Subclasificación de los tipos moleculares de cáncer de mama de acuerdo a la expresión de marcadores inmunohistoquímicos y evolución / Subclassification of the molecular types of breast cancer based on the expression of immunohistochemical markers and evolution

Los carcinomas de la mama se han clasificado desde el punto de vista molecular en cuatro grupos mayores (Luminal A, Luminal B, HER2 y triple negativo). Sin embargo, estos grupos no son homogéneos y existe la necesidad de establecer subcategorías que puedan ser identificadas mediante inmunohistoquímica (IHQ), para así predecir mejor su pronóstico y llevar a cabo un tratamiento más efectivo. El presente estudio se realizó en 354 pacientes diagnosticadas de carcinoma ductal infiltrante de mama. Se analizó la expresión de 22 moléculas por matrices de tejidos y se compararon los resultados obtenidos con las clases moleculares definidas por IHQ, de acuerdo a la expresión de receptores de estrógeno (RE), receptores de progesterona (RP) y HER2, y con la supervivencia global. Con la clase molecular Luminal A se pueden establecer varios subgrupos de significado pronóstico: el subgrupo con expresión exclusiva de RE y RP, con Ki-67 ≤14%, con mejor pronóstico, y el subgrupo de Luminal A con Ki-67 >14%, o con expresión de otros marcadores relacionados con el fenotipo basal. El grupo Luminal B puede ser dividido en subtipos de acuerdo a la expresión de Ki-67 (punto de corte en el 25%). En la clase HER2, parece importante el índice de Ki-67 para el pronóstico (punto de corte en 25%). La clase de TN puede ser dividida según el índice de proliferación en dos categorías pronósticas, con un mejor pronóstico para aquellos tumores con un índice de Ki-67 ≤25%.

Breast carcinomas have been classified from the molecular point of view into four major groups (Luminal A, Luminal B, HER2 and triple negative). However, these groups are not homogeneous and there is a need to establish subcategories that can be identified by immunohistochemistry (IHC), to better predict prognosis and carry out treatments that are more effective. This study was conducted in 354 patients diagnosed with invasive ductal breast carcinoma. The expression of 22 molecules was analyzed by tissue matrices and the results obtained were compared with molecular classes defined by IHC, according to the expression of estrogen receptor (ER), progesterone receptor (PR) and HER2, and the overall survival. The Luminal A molecular class can set various prognostic subgroups: the subgroup with exclusive expression of ER and PR, with Ki-67 ≤14%, with a better prognosis, and the subgroup of Luminal A with Ki-67> 14% or other expression related to the basal phenotype markers. Luminal B group can be divided into subtypes according to the expression of Ki-67 (cutoff at 25%). In the HER2 class it seems important the Ki-67 index for forecasting (cutoff at 25%). The TN class can be divided according to the rate of proliferation into two prognostic categories, with a better prognosis for tumors with Ki-67 index ≤25%.

The NER-related gene GTF2H5 predicts survival in high-grade serous ovarian cancer patients / 부인종양

OBJECTIVE: We aimed to evaluate the prognostic and predictive value of the nucleotide excision repair-related gene GTF2H5, which is localized at the 6q24.2-26 deletion previously reported by our group to predict longer survival of high-grade serous ovarian cancer patients. METHODS: In order to test if protein levels of GTF2H5 are associated with patients' outcome, we performed GTF2H5 immunohistochemical staining in 139 high-grade serous ovarian carcinomas included in tissue microarrays. Upon stratification of cases into high- and low-GTF2H5 staining categories (> and < or = median staining, respectively) Kaplan-Meier and log-rank test were used to estimate patients' survival and assess statistical differences. We also evaluated the association of GTF2H5 with survival at the transcriptional level by using the on-line Kaplan-Meier plotter tool, which includes gene expression and survival data of 855 high-grade serous ovarian cancer patients from 13 different datasets. Finally, we determined whether stable short hairpin RNA-mediated GTF2H5 downregulation modulates cisplatin sensitivity in the SKOV3 and COV504 cell lines by using cytotoxicity assays. RESULTS: Low expression of GTF2H5 was associated with longer 5-year survival of patients at the protein (hazard ratio [HR], 0.52; 95% CI, 0.29 to 0.93; p=0.024) and transcriptional level (HR, 0.80; 95% CI, 0.65 to 0.97; p=0.023) in high-grade serous ovarian cancer patients. We confirmed the association with 5-year overall survival (HR, 0.55; 95% CI, 0.38 to 0.78; p=0.0007) and also found an association with progression-free survival (HR, 0.72; 95% CI, 0.54 to 0.96; p=0.026) in a homogenous group of 388 high-stage (stages III-IV using the International Federation of Gynecology and Obstetrics staging system), optimally debulked high-grade serous ovarian cancer patients. GTF2H5-silencing induced a decrease of the half maximal inhibitory concentration upon cisplatin treatment in GTF2H5-silenced ovarian cancer cells. CONCLUSION: Low levels of GTF2H5 are associated with enhanced prognosis in high-grade serous ovarian cancer patients and may contribute to cisplatin sensitization.

Clinical and pathological evaluation of fibrolamellar hepatocellular carcinoma: a single center study of 21 cases

OBJECTIVES: Fibrolamellar hepatocellular carcinoma is a rare primary malignant liver tumor that differs from conventional hepatocellular carcinoma in several aspects. The aim of this study was to describe the clinical, surgical and histopathological features of fibrolamellar hepatocellular carcinoma and to analyze the factors associated with survival. METHODS: We identified 21 patients with histopathologically diagnosed fibrolamellar hepatocellular carcinoma over a 22-year period. Clinical information was collected from medical records and biopsies, and surgical specimens were reviewed. RESULTS: The median age at diagnosis was 20 years. Most patients were female (67%) and did not have associated chronic liver disease. Most patients had a single nodule, and the median tumor size was 120 mm. Vascular invasion was present in 31% of patients, and extra-hepatic metastases were present in 53%. Fourteen patients underwent surgery as the first-line therapy, three received chemotherapy, and four received palliative care. Eighteen patients had “pure fibrolamellar hepatocellular carcinoma,” whereas three had a distinct area of conventional hepatocellular carcinoma and were classified as having “mixed fibrolamellar hepatocellular carcinoma.” The median overall survival was 36 months. The presence of “mixed fibrolamellar hepatocellular carcinoma” and macrovascular invasion were predictors of poor survival. Vascular invasion was associated with an increased risk of recurrence in patients who underwent surgery. CONCLUSION: Fibrolamellar hepatocellular carcinoma was more common in young female patients without chronic liver disease. Surgery was the first therapeutic option to achieve disease control, even in advanced cases. Vascular invasion was a risk factor for tumor recurrence. The presence of macrovascular invasion and areas of conventional hepatocellular carcinoma were directly related to poor survival. .

Changes in biologic features between primary and recurrent or relapsed breast cancers

Changes in ER, PR and Her2 receptor status between primary and metastatic cancer tissue have been suggested in breast cancer. The frequencies of these changes are still not fully understood. The purpose of this study was to evaluate these changes in breast cancer population of Kuwait. Changes in the biological features between primary and recurrent disease in 70 patients who presented between 2009 and 2012 was studied. Statistical comparisons between groups was done using chi square test while Kaplan Meier method was used to perform analysis of survival after relapse. All analysis was carried out using the IBM-SPSS statistical software. There was a decrease in ER and PR positivity from 61.4% to 58.6% and 61.4% to 44.3% respectively. The overall change in ER and PR status was 28.5% and 25.7% respectively. There was an increase in the Her2 positivity as the tumor relapsed and overall changes were seen in 5.7% of cases. Patients with breast cancer experience change in biological markers through the course of their disease. The changes are more with hormone receptors compared to Her2. Re-biopsy should be considered at relapse if feasible

Perfusion Parameters of Dynamic Contrast-Enhanced Magnetic Resonance Imaging in Patients with Rectal Cancer: Correlation with Microvascular Density and Vascular Endothelial Growth Factor Expression

OBJECTIVE: To determine whether quantitative perfusion parameters of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) correlate with immunohistochemical markers of angiogenesis in rectal cancer. MATERIALS AND METHODS: Preoperative DCE-MRI was performed in 63 patients with rectal adenocarcinoma. Transendothelial volume transfer (Ktrans) and fractional volume of the extravascular-extracellular space (Ve) were measured by Interactive Data Language software in rectal cancer. After surgery, microvessel density (MVD) and vascular endothelial growth factor (VEGF) expression scores were determined using immunohistochemical staining of rectal cancer specimens. Perfusion parameters (Ktrans, Ve) of DCE-MRI in rectal cancer were found to be correlated with MVD and VEGF expression scores by Spearman's rank coefficient analysis. T stage and N stage (negative or positive) were correlated with perfusion parameters and MVD. RESULTS: Significant correlation was not found between any DCE-MRI perfusion parameters and MVD (rs = -0.056 and p = 0.662 for Ktrans; rs = -0.103 and p = 0.416 for Ve), or between any DCE-MRI perfusion parameters and the VEGF expression score (rs = -0.042, p = 0.741 for Ktrans ; r = 0.086, p = 0.497 for Ve) in rectal cancer. TN stage showed no significant correlation with perfusion parameters or MVD (p > 0.05 for all). CONCLUSION: DCE-MRI perfusion parameters, Ktrans and Ve, correlated poorly with MVD and VEGF expression scores in rectal cancer, suggesting that these parameters do not simply denote static histological vascular properties.

Study of the Murine Double Minute 2 status in patients with gastric and colorectal carcinomas and its correlation with prognostic factors.

Background: Gastric and colorectal cancers are the second and the fourth most common cancers in Iran, respectively. The presence of Murine Double Minute 2 (MDM2) has been identified in many cancers and its relationship with prognosis is under investigation. This study aimed to assess the status of MDM2 and its relationship with prognostic factors in gastric and colorectal carcinoma. Materials and Methods: This study was performed on 99 paraffin blocks of gastric and colorectal cancers, during the years 2001 to 2007 from Mostafa Khomeini Hospital, Tehran, Iran. Tissue sections were prepared, stained with Hematoxylin and Eosin and immunohistochemistry to evaluate for MDM2 expression. The type of tumor, lymph node involvement and tumor grade was determined. Results: Of the 99 cases, 34.3% and 65.7% cases were diagnosed with gastric and colorectal adenocarcinoma, respectively. The average tumor size was 5.5 cm. MDM2 expression level was 82.4% and 90.8% in gastric and colorectal adenocarcinoma, respectively. No statistical difference was found between MDM2 expression and various prognostic factors; however, significant correlation was observed between gastric (P = 0.03) and colorectal (P = 0.03) tumor size and the percentage of MDM2 immunoreactivity. Conclusion: Considering the role of MDM2 in cell growth and its positive correlation with tumor size (an established prognostic factor), it can be indirectly concluded that MDM2 is also important in prognosis. However, additional investigation is needed.

Expressão citofotométrica dos marcadores tumorais CD-34 e fator VIII no câncer de cólon / Cytophotometric expression of the tumor markers CD-34 and factor VIII in colorectal cancer

OBJETIVOS: Verificar a posssibilidade de quantificar a expressão dos marcadores tumorais CD-34 e Fator VIII no câncer de cólon; verificar se existe superioridade entre um marcador e outro para estudo da angiogênese; verificar se há correlação na análise do índice de marcagem e a densidade óptica média nos marcadores utilizados. MÉTODOS: Dezessete casos de adenocarcinoma colorretal recuperados de blocos de parafina e confirmados pela hematoxilina-eosina, foram submetidos à coloração imunoistoquímica pelo método da estreptoavidina-biotina-peroxidase e utilizados os marcadores tumorais CD-34 e Fator VIII. Após este processo as lâminas foram submetidas à leitura no sistema Samba 4000® e avaliadas pelo software Immuno®. Os parâmetros estudados foram: índice de marcagem e densidade óptica, expressos por médias, medianas, valores mínimos, valores máximos e desvios-padrão, analisados estatisticamente. RESULTADOS: Para o marcador CD-34 não houve normalidade dos dados em relação ao índice de marcagem e houve para a densidade óptica. Para o Fator VIII, houve normalidade de dados em relação ao índice de marcagem e para a densidade óptica. CONCLUSÃO: Foi possível quantificar a expressão dos marcadores tumorais CD-34 e Fator VIII através do índice de marcagem e da densidade óptica média; não houve diferença entre os marcadores em relação à média do índice de marcagem e da densidade óptica, não sendo possível definir superioridade entre um e outro; não foi observada tendência à correlação quando comparados densidade óptica e índice de marcagem do Fator VIII e do CD-34 isoladamente estudados; não houve correlação entre o índice de marcagem do Fator VIII quando comparado com o CD-34, bem como a densidade óptica do Fator VIII com o CD-34.

OBJECTIVES: In colorectal cancer, to describe the cytophotometric expression of the CD-34 and Factor VIII; to evaluate the degree of correlation between them; and to compare the CD-34 and Factor VIII expressions in relationship to label index and optical density. METHODS: Seventeen cases of colorectal adenocarcinoma recovered from paraffin-embedded archival tissue and confirmed by hematoxilin-eosin staining, were submitted to streptavidin-biotin-peroxidase immunohistochemical method. In this process was used the tumor markers CD-34 and Factor VIII. The obtained slides were analysed using the SAMBA 4000® system with Immuno® software. The results were evaluated into two parameters: label index and optical density, and expressed by averages, medians, minimum values, maximum values, and standard deviation values. The normality condition of the quantitative variables was investigated by using the Shapiro-Wilks test. In order to evaluate the degree of association between the expressions of the markers, Pearson's Correlation Coefficient or Spearman's Correlation Coefficient were applied. To evaluate the comparison degree of the markers expression, Student's t test or Wilcoxon's no parametric test were used. RESULTS: For the CD-34 there was no data normality for the label index and there was normality in the optical density. For the Factor VIII, there was data normality for the label index and for the optical density. CONCLUSION: When the expressions of CD-34 and Factor VIII markers were correlated, there was no difference between them in relationship to the average label index and average optical density. When the expressions of the CD-34 and Factor VIII were compared, there was no correlation between the two variables.

Análisis de expresión global del cáncer cérvico uterino: rutas metabólicas y genes alterados / Global expression analysis in uterine cervical cancer: Metabolic pathways and altered genes

High risk human papillomavirus (HPV) infection is considered to be the most important etiological factor of Cervical Uterine Cancer. In order to determine the global expression pattern and to identify possible molecular markers of cervical cancer, cDNA arrays with probe sets complementary to 8,000 human genes were used to examine the expression profiles among 5 cell lines derived from human cervical cancer, three HPV16(+) tumor samples and three normal cervical tissues HPV(-). The levels of expression of different cellular processes were identified. Hierarchical clustering was performed and the gene expression using RT-PCR was confirmed. Two genes were found to be consistently overexpressed in invasive cervical cancer biopsies; one of them, IL-6 was previously reported to be overexpressed in cervical cancer and one novel gene, MMP10, previously not known to be related to cervical cancer. Hierarchical clustering of the expression data revealed that samples with common HPV type infection grouped together, maybe this could mean that differences between HPV types could be indirectly determined by expression profiles.

La infección por virus de papiloma de alto riesgo (VPH) es considerada como el factor etiológico más importante del cáncer cérvico uterino (CaCU). Con el fin de determinar el patrón de expresión global e identificar algunos posibles genes marcadores del CaCU, se utilizaron microhileras de DNA que contenían 8,000 secuencias que codificaban para transcritos diferentes, para estudiar los perfiles de expresión de cinco líneas celulares derivadas de CaCU, tres muestras tumorales conteniendo VPH 16 y tres muestras normales negativas para la presencia de VPH. Se identificaron los niveles de expresión de genes relacionados con diferentes rutas metabólicas. Se llevó a cabo el análisis de agrupamiento jerárquico y posteriormente se confirmó la sobrexpresión de dos genes mediante RT-PCR. Estos dos genes se encontraron sobrexpresados en biopsias tumorales cervicales. Uno de ellos, el gen de IL6, que ha sido previamente reportado en relación con CaCU, así como el gen de la matriz-metaloproteasa 10 (MMP10) por primera vez relacionado con esta neoplasia. El análisis de agrupamiento jerárquico, además, reveló que las muestras que contienen el mismo tipo viral están asociadas, sugiriendo posibles diferencias en expresión entre tipos virales.

Marcadores biológicos de tumores tiroidianos / Biological markers in thyroid tumors

Um marcador biológico ideal deve ser específico e sensível para identificar o tipo tumoral e caracterizar o estágio da progressão neoplásica. Os tumores de tiróide originam-se de dois tipos celulares: 1) carcinoma medular originário de células parafoliculares; e 2) as neoplasias de células epiteliais foliculares, que incluem bócio, adenomas, carcinomas diferenciados (carcinoma papilífero e carcinoma folicular) e carcinoma indiferenciado (carcinoma anaplásico). O comportamento biológico distinto faz com que cada tipo tumoral necessite de uma conduta terapêutica específica. O conhecimento acumulado ao longo destes anos, utilizando métodos de biologia molecular e, mais recentemente, a genômica, identificou mutações específicas de câncer de tiróide e, atualmente, entendemos muito das alterações que ocorrem na expressão de fatores de crescimento, seus receptores e proteínas sinalizadoras intracelular nas neoplasias tiroidianas. Contudo, apesar desses, até o momento não dispomos de um marcador eficiente que auxilie no diagnóstico e prognóstico e, conseqüentemente, para indicação de uma terapêutica mais adequada. Nesta revisão, discutiremos os principais aspectos relacionados à tumorigênese tiroidiana, avaliando o potencial destes fatores como marcador em neoplasia folicular de tiróide.

Expression and implication of hypoxia inducible factor-1alpha in prostate neoplasm / 华中科技大学学报（医学）（英德文版）

To study the expression of hypoxia inducible factor-1alpha (HIF-1alpha) protein in prostate cancer (Pca) and its biological significance, the expression of HIF-1alpha was assayed by means of immunohistochemical technique in 42 prostate cancer, 12 prostatic intraepithelial neoplasm (PIN) and 9 normal prostate tissue (NP) specimens. Western blot was used to examine the expression of HIF-1alpha in prostate cancer cell line (PC-3M) induced by different oxygen tension. HIF-1alpha expression was positive in 33 Pca and 9 PIN specimens, and the positive rate of HIF-1alpha was higher in distant metastasis patients than in patients without metastasis of prostate cancer (P<0.05), while there was no expression of HIF-1alpha in NP. The level of HIF-1alpha in PC-3M significantly increased with the decrease of oxygen tension (P<0.01). Overexpression of HIF-1alpha is the preliminary event of the formation of Pca, which may induce carcinoma into malignant phenotype. Thus it may serve as an early diagnosis marker and the novel target for Pca treatment.

Significance of mucin secretion in carcinoma of uterine cervix.

Biopsies from 300 cases with clinical diagnosis of carcinoma cervix were subjected to H&E staining, PAS with diastase and alcian blue at pH 2.5. Interpretation of cases on basis of H&E staining alone and on basis of H&E and mucin stains was done and results compared with each other. Categorization into squamous cell carcinoma (well, moderately & poorly differentiated), adenocarcinoma and mixed carcinoma was done. Morphologic assessment of cases of H&E stain revealed 282 (94%) cases of squamous cell carcinoma, 8 (2.66%) cases of adeno carcinoma and 10 (3.38%) cases of mixed carcinoma respectively. While on the basis of H&E and mucin stains, squamous cell carcinoma case turned out to be 266 (88.66%) in number; mixed carcinomas which included adenosquamous carcinoma and squamous cell carcinoma with mucin secretion accounted for 26 (8.66%) of cases, number of adenocarcinoma was unchanged i.e. 8 (2.66%). 16 of 282 cases (5.6%) diagnosed as squamous cell carcinoma on H&E stain alone were reclassified as mixed carcinoma on inclusion of mucin stains. Thus mucin stains are very helpful in deciding the types of carcinoma cervix and should be done in all cases of carcinoma cervix in order to avoid errors in diagnosis and to detect poorly differentiated mixed carcinomas, which may escape detection by H&E staining.

Cyclins D1, E, A expression and synergistic cytotoxicity to a cholangiocarcinoma cell line from recombinant TNF-alpha and PHA supernate.

We studied the cytotoxic effects of recombinant TNF-alpha and supernate of phytohemagglutinin stimulated peripheral blood mononuclear cells individually and in combination against a cholangiocarcinoma cell line. Levels of cyclins D1, E and A in the cell line were detected by immunoblotting, and the cell cycle stage was assayed by propidium iodide staining followed by flow cytometry analysis. Viable and apoptotic cells were assessed by trypan blue dye exclusion, DAPI staining, agarose DNA laddering and propidium iodide staining. At the beginning of each experiment, the majority of cholangiocarcinoma cells expressed cyclin A and were in S phase as determined by propidium iodide staining. Treatment of such cells with recombinant TNF-alpha resulted in cytotoxic effects clearly evident at 36 hours post exposure. There was a synergistic killing effect when recombinant TNF-alpha was combined with PHA supernate and this effect could be partly neutralized by monoclonal anti TNF-alpha, interleukin (IL)-2, IL-12 and IFN-gamma.

Expression of c-erbB-2, p53 and c-myc proteins in male breast carcinoma: Comparison with traditional prognostic factors and survival

There are few data evaluating biological markers for men with breast cancer. The purpose of the present study was to analyze the expression of the oncogenes c-erbB-2 and c-myc and of the suppressor gene p53 by immunohistochemical techniques in archival paraffin-embedded tissue blocks of 48 male breast cancer patients, treated at the A.C. Camargo Cancer Hospital, Säo Paulo, SP, Brazil. The results were compared with clinicopathological prognostic features. Immunopositivity of c-erbB-2, p53 and c-myc was detected in 62.5, 16.7 and 20.8 percent of the cases analyzed, respectively. Estrogen and progesterone receptors were positive in 75 and 69 percent of the cases, respectively. Increasing staging was statistically associated with c-erbB-2 (P = 0.04) and weakly related to p53 positivity (P = 0.06). No significant correlation between specific survival rate (determined by the log rank test) and the molecular markers analyzed was found, whereas the number of compromised lymph nodes and advanced TNM (tumor, node, metastasis) staging were associated with diminished survival

Prognostic significance of E-cadherin/catenin complex expression in gastric cancer

Abnormal expression of E-cadherin/catenin complex in cancer has been associated with poor differentiation and acquisition of invasiveness, suggesting a possible role of this protein as an invasion suppressor. In this study, we conducted an immunohistochemical investigation of all components of the E-cadherin/catenin complex in 65 gastric cancer patients. Abnormal expression of E-cadherin and, alpha- and gamma-catenin occurred more frequently in diffuse than in intestinal type of gastric cancer, and correlated with poor differentiation. Abnormal expression of E-cadherin and beta-catenin correlated with poor survival. Abnormal expression of all four components of the complex was associated with poorly differentiated and diffuse-type carcinoma, and poor survival. In the multivariate analysis, abnormal expression of the E-cadherin/catenin complex was not an independent prognostic factor. These results suggest that the E-cadherin/catenin complex may be a useful marker of differentiation and prognosis in gastric cancer. Further studies are warranted to clarify the impact of the E-cadherin/catenin complex on prognostic factor of gastric cancer.

Avaliação da eficácia de um novo marcador tumoral, a desgamacarboxiprotombina, no diagnóstico do carcinoma hepatocelular / Evaluation of the efficacy of a new tumor marker, the desgamacarboxiprotombine in the hepatocellular carcinoma diagnosis

O objetivo deste trabalho foi avaliar a contribuição de um novo marcador tumoral, a desgamacarboxiprotombina (DCP), no diagnóstico do carcinoma hepatocelular (CHC) e compará-lo com a alfafetoproteína (A.F.P.). Foram estudados 124 pacientes, sendo 92 brasileiros e 32 japoneses. Os pacientes brasileiros foram divididos em cinco grupos: 19 pacientes com carcinoma hepatocelular (grupo I), 19 com cirrose hepática (grupo II), 17 com hemangioma hepático (grupo III), 17 com metástase hepática (grupo IV) e 20 com dispepsia, sem doença hepática (grupo V). Os pacientes japoneses constituíram um outro grupo com CHC. Os exames incluídos no protocolo foram: fosfatase alcalina, gamaglutamiltransferase, aspartato aminotransferase, alanina aminotransferase, tempo de protombina (TP), expresse em RNI (International Normalized Ratio), A.F.P., DCP, ultrasonografia, tomografia computadorizada, sorologia para vírus B e C e biópsia hepática. Para o diagnóstico histológico do CHC, foi utilizado o grau de diferenciação histológico segundo Edmondson-Steiner. A dosagem do nível plasmático da DCP foi realizada em todos os pacientes, utilizando-se o método de enzima imuno-ensaio (EIA) (E-1023: Eitest MONO - P - II, Eisai C., Ltd., Tokyo). A positividade da DCP nos pacientes com CHC foi de 57,9 por cento. Nos outros grupos, de 13,7 por cento. A sensibilidade e especificidade foram de 57,9 por cento e 86,3 por cento, respectivamente. O valor predição positivo, de 52,4 por cento e negativo, de 88,7 por cento. A concentração plasmática da DCP apresentou-se elevada nos pacientes com tumores acima de 5,0 cm e naqueles com lesões multinodulares. Houve associação entre o nível plasmático de DCP e o nível sérico de A.F.P. nos pacientes com CHC (n=49; r=0,58998; p=0,0001). Concluiu-se que, a DCP é um marcador tumoral complementar para o diagnóstico do carcinoma hepatocelular e que sua combinação com a A.F.P. é importante, pois aumenta a taxa de positividade do diagnóstico do CHC.

Alpha feto-protein and albumin in ascitic fluid in hepatocellular carcinoma patients

The aim of this work was to study the value of estimating AFP in ascitic fluid of HCC patients with ascites. This work was a case control study on 32 patients, including 22 cases with ascites and HCC and 10 cases [control group] with ascites due to liver cirrhosis without HCC. The level of AFP was estimated in serum and in ascitic fluid by radioimmunoassay [RIA]. The serum ascites albumin gradient [SAAG] was assessed by measuring albumin in all samples using bromocresol green dye binding. Guided aspiration liver biopsy and ascitic fluid cytology were done, stained with H and E. It was found that AFP level in serum was elevated in 72.7% of HCC patients and in ascitic fluid, it was elevated in 63.6% of HCC patients. Also, there was a highly significant, direct positive correlation between elevation of AFP in serum and in ascitic fluid [r = 0.778]. No elevation of AFP in serum and in ascitic fluid was detected in the control group. Ascitic fluid cytology showed malignant cells in one case only. SAAG was significantly lower in the HCC group [0.83 g/dl] than the control group [2.43 g/dl]

Marcación del anticuerpo monoclonal B2C114 con 111In usando un quelante funcional / 111In labelling of B2C114 monoclonal antibody with a bifunctional chelating agent

El anticuerpo monoclonal (AcMo) B2C114, dirigido contra el antígeno carcinoembrionario (CEA) fue conjugado con el anhídrido bicíclico del DTPA (CA-DTPA) usando diferentes relaciones molares CA-DTPA: AcMo desde 1:1 hasta 30:1. Se determinó para cada caso la eficiencia de acoplamiento y el número de moléculas de DTPA por molécula de AcMo. Se realizó la marcación con 111In para todas las relaciones molares CA-DTPA: AcMo y se determinó la pureza radioquímica por cromatografía instantánea en placa delgada (ITLC Gelman SG) y cromatografía en gel (Sephadex G-25). La biodistribución del AcMo marcado en ratones normales Balb/c y en portadores de tumor reactivo (M3), a diferentes horas post-inyección, mostró una acumulación creciente en el tumor al cabo de 72 h, con captación en hígado y riñón. Se observó también que al aumentar la relación molar CA-DTPA se incrementó el porcentaje de radiactividad asociada al riñón, lo cual indicaría una mayor inestabilidad del radiofármaco

Hormonal modulation of biosynthesis of prostatic specific antigen, prostate specific acid phosphatase and prostatic inhibin peptide.

Hormonal modulation of in vitro biosynthesis of three prostatic secretory proteins, prostate specific acid phosphatase (PSAP), prostate specific antigen (PSA) and prostatic inhibin peptide (PIP) by human benign hyperplasia (BPH) tissue was studied. LH and inhibins caused increase in the synthesis of all three proteins whereas FSH enhanced the synthesis of PIP and PSA only but decreased PSAP synthesis. Prolactin and thyroid releasing hormone decreased synthesis of PIP and PSAP. However, PSA synthesis was enhanced by TRH and was decreased by prolactin. Estradiol caused significant increase in PSA and PSAP but no discernible changes in PIP synthesis were noticed. Testosterone caused an increase in PIP, PSA and PSAP. These data indicate that biosynthesis of PIP, PSA and PSAP by BPH tissue is under multihormonal regulation.