Long-term annual estimation of forest above ground biomass, canopy cover, and height from airborne and spaceborne sensors synergies in the Iberian Peninsula.

The Mediterranean Basin has experienced substantial land use changes as traditional agriculture decreased and population migrated from rural to urban areas, which have resulted in a large forest cover increase. The combination of Landsat time series, providing spectral information, with lidar, offering three-dimensional insights, has emerged as a viable option for the large-scale cartography of forest structural attributes across large time spans. Here we develop and test a comprehensive framework to map forest above ground biomass, canopy cover and forest height in two regions spanning the most representative biomes in the peninsular Spain, Mediterranean (Madrid region) and temperate (Basque Country). As reference, we used lidar-based direct estimates of stand height and forest canopy cover. The reference biomass and volume were predicted from lidar metrics. Landsat time series predictors included annual temporal profiles of band reflectance and vegetation indices for the 1985-2023 period. Additional predictor variables including synthetic aperture radar, disturbance history, topography and forest type were also evaluated to optimize forest structural attributes retrieval. The estimates were independently validated at two temporal scales, i) the year of model calibration and ii) the year of the second lidar survey. The final models used as predictor variables only Landsat based metrics and topographic information, as the available SAR time-series were relatively short (1991-2011) and disturbance information did not decrease the estimation error. Model accuracies were higher in the Mediterranean forests when compared to the temperate forests (R2 = 0.6-0.8 vs. 0.4-0.5). Between the first (1985-1989) and the last (2020-2023) decades of the monitoring period the average forest cover increased from 21 ± 2% to 32 ± 1%, mean height increased from 6.6 ± 0.43 m to 7.9 ± 0.18 m and the mean biomass from 31.9 ± 3.6 t ha-1 to 50.4 ± 1 t ha-1 for the Mediterranean forests. In temperate forests, the average canopy cover increased from 55 ± 4% to 59 ± 3%, mean height increased from 15.8 ± 0.77 m to 17.3 ± 0.21m, while the growing stock volume increased from 137.8 ± 8.2 to 151.5 ± 3.8 m3 ha-1. Our results suggest that multispectral data can be successfully linked with lidar to provide continuous information on forest height, cover, and biomass trends.

Es posible aplicar protocolos de cribado de cáncer de cérvix en la práctica diaria / Cervical screening protocols can be applied in daily clinical practice

Objetivo. Evaluar si podemos aplicar protocolos de cribado de cáncer de cérvix sin retrasar el diagnóstico del cáncer y con buena aceptación por las pacientes. Sujetos y métodos. En 2005 elaboramos un protocolo de diagnóstico precoz del cáncer de cérvix basado en realizar citologías cada 3 años a mujeres mayores de 30 años con 3 citologías previas normales. Estudiamos a 300 pacientes que habían acudido a consulta en 2006 y otras 300 en 2008. Revisamos si les habíamos hecho citología y si estaba indicada, las revisiones recomendadas a los 3 años y si volvían antes. También la adhesión al protocolo en los cánceres diagnosticados desde 2005. Resultados. Las citologías se redujeron en un 32% en 2008 con respecto al 2004, año previo al cribado. En 2008 recomendamos al 21% de las pacientes la próxima revisión en 3 años. Un 3% volvió antes. De 17 cánceres diagnosticados desde 2005, solo una mujer con adenocarcinoma había realizado el cribado. Conclusiones. Evitar el sobreúso de la citología en la práctica diaria es posible (AU)

Objective. To evaluate whether screening protocols for cervical cancer can be implemented without delaying the diagnosis of cancer and whether this practice is well accepted by patients. Subjects and methods. In 2005, we developed a protocol for the early diagnosis of cervical cancer based on carrying out cervical smears every 3 years in women over the age of 30 with three previous normal smears. We studied 300 patients who had attended an appointment in 2006 and another 300 in 2008. We reviewed our records to determine whether we had performed a smear and, if one was indicated, whether we had recommended attendance at a follow-up visit 3 years later, and whether the women had returned earlier. Adherence to the protocol in cancers diagnosed from 2005 was also reviewed. Results. The number of smears decreased by 32% in 2008 compared with 2004, the year prior to screening. In 2008, 21% of women were recommended to attend the next review 3 years later and 3% returned earlier. Of 17 cancers diagnosed since 2005, only one woman with adenocarcinoma had undergone screening. Conclusions. The overuse of cytology/smears in daily clinical practice can be avoided (AU)

Study of matrix metalloproteinases and their tissue inhibitors in ductal in situ carcinomas of the breast.

AIMS: To analyse the expression of metalloproteinases (MMPs) and their inhibitors (TIMPs) in ductal carcinoma in situ of the breast (DCIS). METHODS AND RESULTS: An immunohistochemical study was performed in 56 patients with pure DCIS, in 39 with DCIS adjacent to invasive carcinoma (IDC) and 63 patients with T1 IDC, using tissue microarrays and specific antibodies against MMPs and TIMPs. Immunohistochemical results were categorized using a specific software program. The data were analysed by unsupervised hierarchical cluster analysis by each cellular type. IDC showed a higher expression rate of MMP-7 and TIMP-1 than pure DCIS, as well as a higher expression rate of MMP-9 and TIMP-3 than the DCIS component of mixed cases, whereas pure DCIS showed a higher rate of expression of MMP-9 and -11 and TIMP-3 than in the DCIS component of mixed cases. Pure DCIS with a periductal inflammatory infiltrate showed significantly higher MMP-2, -14 and TIMP-1. Dendograms identified two cluster groups with distinct MMP/TIMP expression profiles in neoplastic cells and fibroblastic or mononuclear inflammatory cells surrounding the neoplastic ducts of pure DCIS. CONCLUSIONS: The results indicate the distinct variability in MMP/TIMP expression by DCIS, which may be of potential biological and clinical interest in breast cancer.

Overexpression of matrix metalloproteinases and their inhibitors in mononuclear inflammatory cells in breast cancer correlates with metastasis-relapse.

An immunohistochemical study was performed using tissue microarrays and specific antibodies against matrix metalloproteinase (MMP)-1, -2, -7, -9, -11, -13 and -14, tissular inhibitors of metalloproteinase (TIMP)-1, -2 and -3. More than 2600 determinations on cancer specimens from 131 patients with primary ductal invasive tumours of the breast were performed. To identify specific groups of tumours with distinct expression profiles the data were analysed by unsupervised hierarchical cluster analysis by each cellular type. We did not find well-defined cluster of cases for tumour cells or fibroblastic cells. However, for mononuclear inflammatory cells the dendogram shows a first-order division of the tumours into two distinct MMP/TIMP molecular profiles, designated group 1 (n=89) and group 2 (n=42). Matrix metalloproteinase-7, -9, -11, -13 and -14, and TIMP-1 and -2, were identified as showing significant high expression in group 2 compared with group 1. Multivariate analysis demonstrated that clustering for mononuclear inflammatory cells was the most potent independent factor associated with distant relapse-free survival (group 2: 5.6 (3.5-9.6), P<0.001). We identify a phenotype of mononuclear inflammatory cells infiltrating tumours, which is associated with the development of distant metastasis. Therefore, this finding suggests that these host inflammatory cells could be a possible target for inhibition of metastasis.

Study of matrix metalloproteinases and their inhibitors in breast cancer.

An immunohistochemical study was performed using tissue microarrays and specific antibodies against matrix metalloproteinases (MMPs) 1, 2, 7, 9, 11, 13, 14, and their tisullar inhibitors (TIMPs) 1, 2, and 3. More than 2600 determinations on cancer specimens from 131 patients with primary ductal invasive tumours of the breast (65 with and 66 without distant metastasis) and controls were performed. Staining results were categorised using a score based on the intensity of the staining and a specific software program calculated the percentage of immunostained cells automatically. We observed a broad variation of the total immunostaining scores and the cell type expressing each protein. There were multiple and significant associations between the expression of the different MMPs and TIMPs evaluated and some parameters indicative of tumour aggressiveness, such as large tumour size, advanced tumour grade, high Nottinham prognostic index, negative oestrogen receptor status, peritumoural inflammation, desmoplastic reaction, and infiltrating tumoural edge. Likewise, the detection of elevated immunohistochemical scores for MMP-9, 11, TIMP-1, and TIMP-2, was significantly associated with a higher rate of distant metastases. The expression of MMP-9 or TIMP-2 by tumour cells, MMP-1, 7, 9, 11, 13, or TIMP-3 by fibroblastic cells, and MMP-7, 9, 11, 13, 14, TIMP-1, or TIMP-2 by mononuclear inflammatory cells, was also significantly associated with a higher rate of distant metastases.

Expression and clinical signification of cytosolic hyaluronan levels in invasive breast cancer.

BACKGROUND: Hyaluronic acid (HA), a high-molecular weight glycosaminoglycan, has been considered to be involved in the growth and progression of malignant tumors in several experimental studies. The objective of this work was to evaluate the cytosolic HA content in breast cancer, its possible relationship with clinicopathological tumor parameters and steroid receptor status, as well as its potential prognostic significance. METHODS: Cytosolic HA levels were examined by means of immunoradiometric techniques in 850 patients with invasive breast cancer. The mean follow-up period for these patients was 55.1 months. RESULTS: Cytosolic HA levels ranged widely in tumors (4-59767 ng/mg protein; median: 4960). Statistical analysis showed that HA levels were significantly higher in younger patients (p=0.0001), as well as in premenopausal than in postmenopausal patients (p=0.001). HA levels were also significantly higher in ductal or lobular histological type than in other histological types (coloid, medullar or papillar types) (p=0.0001). Likewise, HA correlated significantly and positively with tumoral levels of PgR (r sub S: 0.11; p=0.001) in the all group of patients. In the subgroup of patients with ductal invasive type, HA levels were also significantly higher in well differentiated tumors and in diploid tumors. In addition, in this latter group of patients, HA levels in tumors correlated also positively and significantly with the either estrogen-inducible proteins: PgR (r sub S: 0.11; p=0.001), pS2 (r sub S: 0.117; p=0.008) and tPA (r sub S: 0.314; p=0.0001). On the other hand, significant association between HA intratumoral levels and relapse-free survival and overall survival in the overall group of patients was not found. However, high HA intratumoral levels were significantly associated with longer relapse-free survival in the subgroup of patients with ductal histological type tumors (p=0.01), as well as in those patients without any type of systemic adjuvant treatment (p=0.01). CONCLUSIONS: Our results suggest that high intratumoral levels of HA may be associated with tumors of favorable evolution in certain subgroups of patients with breast cancer. Thus, HA may provide additional prognostic information to that given by other biochemical markers currently used in breast cancer.

El derecho a la intimidad y la historia clínica electrónica / The right to privacy and the electronic patient file

El presente artículo tiene por objeto realizar un análisis del derecho a la intimidad y la aplicación de la informática en la gestión de los servicios sanitarios. Para ello, se han estudiado las fuentes normativas que regulan la posible relación-tensión existente entre el derecho a la información y el derecho a la intimidad, así como la normativa sobre la protección de datos de carácter personal, haciendo hincapié en los datos relativos a la salud de las personas. Se pone de relieve la admisión de la historia clínica en cualquier soporte, siendo la presentación electrónica de la misma la aspiración de los gestores. Las enfermeras tienen acceso a la historia clínica con el fin de poder prestar cuidados de Enfermería, salvaguardando la confidencialidad de los datos relativos a los pacientes

The aim of this article if to analyze the right to privacy and the application of IT in the managementof healthcare services. For this purpose, the norms and information sources that govern the possible existing relation-tension between the right to information and the right to privacy as well as the regulations on personal data protection were studied, emphasizing data relating to the health status of individuals. The admission of the clinical history in any format is brought to discussion, being its electronic form what most administrators hope for. Nurses have access to the clinical history to enable them to provide the required nursing services, safeguarding the confidentiality pertaining to the patient’s personal details

Expression and prognostic value of EGFR in invasive breast cancer.

Epidermal growth factor receptor (EGFR) is a membrane receptor expressed in a variety of solid human cancers and directly related with poor prognosis. The objective of this work was to evaluate the EGFR content in breast carcinomas, its possible relationship with different clinical-pathological parameters, and its potential prognostic significance and predictive value. EGFR levels were examined by radioligand binding assays in 846 patients with invasive breast cancer. The median follow-up period was 50 months. There was a wide variability of EGFR levels among the studied tumors (0.01-403 fmol/mg protein). Statistical analysis showed that EGFR levels were significantly higher in younger patients (p=0.0001). EGFR were also notably higher in ER-negative or PgR-negative tumors than in ER-positive (p=0.0001) or PgR-positive tumors (p=0.001). In addition, the presence of high intratumoral EGFR levels (cut-off: 6 fmol/mg protein) was associated with both shorter relapse-free survival (p=0.04) and overall survival (p=0.01) in the group of patients as a whole, as well as with overall survival in the subgroup of patients without any type of systemic adjuvant treatment (p=0.02). However, EGFR levels did not achieve significance as independent prognostic factor in the multivariate analysis. There is a wide variability of intratumoral EGFR levels in breast carcinomas, and these protein levels correlated positively with a poor prognosis in the t univariate analysis. However, further studies are necessary in order to assess the possible clinical value of EGFR in combination with other essential components of the EGFR family network.

Pronóstico del cáncer de cérvix en un hospital de área / Prognostic factors and outcome of cervical cancer in a district hospital

Objetivo: Analizar las características clinicopatológicas de las pacientes diagnosticadas de cáncer invasivo de cérvix en nuestro ámbito clínico, así como su evaluación pronóstica. Sujetos y métodos: Estudio retrospectivo observacional de todas las pacientes con diagnóstico histológico de cáncer invasivo de cérvix en nuestro servicio hospitalario durante el período 1994-2003. Se recogen las características clínicas de las pacientes y de los tumores. Se establecen las curvas de supervivencia según el método de Kaplan-Meier y se comparan mediante la prueba de rangos logarítmicos para el análisis univariante. El análisis multivariante se realizó mediante la regresión de Cox. Resultados: Se identificaron 39 pacientes con una media de edad de 54 años. La mayoría presentaba metrorragias y se encontraba en un estadio inicial (66%) en el momento del diagnóstico. El 84% de los tumores fueron escamosos, moderadamente diferenciados (56%) y sin invasión linfovascular (87%). El tratamiento fue preferentemente radioterapéutico (48%). Los factores pronósticos para la supervivencia global fueron el estadio clínico (p < 0,001), el valor de hemoglobina (p = 0,007) y el grado histológico (p = 0,01). Sólo el estadio se mantuvo como factor pronóstico independiente (p = 0,001) en el análisis multivariante. Conclusiones: Nuestros resultados resaltan la importancia de un diagnóstico precoz del cáncer de cérvix

Objective: To analyze the clinical and pathologic characteristics of invasive cervical cancer in our center and to identify prognostic factors. Subjects and methods: We performed an observational, retrospective study of all women with a histopathological diagnosis of invasive cervical cancer in our department between 1994 and 2003. Clinical and tumoral characteristics were included. Survival curves were calculated with the Kaplan-Meier method and were compared with the log rank test. Multivariate analysis was performed using the Cox regression model. Results: Thirty-nine patients were identified. The mean age was 54 years. At diagnosis, most of the patients showed abnormal bleeding and initial-stage tumors (66%). Thirty-three tumors (84%) were squamous, 22 were moderately differentiated (56%) and 34 showed no lymphovascular invasion (87%). The most frequent treatment was radiotherapy (48%). Prognostic factors for overall survival were clinical stage (p < 0.001), pre-treatment hemoglobin levels (p = 0.007) and histologic grade (p = 0.01). The only independent prognostic factor in the multivariate analysis was clinical stage. Conclusions: Our results emphasize the importance of an early diagnosis in invasive cervical cancer

Clinical significance of cathepsin D concentration in tumor cytosol of primary breast cancer.

BACKGROUND: Cathepsin D is the proteolytic enzyme most frequently implicated as a prognostic factor in primary breast cancer. In the present study we evaluated by means of an immunoradiometric assay the tumor content of this protease in primary breast cancer, its relationship with tumor-related clinical and pathological parameters, and its prognostic significance in a large series of breast cancer patients. METHOD: The study comprised 1033 women with histologically established invasive breast cancer. Cathepsin D was measured in cytosol samples by means of an immunoradiometric assay to determine the total amount of cathepsin D (52 kDa, 48 kDa and 34 kDa). Evaluation of relapse-free survival and cause-specific survival was performed in the group of 1003 patients without evidence of metastasis at the time of initial diagnosis. The median follow-up of the patients who were free of recurrence was 54 months. RESULTS: Cathepsin D levels showed a wide range among the studied tumors (n = 1033; median (range) 41 (0.9-2504) pmol/mg protein). Statistical analysis showed that the median cathepsin D levels were considerably higher in large tumors (T2-4) than in smaller ones (T1) (p = 0.017), as well as in node-positive than in node-negative tumors (p = 0.004). Cathepsin D levels were also higher in ductal tumors than in the other histological types (p = 0.001), as well as in moderately or poorly differentiated tumors (p < 0.001). Likewise, the median value of the protease was significantly higher in ER or PgR-positive tumors than in hormone receptor-negative ones (p = 0.011 and p = 0.004, respectively), as well as in aneuploid tumors than in diploid tumors (p = 0.029). Multivariate analysis demonstrated that elevated cathepsin D levels (> 59 pmol/mg protein) were notably associated with a shorter cause-specific survival in the whole group of patients with breast cancer, as well as in the subgroup of node-positive patients (p < 0.05). CONCLUSIONS: This study suggests that elevated intratumoral cathepsin D levels may identify a subset of node-positive breast cancer patients showing a high probability of earlier death.

Tissue-type plasminogen activator (tPA) in breast cancer: relationship with clinicopathological parameters and prognostic significance.

BACKGROUND: Tissue-type plasminogen activator (tPA) is a serine protease primarily involved in the intravascular dissolution of blood clots. High intratumoral tPA levels are associated with prognosis in several human tumors. In addition, tPA has been shown to be an estrogen-inducible protein in human breast cancer cell lines. The aim of the present study was to analyze the cytosolic tPA content in primary breast carcinomas and its potential clinical value. MATERIALS AND METHODS: tPA was measured by a solid-phase enzyme immunoassay in tumor cytosol samples obtained from 800 patients with breast cancer. The median follow-up period was of 49.2 months. RESULTS: Cytosolic tPA levels ranged widely in breast carcinomas (median: 3.9; range: 0.1- 315.3 ng/mg protein). tPA levels were significantly lower in large tumors, as well as in those showing poor differentiation, estrogen (ER) or PgR-negativity, aneuploidy, or a high S-phase fraction. In addition, low tPA intratumoral levels were associated with a high probability of both shortened relapse-free and overall survival in all patients and in the subgroup with node-negative tumors. However, our results did not show any significant relationship between intratumoral tPA levels and prognosis in the different subgroups of patients, stratified according to the type of systemic adjuvant therapy received (chemotherapy, tamoxifen or chemotherapy plus sequential tamoxifen). CONCLUSION: The results of the present investigation indicate that low intratumoral tPA levels are associated with aggressiveness and poor prognosis in breast cancer patients. However, the study suggests that tPA levels do not predict response to systemic adjuvant therapy.

Clinical significance of cathepsin D concentration in tumor cytosol of primary breast cancer.

BACKGROUND: Cathepsin D is the proteolytic enzyme most frequently implicated as a prognostic factor in primary breast cancer. In the present study we evaluated by means of an immunoradiometric assay the tumor content of this protease in primary breast cancer, its relationship with tumor-related clinical and pathological parameters, and its prognostic significance in a large series of breast cancer patients. METHOD: The study comprised 1033 women with histologically established invasive breast cancer. Cathepsin D was measured in cytosol samples by means of an immunoradiometric assay to determine the total amount of cathepsin D (52 kDa, 48 kDa and 34 kDa). Evaluation of relapse-free survival and cause-specific survival was performed in the group of 1003 patients without evidence of metastasis at the time of initial diagnosis. The median follow-up of the patients who were free of recurrence was 54 months. RESULTS: Cathepsin D levels showed a wide range among the studied tumors (n=1033; median (range) 41 (0.9-2504) pmol/mg protein). Statistical analysis showed that the median cathepsin D levels were considerably higher in large tumors (T2-4) than in smaller ones (T1) (p=0.017), as well as in node-positive than in node-negative tumors (p=0.004). Cathepsin D levels were also higher in ductal tumors than in the other histological types (p=0.001), as well as in moderately or poorly differentiated tumors (p<0.001). Likewise, the median value of the protease was significantly higher in ER or PgR-positive tumors than in hormone receptor-negative ones (p=0.011 and p=0.004, respectively), as well as in aneuploid tumors than in diploid tumors (p=0.029). Multivariate analysis demonstrated that elevated cathepsin D levels (>59 pmol/mg protein) were notably associated with a shorter cause-specific survival in the whole group of patients with breast cancer, as well as in the subgroup of node-positive patients (p<0.05). CONCLUSIONS: This study suggests that elevated intratumoral cathepsin D levels may identify a subset of node-positive breast cancer patients showing a high probability of earlier death. (Int J Biol Markers 2005; 20: 103-11).

Transposición penoescrotal en la infancia. Presentación de un caso / Penoscrotal transposition in childhood: presentation of one case

Se presenta el caso de un niño de 11 años de edad con el diagnóstico de una rara anomalía congénita, poco frecuente en la edad pediátrica conocida con el nombre de transposición penoescrotal; presentaba anomalías no urológicas asociadas como el paladar hendido y estrabismo. Se le realiza procedimiento quirúrgico en dos etapas para reparar el defecto congénito. La fístula uretrocutánea fue la complicación postoperatoria encontrada y requirió trataminto quirúrgico. Actualmente el paciente es adulto y presenta buena apariencia de sus genitales externos y buen desarrollo funcional de los mismos (AU)

[Clinical significance of tumor content of epidermal growth factor receptor in breast cancer]. / Significación clínica del contenido tumoral del receptor del factor de crecimiento epidérmico en el cáncer de mama.

OBJECTIVE: To determine the content of epidermal growth factor receptor (EGFR) using a radioligand method in breast cancer and to analyze the relationship between the EGFR levels and the characteristics of patients and tumors. Prognostic significance was also analyzed. MATERIAL AND METHODS: EGFR was measured by a single point radioligand assay in 265 invasive breast carcinomas tissues. In addition, estrogen and progesterone receptors (ER and PR) were measured by enzymatic immunoassays. We analyze the relationship of EGFR levels with the different clinico-pathologic parameters. RESULTS: EGFR levels in breast carcinomas varied widely (0.1 to 403) with a median at 4 fmol/mg prot. The significantly higher concentrations of EGFR were detected in patients under 60 years old (p = 0.042), undifferentiated tumors (p = 0.04), and carcinomas with negative ER and PR (p < 0.019 y p < 0018, respectively). In addition, there was a negative correlation between EGFR and the ER and PR levels (p < 0.05). EGFR levels did not show any relationship with the patient's prognosis. CONCLUSIONS: In addition, intratumoral levels of EGFR in breast carcinomas vary widely and the highest concentrations are associated with the most aggresive characteristics of the tumor.

Aspartil-proteasas y cáncer de mama / Aspartyl-proteases and breast cancer

Las aspartil-proteasas son un conjunto de enzimasproteolíticas ampliamente distribuidas por el organismo humano, donde desempeñan funciones fisiológicas muy variadas, además de estar implicadas en diferentes procesos patológicos. La catepsina D (Cat D), el pepsinógeno C (pep C) y la GCDFP-15, son tres as-partil-proteasas que han sido implicadas en la patologíamamaria. La Cat D se localiza normalmente en los lisosomas de todas las células del organismo y se relaciona con el catabolismo proteico celular. Su expresión en el cáncer de mama se ha propuesto como marcador de dependencia estrogénica, como factor de crecimiento y como proteasa importante involucrada en la invasión tumoral. Sin embargo, la información existente sobre su valor pro-nóstico en esta neoplasia resulta algo conflictiva. Por otra parte, existen datos que sugieren la presencia de Cat D en las secreciones mamarias podría representar un marcador biológico de transformación maligna. El Pep C es una enzima normalmente involucrada en la digestión de proteínas en el estómago y de expresión muy restringida en el resto de los tejidos del organismo humano. Sin embargo, se ha observado que el epitelio de los quistes de mama y un porcentaje significativo de carcinomas de mama expresan esta aspartil-proteasa. Además, también se ha demostrado que la expresión de Pep C por los carcinomas de mama representa un nue-vo factor pronóstico de evolución favorable, así comoun posible marcador de una vía específica de respuesta hormonal en estos tumores. La GCDFP-15 es un componente proteico mayoritariodel fluido quístico de la enfermedad macroquística de la mama y de la secreción mamaria obtenida a través del pezón de la mayoría de las mujeres no lactantes. Esta proteasa es también expresada por un porcentaje eleva-do de carcinomas mamarios, en los cuales representa un marcador de diferenciación apocrina y un posiblemarcador biológico de respuesta hormonal androgénica (AU)

Importancia de la edad como factor pronóstico determinante de la variabilidad de las características clínico-patológicas de las pacientes con cáncer de mama / Importance of the age as factor determining prognosis of the variability of the clinical-pathological characteristics of patients with breast cancer

Objetivo: analizar la importancia de la edad como factor pronóstico en el cáncer de mama, lo cual podría tener importantes implicaciones en el tratamiento y manejo clínico de las pacientes. Material y métodos: estudio retrospectivo de 769 pacientes intervenidas quirúrgicamente por cáncer de mama (1983-1999). El tiempo medio de seguimiento fue de 34,4 meses. Se realizaron estudios bioquímicos para la determinación de receptores de estrógenos y progesterona, contenido de ADN y fase S. Resultados: la edad media de las 769 pacientes fue de 59 años, y la década de mayor presentación del cáncer de mama fue la de los 50 años (26,5 per cent). Encontramos una asociación estadísticamente significativa entre la edad de las pacientes y el tamaño tumoral (p<0,0001), grado histológico (p<0,018), contenido de receptores de estrógenos (p<0,014) y fase S (p<0,019). Las pacientes de menor edad tuvieron un mayor número de casos de tumores de menor ta maño, histológicamente menos diferenciados y con receptores estrogénicos negativos. El análisis univariante demostró que el mayor tamaño tumoral, el estadio nodal positivo y el grado histológico indiferenciado de los tumores estuvieron significativa y positivamente asociados con un menor tiempo libre de enfermedad y supervivencia total de las pacientes. Sin embargo, no existieron diferencias significativas en el pronóstico entre los diferentes grupos de pacientes clasificadas en función de sus distintas edades. Conclusiones: el presente estudio demuestra diferencias en las características clínicas, morfológicas y biológicas de los carcinomas mamarios en función de la edad de las pacientes. Sin embargo , nuestros resultados no demostraron diferencias significativas en el pronóstico de las pacientes en función de su edad. Ello podría tener importantes implicaciones de cara al tratamiento y manejo clínico de las pacientes, principalmente de aquellas de más avanzada edad (AU)

Expresión y significación clínica del pepsinógeno c y la colagenasa-3 en el carcinoma de endometrio / Expression and clinical significance of pepsinogen C and collagenase-3 in endometrial carcinoma

Objetivo: Analizar la expresión tumoral del pepsinógeno C y de la colagenasa-3 en el adenocarcinoma de endometrio y la relación con las características de las pacientes y de sus tumores.Sujetos y métodos: Analizamos retrospectivamente mediante análisis inmunohistoquímico, utilizando anticuerpos monoclonales, 58 pacientes diagnosticadas y tratadas de adenocarcinoma de endometrio.Resultados: Se detectó pepsinógeno C en 21 tumores (36 por ciento) y colagenasa-3 en 30 (51 por ciento). La expresión de estas proteínas se asoció significativamente con la profundidad de la invasión miometrial, de forma que a mayor invasión del miometrio, menor expresión de pepsinógeno C y mayor de colagenasa-3 (p < 0,005 y p < 0,02, respectivamente). El análisis combinado de ambas enzimas proteolíticas predijo significativamente el grado de invasión miometrial (p < 0,001).Conclusión: Un porcentaje significativo de adenocarcinomas de endometrio expresan pepsinógeno C y colagenasa-3, lo cual refleja un comportamiento biológico diferente, y pueden ser útiles en la predicción preoperatoria de la invasión miometrial en el cáncer de endometrio (AU)

[Analysis of the cytosolic content of the pS2 protein in breast cancer]. / Análisis del contenido citosólico de la proteína pS2 en el cáncer de mama.

OBJECTIVE: To analyze pS2 cytosolic levels in breast carcinomas and their correlation with different clinical characteristics of the patients and their tumours. MATERIAL AND METHODS: Cytosolic pS2 levels were measured by radioimmunometric assay in tumours from 168 breast cancer patients. RESULTS: The pS2 values ranged from 0 to 251 ng/mg protein (mean SD: 21.8 38.1; median: 7.9 ng/mg protein). These protein levels were significantly (p < 0.05) higher in premenopausal patients (27.6 45.2) than in postmenopausal patients (19.5 33.8). Intratumour pS2 levels were also significantly (p < 0.05) correlated with histologic grade of the tumours, and were higher in well diferentiated tumours (grade I: 28.8 42.8) than in moderately differentiated tumours (grade II: 19.7 35.6) and than in poorly differentiated tumours (grade III: 18.9 37.3). Similarly, significant differences in pS2 content were found between positive estrogen receptor (ER) tumours and ER-negative tumours (29.1 46.5 vs 11.3 15.9, respectively; p<0.0001), as well as between positive progesterone receptor (PR) tumours and PR-negative tumours (29.1 49.8 vs 15.3 21.5, respectively; p < 0.05). CONCLUSIONS: The results suggest that pS2 may be a useful prognostic marker in breast cancer, and may also be useful to identify patients who are likely to benefit from hormone therapy.

Análisis del contenido citosólico de la proteína ps2 en el cáncer de mama / Analysis of the cytosolic content of the ps2 protein in breast cancer

Objetivo: Analizar los niveles citosólicos de pS2 en carcinomas de mama y su correlación con las diferentes características clínicas de las pacientes y de sus tumores.Material y métodos: Se determinaron por método inmunorradiométrico los niveles citosólicos de pS2 en 168 tumores de pacientes con cáncer de mama. Resultados: Los valores de pS2 variaron de 0 a 251 ng/mg proteína (media ñ DE: 21,8 ñ 38,1; mediana: 7,9 ng/mg proteína). Esos niveles de la proteína fueron significativamente (p < 0,05) más elevados en las pacientes premenopáusicas (27,6 ñ 45,2) que en las pacientes postmenopáusicas (19,5 ñ 33,8). Los niveles intratumorales de pS2 también estuvieron significativamente (p < 0,05) correlacionados con el grado histológico de los tumores, siendo más elevados en los tumores bien diferenciados (grado I: 28,8 ñ 42,8) que en los tumores moderadamente diferenciados (grado II: 19,7 ñ 35,6) y que en los tumores pobremente diferenciados (grado III: 18,9 ñ 937,3). Similarmente, se encontraron diferencias significativas en el contenido de pS2 entre los tumores receptor de estrógeno (RE)-positivos y los tumores RE-negativos (29,1 ñ 46,5 vs 11,3 ñ 15,9, respectivamente; p < 0,0001), así como también entre los tumores receptor de progesterona (RP)-positivos y los tumores RP-negativos (29,1 ñ 49,8 vs 15,3 ñ 21,5, respectivamente; p < 0,05). Conclusión: Estos resultados sugieren que la pS2 puede ser un útil marcador pronóstico en el cáncer de mama, así como también para identificar pacientes que pueden beneficiarse de terapia hormonal (AU)

Lysozyme expression by breast carcinomas, correlation with clinicopathologic parameters, and prognostic significance.

BACKGROUND: Here we evaluate the expression and prognostic value of lysozyme, a milk protein that is also synthesized by a significant percentage of breast carcinomas, in women with breast cancer. METHODS: Lysozyme expression was examined by immunohistochemical methods in a series of 177 breast cancer tissue sections. Staining was quantified by using the HSCORE system, which considers both the intensity and the percentage of cells staining at each intensity. The prognostic value of lysozyme was retrospectively evaluated by multivariate analysis that took into account conventional prognostic factors. RESULTS: A total of 126 of 177 carcinomas (69.4%) stained positive for this protein, but there were clear differences among them with regard to the intensity and percentage of stained cells. Lysozyme values were higher in well-differentiated and moderately differentiated tumors than in poorly differentiated tumors (P < .05). Similarly, lysozyme levels were higher in small and node-negative tumors than in large and node-positive tumors (P < .05). Moreover, results indicated that low lysozyme content predicted shorter relapse-free survival and overall survival (P < .005). Separate Cox multivariate analysis in subgroups of patients as defined by node status showed that lysozyme expression was an independent prognostic factor able to predict both relapse-free survival and overall survival in node-negative patients (P < .05). CONCLUSIONS: Tumoral expression of lysozyme is associated with lesions of favorable evolution in breast cancer. This milk protein may be a new prognostic factor in patients with breast cancer.