[Possible prognostic value of arterial hypertension in postmenopausal women with breast cancer in complete clinical remission. Pilot study]. / Posible valor pronóstico de la hipertensión arterial en mujeres postmenopáusicas con cáncer de mama. Estudio piloto.

BACKGROUND: The objective of this work was to determine the blood pressure of postmenopausal women with breast cancer in complete clinical remission of long duration. MATERIAL AND METHODS: It in a pilot study of case and controls, in which we measure the Blood Pressure (BP) of 83 postmenopausal women, with breast cancer histologically confirmed, in complete clinical remission of long duration, recruited by consecutive sampling, to compare it with that of 70 normal postmenopausal women of the same age used as controls. They ara calculated the body mass index (BMI), the corporal surface, the confidence intervals (CI) of the means, the correlation between the BMI and the BP in both groups (breast cancer patients and normal control) and between the free disease interval and the systolic and diastolic blood pressures. RESULTS: The mean of the systolic BP in 93 breast cancer patients in complete clinical remission was 163 mm Hg (95% CI 155-171) and in 70 normal controls was 134 mm Hg (95% CI 129-139). The difference between both groups in statistically significant (p < 0.001). The mean of the diastolic BP in the breast cancer patient in complete remission it was 98 mm Hg (94-104) and in the normal controls was 78 mm Hg (74-82). The difference between both groups was statistically significant (p < 0.001). CONCLUSIONS: This arterial hypertension, independent of the BMI and from the duration of the free disease interval, is associated with a long duration of the complete remission in postmenopausal breast cancer patients and consequently with a good prognostic of this disease.

La proteína p53 y el cáncer de mama. Revisión crítica / The p53 protein and breast cancer

Es una revisión crítica de las bases biológicas de la proteína p53 en la apoptosis, su importancia en la carcinogénesis experimental y humana y los procedimientos técnicos de laboratorio que pueden emplearse para su determinación en los enfermos de cáncer. La hiperexpresión de p53 por la presencia de una mutación origina una acumulación excesiva en los tejidos, relacionada con la vida media de la proteína mutada que es aproximadamente unas 60 veces más larga que la proteína natural. Los clínicos hablan de positividad de la p53 como la presencia de p53 mutada. Quizás, uno de los aspectos mejor estudiados de esta proteína es su comportamiento en el cáncer de mama. Actualmente puede ser considerada un factor pronóstico del cáncer de mama y es recomendable incluirla entre las determinaciones inmunohistoquímicas a realizar en la pieza por el anatomopatólogo clínico. Los procedimientos empleados para investigar la p53 son:a) análisis molecular; b) análisis inmunohistoquímico, y c) análisis serológico. El último es un nuevo y prometedor procedimiento serológico para detectar la p53 mutada en sangre periférica que abre importantes expectativas. Es útil para identificar los casos de mal pronóstico entre el grupo favorable con N0 (ganglios axilares negativos) (AU)

Posible valor pronóstico de la hipertensión arterial en mujeres postmenopáusicas con cáncer de mama. Estudio piloto / Possible prognostic value of arterial hypertension in postmenopausal women with breast cancer in complete clinical remission. Pilot study

Fundamento: El objetivo de este trabajo fue determinar la presión arterial (PA) en mujeres postmenopáusicas con cáncer de mama en remisión clínica completa de larga duración. Material y métodos: Se trata de un estudio piloto, de casos y controles, en los cuales se midieron la presión arterial de 83 mujeres postmenopáusicas, con cáncer de mama histológicamente confirmado en situación de remisión clínica completa de larga duración comparándolo con un grupo control de 70 mujeres sanas postmenopáusicas, de la misma edad. Se calculó el índice de masa corporal (BMI), la superficie corporal, el intervalo de confianza de la media, la correlación entre el BMI y la PA, en ambos grupos (cáncer de mama/mujeres sanas) y las presiones sistólicas y diastólicas. Resultados: La media de la presión sistólica en las 83 mujeres con cáncer de mama fue de 163 mm de Hg (95 por ciento CI 155-171) y en los 70 controles normales fue de 134 mm de Hg (95 por ciento CI 129-139). La diferencia entre ambos grupos fue estadísticamente significativa (p<0,001). La media de la presión diastólica en las mujeres con cáncer fue de 98 mm de Hg (94-104) y en los controles normales fue de 78 mm de Hg (74-82). La diferencia entre ambos grupos fue estadísticamente significativa (p<0,001). Conclusiones: La hipertensión arterial, independientemente del BMI y de la duración del intervalo libre de enfermedad, está asociado con una mayor duración de la remisión clínica completa en las mujeres postmenopáusicas con cáncer de mama y consecuentemente con un mejor pronóstico de su enfermedad cancerosa (AU)

Prevención del cáncer de mama en atención primaria / Prevention of breast cancer in primary care

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Prevalence of Helicobacter pylori infection in two Spanish regions with different incidence of gastric cancer.

It is a cross-sectional study, comparing the prevalence of Helicobacter pylori infection (prevalence of IgG antibodies to H. pylori) in the healthy population of Ubrique and Grazalema (mountain location, mortality from stomach cancer 20/100,000) and in Barbate, (coastal location, mortality from stomach cancer 10/100,000) in the province of Cadiz, southern Spain. The subjects were randomly selected, 163 men and 169 women, 18 years or older; 179 persons were studied in the inland, and 154 in the littoral in January 1997. Of the 332 subjects investigated, 43% were positive, a mean antibody titer of 337 IU/1 (95 % CI: 254-420), and 56% were negative, with a mean titer of 18 IU/1 (95% CI: 15-19). In the coastal population, 30% has positive titers and 54% in the mountain location. By age: 18-40 years, 30% of littoral and 41% of inland population had positive titers; 41-60 years, 35% of those living in the littoral and 58% of inland population had positive titers; > 60 years, 24% of coastal inhabitants and 62% of those living in the inland had positive titers. Living in mountain locations in the province of Cadiz involves a greater ecological risk for H. pylori infection (p < 0.05).

Serum ceruloplasmin as a diagnostic marker of cancer.

The pursuit of the ideal tumor marker has generated many tests for use in the diagnosis and management of cancer, several of which are now widely available. The objective of this study was to evaluate the diagnostic utility as a cancer marker of plasmatic levels of ceruloplasmin. Ceruloplasmin is a glucoprotein that transports serum copper. A case-control design was used. Serum values were evaluated in 144 patients and 103 normal controls by receiver operating characteristic (ROC) curve analysis to define the optimal cut-off levels for the serum values of ceruloplasmin in the diagnosis of cancer. The ROC analysis showed that ceruloplasmin is considerably sensitive in men (80%) at the specificity level of 80.3% and in women the sensitivity (Se) was (63.2%) and the specificity (Sp) was (63.3%). According to this study, it would seem optimal to use the cut-off level of 358 mg/l in men and 383 mg/l in women. In conclusion, serum ceruloplasmin was significantly elevated in advanced stages of solid malignant tumors, however, locally advanced or locoregionally spreading tumors did lead to significant increases (P < 0.01). Finally, the results of ROC curve analysis suggest that the ceruloplasmin is characteristic of good diagnostic markers.

Evaluation of lipid-bound sialic acid (LSA) as a tumor marker.

The objective of this study is the evaluation of serum levels of lipid-bound sialic acid (LSA) as a of marker cancer. This is a case-control study, and the levels of LSA were determined with blinded duplicates of cases and controls. Histologic verification of all cancer cases was used to confirm the diagnosis. The study included 135 patients with cancer (breast carcinoma, head and neck squamous cell carcinoma, lung cancer and gastrointestinal cancer) and 95 controls (57 normal subjects and 38 with chronic non-malignant diseases). Marker determination was done by the spectrophotometric procedure of Katopodis with resorcinol. The mean LSA level in the 57 healthy individuals was 15.09 mg/dl(95% C.I., 13.51-16.67), in the entire control group of 95 non-tumoral individuals it was 19.21 mg/dl (17.18-21.24), and in the 135 cancer patients it was 26.64 mg/dl (24.42-28.87). There was a statistically significant difference between patients with chronic non-tumoral diseases and healthy individuals (p < 0.001) and also between cancer patients and healthy individuals (p > 0.001), but not between cancer patients and patients with chronic non-tumoral diseases (p> 0.05). The mean LSA serum values related to tumor site were (mg/dl): breast cancer, 21.49; gastrointestinal tumors, 28.45; head and neck cancer, 28.61 and lung cancer, 32.54. The means according to clinical stage were: complete remission, 18.50 significantly higher than the healthy controls (p< 0.05); local disease, 23.50 (p < 0.01); locoregional disease, (p < 0.05); local disease, 23.50 (p < 0.01); locoregional disease, 27.21 (p < 0.001); metastatic disease, 34.49 (p < 0.001), and relapses, 20.87 (p< 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

[Diagnosis using monoclonal antibody imaging in the clinical follow-up of colorectal cancer]. / Diagnóstico por imagen con anticuerpos monoclonales en el seguimiento clínico del cáncer colorrectal.

A total of 44 patients with a range of ages between 34 and 72 were studied by immunoscintigraphy. They have surgical treatment for colon and rectum carcinomas. The immunoradiotracer used was a cocktail of F(ab')2 monoclonal-antibodies anti-CEA and CA 19.9. Planar images were obtained 4th, 6th, and 10th days postinjection. In some cases we used digital subtraction of image. Both CEA and CA 19.9 tumor markers were measured in patients serum. The method shows a global high sensitivity (88%), and specificity (92%).

A phase II trial of a new combination chemotherapy (cisplatin, bleomycin, VP-16 and methylprednisolone) in advanced recurrent squamous cell carcinoma of the head and neck.

UNLABELLED: With the aim of increasing complete responses and improving survival in advanced recurrent (after surgery and/or RXT) squamous cell carcinoma of the head and neck, we scheduled 31 patients to receive the following regimen: VP-16, 100 mg/m2 i.v. on days 1, 3 and 5; bleomycin, 10 mg/m2 i.v. on days 4, 11 and 18; cisplatin, 120 mg/m2 on day 6, and 6-methylprednisolone, 40 mg/m2 on days 1-7. Courses were repeated every 21 days. In all, 29 patients were evaluable. RESULTS: complete responses (CR) were achieved in 7 cases (24%); partial responses (PR) in 7 cases (24%); the overall response rate was 48%; stable disease in 7 cases (24%), and progressive disease in 8 cases (27.5%). In 20 cases of the N3 category there were 4 CR (20%) and 6 PR (30%). Survival: entire groups, 32.7 weeks; CR 63.8 (22+28+72+); PR, 30.2; cases of no change, 29 weeks and in nonresponders, 10 weeks. TOXICITY: leukopenia, 5/29 (17%); thrombocytopenia, 3/29 (10.3%); anemia, 10/29 (34.4%); nephrotoxicity, 8/29 (10.3%), and alopecia, reversible, 100%. CONCLUSION: this therapeutic regimen improves the CR rate and survival time with a tolerable toxicity.