[Evaluation of bone marrow involvement in surgically resected patients with esophageal cancer]

Bone marrow samples obtained during rib resections in esophageal cancer patients evaluated by immunohistochemical and quantitative polymerase chain reaction techniques revealed disseminated tumor cells in up to 90% samples, but the clinical relevance of these findings is unclear. Evaluation of bone marrow involvement in these patients and its correlation with clinicopathological finding of tumor. 43 patients with esophageal cancer who referred to Omid and Ghaem hospitals from April 2008-2009 were selected to transthorasic surgery[without neoadjuvant treatment].Bone marrow samples from rib were evaluated by Hematoxylin-Eosin staining for tumoral involvement and cytokeratin immunohistochemistry to determine micrometastatic cells. The results were compared with primary tumor histopathologial characteristics; T stage, N stage, tumoral length and personal characteristics; age and sex. Patients mean age was 60.9 [51-70 years], the ratio of male to female was 2.9. 38 cases [88.4%] had squamous cell carcinoma and 5 [11.6%] adenocarsinoma. In 9 cases [20.9%] Hematoxylin-Eosin staining and 13 cases [30.2%] immunohistochemistry results were positive. There was no correlation between pathologic type and T stage with Hematoxylin-Eosin and cytokeratin results. [p=0.277, p=0.153] and [p=0.221, p=0.097]. There was a significant relation between bone marrow dissemination and mediastinal involvement and tumoral grade [p=0.008, p=0.001] and [p=0.002, p=0.001]. According to our study, there is a correlation between grade and N stage and bone marrow involvement in esophageal cancer patients and there is no statistically correlation with other clinicopathologial characteristic there is a low bone marrow involvement in our region patients, overally

[Study of Her2/neu protein over expression frequency and its relationship with grade, stage in patients with non metatstatic transitional cell carcinoma and disease free survival]

HER2 over-expression has been identified in a variety of malignant tumors including bladder transitional carcinoma. In some researches H.ER2 was detected in 10%-50% of muscle invasive bladder cancers. In this study we evaluated the correlation between HER2 over-expression and pathological characteristics as well as its impact on the disease free survival [DFS] of patients with non-metastatic bladder transitional carcinoma. Study of Her2/neu Protein over Expression Frequency and its Relationship with Grade, Stage in Patients with Non Metatstatic Transitional Cell Carcinoma and Disease Free Survival. In this retrospective cohort study, paraffin-embedded specimens from 50 patients with non-metastatic bladder transitional cell carcinoma, referred to Omid hospital from 2003 to 2007, were examined immunohistochemically for HER-2/neu over-expression. The specimens were also reviewed for tumor grade. The patients with superficial tumors underwent TURBT and a full course of intravesical BCG therapy and cases with muscle invasive tumor received cisplatin based chemoradiation. There were 27 [54%] high grade and 23 low grade tumors. The specimens stained for HER-2 over-expression as follow: 11 as Zero, 11 as 1+, 13 as 2+ and 15 as 3+. The T stages of Tis, T1, T2 and T3 were detected in 14, 19, 10, and 7 cases respectively. The frequency of strong positive HER-2 tumors [3+] was significantly higher among patients with muscle invasive tumors compared to those with superficial lesions [58.8% vs. 15.2%, p<0.001]. There was also a relatively significant association between strong positive HER-2 expression and high grade tumors [43.5% vs. 18.5% p= 0.055]. The Median follow up time was 14 months [range, 4-52 months] during which 17 cases [34%] experienced recurrence [12 local, 3 bones and 2 lungs]. For all patients 3-year DFS was 62.7% +/- 7.4% which was significantly better for cases with superficial tumors than patients with muscle invasive tumors [78.1% vs. 19.5%, p=0.005]. In patients with strong positive HER-2 expression tumors, DFS was significantly lower compared to the other cases [3-year DFS: 19.4% vs. 80%, p<0.001]. No significant difference in DFS was found between high grade and low grade tumors [3-DFS: 53.9% vs. 70%, p=0.20]. In This study, strong HER-2 over-expression [3+] was significantly associated with higher T stages as well as high grade tumors. In addition to T stage, strong HER-2 over-expression was a significant predictor of lower disease free survival