Primary Pericardial Mesothelioma: Report of a Patient and Literature Review

Primary mesothelioma of the pericardium is a rare tumor and carries a dismal prognosis. This case report presents a 38-year-old man who suffered from recurrent pericardial fluid. Initial symptoms were unspecific, with dry cough and progressing fatigue. Pericardiocentesis was performed, but analyses for malignant cells and tuberculosis were negative. After recurrence a pericardiectomy was planned. At operation, partial resection of tumor tissue surrounding the heart was performed. Histopathologic examination including immunohistochemical staining for calretinin showed a biphasic mesothelioma. During the postoperative period the patient's condition ameliorated, but symptoms recurred and the patient died 3 months after diagnosis and 15 months after the first symptoms. At autopsy, the pericardium was transformed by the tumor that also expanded into the mediastinum and had set metastases to the liver. A review of 29 cases presented in the recent literature indicates a higher incidence of malignant pericardial mesothelioma among men than women. Median age was 46 (range, 19–76) years. In pleural mesotheliomas, exposure to asbestos is a known risk factor. However, in primary pericardial mesotheliomas the evidence for asbestos as an etiologic factor seems to be less convincing (3 exposed among 14 cases). Symptoms are often unspecific and cytologic examination of pericardial fluid is seldom conclusive (malignant cells demonstrated in 4/17 cases). Partial resection of the tumor can give a period of symptom reduction. Only a few patients have been treated with chemotherapy. Median survival of patients with pericardial mesotheliomas is approximately 6 months

Gene Expression Profiling Predicts Survival in Conventional Renal Cell Carcinoma

BACKGROUND: Conventional renal cell carcinoma (cRCC) accounts for most of the deaths due to kidney cancer. Tumor stage, grade, and patient performance status are used currently to predict survival after surgery. Our goal was to identify gene expression features, using comprehensive gene expression profiling, that correlate with survival. METHODS AND FINDINGS: Gene expression profiles were determined in 177 primary cRCCs using DNA microarrays. Unsupervised hierarchical clustering analysis segregated cRCC into five gene expression subgroups. Expression subgroup was correlated with survival in long-term follow-up and was independent of grade, stage, and performance status. The tumors were then divided evenly into training and test sets that were balanced for grade, stage, performance status, and length of follow-up. A semisupervised learning algorithm (supervised principal components analysis) was applied to identify transcripts whose expression was associated with survival in the training set, and the performance of this gene expression-based survival predictor was assessed using the test set. With this method, we identified 259 genes that accurately predicted disease-specific survival among patients in the independent validation group (p < 0.001). In multivariate analysis, the gene expression predictor was a strong predictor of survival independent of tumor stage, grade, and performance status (p < 0.001). CONCLUSIONS: cRCC displays molecular heterogeneity and can be separated into gene expression subgroups that correlate with survival after surgery. We have identified a set of 259 genes that predict survival after surgery independent of clinical prognostic factors

Fruit and vegetable consumption and lung cancer risk: updated information from the European Prospective Investigation into Cancer and Nutrition (EPIC)

The association of fruit and vegetable consumption and lung cancer incidence was evaluated using the most recent data from the European Prospective Investigation into Cancer and Nutrition (EPIC), applying a refined statistical approach (calibration) to account for measurement error potentially introduced by using food frequency questionnaire data. Between 1992 and 2000, detailed information on diet and life-style of 478,590 individuals participating in EPIC was collected. During a median follow-up of 6.4 years, 1,126 lung cancer cases were observed. Multivariate Cox proportional hazard models were applied for statistical evaluation. In the whole study population, fruit consumption was significantly inversely associated with lung cancer risk while no association was found for vegetable consumption. In current smokers, however, lung cancer risk significantly decreased with higher vegetable consumption; this association became more pronounced after calibration, the hazard ratio (HR) being 0.78 (95% CI 0.620.98) per 100 g increase in daily vegetable consumption. In comparison, the HR per 100 g fruit was 0.92 (0.85-0.99) in the entire cohort and 0.90 (0.81-0.99) in smokers. Exclusion of cases diagnosed during the first 2 years of follow-up strengthened these associations, the HR being 0.71 (0.55-0.94) for vegetables (smokers) and 0.86 (0.78-0.95) for fruit (entire cohort). Cancer incidence decreased with higher consumption of apples and pears (entire cohort) as well as root vegetables (smokers). In addition to an overall inverse association with fruit intake, the results of this evaluation add evidence for a significant inverse association of vegetable consumption and lung cancer incidence in smokers. (C) 2007 Wiley-Liss, Inc

Characteristics of Medical Research News Reported on Front Pages of Newspapers

Background: The placement of medical research news on a newspaper's front page is intended to gain the public's attention, so it is important to understand the source of the news in terms of research maturity and evidence level. Methodology/Principal Findings: We searched LexisNexis to identify medical research reported on front pages of major newspapers published from January 1, 2000 to December 31, 2002. We used MEDLINE and Google Scholar to find journal articles corresponding to the research, and determined their evidence level. Of 734 front-page medical research stories identified, 417 (57%) referred to mature research published in peer-reviewed journals. The remaining 317 stories referred to preliminary findings presented at scientific or press meetings; 144 (45%) of those stories mentioned studies that later matured (i.e. were published in journals within 3 years after news coverage). The evidence-level distribution of the 515 journal articles quoted in news stories reporting on mature research (3% level I, 21% level II, 42% level III, 4% level IV, and 31% level V) differed from that of the 170 reports of preliminary research that later matured (1%, 19%, 35%, 12%, and 33%, respectively; chi-square test, P = .0009). No news stories indicated evidence level. Fewer than 1 in 5 news stories reporting preliminary findings acknowledged the preliminary nature of their content. Conclusions/Significance: Only 57% of front-page stories reporting on medical research are based on mature research, which tends to have a higher evidence level than research with preliminary findings. Medical research news should be clearly referenced and state the evidence level and limitations to inform the public of the maturity and quality of the source. © 2009 Lai, Lane.published_or_final_versio

Unsupervised Hierarchical Clustering Analysis of 177 cRCCs

<div><p>(A) Overview of the gene expression patterns of 3,674 genes whose expression varied more than 3-fold in at least ten samples across the 177 samples. Each row represents a single gene, and each column an experimental sample. Colored bars identify the locations of the inserts in (C–J). The degree of color saturation corresponds with the ratio of gene expression shown at the top of the image.</p> <p>(B) Dendrogram representing similarities in the expression patterns between experimental samples. Samples were separated into two main groups and five subgroups (one in purple, two in blue, three in dark green, four in orange, and five in light blue) by the clustering algorithm.</p> <p>(C) Hypoxia-induced gene cluster.</p> <p>(D) Collagen gene cluster.</p> <p>(E) Proliferation gene cluster.</p> <p>(F–I) Genes distinguishing the two main groups (subgroups 1 and 2 from subgroups 3, 4, and 5).</p> <p>(H) Energy generation gene cluster.</p> <p>(J) Genes downregulated uniquely in subgroup 5.</p></div

Relationship of Gene Expression Subgroups to Clinical Parameters and SPC Risk Score in 177 cRCCs

<div><p>(A) Dendrogram from the hierarchical cluster, with the clinical information for each of the samples. Subgroups are color-coded as in <a href="http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.0030013#pmed-0030013-g001" target="_blank">Figure 1</a>. Color shade corresponds to the ranges of each of the clinical parameters displayed. Expected survival times for the censored observations were estimated from the Kaplan-Meier curve for all patients.</p> <p>(B) Distribution of stage, grade, and patient performance status among five subgroups.</p> <p>(C) Kaplan-Meier estimates of disease-specific survival in the two main gene expression groups of patients (subgroups 1 and 2 shown by the red bar below the dendrogram, compared to subgroups 3, 4, and 5 designated by the green bar).</p> <p>(D) Kaplan-Meier estimates of disease-specific survival in the five subgroups of patients.</p> <p>The X symbols in (C) and (D) denote censored data.</p></div

Overview of the Strategy Used for the Development and Validation of a Prognostic Gene List

<p>Overview of the Strategy Used for the Development and Validation of a Prognostic Gene List</p