Prognostic and Predictive Role of Excision Repair Cross-complementation Group 1 and Thymidylate Synthase in Colorectal Carcinoma Patients Received FOLFOX Chemotherapy: An Immunohistochemical Study.

BACKGROUND AND STUDY AIMS: We aim to determine the frequency of thymidylate synthase (TS) and excision repair cross-complementation group 1 (ERCC-1) immunohistochemical (IHC) expression and its relationship with clinicopathologic variables in colorectal carcinoma (CRC) patients. In addition, we aim to assess the correlation between TS and ERCC-1 expression and the response of these cases to oxaliplatin and 5-fluorouracil chemotherapy (FOLFOX). PATIENTS AND METHODS: Fifty-one CRC patients were prepared for IHC analysis of ERCC-1 and TS protein expression. All patients received oxaliplatin and 5-fluorouracil combined chemotherapy (FOLFOX) and were followed up for 24 months. RESULTS: The data analysis showed that high ERCC-1 and TS expression was significantly associated with early treatment failure (P=0.020 and 0.000). In contrast, TS immunoexpression affects the disease-free survival rate (P=0.010). The presence of deep tumor invasion, distant metastasis, lymph node metastasis, and high Dukes' classification were significantly statistically associated with early treatment failure (P=0.001, 0.000, 0.041, and 0.015, respectively). CONCLUSIONS: Our results showed that both ERCC-1 and TS are predictive factors for early treatment failure in CRC patients. TS protein is a prognostic factor for disease-free survival rates. This supports the theory that both ERCC-1 and TS can be used to improve chemotherapeutic outcomes in CRC patients. High expression of TS and ERCC-1 helps in the identification of cases that will get fewer benefits from FOLFOX chemotherapy. As an innovative strategy, in these cases, we can use alternative chemotherapeutic regimens or add an extra agent. In addition, Dukes' classification and lymph node metastasis are predictive factors for early treatment failure. Thus, all those values can be used to predict CRC patients with bad prognosis and those who will get fewer benefits from FOLFOX.

Huge corneal dermoid in a well-formed eye: a case report and review of the literature.

A 25-day-old boy presented with a left corneal mass and left nasal obstruction. The mass involved the entire cornea with a skin-like surface and protruded outside the palpebral fissure. CT of the orbits disclosed a large cyst coating the entire left cornea, in an eye with a well-formed anterior chamber and a clearly evident lens. CT also revealed left nasal meningo-encephalocele. The eye with the mass was excised. The histopathologic report confirmed the diagnosis of corneal dermoid in an otherwise normally developed eye. This report of a huge dermoid involving the entire corneal diameter and extending into the sclera without ocular alteration posterior to Descemet's membrane is the first such report in the literature. The literature on corneal dermoids is also reviewed.

Treatment of primary lymphoma of the lacrimal gland by surgical excision alone: A 5-year follow-up study.

PURPOSE. To evaluate the long-term efficacy of surgical excision alone in the treatment of non-Hodgkin(1)s lymphoma localized to the lacrimal gland. MATERIALS AND METHODS. Thirteen patients with primary lacrimal gland lymphoma were included. The presumptive diagnosis was based on: (1) The painless and relatively slow onset of unilateral lacrimal gland swelling, mostly in elderly adults; (2) The CT pattern of a soft tissue mass in the lacrimal gland region with defined margins and molds to the globe; (3) The negative results of systemic work-up. The involved lacrimal gland was excised via an anterior trans-septal approach in 12 cases and by lateral canthotomy, upper cantholysis, and a trans-periosteal approach in one case. Following histopathologic confirmation of the diagnosis, no supplemental therapy was given. The patients were followed for a minimum of 5 years (5-8 years). RESULTS. In all patients, the excised lacrimal gland lymphoma was firm, nodular and appeared encapsulated. The histologic subtypes of the excised masses were: low-grade lymphomas in 11 cases (7 small lymphocytic, 3 plasmacytoid lymphocytic, 1 follicular small cleaved) and intermediate grade in 2 cases (1 follicular large cell and 1 diffuse small cleaved). No evidence of local recurrence or systemic dissemination was reported during the follow-up period in any of the patients. CONCLUSIONS. Surgical excision of the tumor is a new curative technique for lymphoma localized to the lacrimal gland without any other orbital or systemic involvement. By this technique, orbital radiotherapy and its potential ocular complications can be avoided. However, more study is recommended.