Factores predictores de mortalidad en la oclusión intestinal por cáncer colorrectal y anal

Introducción:El cáncer colorrectal y anal es una enfermedad de elevada incidencia y mortalidad y la oclusión intestinal su complicación más frecuente.Objetivo:Identificar los factores predictores de mortalidad en la oclusión intestinal mecánica por cáncer colorrectal y anal.Métodos:Se realizó un estudio observacional analítico que incluyó todos los pacientes con oclusión intestinal mecánica por cáncer colorrectal y anal ingresados consecutivamente en el Hospital “Camilo Cienfuegos” de Sancti Spíritus, Cuba, en el período comprendido del 1ro de enero de 2016 al 31 de diciembre de 2018. Se registraron un total de 126 pacientes con este diagnóstico. Se incluyeron las variables demográficas y los factores de riesgo asociados. Se determinaron la glucemia, la creatinina y la gasometría arterial. Se evaluaron además el tiempo quirúrgico, el tiempo desde el ingreso a la cirugía, la estadía hospitalaria y la clasificación de la Sociedad Americana de Anestesia. Para el análisis estadístico se realizó una regresión logística binaria y un árbol de clasificación.Resultados:La mortalidad de la serie estudiada fue de un 27 %. La edad mayor o igual a 75 años, la clasificación de la Sociedad Americana de Anestesia mayor o igual III, las reintervenciones y las complicaciones aumentaron el riesgo de fallecer mediante la estadística descriptiva e inferencial.Conclusiones:Los resultados obtenidos sugieren evaluar las complicaciones, la edad avanzada, el riesgo anestésico y las reintervenciones como predictores de mortalidad en estos pacientes. La probabilidad de muerte es baja en pacientes no complicados con edad menor de 75 años.[AU]

Comparing the effects of endogenous and synthetic cannabinoid receptor agonists on survival of gastric cancer cells.

AIMS: Anti-neoplastic activity induced by cannabinoids has been extensively documented for a number of cancer cell types; however, this topic has been explored in gastric cancer cells only in a limited number of approaches. Thus, the need of integrative and comparative studies still persists. MATERIALS AND METHODS: In this study we tested and compared the effects of three different cannabinoid receptor agonists-anandamide (AEA), (R)-(+)-methanandamide (Meth-AEA) and CP 55,940 (CP)- on gastric cancer cell morphology, viability and death events in order to provide new insights to the use of these agents for therapeutic purposes. KEY FINDINGS: The three agents tested exhibited similar concentration-dependent effects in the induction of changes in cell morphology and cell loss, as well as in the decrease of cell viability and DNA laddering in the human gastric adenocarcinoma cell line (AGS). Differences among the cannabinoids tested were mostly observed in the density of cells found in early and late apoptosis and necrosis, favoring AEA and CP as the more effective inducers of apoptotic mechanisms, and Meth-AEA as a more effective inducer of necrosis through transient and rapid apoptosis. SIGNIFICANCE: Through a comparative approach, our results support and confirm the therapeutic potential that cannabinoid receptor agonists exert in gastric cancer cells and open possibilities to use cannabinoids as part of a new gastric cancer therapy.

Braf V600E mutation in melanoma: translational current scenario

Melanoma was one of the translational cancer examples in clinic, including target therapy related to specific biomarkers impacting in the outcome of melanoma patients. Melanomagenesis involved a wide variety of mutations during his evolution; many of these mutated proteins have a kinase activity. One of the most cited proteins in melanoma is BRAF (about 50-60 % of melanomas harbors activating BRAF mutations), for these the most common is a substitution of valine to glutamic acid at codon 600 (p.V600E). Therefore, the precise identification of this underlying somatic mutation is essential; knowing the translational implications has opened a wide view of melanoma biology and therapy (AU)

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Braf V600E mutation in melanoma: translational current scenario.

Melanoma was one of the translational cancer examples in clinic, including target therapy related to specific biomarkers impacting in the outcome of melanoma patients. Melanomagenesis involved a wide variety of mutations during his evolution; many of these mutated proteins have a kinase activity. One of the most cited proteins in melanoma is BRAF (about 50-60 % of melanomas harbors activating BRAF mutations), for these the most common is a substitution of valine to glutamic acid at codon 600 (p.V600E). Therefore, the precise identification of this underlying somatic mutation is essential; knowing the translational implications has opened a wide view of melanoma biology and therapy.

On the effects of CP 55-940 and other cannabinoid receptor agonists in C6 and U373 cell lines.

Cannabinoid receptor (CBs) agonists affect the growth of tumor cells via activation of deadly cascades. The spectrum of action of these agents and the precise role of the endocannabinoid system (ECS) on oncogenic processes remain elusive. Herein we compared the effects of synthetic (CP 55-940 and WIN 55,212-2) and endogenous (anandamide or AEA) CBs agonists (10-20 µM) on morphological changes, cell viability, and induction of apoptosis in primary astrocytes and in two glioblastoma cell lines (C6 and U373 cells) in order to characterize their possible differential actions on brain tumor cells. None of the CBs agonist tested induced changes in cell viability or morphology in primary astrocytes. In contrast, CP 55-940 significantly decreased cell viability in C6 and U373 cells at 5 days of treatment, whereas AEA and WIN 55,212-2 moderately decreased cell viability in both cell lines. Treatment of U373 and C6 for 3 and 5 days with AEA or WIN 55,212-2 produced discrete morphological changes in cell bodies, whereas the exposure to CP 55-940 induced soma degradation. CP 55-940 also induced apoptosis in both C6 and U373 cell lines. Our results support a more effective action of CP 55-940 to produce cell death of both cell lines through apoptotic mechanisms. Comparative aspects between cannabinoids with different profiles are necessary for the design of potential treatments against glial tumors.

Clinicopathological characterization of primary oral and sinonasal melanoma in a referral centre in Mexico City: 2000-2012.

In Mexico, there have been few studies on primary oral and sinonasal melanoma, an aggressive neoplasm with a low survival rate and few therapeutic alternatives. Further, there is limited information about its clinical and histopathological characteristics. The aim of this retrospective study was to describe the clinicopathological profile of these tumours in patients attending a major oncology reference centre in Mexico City over a 12-year period. Demographic and clinical data were obtained from the clinical charts, and histopathological features were evaluated. χ(2), Fisher's exact, and Mann-Whitney U-tests were used for analysis; significance was set at P<0.05. Thirty-three cases were studied (73% sinonasal melanoma (SNM) and 27% oral melanoma (OM)); 58% were female and the median age was 66 (Q1-Q3 55.5-75) years. Compared with OM patients, SNM patients had a shorter time to diagnosis (16.7 vs. 11.7 months, P=0.022), were identified at earlier stages (33.3% vs. 58.3%, P=0.010), and all presented symptoms (66.7% vs. 100%, P=0.015). All samples showed vertical growth and 96.9% exhibited pleomorphism. A higher proportion of cases with pleomorphism developed metastases at follow-up than those without (60% vs. 12.5%, P=0.026). The present study provides valuable information that could form the basis of future studies in the search for advanced therapy modalities.

Immunoexpression of matrix metalloproteinases and their inhibitors in different areas of oral squamous cell carcinoma.

BACKGROUND: Several studies have shown the participation of MMPs in oral squamous cell carcinoma, the most frequent malignant neoplasm of the oral cavity. The expression of some MMPs correlates with a more aggressive biological behaviour. The objective of this study was to determine which MMPs and TIMPs were expressed in both neoplastic and peritumoural stromal cells in different histopathology areas. METHODS: Patients who underwent primary tumour neck dissection for oral squamous cell carcinoma were included. Immunoexpression of MMP-1, -2, -3, -7, -9, -11, -13, and TIMP-1 and -2 in different areas of pathologic specimens (in situ carcinoma, primary tumour, invasive front, distant invasion carcinoma, and lymph node metastasis) was evaluated. Enzyme expression on mucosa adjacent to tumour served as control. RESULTS: Thirty cases were included. Only 6 MMPs and 1 TIMP were expressed in the studied areas. Statistically significant differences in the number of cases with positive MMPs or TIMP expression, in both neoplastic and peritumoural cells, between control and the rest of the areas were observed. MMP-2 expression was constant in the areas with a more aggressive biological behaviour. CONCLUSIONS: MMP-2 expression may represent a dynamic interaction between host and tumour that favours the establishment of neoplastic cells at distant sites.

Prognostic factors and recurrence in breast cancer: experience at the national cancer institute of Mexico.

The purpose of this study was to analyze the prognostic and predictive factors that relate to locoregional or distant recurrences in breast cancer patients who have been treated at the National Cancer Institute of Mexico. Multivariate, time-dependent Cox regression analyses indicate that the pN status (positive versus negative lymph node; P = 0.003; HR (hazard ratio), 3.47; CI (confidence interval), 1.52-7.91) and the pathological complete response of the patient to neoadjuvant chemotherapy (yes versus no; P = 0.061; HR, 0.38; CI, 0.14-1.04) were important prognostic factors for recurrence.

Epidemiología del dolor por cáncer / Epidemiology of cancer pain

Cada año se diagnostican aproximadamente nueve millones de personas con cáncer. El dolor es uno de los síntomas más comunes en este tipo de población. Su fisiopatología es múltiple y va desde el síntoma doloroso causado por la propia enfermedad, hasta el relacionado a procedimientos diagnósticos y/o terapéuticos, pasando por el asociado a enfermedades no oncológicas ligadas al cáncer. Esta revisión representa un análisis crítico de los estudios epidemiológicos sobre la prevalencia de dolor por cáncer en la población mundial. Se muestran grandes variaciones en cuanto a la prevalencia, debido quizá a aspectos metodológicos que dificultan la comparación de los resultados o, dicho de otra manera, por los diferentes criterios utilizados para conceptualizar y caracterizar el dolor por cáncer, los contrastes entre la población estudiada y los métodos de recolección de datos. Si a esto le agregamos que existen diferentes tipos de dolor y que la terapéutica puede diferir de un medio hospitalario a otro, no es raro que la validez de los reportes se limite y su uniformidad varíe considerablemente. La sociedad mexicana poco conoce sobre la prevalencia de dolor oncológico y sobre los prejuicios personales y socioeconómicos que conlleva esta temible enfermedad, por lo que, considerando los estudios existentes en la literatura, sugerimos que las pesquisas epidemiológicas en nuestro país deberán realizarse bajo estricto control metodológico, estudiando los diferentes grupos de edad, tipo de dolor, intensidad, diagnóstico oncológico, estadio clínico, terapéutica anticáncer, terapia analgésica farmacológica y no farmacológica, y los fármacos coadyuvantes (AU)

Each year, approximately, nine million people with cancer are diagnosed. Pain is one of the most common symptoms in this population. Its pathophysiology is multiple and varies from the painful symptoms caused by the disease itself until linked to diagnostic procedures and therapeutic, or else to that pain associated with non-oncological diseases linked to cancer. This review represents a critical analysis of epidemiological studies on the prevalence of cancer pain in the world population. Great variations are shown in prevalence, perhaps because of methodological issues that hinder the comparison of results. In others words, by different criteria used to conceptualize and characterize cancer pain, the contrasts among the study population and data collection methods. If we add to this that there are different types of pain therapeutics and may differ from one hospital to another, the validity and consistency of the reports are limited considerably. Mexican society little known about the prevalence of cancer pain and on personal and socioeconomic bias involved in this terrible disease. Whereas existing studies in the literature, we suggest that epidemiological investigations should be conducted under strict methodological control, studying the different age groups, type of pain, intensity, oncology diagnosis, clinical stage, used anticancer therapeutics, drug therapy and nonpharmacologic analgesic; without forgetting the adjuvant drugs associated with this management (AU)

Organization of a tumor bank: the experience of the National Cancer Institute of Mexico.

A tumor bank (TB) is an ordered collection of neoplastic samples, normal tissue, and/or fluids preserved under optimal conditions, as well as storing patients' clinical information. The objective of this article is to outline the planning and logistics necessary for the functioning of the Instituto Nacional de Cancerología (INCan) TB in Mexico City. For the planning and logistics of a TB, several technical, legal, medical, structural, and physical aspects were considered, which can be grouped under four headings: (1) design and structure, (2) equipping the area and informatics, (3) ethical-legal aspects, and (4) sample collection, preservation, and quality control. One crucial element of interinstitutional interest will be the transfer of these concepts to the different oncological centers, integrating in this manner a network that enables the exploration of the different pathologies from therapeutic, epidemiological, and molecular points of view.