High MET expression is an adverse prognostic factor in patients with triple-negative breast cancer.

BACKGROUND: The mesenchymal-epithelial transition (MET) pathway is frequently altered in tumours. The purpose of our study was to determine the prognostic value of tumour MET expression levels in patients with triple-negative breast cancer (TNBC), in order to strengthen the rationale for targeted therapy of TNBC using MET inhibitors. METHODS: We determined expression of MET in formalin-fixed paraffin-embedded surgical specimens of TNBC by immunohistochemistry. Recurrence-free and overall survival was analysed with Cox models adjusted for clinical and pathological factors. RESULTS: Immunostaining for MET was classified as high in 89 of 170 (52%) tumours. MET expression was more frequently observed in G3 carcinomas (P=0.02) but was not significantly associated to any of the other clinical or pathological parameters. High MET expression predicted shorter survival of the patients. Multivariate Cox proportional hazards regression analyses identified MET to be an independent prognostic factor for recurrence (adjusted hazard ratio (HR) for recurrence 3.43; 95% confidence interval (CI) 1.65-7.12; P=0.001) and death (adjusted HR for death 3.74; 95% CI 1.65-8.46; P=0.002). CONCLUSION: These results provide further evidence that the MET pathway could be exploited as a target for TNBC.

Chlamydial infection in female lower genital tract and its correlation with cervical smear abnormalities.

BACKGROUND: It is widely known that infection by Chlamydia trachomatis (CT) is the most common curable sexually transmitted infection (STI) among the young population.Chlamydial cervicitis has been suspected in the past to be a risk factor for squamous intraepithelial neoplasia (SIL) and cervical cancer on the basis of case-control comparisons of serological tests. METHODS: A total of 110 women with symptomatic cervicitis were examined and samples for microbiologic detection of Chlamydia trachomatis antigen were obtained. Colposcopic, cytologic and microbiologic analyses were performed. All results were statistically analysed and correlated. RESULTS: 41 patients (37.2 %) were found positive for Chlamydia trachomatis antigen (Group I) and 69 patients (62.8 %) were negative for Chlamydia trachomatis antigen (Group II). When compared to group II, the chlamydia-infected group I of women presented a larger percentage of dyspareunia (60 %), and the dysuric complaints were more common. The chlamydia-positive group revealed a higher incidence of atypical squamous metaplasia (52.5 % vs 27.9 %). Among the women with positive ELISA for chlamydia, a higher percentage of low-grade SIL was observed (6.3 % vs 3.6 %). CONCLUSIONS: Chlamydial infection, especially chlamydial cervicitis occurs often among young women of reproductive age. In these women, a good clinical assessment is necessitated including previous clinical history record, as well as detailed microbiologic, cytologic and colposcopic evaluations (Tab. 5, Ref. 19).

Evaluation of the prognostic and predictive value of p53 and Bcl-2 in breast cancer patients participating in a randomized study with dose-dense sequential adjuvant chemotherapy.

PURPOSE: To assess the prognostic and predictive significance of p53 and Bcl-2 protein expression in high risk patients with breast cancer treated with dose-dense sequential chemotherapy. PATIENTS AND METHODS: From June 1997 until November 2000, 595 patients were randomized to three cycles of epirubicin (E) 110 mg/m2 followed by three cycles of paclitaxel (P) 250 mg/m2 followed by three cycles of 'intensified' CMF (cyclophosphamide 840 mg/m2, methotrexate 47 mg/m2 and fluorouracil 840 mg/m2) or to four cycles of E, followed by four cycles of CMF. p53 and Bcl-2 expression was investigated by immunohistochemistry in 392 and 397 patients respectively. RESULTS: Positive expression of p53 was detected in 104 (26.5%) patients and was significantly associated with negative hormonal status, worse histologic grade, higher incidence of disease relapse and higher rate of death. p53 positive expression was a significant negative predictor of overall survival (OS) (P = 0.002) and disease-free survival (DFS) (P = 0.001). Negative expression of Bcl-2 was detected in 203 (51%) patients and was significantly associated with negative hormonal status. Multivariate analysis revealed that, positive p53 expression, higher number of positive nodes and worse tumor grade were related to significantly poorer OS and DFS. CONCLUSIONS: For both treatments, p53 positive expression was a significant negative prognostic factor for OS and DFS while Bcl-2 was not. No predictive ability of p53 status or Bcl-2 status for paclitaxel treatment was evident.

Vaginal fibroma. Case report.

A case of a vaginal fibroma in a 50-year-old woman is presented. The tumor presented as a solid mass in the upper third of the anterior vaginal wall. Intravenous pyelography (IVP) and cystoscopy excluded any association of the mass with the urinary tract. Surgical excision of the tumor was easily accomplished and histopathological examination established the diagnosis of a fibroid tumor of the vagina.

Primary squamous cell carcinoma of the endometrium. A report of 3 cases.

Primary squamous cell carcinoma of the endometrium (PSCCE) is a rare disease of unknown etiology. Diagnosis is based on the identification of squamous cell carcinoma in the endometrium with no coexisting analogous cervical component or endometrial adenocarcinoma. There must also be no connection between the endometrial tumour and the squamous epithelium of the cervix. Although the majority of patients are classified as stage I disease, prognosis is rather dismal. We report two new cases of primary squamous cell carcinoma of the endometrium which fulfill all the above criteria and we discuss another interesting case of squamous cell carcinoma of questionable endometrial origin. Management by abdominal hysterectomy and adjuvant pelvic irradiation resulted in long-term survival of our patients.

The possible role of p53 and bcl-2 expression in cervical carcinomas and their premalignant lesions.

OBJECTIVE: The purpose of this study was to assess the expression and clinical significance of bcl-2 and p53 in the progression of cervical neoplasias. METHODS: One hundred seventy-one cervical specimens, consisting of normal cervical epithelium (n = 13), lesions with histological features of HPV infection (n = 14), CIN (cervical intraepithelial neoplasia) lesions (n = 63), and cervical carcinomas (n = 81) were examined immunohistochemically in paraffin sections. RESULTS: Twenty-three specimens showed p53 expression [3/20 (15%) CIN III, 18/63 (29%) ISCC (invasive squamous cervical carcinoma), and 2/18 (11%) adenocarcinomas] while 63 cases expressed the bcl-2 gene [10/13 (77%) normal, 0/14(0%) condylomas, 6/23 (26%) CIN I, 9/20 (45%) CIN II, 15/20 (75%) CIN III, 18/63 (29%) ISCC, and 5/18 (28%) adenocarcinomas]. The expression of bcl-2 was found to increase in direct relation to the grade of CIN (P = 0.02) whereas such a trend was not observed for p53. p53 was not detected in normal or premalignant lesions (except 3 out of 20 cases of CIN III). There was no significant correlation between the expression of p53 and the histological type of cervical carcinoma, even though expression of p53 was higher in ISCC than in adenocarcinomas (29% vs 11%, respectively). In cervical cancer patients, expression of bcl-2 was correlated to a greater than 5-year survival (P < 0.01) while no prognostic significance of p53 expression was found. CONCLUSION: Evaluation of bcl-2 expression may provide additional and independent prognostic information for the clinical course of the disease and therefore to be developed as a prognostic indicator for cervical cancer.