Novel diagnostic tests for breast cancer

W niniejszej pracy zaprezentowano nowoczesne testy diagnostyczne stosowane w raku piersi. OncotypeDx jest zbadanym klinicznie, wielogenowym testem dla pacjentów z wczesnym rakiem piersi, za pomocą którego ocenia się prawdopodobieństwo nawrotu choroby oraz przewiduje korzyść z zastosowanej chemioterapii, co umożliwia zaplanowanie optymalnego leczenia. GeneSearch pozwala wykryć przerzuty raka piersi do regionalnych węzłów chłonnych, stanowiąc cenną alternatywę dla współczesnych technik śródoperacyjnych. CellSearch to zaawansowana platforma diagnostyczna analizująca krążące komórki guza u pacjentów z uogólnionym rakiem piersi. Przewiduje ona przeżycia wolne od progresji oraz całkowite przeżycia lepiej niż obecne metody diagnostyczne.The current paper presents novel diagnostic tests for breast cancer. OncotypeDx is the clinically validated multi-gene assay for early-stage breast cancer that quantifies the likelihood of distant breast cancer recurrence to assist in treatment planning and predicts the magnitude of chemotherapy benefit. GeneSearch is the objective test system for breast cancer lymph node analysis, a viable alternative to current intraoperative techniques. CellSearch is an advanced diagnostic platform for the analysis of circulating tumor cells (CTC) in patients with metastatic breast cancer. Circulating tumor cells analysis provides valuable diagnostic information for predicting progression-free survival and overall survival earlier than the current standard of care

Association of microRNAs and pathologic response to preoperative chemotherapy in triple negative breast cancer: preliminary report

Triple negative breast cancer (TNBC) has caught the attention of oncologists worldwide because of poor prognosis and paucity of targeted therapies. Gene pathways have been widely studied, but less is known about epigenetic factors such as microRNAs (miRNAs) and their role in tailoring an individual systemic and surgical approach for breast cancer patients. The aim of the study was to examine selected miRNAs in TNBC core biopsies sampled before preoperative chemotherapy and the subsequent pathologic response in mastectomy or breast conservation specimens. Prior to treatment, core needle biopsies were collected from 11 female patients with inoperable locally advanced TNBC or large resectable tumors suitable for down-staging. In all 11 TNBC core biopsies we analyzed 19 miRNAs per sample: 512, 190, 200, 346, 148, 449, 203, 577, 93, 126, 423, 129, 193, 182, 136, 135, 191, 122 and 222 (miRCURY LNA™ Universal RT microRNA polymerase chain reaction Custom Pick & Mixpanels). The Wilcoxon signed-rank test was used to compare related samples. Ingenuity pathway analysis was used to evaluate potential functional significance of differentially expressed miRNAs. Statistical analysis showed that 3 of 19 miRNAs differed in relation to pathologic response i.e. good versus poor. These differences failed to reach statistical significance, although a trend was observed (p = 0.06). Among these miRNAs, we identified—miR-200b-3p, miR-190a and miR-512-5p. In summary, our results indicate that higher miR-200b-3p, higher miR-190a and lower miR-512-5p expression levels in core biopsies sampled from TNBC patients may be associated with better pathologic response to chemotherapy and the increased feasibility of breast conserving surgery in these patients. Although these results were from a small cohort, they provide an important basis for larger, prospective, multicenter studies to investigate the potential role of miRNAs in neoadjuvant setting

Giant urothelial carcinoma of unknown origin invading the sigmoid mesocolon – a case report

BackgroundTransitional cell carcinoma, also called urothelial carcinoma, is the most common malignancy of the urinary bladder. Additionally, it can develop in the lining of the renal pelvis, ureter, prostate and urethra. Exceptionally, cancer can arise from the urachus. Also primary transitional cell carcinoma of the endometrium or ovary is a rare entity.AimThe aim of this article was to present a case of giant urothelial carcinoma of unknown origin invading the sigmoid mesocolon.Case ReportWe report a rare case of urothelial carcinoma invading the sigmoid mesocolon in a 60-year-old female admitted to our department. The patient presented with a 25-cm intra-abdominal mass and 6-cm ulcerated lesion at the top of the umbilicus. Laparotomy was performed which demonstrated a huge polycystic and solid tumour of the sigmoid mesentery infiltrating the sigmoid colon and appendix. Appendectomy and resection of the tumour with an infi ltrated sigmoid loop were performed. A right ovarian cyst – not contiguous to the aforementioned tumour – was found at the time of the operation and excised. We also removed the 6-cm skin lesion in the umbilical area.Histopathological examination revealed urothelial carcinoma with squamous cell metaplasia of the sigmoid mesocolon with bowel and umbilical invasion.Concurrent desmoid cyst (mature teratoma) of the right ovary was found.ConclusionsIn conclusion, this patient with a sigmoid mesocolon invasion from urothelial carcinoma of unknown origin posed a diagnostic dilemma

Lipid peroxidation and glutathione peroxidase activity relationship in breast cancer depends on functional polymorphism of GPX1

Functional SNPs selected for the study. Table S2. Restriction fragment analysis for BRCA1 mutations. Table S3. Oxidative stress parameters in breast cancer cases according to treatment. (DOCX 31 kb

Chest pain: is it always what it seems to be?

Pacjent w wieku 56 lat, po pilnej operacji tętniaka rozwarstwiającego aorty (AAD) (31.03.2017 r.), po udrożnieniu tętnicy biodrowej wspólnej (CIA) z powodu ostrego niedokrwienia kończyny dolnej (marzec, 2017 r.), z 70-procentowym dystalnym zwężeniem gałęzi przedniej zstępującej (LAD) (w angiografii tomografii komputerowej [angio-CT], od roku, dotąd niekwalifikowanym do koronarografii/tomografii emisyjnej pojedynczego fotonu), wydolny krążeniowo-oddechowo, przyjęty z tygodniowym wywiadem stałego bólu w klatce piersiowej, promieniującego do okolicy międzyłopatkowej, lewego barku, niezależnego od wysiłku fizycznego, bez duszności. Kolejne elektrokardiogramy: rytm zatokowy miarowy, zmienny oddechowo q III, nieswoiste zmiany odcinka ST-T w odprowadzeniach I, aVL do –0,5 mm, w odprowadzeniach V4–V6 do –1 mm, bez ewolucji. Wartości troponiny T oznaczanej metodą wysokoczułą i frakcji sercowej kinazy kreatynowej w normie. Nitrogliceryna podawana dożylnie spowodowała tylko zmniejszenie dolegliwości. Angio-CT aorty bez zmian w porównaniu z wcześniejszym badaniem (z 17.10.2017 r.): proteza bez przecieku, stare rozwarstwienie od aorty zstępującej do rozwidlenia, obejmujące CIA. Angio-CT tętnic wieńcowych: istotne długie zwężenie LAD. Bez wskazań do interwencji kardiochirurgicznej. Echokardiografia serca: frakcja wyrzutowa lewej komory 65%, dobry odległy efekt operacji naprawczej AV. Rozpoznano ostry zespół wieńcowy–dławicę piersiową (ACS-UA). Koronarografia: LAD segm. 7 długie zwężenie 80%, izolowane. Aortografia: dobry efekt protezowania aorty wstępującej. Jednoczasowo przezskórna interwencja wieńcowa (PCI)-LAD: segm. 7/IDg (bifurkacja) z implantacją stentu uwalniającego lek. Dolegliwości ustąpiły. Nietypowe bóle w klatce piersiowej u chorego z tętniakiem aorty, nawet po skutecznej operacji, mogą odpowiadać ACS, stanowiąc wskazanie do koronarografii/PCI, po wykluczeniu przyczyn ze strony aorty. Opóźniona koronarografia/PCI/leczenie przeciwpłytkowe w ACS zmniejsza szanse powodzenia leczenia. U opisanego pacjenta stwierdzono dodatni wywiad w kierunku chorób aorty, ujemne markery niedokrwienia mięśnia sercowego, ból promieniujący do typowej dla AAD lokalizacji (do pleców). Pierwszym krokiem była angio-CT w celu wykluczenia kolejnego AAD. Ból w klatce piersiowej nie zawsze jest tym, czym się wydaje. Po wykluczeniu najbardziej oczywistej przyczyny konieczne jest przeprowadzenie diagnostyki różnicowej, ponieważ leczenie terapeutyczne odpowiednie dla jednej choroby lub opóźnienie właściwego leczenia może utrudnić/uniemożliwić leczenie innej.A 56-year-old patient after emergency acute aortic dissection (AAD) surgery (31.03.2017), after common iliac artery (CIA) vascular surgery due to acute right lower limb ischemia (March 2017), with a 70% lesion in distal left anterior descending (LAD) in angiography computed tomography (angio-CT) detected a year ago (not yet qualified for coronarography/single-photon emission computed tomography), hemodynamically stable, presented to hospital due to one-week history of constant, continuous chest pain radiating to the back and left shoulder and independent of physical effort, without dyspnea. Electrocardiography (ECG) in hospital at admission (and a day ago): regular sinus rhythm, respiratory variable q III, non-specific ST-T wave abnormalities in leads I, aVL up to –0.5 mm, in leads V4–V6 up to –1 mm, no evolution. Immobilization, nitroglicerin intravenous. administration — only symptoms reduction. High-sensitivity troponin T and creatine kinase-myocardial bound mass negative. Aortic angio-CT scan: in comparison to the previous study (17.10.2017) without significant changes; no leakage signs within the prosthesis; further dissection of the aortic wall from the level of the descending aorta to the bifurcation and CIA. Coronary angio-CT: significant, long stenosis in proximal LAD. Cardiac surgeon consultation: no indications for intervention. Echocardiography: left ventricular ejection fraction 65%, aortic regurgitation trace, right ventricular systolic function preserved. Diagnosis: acute coronary syndrome–unstable angina (ACS-UA). Coronarography: in LAD segm 7 isolated 80% stenosis. Aortography confirmed good prosthetic effect of the ascending aorta. Simultaneously percutaneous coronary intervention (PCI)-LAD, segm 7/IDg (bifurcation) with drug-eluting stent implantation was performed. The symptoms disappeared. Atypical chest pain in a patient with aortic aneurysm, even after successful cardiac surgery, may suggest an ACS, being an indication for coronary angiography/PCI, after exclusion aortic reasons. Delayed coronarography/coronaroplasty/antiplatelet therapy in ACS reduces the chances of successful treatment. The patient had a history of aortic diseases, negative myocardial ischemia markers, pain radiating to typical for AAD location (back pain). The first step was angio-CT to exclude another AAD. Chest pain is not always what it seems to be. After excluding the most obvious cause, it is necessary to perform differentia diagnostics, because therapeutic approach appropriate for one disease or delay in proper treatment may make it difficult/impossible to treat another one

Polish 2010 growth references for school-aged children and adolescents

Growth references are useful in monitoring a child's growth, which is an essential part of child care. The aim of this paper was to provide updated growth references for Polish school-aged children and adolescents and show the prevalence of overweight and obesity among them. Growth references for height, weight, and body mass index (BMI) were constructed with the lambda, mu, sigma (LMS) method using data from a recent, large, population-representative sample of school-aged children and adolescents in Poland (n = 17,573). The prevalence of overweight and obesity according to the International Obesity Taskforce definition was determined with the use of LMSGrowth software. Updated growth references for Polish school-aged children and adolescents were compared with Polish growth references from the 1980s, the Warsaw 1996–1999 reference, German, and 2000 CDC references. A positive secular trend in height was observed in children and adolescents from 7 to 15 years of age. A significant shift of the upper tail of the BMI distribution occurred, especially in Polish boys at younger ages. The prevalence of overweight or obesity was 18.7% and 14.1% in school-aged boys and girls, respectively. The presented height, weight, and BMI references are based on a current, nationally representative sample of Polish children and adolescents without known disorders affecting growth. Changes in the body size of children and adolescents over the last three decades suggest an influence of the changing economical situation on anthropometric indices