Rendimiento de la PET/TC con 11C-colina en el seguimiento del cáncer de próstata / Effectiveness of 11C-choline PET/CT in prostate cancer surveillance

Objetivo Analizar el rendimiento diagnóstico de la PET/TC con 11C-colina en el seguimiento del cáncer de próstata (CaP), especialmente en pacientes con antígeno prostático específico (PSA)>1ng/ml. Material y métodos Se evaluaron retrospectivamente 329 exploraciones PET/TC con 11C-colina de 191 pacientes (68,2±7,2 años) con CaP con recaída bioquímica o en seguimiento (PSA en el momento de la PET/TC: 13,0±84,2ng/ml). El tratamiento inicial fue prostatectomía radical en 81 pacientes y otros tratamientos (radioterapia, quimioterapia, hormonoterapia) en 110. La PET/TC se adquirió 20min después de la inyección de 555-740MBq de 11C-colina. El seguimiento mínimo fue superior a 12 meses. Resultados Doscientas diecinueve (66,6%) de las 329 exploraciones PET/TC fueron positivas. El porcentaje de positivos fue significativamente mayor en los pacientes con otro tratamiento inicial diferente a la prostatectomía radical (85,6 frente a 43,6%, respectivamente). Ciento treinta PET/TC (59,4%) mostraron recidiva local, 48 (21,9%) a distancia y 41 (18,7%) local más a distancia. El abordaje terapéutico inicial se modificó en 139 casos (63,5%). De las 81 PET/TC con 11C-colina realizadas con PSA<1ng/ml, 23 (28,4%) fueron positivas. El abordaje terapéutico inicial se modificó en 9 (11,1%). Tres de 63 pacientes (4,8%) fallecieron por CaP. Conclusiones La PET/TC con 11C-colina demostró su eficacia en el seguimiento y la reestadificación del CaP, incluso en pacientes con PSA sérico<1ng/ml. El rendimiento diagnóstico fue diferente según el tratamiento inicial al que fueron sometidos los pacientes, siendo mayor en aquellos tratados inicialmente con otros tratamientos distintos de la PR prostatectomía radical (AU)

Aim Our aim was to analyse the performance of 11C-choline PET/CT in prostate cancer (PCa) surveillance, especially in patients with prostate specific antigen (PSA)<1ng/ml. Material and methods Three hundred and twenty-nine 11C-choline PET/CT examinations from 191 patients (68.2±7.2 years) submitted for PCa surveillance or biochemical recurrence were retrospectively evaluated (PSA at study was 13.0±84.2ng/ml). Main initial treatment was radical prostatectomy in 81 patients, and other treatments (radiotherapy, chemotherapy, hormonotherapy) in 110. PET/CT was acquired 20min after injection of 555-740MBq of 11C-choline. Minimum follow-up was 12 months. Results Two hundred and nineteen (66.6%) out of the 329 PET/CT examinations were positive. The percentage of positive examinations was significantly higher in patients with other initial treatment than radical prostatectomy compared to patients with radical prostatectomy (85.6 vs. 43.6%, respectively). One hundred and thirty PET/CT (59.4%) showed local recurrence, 48 (21.9%) distant recurrence, and 41 (18.7%) local plus distant recurrence. Initial therapeutic approach was changed in 139 cases (63.5%). In the subgroup of 81 11C-choline PET/CT scans performed with PSA<1ng/ml, 23 (28.4%) showed a positive result. Initial therapeutic approach was changed in 9 (11.1%). Three (4.8%) out of 63 patients died as per PCa. Conclusions 11C-choline PET/CT demonstrated its effectiveness in PCa surveillance and restaging, even in patients with serum PSA<1ng/ml. The diagnostic performance was different depending on the initial treatment, been higher in patients with non-surgical treatment (AU)

Effectiveness of 11C-choline PET/CT in prostate cancer surveillance.

AIM: Our aim was to analyse the performance of [11C]choline PET/CT in prostate cancer (PCa) surveillance, especially in patients with prostate specific antigen (PSA) < 1 ng/mL. MATERIAL AND METHODS: Three hundred and twenty-nine [11C]choline PET/CT examinations from 191 patients (68.2 ±â€¯7.2 years) submitted for PCa surveillance or biochemical recurrence were retrospectively evaluated. PSA at study was 13.0 ±â€¯84.2 ng/mL. Main initial treatment was radical prostatectomy (RP) in 81 patients, and other treatments (radiotherapy, chemotherapy, hormonotherapy) in 110. PET/CT was acquired 20' after injection of 555-740 MBq of [11C]choline. Minimum follow-up was 12 months. RESULTS: Two hundred and nineteen (66.6%) out of the 329 PET/CT examinations were positive. The percentage of positive examinations was significantly higher in patients with other initial treatment than RP compared to patients with RP (85.6% vs. 43.6%, respectively). One hundred and thirty PET/CT (59.4%) showed local recurrence, 48 (21.9%) distant recurrence, and 41 (18.7%) local plus distant recurrence. Initial therapeutic approach was changed in 139 cases (63.5%). In the subgroup of 81 [11C]choline PET/CT scans performed with PSA < 1 ng/mL, 23 (28.4%) showed a positive result. Initial therapeutic approach was changed in 9 (11.1%). Three (4.8%) out of 63 patients died as per PCa. CONCLUSION: [11C]choline PET/CT demonstrated its effectiveness in PCa surveillance and restaging, even in patients with serum PSA < 1 ng/mL. The diagnostic performance was different depending on the initial treatment, been higher in patients with non-surgical treatment.

Adaptación del módulo de 18FDG para la preparación de una disolución inyectable de [18F] fluoruro sódico de conformidad con la Farmacopea Americana (USP 32) y Europea (PhEur 6) / Adaptation of the 18FDG module for the preparation of a sodium fluoride [18F] injection solution in agreement with the United States (USP 32) and European Pharmacopeia (PhEur 6)

Objetivos. Establecer un procedimiento automatizado para la preparación de la disolución inyectable de [18F] NaF utilizando los recursos disponibles en nuestro laboratorio para la preparación de 18FDG, analizando la repercusión del acondicionamiento de la columna de atrapamiento del ion fluoruro sobre las características del producto final. Material y método. Se modificó la secuencia de un módulo de síntesis de 18FDG automatizado de manera que el ion fluoruro procedente del ciclotrón se atrapa en resina de intercambio aniónico y se eluye con cloruro sódico 0,9%. La disolución final se dosifica y autoclava en envase final en equipo automatizado. Dentro del proceso, se estudiaron tres protocolos diferentes de acondicionamiento de columna. Se realizaron los controles de calidad descritos en USP 32 y PhEur 6, añadiendo el control de etanol como disolvente residual y los controles de calidad de la disolución a las 8 h de la preparación. Resultados. La activación de los cartuchos de resina con etanol y agua presenta una atrapamiento del ion fluoruro > 95% y pH en torno a 7, por lo que es el procedimiento de acondicionamiento de elección. La concentración de etanol se mantuvo < 5.000 ppm. Los controles efectuados a las 8 h indicaban que la disolución mantenía las especificaciones de USP 32 y PhEur 6. Conclusiones. Se describe un método automatizado sencillo, económico y reproducible, de preparación de una disolución inyectable de 18F-fluoruro sódico al alcance de cualquier centro con equipamiento convencional para síntesis y control de calidad de 18FDG(AU)

Objective. To establish an automated procedure for the preparation of sodium fluoride 18F injection using the resources available in our laboratory for the preparation of 18FDG and to analyze the repercussion of the conditioning column of the fluoride ion entrapment on the characteristics of the final product. Material and method. The sequence of an 18FDG synthesis module prepared so that it traps the fluoride ion from the cyclotron in ion-exchange resin diluted with 0.9% sodium chloride. The final solution was dosified and sterilized in a final vial in an automatized dispensing module. Three different column conditioning protocols within the process were tested. Quality controls were run according to USP 32 and EurPh 6, adding control of ethanol levels of residual solvent and quality controls of the solution at 8 h post-preparation. Results. Activation of the resin cartridges with ethanol and water was the chosen procedure, with fluoride ion trapping > 95% and pH around 7. Ethanol levels were < 5.000 ppm. Quality controls at 8 h indicated that the solution was in compliance with the USP 32 and EurPh 6 specifications. Conclusion. This is an easy, low-cost, reliable automated method for sodium fluoride preparation in PET facilities with existing equipment for 18FDG synthesis and quality control(AU)

[Adaptation of the (18)FDG module for the preparation of a sodium fluoride [(18)F] injection solution in agreement with the United States (USP 32) and European Pharmacopeia (PhEur 6)]. / Adaptación del módulo de (18)FDG para la preparación de una disolucióninyectable de [(18)F] fluoruro sódico de conformidad con la Farmacopea Americana(USP 32) y Europea (PhEur 6).

OBJECTIVE: To establish an automated procedure for the preparation of sodium fluoride (18)F injection using the resources available in our laboratory for the preparation of (18)FDG and to analyze the repercussion of the conditioning column of the fluoride ion entrapment on the characteristics of the final product. MATERIAL AND METHOD: The sequence of an (18)FDG synthesis module prepared so that it traps the fluoride ion from the cyclotron in ion-exchange resin diluted with 0.9% sodium chloride. The final solution was dosified and sterilized in a final vial in an automatized dispensing module. Three different column conditioning protocols within the process were tested. Quality controls were run according to USP 32 and EurPh 6, adding control of ethanol levels of residual solvent and quality controls of the solution at 8 h post-preparation. RESULTS: Activation of the resin cartridges with ethanol and water was the chosen procedure, with fluoride ion trapping > 95% and pH around 7. Ethanol levels were < 5.000 ppm. Quality controls at 8 h indicated that the solution was in compliance with the USP 32 and EurPh 6 specifications. CONCLUSION: This is an easy, low-cost, reliable automated method for sodium fluoride preparation in PET facilities with existing equipment for (18)FDG synthesis and quality control.

[A clinico-anatomical correlation study of logorrhoea]. / Estudio de correlación clinicoanatómica de la logorrea.

INTRODUCTION: The degree of verbal production necessary to be considered logorrhoea has still not been defined, and no clear correlation has been established between the topography of the dysfunction and this symptom. AIMS: To provide quantitative data about normal verbal production and to identify the location within the brain of the alterations observed in neuroimage of patients with logorrhoea. SUBJECTS AND METHODS: The oral verbal production of 60 control subjects between 20 and 80 years of age was quantified by analysing five speeches. Ten patients who exceeded the 75th percentile in at least two of the five speeches underwent structural and functional neuroimaging tests. RESULTS. The data on verbal production of normal subjects are reported. Age, sex and habits (smoking, coffee, alcoholic drinks) did not exert an influence, but the degree of schooling was seen to have an effect. All the patients were diagnosed with frontotemporal degeneration, although in one case there were also coexisting vascular risk factors and subcortical vascular lesions, which reduce the degree of certainty of the diagnosis. Cortical atrophy is located in the right anterior temporal lobes (100% anteromedial, 100% anteroinferior, 70% anterolateral), left anterior temporal (90% anteromedial, 90% anteroinferior, 60% anterolateral), right prefrontal (30% basal, 50% dorsolateral, 20% medial) and left prefrontal (20% basal, 30% dorsolateral, 20% medial). CONCLUSIONS: Oral verbal production is influenced by level of education and, in a sample of patients with probable frontotemporal degeneration and logorrhoea, all the patients showed alterations in the anteroinferior and anteromedial regions of the right temporal lobe.

Estudio de correlación clinicoanatómica de la logorrea / A clinico anatomical correlation study of logorrhoeaa

Resumen. Introducción. Aún no se ha definido el grado de producción verbal necesario para identificar una logorrea y tampoco se ha establecido una correlación clara entre la topografía de la disfunción y el síntoma. Objetivos. Aportar datos cuantitativos de producción verbal normal e identificar la localización cerebral de las alteraciones en neuroimagen de pacientes con logorrea. Sujetos y métodos. Se ha cuantificado la producción verbal oral de 60 sujetos de control de entre 20 y 80 años, analizando cinco discursos. A 10 pacientes que superaron el percentil 75 en al menos dos de los cinco discursos se les realizaron pruebas de neuroimagen estructural y funcional. Resultados. Se presentan los datos de producción verbal de los sujetos normales. La edad, el sexo y hábitos (tabaco, café, bebidas alcohólicas) no mostraron influencia, pero sí el grado de formación académica. Todos los enfermos fueron diagnosticados de degeneración frontotemporal, aunque en un caso coexistían factores de riesgo vascular y lesiones vasculares subcorticales, que reducen seguridad al diagnóstico. La atrofia cortical se localiza en los lóbulos temporal anterior derecho (el 100% anteromedial, el 100% anteroinferior, el 70% anterolateral), temporal anterior izquierdo (el 90% anteromedial, el 90% anteroinferior, el 60% anterolateral), prefrontal derecho (el 30% basal, el 50% dorsolateral, el 20% medial) y prefrontal izquierdo (el 20% basal, el 30% dorsolateral, el 20% medial). Conclusiones. La producción verbal oral está influida por la formación académica y, en una muestra de pacientes con degeneración frontotemporal probable y logorrea, todos los enfermos mostraron alteración en las regiones anteroinferior y anteromedial del lóbulo temporal derecho (AU)

Summary. Introduction. The degree of verbal production necessary to be considered logorrhoea has still not been defined, and no clear correlation has been established between the topography of the dysfunction and this symptom. Aims. To provide quantitative data about normal verbal production and to identify the location within the brain of the alterations observed in neuroimage of patients with logorrhoea. Subjects and methods. The oral verbal production of 60 control subjects between 20 and 80 years of age was quantified by analysing five speeches. Ten patients who exceeded the 75th percentile in at least two of the five speeches underwent structural and functional neuroimaging tests. Results. The data on verbal production of normal subjects are reported. Age, sex and habits (smoking, coffee, alcoholic drinks) did not exert an influence, but the degree of schooling was seen to have an effect. All the patients were diagnosed with frontotemporal degeneration, although in one case there were also coexisting vascular risk factors and subcortical vascular lesions, which reduce the degree of certainty of the diagnosis. Cortical atrophy is located in the right anterior temporal lobes (100% anteromedial, 100% anteroinferior, 70% anterolateral), left anterior temporal (90% anteromedial, 90% anteroinferior, 60% anterolateral), right prefrontal (30% basal, 50% dorsolateral, 20% medial) and left prefrontal (20% basal, 30% dorsolateral, 20% medial). Conclusions. Oral verbal production is influenced by level of education and, in a sample of patients with probable frontotemporal degeneration and logorrhoea, all the patients showed alterations in the anteroinferior and anteromedial regions of the right temporal lobe (AU)

[The immunohistochemical expression of cyclin B1 is associated with higher SUV in 18F-FDG-PET in non-small cell lung cancer patients. Initial results]. / La expresión inmunohistoquímica de ciclina B1 conlleva mayores valores de SUV en la 18F-FDG-PET de pacientes con carcinomas no microcíticos de pulmón. Primeros resultados.

AIM: to study the expression of cyclin B1 and its possible relationship with the maximum SUV in FDG-PET and MIB1 expression in patients with NSCLC. MATERIALS AND METHODS: 49 patients (15 adenocarcinomas, 27 squamous cell carcinomas and 7 bronchoalveolar carcinomas) were included in this study; the immunohistochemical expression of cyclin B1 was determined using the tissue-array technique. Each PET was performed 60 minutes after the i.v. administration of 350-518 MBq of FDG on an Advance system (GE) in 2D acquisition mode. RESULTS: cyclin B1 expression was detected in 40 out of 45 cases. The SUV values were higher (p=0.04) in the cyclin B1+ cases than in the negative cases (16.4+/-8.1 vs 10.9+/-6.2). Cyclin B1 expression and SUV values were not correlated with the clinical stage. The expression of cyclin B1+ correlated positively (p<0.0001) with that of MIB1. After univariate analysis, only the cellular proliferation was a prognostic factor (p=0.037). CONCLUSIONS: our results suggest that there is a direct correlation between cyclin B1 expression and max-SUV values in the PET of NSCLC patients. When the association of cyclin B1 with positive MIB1 is also considered, our results support the role of cell proliferation in FDG uptake by the tumour.

La expresión inmunohistoquímica de ciclina B1 conlleva mayores valores de SUV en la 18F-FDG-PET de pacientes con carcinomas no microcíticos de pulmón. Primeros resultados / The immunohistochemical expression of cyclin B1 is associated with higher SUV in 18F-FDG-PET in non-sma ll cell lung cancer patients. Initial results

Objetivo: estudiar la posible correlación entre la expresión de ciclina B1, proliferación celular y la SUV máxima-18F-FDG-PET en pacientes con carcinomas no microcíticos pulmonares. Material y metodo: se incluyó a 49 pacientes (15 adenocarcinomas, 27 carcinomas escamosos y 7 carcinomas broncoalveolares) y se realizó la expresión inmunohistoquímica de ciclina B1 mediante tissue-arrays. Asimismo, analizamos la proliferación celular (MIB-1). El PET se realizó 60 min después de la administración intravenosa (i.v.) de 350-518 MBq de 18F-FDG en un PET (Advance, GE) y adquisión en 2D. Resultados: la expresión inmunohistoquímica de ciclina B1 se detectó en 40 (81,6%) casos y no se relacionó con el estadio clínico (I-II: 17/21 frente a III-IV: 23/28). Los valores de SUV fueron mayores (p = 0,04) en los casos positivos (16,4 ± 8,1) que en los negativos (10,9 ± 6,2) y no difirieron en función del estadio clínico. La expresión de ciclina B1 se correlacionó (p < 0,0001) con la de MIB1. Tras análisis univariable, la ciclina B1 y los valores SUV no fueron factores pronósticos, pero sí la proliferación celular (p = 0,037). Conclusiones: nuestros resultados muestran una relación directa entre la expresión de ciclina B1 y los valores max SUV en el PET de pacientes afectos de carcinomas no microcíticos de pulmón, lo cual, unido a la asociación de aquella con la positividad del MIB1, apoya el papel de la proliferación celular en la captación del radiofármaco por el tumor(AU)

Aim: to study the expression of cyclin B1 and its possible relationship with the maximum SUV in FDG-PET and MIB1 expression in patients with NSCLC. Materials and methods: 49 patients (15 adenocarcinomas, 27 squamous cell carcinomas and 7 bronchoalveolar carcinomas) were included in this study; the immunohistochemical expression of cyclin B1 was determined using the tissue-array technique. Each PET was performed 60 minutes after the i.v. administration of 350-518 MBq of FDG on an Advance system (GE) in 2D acquisition mode. Results: cyclin B1 expression was detected in 40 out of 45 cases. The SUV values were higher (p = 0.04) in the cyclin B1+ cases than in the negative cases (16.4 ± 8.1 vs 10.9 ± 6.2). Cyclin B1 expression and SUV values were not correlated with the clinical stage. The expression of cyclin B1+ correlated positively (p < 0.0001) with that of MIB1. After univariate analysis, only the cellular proliferation was a prognostic factor (p = 0.037). Conclusions: our results suggest that there is a direct correlation between cyclin B1 expression and max-SUV values in the PET of NSCLC patients. When the association of cyclin B1 with positive MIB1 is also considered(AU)

[The immunohistochemical expression of cyclooxygenase 2 is inversely associated with (18)F-FDG-PET SUV values in non-small-cell lung cancers. Initial results]. / La expresión inmunohistoquímica intensa de ciclooxigenasa 2 se asocia inversamente con los valores máximos de SUV en la (18)F-FDG-PET de pacientes afectados de carcinomas no microcíticos de pulmón. Relación con otros factores biológicos.

OBJECTIVE: To study the expression of COX-2 and its possible relationship with the maximum standardized uptake value (SUV) in FDG-PET, and EGFR, p16 and MIB1 expression in patients with NSCLC. MATERIAL AND METHOD: 45 patients (12 adenocarcinomas and 33 squamous cell carcinomas) were included in this study; the immunohistochemical expression of COX-2, MIB-1, p16 and EGFR was determined using tissue-array. Each PET was performed 60 minutes after the i.v. administration of 350-518 MBq of FDG on an Advance system (GE) in 2D acquisition mode. RESULTS: COX-2 expression was detected in 35 out of 45 cases, and was very significant (> ++) in 12 of them. SUV values were lower in the COX-2 > ++ cases that in the remaining cases (13.4 +/- 1.2 vs. 12.9 vs. 17.1 +/- 1.5; p = 0.059). COX-2 > ++ expression and maxSUV values were not correlated with the clinical stage. The expression of COX-2 > ++ was correlated positively with p16 (r = 0.36; p = 0.014) and negatively with MIB1 (r = -0.32; p = 0.041) expression, whereas the SUV was correlated positively with EGFR (r = 0.44; p = 0.004) and negatively with p16 (r = -0.29; p = 0.041) expression. CONCLUSIONS: Our results suggest that: a) the expression of COX-2 > ++ is often found in this kind of lung cancer and is not associated with the clinical stage; b) the maxSUVs were not related to the stage and were lower in COX-2 > ++ tumours than in the other cases; and c) the different behaviour of both parameters can be explained by their correlation with cell proliferation (MIB1), EGFR and p16 expression.

La expresión inmunohistoquímica intensa de ciclooxigenasa 2 se asocia inversamente con los valores máximos de SUV en la 18F-FDG-PET de pacientes afectados de carcinomas no microcíticos de pulmón. Relación con otros factores biológicos / The immunohistochemical expression of cyclooxygenasa 2 is inversely associated with 18F-FDG-PET SUV values in non-small cell lung cancers. Initial results

Objetivo: estudiar la expresión de COX-2 y sus posibles relaciones con el valor de captación estándar (SUV, standardized uptake value, valor de captación estándar) máximo-FDG-PET y la expresión de MIB1, p16 y receptor del factor de crecimiento epidérmico (EGFR) en pacientes afectados de carcinoma no microcítico de pulmón (CPNM). Material y método: se incluyó 45 pacientes (12 adenocarcinomas y 33 carcinomas escamosos) en los que se analizó, mediante tissue-arrays, la expresión de los factores biológicos. Los valores de SUV se obtuvieron 60 min después de la administración del radiofármaco y la imagen se efectuó en un PET Advanced System (GE). Resultados: la expresión de COX-2 se apreció en 35/45 casos, y fue muy importante (> ++) en 12. Los valores de SUV fueron menores (p = 0,059) en los casos COX-2 > ++ que en los restantes (13,4 ± 1,2 frente a 12,9 frente a 17,1 ± 1,5). La expresión de COX-2 > ++ no se correlacionó con el estadio, ni tampoco lo hizo el SUV. La expresión de COX-2 > ++ se correlacionó positivamente con la de p16 (r = 0,36; p = 0,014) y negativamente con la de MIB1 (r = -0,32; p = 0,041), mientras que la SUV lo hizo positivamente con la del EGFR (r = 0,44; p = 0,004) y negativamente con la de p16 (r = -0,29; p = 0,041). Conclusiones: a) la expresión intensa (> ++) de COX-2 se constata en el 26,6% de los CPNM y es independiente del estadio clínico; b) los valores de SUV tampoco se relacionaron con el estadio y fueron menores en los tumores COX-2++ que en el resto de casos, y c) este comportamiento diferente de ambos parámetros se podría explicar por sus distintas relaciones con la proliferación celular (MIB1) y la expresión de EGFR y p16 (AU)

Objective: To study the expression of COX-2 and its possible relationship with the maximum standardized uptake value (SUV) in FDG-PET, and EGFR, p16 and MIB1 expression in patients with NSCLC. Material and method: 45 patients (12 adenocarcinomas and 33 squamous cell carcinomas) were included in this study; the immunohistochemical expression of COX-2, MIB-1, p16 and EGFR was determined using tissue-array. Each PET was performed 60 minutes after the i.v. administration of 350-518 MBq of FDG on an Advance system (GE) in 2D acquisition mode. Results: COX-2 expression was detected in 35 out of 45 cases, and was very significant (> ++) in 12 of them. SUV values were lower in the COX-2 > ++ cases that in the remaining cases (13.4 ± 1.2 vs. 12.9 vs. 17.1 ± 1.5; p = 0.059). COX-2 > ++ expression and maxSUV values were not correlated with the clinical stage. The expression of COX-2 > ++ was correlated positively with p16 (r = 0.36; p = 0.014) and negatively with MIB1 (r = -0.32; p = 0.041) expression, whereas the SUV was correlated positively with EGFR (r = 0.44; p = 0.004) and negatively with p16 (r = -0.29; p = 0.041) expression. Conclusions: Our results suggest that: a) the expression of COX-2 > ++ is often found in this kind of lung cancer and is not associated with the clinical stage; b) the maxSUVs were not related to the stage and were lower in COX-2 > ++ tumours than in the other cases; and c) the different behaviour of both parameters can be explained by their correlation with cell proliferation (MIB1), EGFR and p16 expression. © 2008 Elsevier España, S.L. and SEMN. All rights reserved (AU)

Deficiencia del transportador de glucosa tipo I: una enfermedad neurometabólica tratable / Glucose transporter type 1 deficiency: a treatable neuro-metabolicdisorder

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Reduced clinicopathological influence of hormone-dependence on breast carcinomas in women older than 70 years.

In order to evaluate the influence of hormone dependence on the features of infiltrating ductal carcinoma of the breast we have assayed the cytosolic levels of estrogen receptor (ER), progesterone receptor (PR), pS2 and cathepsin D in 53 women aged over 70 years and in 95 women aged between 55 and 70 years. Tumor size, axillary involvement, distant metastasis, histological grade, ploidy and S-phase were taken into account. Carcinomas of women aged over 70 did not show higher concentrations or higher positive results for ER and PR than those of women in the 55-70-year age group. In older patients, negativity for ER was associated only with higher S-phase fraction, while negativity for PR was not associated with any of the parameters analyzed. In the younger subgroup, negativity for ER was associated with larger tumor size, higher S-phase fraction, lymph node involvement, histological grade 3 and lower pS2 values. Negativity for PR was associated with the same parameters, as well as with a higher frequency of recurrence. Our results suggest a reduced influence of hormone dependence on the clinicopathological features of breast carcinomas in patients older than 70 years compared with women aged between 55 and 70 years.

CA15.3 sérico y proliferación celular en carcinomas ductales infiltrantes de mama / Preoperative CA15.3 serum levels and cellular proliferation in patients having infiltrating ductal carcinomas of the breast

Objetivo. Estudiar la posible correlación entre las concentraciones séricas preoperatorios de CA15.3 y laproliferación celular medida por la fase de síntesis (FS) en carcinomas ductales infiltrantes de mama (CDI).Material y métodos. El grupo estudio incluyó 79 pacientesde edades comprendidas entre los 39 y 86 años (64,8 ± 11,8). La ploidía y FS fueron determinadas por citometría de flujo en muestras en fresco (Fascam. Beckton Dikinson. EE.UU.). Resultados. Tomando como dintel de positividad para la FS el valor de 7 %, que representa la mediana obtenida previamente en un grupo de 321 CDI (i: 0,8-51,2; 9,3 ± 7,9; percentiles 25 y 75; 4,3 y 11,8 %), observamos que las concentraciones del marcador fueron mayores (p: 0,015) en los casos con menor proliferación celular. Esto mismo se constató al valorar cualitativamente (> 30 U/ml) el marcador. Asimismo, las concentraciones de CA15.3 aumentaron significativamente (p = 0,007) al pasar la FS de < 4,3 % a FS comprendida entre 4,3 y 7,1 %, para luego descender (p = 0,010) en los casos con FS entre 7,11 y 11,8% y no modificarse cuando aquella fue > 11,8 %. Este mismo comportamiento lo observamos en los tumores sin afectación axilar. Conclusiones. a) La liberación del CA15.3 ocurre cuando la FS se incrementa hasta alcanzar el valor del 7,1 %, para luego ir disminuyendo aunque aquella aumente, y b) este mismo comportamiento del marcador con la fase S se constató cuantitativamente en los tumores aneuploides y sin afectación axilar

Objective. To study the possible correlations betweenthe preoperative CA15.3 serum levels and the cellularproliferation, measured by S-phase (SP), in patients having infiltrating ductal carcinomas (IDC) of the breastMaterial and methods. The study group included 79 patients with an age ranged between 39 and 86 yrs (64,8 ± 11,8). Ploidy and S-phase were measured by cytometry (Fascam. Beckton Dikinson. USA) in fresh samplesResults: Using as cut-off for SP the value of 7 %, which represents the median obtained previously in 321 patients with IDC (r: 0,8-51,2; 9,3 ± 7,9; percentiles 25 y 75; 4,3 y 11,8 %), we can observed that the antigenic levels were higher (p:0,015) in the tumors with low SP. These same behavior was noted when 30U/ml was used as cut-off for CA15.3. Likewise, the levels of the tumor marker increased significantly (p:0,007)when the SP moved from < 4,3 % to 7,1 %, to decrease later (p:0,010) when the SP value was comprised between 7,11% and 11,8 %. The same behavior of this tumor marker in relation to the SP was noted in tumors without axillary involvement tumors, as well as in aneuploid carcinomas. Conclusion: a) Release of CA15.3 happens when SP increases to rise the 7,1 % value, to decrease later although that goes on increasing, and b) The same behaviour of this marker with the S-phase was observed in tumors without axillary involvement, as well as in aneuploid carcinomas

[Preoperative CA15.3 serum levels and cellular proliferation in patients having infiltrating ductal carcinomas of the breast]. / CA15.3 sérico y proliferación celular en carcinomas ductales infiltrantes de mama.

OBJECTIVE: To study the possible correlations between the preoperative CA15.3 serum levels and the cellular proliferation, measured by S-phase (SP), in patients having infiltrating ductal carcinomas (IDC) of the breast MATERIAL AND METHODS: The study group included 79 patients with an age ranged between 39 and 86 yrs (64,8 +/- 11,8). Ploidy and S-phase were measured by cytometry (Fascam. Beckton Dikinson. USA) in fresh samples RESULTS: Using as cut-off for SP the value of 7 %, which represents the median obtained previously in 321 patients with IDC (r: 0,8-51,2; 9,3 +/- 7,9; percentiles 25 y 75; 4,3 y 11,8 %), we can observed that the antigenic levels were higher (p:0,015) in the tumors with low SP. These same behavior was noted when 30U/ml was used as cut-off for CA15.3. Likewise, the levels of the tumor marker increased significantly (p:0,007) when the SP moved from < 4,3 % to 7,1 %, to decrease later (p:0,010) when the SP value was comprised between 7,11 % and 11,8 %. The same behavior of this tumor marker in relation to the SP was noted in tumors without axillary involvement tumors, as well as in aneuploid carcinomas. CONCLUSION: a) Release of CA15.3 happens when SP increases to rise the 7,1 % value, to decrease later although that goes on increasing, and b) The same behaviour of this marker with the S-phase was observed in tumors without axillary involvement, as well as in aneuploid carcinomas.

Evolución, mediante estudios con 18F-FDG, de un caso de enfermedad de Hodgkin tipo esclerosis nodular después de tratamiento y autotrasplante / Evolution in 18f-FDG-pet, of a case of Hodgkin disease, Nodular Sclerosis variety, after treatment and autotrasplant

La tomografía por emisión de positrones (PET) se ha convertido, en los últimos años, en una técnica muy útilpara el control de los pacientes afectos de enfermedad deHodgkin (EH). Ante la sospecha de persistencia de enfermedad tras el tratamiento, esta técnica permite valorar la actividad de las lesiones residuales que se observan en la tomografía axial computarizada y, gracias al estudio de cuerpo completo, detectar nuevas localizaciones tumorales, lo que cambia, en numerosas ocasiones, la intención terapéutica. Hay que teneren cuenta, sin embargo, que la 18F-FDG es un marcador muysensible pero poco específico, pues ciertos procesos inflamatorios o infecciosos pueden asociarse a captaciones importantes del radiofármaco. Por ello, es fundamental la integración de la información aportada por la PET con el resto de las pruebas de imagen, la clínica y la evolución del paciente para tratar demejorar la especificidad diagnóstica. Presentamos el caso de una paciente con EH, en cuyo control tras el tratamiento se incluyó la PET, presentándose ambosprocesos (tumoral e infeccioso) en diferentes momentosde la evolución, y en la que la integración de toda la información, radiológica, clínica, analítica y metabólica, permitió un mejor y correcto conocimiento de la enfermedad

Positron Emission Tomography (PET) has become a very useful tool for monitoring Hodgkin’s disease patients in the last years. When there is suspicion of disease persistence after treatment, this technique makes it possible to evaluate treatment activity of the residual lesions observed in the CT scan. Furthermore, due to the whole body study, new tumor sites, which very often change the therapeutic option, can be detected. We must take into account, however, that 18F-FDG is a very sensitive but not very specific tumor marker, since some inflammatory or infectious conditions may be associatedto significant radiopharmaceutical uptakes. Thus, inorder to increase specificity it is mandatory to correlate the PET information with the rest of the conventional imaging and clinical data and evolution of the patient. We present the case of a woman with Hodgkin’s disease in which 18F-FDG PET was included in the follow-up. Both conditions, tumor and infection, were present in different times of the course. The integration of all the x-ray, clinical, laboratory andmetabolic information allowed for a better and correct management of this patient (AU)

[Evolution in 18F-FDG-PET of a case of Hodgkin disease, nodular sclerosis variety, after treatment and autotrasplant]. / Evolución, mediante estudios con 18F-FDG, de un caso de enfermedad de Hodgkin tipo esclerosis nodular después de tratamiento y autotrasplante.

Positron Emission Tomography (PET) has become a very useful tool for monitoring Hodgkin's disease patients in the last years. When there is suspicion of disease persistence after treatment, this technique makes it possible to evaluate treatment activity of the residual lesions observed in the CT scan. Furthermore, due to the whole body study, new tumor sites, which very often change the therapeutic option, can be detected. We must take into account, however, that 18F-FDG is a very sensitive but not very specific tumor marker, since some inflammatory or infectious conditions may be associated to significant radiopharmaceutical uptakes. Thus, in order to increase specificity it is mandatory to correlate the PET information with the rest of the conventional imaging and clinical data and evolution of the patient. We present the case of a woman with Hodgkin's disease in which 18F-FDG PET was included in the follow-up. Both conditions, tumor and infection, were present in different times of the course. The integration of all the x-ray, clinical, laboratory and metabolic information allowed for a better and correct management of this patient.