ABSTRACT
AIMS: To report a case of paediatric malignant peritoneal mesothelioma (MPM) with evidence of anaplastic lymphoma kinase (ALK) translocation. METHODS AND RESULTS: We describe a 10-year-old girl who presented with abdominal pain and progressive abdominal distension. She had no history of asbestos exposure. Histopathological, immunohistochemical and ultrastructural analyses were performed and showed a biphasic malignant mesothelioma. In addition, we also studied on a selected set of immunomarkers which may be the potential therapeutic molecular targets including ALK, c-kit (CD117), epidermal growth factor receptor (EGFR) and human epidermal growth factor 2 (HER2)/neu, as well as corresponding molecular analysis. Consequently, we identified ALK expression by immunohistochemistry, together with evidence of ALK translocation by fluorescent in-situ hybridization (FISH) analysis. CONCLUSIONS: Paediatric MPM is associated with ALK translocation in our case. The results may open up a new avenue for the study of molecular genesis of paediatric malignant mesothelioma in the future and help to determine whether patients MMs with ALK translocation would benefit from ALK inhibitor treatment.
Subject(s)
Lung Neoplasms/genetics , Lung Neoplasms/pathology , Mesothelioma/genetics , Mesothelioma/pathology , Peritoneal Neoplasms/genetics , Peritoneal Neoplasms/pathology , Receptor Protein-Tyrosine Kinases/genetics , Anaplastic Lymphoma Kinase , Child , Female , Humans , Immunohistochemistry , In Situ Hybridization, Fluorescence , Mesothelioma, Malignant , Microscopy, Electron, Transmission , Polymerase Chain Reaction , Translocation, GeneticABSTRACT
BACKGROUND: Ki67 labeling index (Ki67 LI) is a measure of tumor proliferation. In breast cancer, evidence supporting its prognostic value is clear and its predictive value for response to treatment finds some benefits. However studies of Ki67 LI as a predictive marker in early breast cancer are still limited worldwide and there is no data in Thailand. OBJECTIVE: To assess the predictive value of Ki67 expression for adjuvant chemotherapy in patients with node-negative, hormone receptor-positive breast cancer MATERIAL AND METHOD: The authors retrospectively evaluated 127 diagnosed early breast cancer with node-negative, hormone receptor-positive patients and receiving adjuvant systemic treatment at Siriraj hospital. Disease free survival (DFS) was compared with the log-rank test according to Ki67 LI and adjuvant systemic treatment (chemoendocrine therapy and endocrine therapy alone). RESULTS: At a median follow-up of 3.3 years. The 5-year DFS rate was 79% for patients with low Ki67 expression and 75% for patients with high Ki67 expression. Of the 127 patients, 56 (44.1%) received chemoendocrine therapy and 71 (55.9%) were treated with endocrine therapy alone. There was no different effect of DFS among those receiving adjuvant endocrine therapy alone and those receiving adjuvant chemoendocrine therapy depending on Ki67 expression. CONCLUSION: Among patients with node-negative, hormone receptor-positive breast cancer, a high Ki67 LI had worse DFS trend than a low Ki67 LI but the Ki67 LI did not predict the efficacy of adjuvant chemotherapy.
Subject(s)
Breast Neoplasms/chemistry , Breast Neoplasms/drug therapy , Ki-67 Antigen/analysis , Adult , Aged , Aged, 80 and over , Breast Neoplasms/diagnosis , Breast Neoplasms/metabolism , Chemotherapy, Adjuvant , Female , Humans , Middle Aged , Predictive Value of Tests , Receptor, ErbB-2/analysis , Receptors, Estrogen/analysis , Receptors, Progesterone/analysis , Retrospective StudiesABSTRACT
The incidence and factors associated with inappropriate use of antifungal medications were studied in a Thai tertiary care center. The incidence of inappropriate antifungal use was 74% (in 42 of 57 patients). Isolation of Candida species from urine (P = .004) was a risk factor, whereas receipt of an infectious diseases consultation (P = .004) was protective.
