THE ROLE OF COMPLETE BLOOD COUNT PARAMETERS IN PATIENTS WITH COLORECTAL CANCER.

- Chronic inflammation has been linked with many cancers. It seems that easily available and usual blood inflammatory markers might serve as a prognostic factor for overall survival and disease-free survival in patients with various cancers. Preoperative neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR), as well as hemoglobinemia, thrombocytosis, elevated C-reactive protein values, neutropenia and leukocytosis have been shown to affect overall survival and disease-free survival in patients with colorectal cancer (CRC), however, with controversial results. Complete blood count, NLR and PLR were determined in 71 patients with CRC (stages 3 and 4) after neoadjuvant chemo-radiotherapy and before surgery, treated at Hospital for Tumors in Zagreb. Statistical analysis included Mann-Whitney U test, Student's t-test, univariate and multivariate analysis. The results of Mann-Whitney U test and Student's t-test showed that neutrophil count (p=0.024), NLR (p=0.003) and PLR (p=0.007) correlated significantly with overall survival. However, there was no significant correlation of age, leukocyte, lymphocyte and platelet counts and hemoglobin values with overall survival of patients. Furthermore, the same tests showed that leukocyte (p=0.04), neutrophil (p=0.0014) and platelet (p=0.006) counts, NLR (p=0.0006) and PLR (p=0.0015), as well as hemoglobin values (p=0.028) correlated significantly with disease-free survival. The results of univariate analysis showed that unlike PLR, NLR correlated with overall survival and disease-free survival (p=0.0002), although the correlation of PLR and disease-free survival almost reached significance (p=0.059). Furthermore, the results of univariate analysis showed significant correlation of advanced pathological TNM stage with overall survival. There was no correlation of patient age and gender, tumor stage and neoadjuvant chemo-radiotherapy with overall survival and disease-free survival. The results of multivariate analysis showed that NLR (cut-off value 3.27) and advanced pathological TNM stage significantly correlated with disease-free survival but not with overall survival. It seems that NLR might be an accurate marker for overall survival and disease-free survival in CRC patients after neoadjuvant chemo-radiotherapy and before surgery.

The impact of human epidermal growth factor receptor-2 status of invasive breast tumors on thermography findings.

OBJECTIVE: To analyze the impact of prognostic human epidermal growth factor receptor-2 (HER-2) in invasive breast cancers on the findings of thermography tests. METHODS: The study was carried out at the Department of Surgical Oncology and the Department of Pathology, University Clinical Hospital Center, Sisters of Mercy, Zagreb, Croatia, in collaboration with licensed infrared (IR) thermography experts. The study involved 75 female patients diagnosed with invasive breast cancer from May to July 2011. Thermography findings were compared between different immune-histochemical (IHC) findings (HER-2 status: positive or negative). RESULTS: Significantly higher temperatures were recorded in invasive cancer breasts than in healthy breasts. The cancer sites and the entire cancer breasts were significantly warmer (p less than 0.001) than the healthy breasts and opposite tumors mirror sites. Considering the HER-2 status, HER-2 positive invasive cancers were significantly warmer in comparison with the HER-2 negative cancers (p=0.035). CONCLUSION: The trend of increased temperature in HER-2+ tumors was noted. The findings clearly indicate that HER-2+ status has a higher impact on the increased thermographic temperature findings.

The relation between tumor marker Ca 15-3 and metastases in interpectoral lymph nodes in breast cancer patients.

OBJECTIVE: We aimed at analyzing the metastatic involvement in interpectoral (Rotter's) lymph nodes (RLN) in relation to tumor marker CA 15-3. METHODS: The study included 177 female patients undergoing surgery for primary breast cancer at the University Hospital for Tumors, Zagreb, Croatia from November 2001 to March 2004. In addition to the standard surgical procedure, interpectoral RLNs were removed in all of the patients. Levels of the serum tumor marker CA 15-3 was determined prior to surgery. RESULTS: Rotter's lymph nodes were identified in 66.2% of the patients, with metastatic involvement revealed in 18.6% of the RLNs. Metastatic involvement of RLNs in patients with negative axillary lymph nodes was 2.8% and positive in 34.6%. Elevated serum levels of tumor marker CA 15-3 had 22 (12.4%) patients. Of 33 Rotter's node-positive patients, 27.3% had elevated serum levels of tumor marker CA 15-3 and in Rotter's node-negative patients only 9% had elevated serum levels of tumor marker CA 15-3, with the level statistically significantly higher in Rotter's positive patients compared to those with negative (or absent) RLNs (chi2=8.22, p=0.004). CONCLUSION: Tumor marker CA 15-3 is more frequently elevated in patients with positive RLNs. Elevated values of tumor marker CA 15-3 could be warning for possible positive interpectoral nodes. The removal of the RLNs may be beneficial for patients with (massive) axillary nodal involvement. For axillary node negative patients, sentinel node biopsy could avoid the unnecessary removal of the RLNs.