The molecular profile of breast cancer: primary tumor versus corresponding lymph node metastases.

Breast cancer (BrCa) is the most frequent malignancy in female, and lymph node metastases (LNM) is an important prognostic and therapeutic parameter. The molecular classification is nowadays largely applied to characterize the primary tumors, but few studies focused on the comparison between the molecular profiles of the primary with corresponding LNM. In the current work, we investigated the expression of conventional markers used by molecular classification in both primary tumors and axillary LNM. A series of 156 patients with BrCa was investigated, and from these 80 cases showed LNM. After routine pathological investigation, including the histopathological form and grade, we performed additional step sections from the primary and lymph nodes for immunohistochemistry. All procedures for hormone receptors, human epidermal growth factor receptor 2 (HER2), Ki67, cytokeratin 5 (CK5), epidermal growth factor receptor (EGFR), p53, E-cadherin, and B-cell leukemia∕lymphoma-2 (Bcl-2) were performed using the standard automated procedures. We found significant differences between the primary tumors and corresponding LNM in luminal A, luminal B, and basal-like carcinoma. No phenotypical interconversions were noticed in HER2 and unclassified BrCa. Our data demonstrate that in almost 20% of the cases the molecular profile of the primary does not overlap with aspects found in the lymph nodes. Our results strongly suggest performing the molecular classification in both primary tumors and in LNM. Current data suggest that the application of this diagnostic procedure will significantly influence the therapeutic strategy.

Therapeutic approach comparison in bicuspid aortic valve aortopathy and clinical practice implications.

Bicuspid aortic valve (BAV) is the most common heart valve malformation, and it may be associated with the development of long-term complications, such as aortic stenosis (AS) secondary to valvular calcification and aortic insufficiency (AI), with or without ascending aortic aneurysm (AAA). This study was performed at the Institute of Cardiovascular Diseases, Timisoara, Romania, from 2015 through 2018 and included a total of 105 patients with BAV. Out of the 105 BAV patients, 14 displayed AAA, alongside either AS or AI, and were selected undergo aortic valve replacement (AVR) alongside surgical replacement or aortoplasty of the ascending aorta, and the elastic fiber loss in the ascending aortic wall was evaluated for each patient. Two surgical interventions used alongside AVR in BAV patients with AAA and AS or AI were compared in this study: reduction ascending aortoplasty (RAA) and ascending aorta replacement (AAR). Postoperative follow-ups have shown RAA is useful short-term but that, in contrast to AAR, it leads to aortic redilatation over time. These results can contribute to a major future meta-analysis with the goal of improving the current clinical practice guidelines for BAV aortopathy.

Prognostic significance of E-cadherin expression in hepatocellular carcinoma: correlations with clinical features.

BACKGROUND: Hepatocellular carcinoma (HCC) represents a major public health issue, being associated with high morbidity and mortality rates. Previous studies have demonstrated that reduction and∕or absence of E-cadherin expression is correlated with a potential for invasion and low survival rate in patients with HCC. PATIENTS, MATERIALS AND METHODS: We assessed the immunohistochemical expression of E-cadherin in 32 HCCs and peritumoral hepatic tissues using monoclonal anti-E-cadherin antibody (clone EP700Y), at 1:50 dilution, followed by incubation with Labeled Streptavidin-Biotin 2 (LSAB2) for 20 minutes, visualization of the reaction with 3,3'-Diaminobenzidine (DAB) and counterstaining with Mayer's Hematoxylin. RESULTS: The results we obtained show: an aberrant E-cadherin expression more frequent in dysplastic nodules (p=0.285) and in 81.25% of HCC cases, as compared to normal hepatic tissue (p<0.001); the absence of a statistically significant relationship between E-cadherin expression and patients' gender (p=0.854), tumor localization (p=0.429), associated viral infection [hepatitis B virus (HBV) or hepatitis C virus (HCV)] (p=0.513) or tumor size (p=0.788); the rate of positive E-cadherin expression was significantly higher in tumors with capsular infiltration (75%) (p=0.017) and does not appear to be influenced by vascular invasion (62.5%) (p=0.411), the presence of satellite nodules (p=0.285) or the serum level of alpha-fetoprotein (α-FP) (p=0.787). CONCLUSIONS: Reduced E-cadherin expression indicates a poor prognosis for patients with HCC and can be considered a potential predictive marker for the prognosis of these patients.

The role of PDGF-B/PDGFR-BETA axis in the normal development and carcinogenesis of the breast.

PDGFs/PDGFRs axis is documented as an important tumor-promoting agent and potential therapeutic target for several human carcinomas, including breast cancer. However, little is known about the role played by the PDGF family members in the normal development of the breast tissue, breast carcinogenesis and tumor-microenvironment dynamics Despite its potent pro-lymphangiogenic effects, PDGF-B/PDGFR-beta axis remains controversial and incompletely elucidated in the field of breast cancer, with emphasis to its differential implications in breast cancer molecular subtypes. Although some data are available concerning this aspect, little or no information is found regarding the role of the PDGF-B/PDGFR-beta axis in rare and aggressive types of breast cancers, such as triple negative breast cancers (TNBCs) and its associated subtypes This review attempted to gather as many data as possible concerning PDGFs family members in the normal breast tissue and in breast carcinogenesis with special focus on their role in diagnosis and therapeutic approach.

Gait analysis and functional outcomes after twelve-week rehabilitation in patients with surgically treated ankle fractures.

Ankle fractures are the most common type of lower extremity fractures. The objective of our study was to analyse the changes of temporal and spatial gait parameters and functional outcomes in patients with bimalleolar fractures who followed surgery and rehabilitation compared to healthy controls. 49 patients with ankle fractures and 21 age-matched healthy volunteers were recruited. There were two assessments for the study group: T1 - once weight-bearing was allowed and T2 - twelve weeks after exercise-based rehabilitation programme. Each evaluation consisted in a functional questionnaire (Olerud-Molander Ankle Score-OMAS) and temporal and spatial gait parameters analysis. The gait parameters were analysed using a Zebris FDM platform. 30 patients completed the final assessment and their data were analysed. In T1 assessment there were significant differences in all temporal and spatial gait parameters between the patients group and controls. In T2 evaluation step time in affected ankle and non-affected ankle, swing time and stance time on affected ankle, stride time and cadence showed no significant differences in patients compared with controls. The within-group analysis showed significant differences in all temporal and spatial gait parameters except for single support time on non-affected ankle after rehabilitation. The OMAS improved significantly from T1 to T2 in all subscales except for squatting. Median value of OMAS improved from 60 (35-90) to 95 (55-100). Our study revealed significant improvements of all temporal and spatial gait parameters, as well as of the functional outcome in patients with surgically treated ankle fractures after twelve-week rehabilitation.