Can the clinical outcome in stage II colon carcinomas be predicted by determination of molecular marker expression?

BACKGROUND: Conventional staging procedures are often unable to precisely predict prognosis in colon cancer (CC). In this study, we set out to investigate the possible role of molecular/structural indicators involved in cell cycle regulation (Ki-67, p53), apoptosis (p53 and bcl-2) and tumour neoangiogenesis (anti-VIII factor) in predicting tumour behaviour and clinical outcome in stage II CC patients. EXPERIMENTAL DESIGN: Analysis of the above indicators was performed by immunohistochemistry on 162 CC patient samples with curative intention surgery. Clinicopathological data included tumour grade, vascular and nervous invasion, production of mucin, lymphatic permeation and carcinoembryonic antigen levels. RESULTS: p53 protein was overexpressed in 58%, bcl-2 overexpression in 21.5%, Ki-67 in 60.1% and anti-VIII factor stained positive in 40.16% of the cases. Multiple regression analysis showed that some molecular markers were correlated. A significant relationship was seen between p53 and Ki-67, and bcl-2 and p53, but there was no correlation between bcl2 and Ki- 67 overexpression. Stepwise regression selected Ki-67 and anti-VIII factor as the best combination of variables capable of predicting both disease-specific and diseasefree survival. CONCLUSIONS: Only Ki-67 and anti-VIII factor were shown to be useful for the prediction of outcome and recurrence rate in curatively treated CC patients. In conjunction with clinical and pathological staging, they may provide a stronger indication of clinical outcome than staging alone and help better select therapeutic options in CC patients.

Can the clinical outcome in stage II colon carcinomas be predicted by determination of molecular marker expression?

BACKGROUND: Conventional staging procedures are often unable to precisely predict prognosis in colon cancer (CC). In this study, we set out to investigate the possible role of molecular/structural indicators involved in cell cycle regulation (Ki-67, p53), apoptosis (p53 and bcl-2) and tumour neoangiogenesis (anti-VIII factor) in predicting tumour behaviour and clinical outcome in stage II CC patients. EXPERIMENTAL DESIGN: Analysis of the above indicators was performed by immunohistochemistry on 162 CC patient samples with curative intention surgery. Clinicopathological data included tumour grade, vascular and nervous invasion, production of mucin, lymphatic permeation and carcinoembryonic antigen levels. RESULTS: p53 protein was overexpressed in 58%, bcl-2 overexpression in 21.5%, Ki-67 in 60.1% and anti-VIII factor stained positive in 40.16% of the cases. Multiple regression analysis showed that some molecular markers were correlated. A significant relationship was seen between p53 and Ki-67, and bcl-2 and p53, but there was no correlation between bcl2 and Ki- 67 overexpression. Stepwise regression selected Ki-67 and anti-VIII factor as the best combination of variables capable of predicting both disease-specific and diseasefree survival. CONCLUSIONS: Only Ki-67 and anti-VIII factor were shown to be useful for the prediction of outcome and recurrence rate in curatively treated CC patients. In conjunction with clinical and pathological staging, they may provide a stronger indication of clinical outcome than staging alone and help better select therapeutic options in CC patients (AU)

[Steatosis and cirrhosis secondary to insulin resistance in children. Possible physiopathological mechanisms]. / Esteatosis y cirrosis hepática asociada a resistencia insulínica.Posibles mecanismos fisiopatológicos.

We describe two girls who showed physical and biochemical features of insulin resistance and steatohepatitis. The possible pathophysiological mechanisms involved in fatty liver and hepatotoxicity are discussed.

Esteatosis y cirrosis hepática asociada a resistencia insulínica. Posibles mecanismos fisiopatológicos / Steatosis and cirrhosis secondary to insulin resistance. Possible physiopathological mechanisms

Se describen los casos de 2 niñas con rasgos físicos y bioquímicos de resistencia a la insulina y esteatohepatitis, y se comentan los mecanismos fisiopatológicos que podrían originar hígado graso y hepatotoxicidad (AU)

Punción aspiración con aguja fina de nódulos cutáneos y subcutáneos metastásicos / Fien neddle aspiration of metastatic cutaneous and subcutaneous nodules

Hemos estudiado los hallazgos clinicocitológicos de 142 nódulos cutáneos y subcutáneos metastásicos pertenecientes a 142 pacientes, por medio de punción aspiración con aguja fina (PAAF); de estos, 76 tenían antecedentes de neoplasia primaria. En 120 pacientes se dispuso de la histología del tumor primario. Las localizaciones más frecuentes de los nódulos cutáneos y subcutáneos metastásicos fueron el torax y el abdomen (61,9 por ciento), y de los tumores primarios, el pulmón (25,3 por ciento) y la piel (16,2 por ciento). con base en el patrón citoarquitectural dominante los aspirados fueron clasificados en seis categorías: adonocarcinoma (n=75), carcinoma escamoso (n=34), linfoma (n=6), melanoma (n=18), célula pequeña (n=8) y sarcoma (n=1). El patrón citoarquitectural más frecuente fue el de adenocarcinoma (52,8 por ciento). En los 120 casos en los cuales se efectuó correlación entre los hallazgos citológicos de los aspirados de los nódulos cutáneos y subcutáneos metastásicos y la histología del tumor primario la sensibilidad fue del 100 por ciento y el valor predictivo de un resultado positivo, también del 100 por ciento. De acuerdo con nuestras observaciones, la PAAF de los nódulos cutáneos y subcutáneos metastásicos es una técnica útil por su gran sensibilidad, rapidez de diagnóstico y bajo coste, y sirve de ayuda al clínico en el tratamiento de los pacientes con cáncer (AU)

[Anti-Sp100 and anti-Gp210 in the diagnosis of primary biliary cirrhosis in patients with autoimmune cholangitis]. / Anti-Sp100 y anti-Gp210 en el diagnóstico de cirrosis biliar primaria en pacientes con colangitis autoinmune.

We describe 2 women with features of autoimmune cholangitis. Serum biochemical studies showed cholestasis and increased immunoglobulin M with negative antimitochondrial antibodies. Markers of hepatitis B and C viruses were absent. Both had positive antinuclear antibodies. One had a speckled pattern (multiple nuclear dots) and the other a perinuclear pattern (pore nuclear). In the first case anti-Sp100 was positive by EIA and in the second anti-Gp210 was detected by immunoblot. Diagnosis of primary biliary cirrhosis was made and the patients were treated with UDCA. Current knowledge indicates that determination of anti-Sp100 and anti-Gp210 substantially improves diagnosis of primary biliary cirrhosis as these ANA are highly specific for this disease. These autoantibodies may lead to the classification of different groups of patient included in autoimmune cholangitis. All patients with autoimmune cholangitis should be tested for anti-Sp100 and anti-Gp210.

Utility of fine-needle aspiration in the diagnosis of granulomatous lesions of the breast.

Fourteen cases of granulomatous mastitis (GM) studied by fine-needle aspiration (FNA) are reviewed and nine cytologic features (necrosis, neutrophil granulocytes, foamy cells, plasma cells, granulomas, epitheloid cells, multinucleated giant cells of foreign body type and Langhans' type, duct cells, and the presence of acid-fast bacilli) are reappraised in a semiquantitative manner. The main objective of this study was to find out if one or more of these features would permit the various granulomatous entities identified in surgical pathology to be separated cytologically. The results suggest that FNA does not permit the various granulomatous lesions identified in surgical pathology to be differentiated, since in this series different entities share a common cytologic pattern. Only the presence of acid fast bacilli in smears would enable a tuberculous etiology to be diagnosed. The opinion is put forward that the term GM should be avoided in the cytologic report and substituted by the noncommitted term "granulomatous lesion of the breast.

[Non alcoholic steatohepatitis. Mid-term clinical and histologic course in 10 patients]. / Esteatohepatitis no alcohólica. Evolución clínica e histológica a medio plazo de diez pacientes.

BACKGROUND: The progressive character of the hepatic lesions in nonalcoholic steatohepatitis (NASH) has not been well established. In the present study, the clinical and histological course of this condition was evaluated at medium term. METHODS: Then patients (6 females and 4 males) with NASH, in a non-cirrhotic stage at the time of diagnosis, were followed up during 58 +/- 7 months (range 24 to 88 months). RESULTS: Nine patients were obese, but a significant reduction of body weight was found at the end of the study (p = 0.0072). Other clinical, physical or laboratory changes were not found, although in two cases hepatic biochemical tests were within normal limits when the follow-up biopsy was performed. Changes in the characteristic hepatic features were also absent, although fat infiltrates disappeared in three cases. Six patients had increased fibrosis and a progression of the hepatic architectural distortion; four reached the stage of cirrhosis. The evolution of the hepatic lesion correlated with the interval between diagnostic and follow-up biopsies (r = 0.69; p less than 0.05) and with the reduction in body weight (r = 0.64; p less than 0.05). CONCLUSIONS: In most cases, NASH results in a progressive hepatic distortion with can end in cirrhosis, although the change is slow and silent.