ki67 labeling index was 30%. Disease progression was detected in 36.19% of the patients. According to PR expression, a tendency to better prognosis (i.e. longer disease free- and overall survival) was detected in cases showing >10% PR positivity. However, no difference was found regarding tumor size, axillary stage, grade and age when comparing lower and higher PR expressing tumors. Conclusions: LUMB1 breast carcinomas are typically grade 2 and grade 3, the Ki67 labeling index is often 30% or higher. Distant metastases occur in more than one third of the cases. Within this subgroup, those cases with low PR expression represent a poor prognostic cohort. These findings require further investigations in larger number of LUMB1 breast cancer cases

Διαμόρφωση παράκτιας ζώνης και δημιουργία μικρού κέντρου θαλάσσιων ερευνών στον Άγιο Νικόλαο, Αναβύσσου

Στη σύγχρονη εποχή είναι σημαντική η ήπια ανάπτυξη και η προστασία των παράκτιων περιοχών που βάλλονται από την ανθρώπινη παρουσία. Επέλεξα την περιοχή του Αγίου Νικολάου, Αναβύσσου που είναι υψίστου φυσικό κάλλους και όπου εξαιτίας της θέσης της στην Αττική, απειλείται από την άναρχη δόμηση και την τουριστικοποίηση. Η πρότασή μου αφορά την προστασία, την ανάδειξη και την ήπια αξιοποίηση της περιοχής. Ένας στενός λαιμός άμμου ενώνει το νησί του Αγίου Νικολάου με τη στεριά της Αττικής. Ανατολικά του στα λιμνάζοντα νερά του απάνεμου κόλπου, με χρήση φυσικού λιμανιού, συναντούμε έναν σπάνιο βιότοπο. Αρχικά χαράσσεται ένα μονοπάτι που εισέρχεται στον πευκόφυτο λόφο και ενώνει το τελευταίο όριο της Αναβύσσου με τον ʼγιο Νικόλα. Η κίνηση του μονοπατιού δεν είναι συνεχής. Παύσεις και μικροί τοίχοι αντιστήριξης υποδεικνύουν την κατεύθυνση του περιπατητή. Ένα υπαίθριο αναψυκτήριο ελαφριάς κατασκευής βρίσκεται στο σημείο συνάντησης του μονοπατιού με το νερό, ενώ στάσεις με την μορφή κήπων με τοπική βλάστηση συναντιόνται σε όλη την πορεία του. Όταν το μονοπάτι φτάνει στο νερό, αλλάζει μορφή και συνεχίζει ως προβλήτα που το συνδέει με το νησί του Αγίου Νικολάου. Το μονοπάτι συνεχίζει δίπλα από το εκκλησάκι με τους μικρούς κήπους και επιστρέφει πάλι σε αυτό, κινούμενο περιμετρικά του λόφου και διασχίζοντας την κορυφή του. Πέραν όμως των υπαίθριων μονάδων διημέρευσης, το κίνηση του μονοπατιού διακόπτεται από ένα μικρό κέντρο θαλάσσιων ερευνών στην κορυφή ενός λόφου, που ασχολείται με τοπικού ενδιαφέροντος ζητήματα και κυρίως με την προστασία του θαλάσσιου βιοτόπου. Στόχος της επέμβασής μου στην περιοχή είναι να αναδείξω τις αναξιοποίητες μέχρι σήμερα πτυχές και εικόνες αυτού του τόπου. Τα ήπια εγχειρήματα στην τοπογραφία μεταφέρουν δράσεις και ανθρώπους πιο κοντά στην φύση

Serum Dipeptidyl Peptidase-4 Activity in Insulin Resistant Patients with Non-Alcoholic Fatty Liver Disease: A Novel Liver Disease Biomarker

Background: In a cross-sectional study we studied the fasting serum DPP-4 enzymatic activity (sDPP-4) and the insulin resistance index (HOMA2-IR) in gliptin naive patients with type 2 diabetes and in non-alcoholic fatty liver disease (NAFLD) and in healthy controls (CNTRL). Methods and Findings: sDPP-4 was measured by kinetic assay in 39 NAFLD (F/M: 19/20, mean age: 47.42 yrs) and 82 type 2 diabetes (F/M:48/34, 62.8 yrs) patients and 26 (F/M:14/12, 35.3 yrs) controls. Definition of T2D group as patients with type 2 diabetes but without clinically obvious liver disease created non-overlapping study groups. Diagnosis of NAFLD was based on ultrasonography and the exclusion of other etiololgy. Patients in T2D and NAFLD groups were similarly obese. 75 g CH OGTT in 39 NAFLD patients: 24-NGT, 4-IGT or IFG ("prediabetes''), 11-type 2 diabetes. HOMA2-IR: CNTRL: 1.44; T2D-group: 2.62 (p = 0.046 vs CNTRL, parametric tests); NAFLD(NGTonly): 3.23 (p = 0.0013 vs CNTRL); NAFLD(IFG/IGT/type 2 diabetes): 3.82 (p<0.001 vs CNTRL, p = 0.049 vs 2TD group). sDPP-4 activity was higher in NAFLD both with NGT (mean: 33.08U/L) and abnormal glucose metabolism (30.38U/L) than in CNTRL (25.89U/L, p<0.001 and p = 0.013) or in T2D groups (23.97U/L, p<0.001 and p = 0.004). Correlations in NAFLD among sDPP-4 and ALT: r = 0.4637, p = 0.0038 and gamma GT: r = 0.4991, p = 0.0017 and HOMA2-IR: r = 0.5295, p = 0.0026 and among HOMA2-IR and ALT: r = 0.4340, p = 0.0147 and gamma GT: r = 0.4128, p = 0.0210. Conclusions: The fasting serum DPP-4 activity was not increased in T2D provided that patients with liver disease were intentionally excluded. The high serum DPP-4 activities in NAFLD were correlated with liver tests but not with the fasting plasma glucose or HbA1C supporting that the excess is of hepatic origin and it might contribute to the speedup of metabolic deterioration. The correlation among cGT, ALT and serum DPP-4 activity and also between serum DPP-4 activity and HOMA2-IR in NAFLD strongly suggests that serum DPP-4 activity should be considered as a novel liver disease biomarker

Significant correlation (r = 0.3827; p = 0.019) between the liver disease biomarker γGT and the fasting serum DPP-4 enzymatic activity after logarithmic transformation in NAFLD patients.

<p>Significant correlation (r = 0.3827; p = 0.019) between the liver disease biomarker γGT and the fasting serum DPP-4 enzymatic activity after logarithmic transformation in NAFLD patients.</p

Significant correlation (r = 0.5295; p = 0.0026) between the HOMA2-Insulin resistance index and the fasting serum DPP-4 enzymatic activity in NAFLD patients.

<p>Significant correlation (r = 0.5295; p = 0.0026) between the HOMA2-Insulin resistance index and the fasting serum DPP-4 enzymatic activity in NAFLD patients.</p

Significant correlation (r = 0.4087; p = 0.0120) between the liver disease biomarker ALT and the fasting serum DPP-4 enzymatic activity after logarithmic transformation in NAFLD patients.

<p>Significant correlation (r = 0.4087; p = 0.0120) between the liver disease biomarker ALT and the fasting serum DPP-4 enzymatic activity after logarithmic transformation in NAFLD patients.</p