Lack of influence of cyclooxygenese-2 expression in hepatocellular carcinomas on patient survival.

Recent studies suggest that cyclooxygenese-2 (COX-2) enzyme activation may play a role in hepatocarcinogenesis. However, the clinical significance of COX-2 expression in hepatocellular carcinoma (HCC) remains obscure. This study evaluated COX-2 expression in hepatitis B and hepatitis C virus related HCC and in HCC patients with an unknown etiology. Liver tissue samples of 31 patients with HCC (27 men and 4 women; age range, 48-75 years) were analyzed. COX-2 expression was evaluated by immunohistochemically in the tumor tissues. Patient data including age, sex, Child score, stage, grade of the tumor and survival were analyzed. Of these patients 19 were positive for hepatitis B virus (HBV), 6 were positive for hepatitis C virus (HCV) and 6 patients were negative for all viral markers and other etiologic factors. COX-2 staining were evaluated in 2 groups (group 1: COX-2 expression less than 25% (grades 1-2 COX-2 expression), and group 2: Cox-2 expression 25% or more (grades 3-5 COX-2 expression). COX-2 expression was shown in all HCC samples with positive or negative viral markers. No difference was found between degree of COX-2 expression and the etiology of HCC. COX-2 expression was not correlated with number of lesion or stage of the disease or grade of the tumor. COX-2 expression was not related with Child score of the patients. Median survival of all patients was 32 months. Median survival of patients did not differ according to patient's viral marker status. No difference was observed in median survival of patients in group 1 and 2. As a result, COX-2 system seem to be shared part in hepatocarcinogenesis regardless factors that initiate the disease. Although COX-2 expression appears to be independent of disease's characteristics', treatments that target this system appear to be feasible in the management of HCC.

Incidental papillary microcarcinoma of the thyroid.

Papillary microcarcinoma (PMC) is a thyroid tumor measuring 10mm or less in maximum diameter and comprise up to 30% of all papillary thyroid cancers. Most of them are detected incidentally and defined as incidental papillary microcarcinoma (IPC<or=10mm). The incidence of such incidental cancers found in surgical specimens of benign thyroid diseases is high. Although most PMC are incidental, all incidental papillary cancers cannot be classified as microcarcinoma, owing to their size that may be larger than 10mm. Not much is known about the biological behavior and clinical course of IPC<or=10mm. There is an ongoing discussion among endocrinologists, endocrine surgeons and nuclear medicine specialists about the optimal therapeutic strategy for the patients with IPC<or=10mm. Some investigators advocate in favor of not performing further treatment in addition to initial thyroid surgery, whereas others suggest an aggressive surgical approach followed by radioiodine ablation therapy. Randomized prospective trials of observation versus standard thyroid cancer care are required to high-lighten this dilemma.

Cancer cachexia: pathophysiologic aspects and treatment options.

Cancer cachexia is a syndrome characterized with progressive weight loss and abnormal wasting of fat and muscle tissue, and affects 40 to 85% of all terminally ill patients, accounting more than 20% of all cancer deaths. Current treatment for cancer cachexia principally depends on its prevention rather than reversing the present disease state, and the clinical results are far from being satisfactory. Although the exact mechanism and predisposing factors have yet to be clarified in detail, our growing knowledge about the pathophysiology and biochemical changes considering this life threatening condition should help in development of future therapeutic strategies. In the present paper, the current preclinical and clinical features considering the pathophysiology and treatment of cancer related cachexia are reviewed.

Early diagnosis of cancer in renal transplant patients: a single center experience.

Renal transplantation confers increased survival with improvement of immune suppressive drugs, but certain types of neoplasm can arise as secondary complications. It is thus well known that recipients have significantly increased risk of developing de novo malignancy when compared with the age-matched general population. Cancer is the 4th most common cause of death in transplant patients after cardiovascular disease, infections and liver failure. Our transplantation team has performed 1,582 kidney transplantations since 1975. Fifty-nine of the patients developed malignancies in the posttransplantation period. The most common was Kaposi's sarcoma (19 patients, 32.2 %), followed by lymphomas (16 patients, 27.1 %) and skin carcinomas (13 patients, 22.0 %). Many factors can contribute to high susceptibility in these patients; age at transplantation, certain types of viral infections like Epstein-Barr virus, human herpes virus-8, human papilloma virus or chronic usage of immune suppressive agents, type of immune suppressive drugs, and ethnic characteristics. Transplant recipients generally have advanced stage cancers at the time of diagnosis with a poor prognosis. Since some neoplasms are common early detection of cancer is important to decrease cancer related mortality and morbidity. This article considers risk factors and recommendations for early diagnosis of cancer in renal transplant patients.

Hodgkin's disease in an elderly patient with B-cell chronic lymphocytic leukemia.

Chronic lymphocytic leukemia (CLL) is the most common type of leukemia worldwide. It is an indolent disease, almost exclusively of B-cell origin. Some CLLs evolve into a more aggressive lymphoid malignancy. The most common of these is Richter's syndrome. Transformation to acute lymphoblastic leukemia, plasma cell leukemia, multiple myeloma, or Hodgkin's disease (HD) may also occur. CLL patients are also at a significantly increased risk of developing a second malignant neoplasm later in life. One of the most common of these is HD. Herein, we report a case of HD in an elderly man with a history of B-cell CLL.

Olive: fruit of peace against cancer.

The olive has a history almost as long as that of Western civilization and has been looked upon as a sign of hope, peace, and sacredness. Olive oil, extracted from the olive, is the principal source of dietary fat in the Mediterranean basin. The composition differs from that of other dietary fats in that olive oil is rich in monounsaturated fatty acids. Even other than as a source of monounsaturated fats, olive oil has own unique effects. Accumulating evidence suggests that olive oil may have beneficial health effects, especially when it comes to reducing risk factors for coronary heart diseases, preventing cancer, and modifying immune and inflammatory responses. However, evidence remains limited, definitive conclusions are difficult to draw, and there remains a significant need for further studies, particularly prospective cohort and well-designed, controlled intervention studies. In this manuscript, the beneficial health effects of olive oil are reviewed, with particular attention paid to cancer prevention and immune functions..