[Suspected diagnosis of cancer in hospital emergency services]. / Diagnóstico de sospecha del cáncer en los servicios de urgencia hospitalarios.

BACKGROUND: To measure the frequency, trends and distribution of cancers with suspected diagnosis in the Hospital Emergency Services (HES) in Asturias during 2006-12. To describe the clinical characteristics of these cancers and to determine if they differ from those whose diagnosis is made in other services. METHODS: Population based descriptive study of cancers registered in the Hospital Tumour Registry of Asturias (Spain), which provided data of patient characteristics, cancer variables (site, histology, stage, metastasis and delay), the hospital and service of diagnosis. Patients with confirmed diagnosis of cancer (non-melanoma of skin excluded) in the study period were included (N=26,020). Differences of cancer cases according to the service that had performed the suspected diagnosis were analyzed. We performed regression analysis of the time between the first symptom and the suspected diagnosis, the definitive diagnosis and treatment, controlling main confounders. RESULTS: Seven point nine percent (n=2,056) of all cancer cases were suspected in a HES (annual minimum of 5.3% and maximum 10.4%, with an upward trend). These patients were mainly men (60.6%), with a mean age of 67.7 years, and with lung (21.0%) and colon cancer (15.5%). The HES ranks 6th place in the list of services which diagnosed cancer. There was more diagnosis of advanced tumours (33.0%) and metastasis (29.5%) in the HES. The HES halved the time between the first symptom and the SD (-63.3 days; p<0.001), and between definitive diagnosis and initiation of treatment (-15.9 days; p<0.001) compared to the other services. CONCLUSIONS: The HES contribute significantly to suspected cancer diagnosis, mainly advanced and metastatic tumours in the respiratory and digestive system, whose symptoms escape accidental diagnosis conducted in primary care, and they start abruptly.

Synthesis and characterization of hematite pigment obtained from a steel waste industry.

Pigments that meet environmental and technology requirements are the focus of the research in the ceramic sector. This study focuses on the synthesis of ceramic pigment by encapsulation of hematite in crystalline and amorphous silica matrix. Iron oxide from a metal sheet rolling process was used as chromophore. A different content of hematite and silica was homogenized by conventional and high energy milling. The powders obtained after calcinations between 1050 and 1200 °C for 2h were characterized by X-ray diffraction and SEM analysis. The pigments were applied to ceramic enamel and porcelain body. The effect of pigment was measured by comparing L*a*b* values of the heated samples. Results showed that the color developed is influenced by variables such as oxide content employed, conditions of milling and processing temperature. The results showed that the use of pigment developed does not interfere in microstructural characteristics of pigmented material. The best hue was obtained from samples with 15 wt% of chromophore, heated at 1200 °C in amorphous silica matrix.

Snail nuclear expression parallels higher malignancy potential in neuroendocrine lung tumors.

INTRODUCTION: The aim of our study was to determine the integrity of the cell-cell adhesion E-cadherin-beta-catenin complex in neuroendocrine lung tumors (NELTs) and the possible involvement of Snail in its deregulation. METHODS: The studied series consisted of formalin-fixed-paraffin-embedded tissue samples from 70 patients diagnosed with NELT (2000-2006) including tumors of low malignancy potential (3 tumorlets, 33 typical carcinoids), intermediate malignancy potential (3 atypical carcinoids) and tumors of high malignancy potential (10 large cell neuroendocrine carcinomas-LCNEC and 21 small cell carcinoma-SCLC). E-cadherin, beta-catenin and Snail expression were immunohistochemically evaluated and mRNA levels were assessed by Q-RT-PCR for E-cadherin and Snail. RESULTS: Nuclear Snail signal was high in 46% tumors with the strongest level observed in high malignancy tumors. Furthermore, Snail levels correlated with tumor size, lymph node involvement and tobacco consumption. E-cadherin expression was downregulated in 24% cases and it was absent from the membrane in 31%, all of them cases of high malignancy potential. High E-cadherin levels and a membrane pattern were associated with tumor-free lymph node patients and inversely proportional to Snail protein expression. beta-catenin levels were weak in 43% and absent from the membrane in 59% cases. Interestingly, among high malignancy potential tumors, beta-catenin levels were significantly higher in LCNEC than in SCLC. The integrity of the E-cadherin-beta-catenin complex was retained in 37% cases, most of them carcinoid tumors, and correlated with low Snail levels, low malignancy potential and free lymph nodes. CONCLUSION: Snail nuclear expression and loss of integrity of cell adhesion complex E-cadherin/beta-catenin parallels higher malignancy potential in NELTs.

Multiple primary cancer: an increasing health problem. Strategies for prevention in cancer survivors.

This study was set to look for associations between the sites of the first and subsequent tumours in patients with multiple primary cancer (MPC) diagnosed from 1975 to 2002 in the reference hospital of a Spanish northern region, and propose prevention strategies. Patient and tumour variables were measured. Crude and standardized incidence rates per 100 000 inhabitants were obtained, and the association between MPC incidence and time was analysed by means of lineal regression. Relative risks were calculated to analyse associations between tumour sites. A total of 2737 MPC cases were registered (male/female ratio = 2). The percentage of MPC with respect to the total cancer increased from 1.78% in the 1975-1979 period to 7.08% in the 2000-2002 period (R(2) = 0.92; P = 0.003). Great increase of incidence by time was found (R(2) = 0.90; P = 0.004). Breast, prostate and bladder cancers increase risk of second tumour in female genital organs [RR 4.78 (3.84-5.93)], urinary system [RR 3.69 (2.89-4.69)] and male genital organs [RR 3.76 (2.84-4.69)] respectively. The MPC incidence is increasing. Interventions for MPC prevention, according to the European Code against Cancer, should be implemented early after the first cancer principally if patients suffer breast, bladder, prostate, larynx and colon cancers.

Cell proliferation activity and prognostic index in squamous cell lung carcinoma.

Flow Cytometry (FC) has been incorporated into cancer research in relation to its prognostic value together with histological parameters and TNM stages. We have studied by means of FC the cell cycle of 132 samples from male patients with Squamous Cell Lung Carcinoma (SQCLC). All of the patients received curative surgery and the clinical follow-up was 60 months. The clinical and cytometric parameters were evaluated in order to predict the patients' outcome. The presence of tumoural recurrence and the tumoural stage showed statistical significance associated with survival. The multivariant analysis reveals radiotherapy (p = 0.004) as protective variable and the high S-phase fraction (SPF) (p = 0.001) and stage IIIA (p = 0.012) as risk factors. The SPF appears as an independent prognostic factor for overall survival time. We can build a prognostic index representative of different prognostic groups, which allows us to improve the individual monitoring of these patients.