ABSTRACT
Breast cancer is classified based on clinical stage, cellular morphology and immunohistochemical analysis. More precise prognostic factors are necessary to aid with therapeutic decisions. Breast cancer subtypes that differ in their genetic expression and prognosis have been determined using cDNA microarrays. These findings confirm the differences between the phenotypes and provide new knowledge about the biology of breast cancer. Based on the presence or absence of expression of the estrogen receptor (ER), breast cancer is divided in two groups: ER+ and ER-. Genetic expression profile has identified two subtypes of the ER+ tumors: luminal A and luminal B. ER- tumors also include two subtypes, the HER2+ and the basal type. These subtypes differ in their biology and both demonstrate short disease-free periods after treatment and poorer outcome. This classification has shown the relationship between cDNA microarrays and clinical outcome of these tumors. This classification is proposed as a method of identifying those patients who will demonstrate better results with the different adjuvant modalities.
Subject(s)
Humans , Female , Gene Expression Profiling , Breast Neoplasms/classification , DNA, Complementary/genetics , DNA, Neoplasm/genetics , Cell Division/genetics , Forecasting , Kaplan-Meier Estimate , Models, Biological , Mexico/epidemiology , Breast Neoplasms/chemistry , Breast Neoplasms/drug therapy , Breast Neoplasms/epidemiology , Breast Neoplasms/genetics , Oligonucleotide Array Sequence Analysis , /analysis , Receptors, Estrogen/analysis , Receptors, Estrogen/genetics , Treatment Outcome , Cell Transformation, Neoplastic/geneticsABSTRACT
BACKGROUND: Adenosarcomas are rare tumors usually derived from the endometrium. About 50 cases of adenosarcomas of the ovary have been reported. The relationship between adenosarcoma and CA125 has not been described. The authors present a case of adenosarcoma with elevated CA125 because of the unusual presentation of this pathology and also because elevation of the CA125 antigen has not been reported in the literature. CLINICAL CASE: A 42-year-old woman presented for consultation for incidental right ovarian tumor and CA125 of 1100 U/mL. Histology revealed a homologous Müllerian adenosarcoma of the right ovary with sarcomatous overgrowth. CA125 decreased to 16 U/mL after surgery. Sixteen months post-surgery, the patient is disease free and with normal CA125. DISCUSSION: Ovarian adenosarcomas are more aggressive than adenosarcomas of the uterus. Because of the embryological origin, ovarian adenosarcomas are able to produce CA125 antigen, especially in the presence of sarcomatous overgrowth. With these facts, CA125 antigen may be useful as a prognostic factor because it may represent an indirect marker of sarcomatous overgrowth. CONCLUSIONS: CA125 may be useful for follow-up of ovarian adenosarcomas. Elevated CA125 antigen in adenosarcomas of the ovary may be indicative of sarcomatous overgrowth and poor prognosis.
Subject(s)
Humans , Female , Adult , Adenosarcoma/blood , /blood , Biomarkers, Tumor/blood , Ovarian Neoplasms/blood , Adenosarcoma/drug therapy , Adenosarcoma/embryology , Adenosarcoma/pathology , Adenosarcoma/surgery , Antineoplastic Agents, Hormonal/therapeutic use , Chemotherapy, Adjuvant , Mullerian Ducts/embryology , Hysterectomy , Incidental Findings , Lymph Node Excision , Medroxyprogesterone/therapeutic use , Ovarian Neoplasms/drug therapy , Ovarian Neoplasms/embryology , Ovarian Neoplasms/pathology , Ovarian Neoplasms/surgery , Ovariectomy , Omentum/surgery , Prognosis , Remission InductionABSTRACT
Presenta estudio sobre el cancer diferenciado de tiroides (CDT). Se estudiaron un cohorte de 47 pacientes en 5 años (papilar, n=44; folicular, n=3) y una media de seguimeinto 2 años, para identificar los factores pronósticos y comparar el riesgo de recurrencia o muerte. La edad media fue de 43 años con una relación M: H 5:1. Se realizaron 80.9 porciento de tiroidectomias totales en los pacientes. De los diferentes factores pronósticos identificados tuvieron significancia: nivel de resolución quirúrgica del cirujano (p 0.009), tmaño del tumor primario (p 0.007), tipo histológico (p 0.0042), resección completa del tumo (p 0.012), metástasis a distancia (p 0.013), uso de 1 131 (p 0.017), supresión de TSH con levotiroxina (p 0.002) y radioterapia externa (p 0.031). Aplicando el sistema AMES se encontró que 32 porciento de los pacientes eran de alto riesgo y con los sitemas MACIS y EORTC solo el 23,4 porciento de estos, con diferencias significativas para cada grupo de riesgo en los diferentes sistemas (p 0.020, p 0.009 respectivamente). Basados en los factores pronósticos identificados y aplicando los sistemas (AMES, MACIS y EORTC), podemos seleccionar las estrategias de tratamiento y seguimiento oncológico