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Background/Aim. Pterygium is considered to be a degenerative disease of the conjunctiva, however, the presence of tumor markers in pterygium reinforces the hypothesis that this lesion is similar to tumor. Inactivation of p53 function removes an obstacle to increased proliferation. Factors affecting the prevalence of p53 expression in pterygium deserve investigation. The aim of the study was to investigate the expression of p53 and Ki-67 proteins in pterygium and normal conjunctiva, the effects of gender and age on p53 expression, and the relationship between the expression of p53 and Ki-67 proteins. Methods. A total of 34 samples of pterygium and 34 samples of the normal conjunctiva were analyzed. The samples were studied by immunohistochemistry using antibodies against p53 and Ki-67. Results. Totally 15 (44%) samples of pterygia were p53 positive. Correlations between the expression of p53 protein and sex, and age were not established. The number of Ki-67 positive cells in pterygium (9.74%) was significantly higher than the number of Ki-67 positive cells in the normal conjunctiva (1.74%), (p = 0.001). Between the expression of p53 protein and Ki-67 protein in pterygium there was a significant positive correlation (p = 0.000). Conclusion. The prevalence of p53 positive samples of pterygium was 44%. The influence of sex and age on p53 protein expression in pterygium was not found. The increased proliferative acivity was present in the epithelium of pterygium. The expression of Ki-67 protein is associated with the expression of p53 protein in pterygium. The findings of our study support the thesis of pterygium as tissue growth disorder.

Abstract BACKGROUND: Melanoma inhibitory activity is a protein secreted by melanoma cells and has been used as a tumor marker. Increased Melanoma inhibitory activity serum levels are related to metastatic disease or tumor recurrence. Currently there are no studies on Melanoma inhibitory activity and cutaneous melanoma involving Brazilian patients. OBJECTIVE: To evaluate the performance and feasibility of measuring Melanoma inhibitory activity levels in Brazilian patients with cutaneous melanoma. METHODS: Blood was obtained from ten patients with proved metastatic cutaneous melanoma (Group 1), 15 patients resected for cutaneous melanoma without metastasis (Group 2) and 5 healthy donors (Group 3). Melanoma inhibitory activity was measured using a commercially available ELISA kit. RESULTS: There was a statistically significant difference of Melanoma inhibitory activity levels between patients with and without metastasis (p=0.002), and between patients with metastasis and healthy donors (p=0.002). There was no difference between patients without metastasis and healthy donors (p=0.443). CONCLUSION: Melanoma inhibitory activity is a tumor marker for cutaneous melanoma and the Melanoma inhibitory activity-ELISA test can be easily performed. Patients with metastasis have increased Melanoma inhibitory activity serum levels when compared to patients without metastasis and healthy donors.

Introduction. Solitary fibrous tumors are rare soft tissue tumors of submesothelial origin and variable malignant potential. The most common localization is pleural, whereas only 0.6% are of extrapleural localization. Solitary fibrous tumor of the peritoneum, especially of gastric serosa is an extremely rare form of this tumor. Case report. We presented a 65- year-old female patient with solitary fibrous tumor of the stomach. Histopathological analysis of removed tissue showed the presence of tumor tissue built of spindle cells, elongated nuclei with moderately abundant cytoplasm. Cells were in a noncohesive arrangement, in smaller areas distributed in the form of palisade. There were amounts of hipocellular connective tissue, hyalinised, with small foci of dystrophic calcification. Mitoses were rare (less than 3/10 HPF). Blood vessels surrounded the connective tissue. Reviewed material did not contain elements of the parent organ. Immunohistochemically there were positivity on CD34 and vimentin, and negativity to S100, SMA, CD117, dezmin, and Ki-67 is < 2%. The change was diagnosed as a solitary fibrous tumor. Conclusion. Considering that benign solitary fibrous tumors of extrathoracic localizations are extremely rare neoplasms with unpredictable biological behavior and the possibility of recurrence, a long-term clinical and endoscopic follow-up on yearly basis of patients with this disease is recommended.

Patients with hepatocellular carcinoma (HCC) often have underlying liver diseases, and unlike other types of cancer, the features of HCC and residual liver function may affect patient survival after surgery. In order to help clinicians identify patients who can benefit from radical hepatectomy, this article summarizes common laboratory parameters which have guiding significance for the prognosis of HCC patients, with reference to preliminary laboratory studies and literature review. This article particularly introduces prealbumin, a serological marker which reflects liver synthetic function, and as an independent prognostic factor for HCC patients after surgery, prealbumin is integrated into the traditional Child-Pugh classification system to develop a modified liver function scoring system, which can accurately predict the prognosis of patients undergoing radical hepatectomy. This scoring system may help clinicians select HCC patients suitable for surgery. [ABSTRACT FROM AUTHOR]

Human epididymis protein 4 (HE4) is a new tumor biomarker in recent years, many scholars at home and abroad have researched about it. HE4 originally found in people distal epididymal epithelial cells which have the ability to inhibit proteases and express in multiple tissue of the human body. HE4 has important value in diagnosis of ovarian cancer, especially in the early ovarian cancer which can diagnose of benign and malignant ovarian tumors, and also has superiority in monitoring recurrence. At the same time, research has shown that HE4 has a guiding significance in diagnosis, prognosis and staging of endometrial carcinoma. In addition, HE4 can also be used for the diagnosis and monitoring of benign disease of gynecology such as endometriosis, uterine adenomyosis, etc. We has been adopting the recommended HE4 reference value of America as a diagnostic criteria for the lack of crowd HE4 reference research in China. In view of this, HE4 Chinese population reference multicenter study was officially launched in 2012. Through the study of the large sample of people in our country, it provided the reference range of HE4 levels, which will guide Chinese doctor to apply HE4 results for clinical diagnosis and treatment, effectively improve the clinical management of gynecological oncology. [ABSTRACT FROM AUTHOR]

Endometrial carcinoma, which is one of the three most common gynecologic malignant tumors, severely threatens women′s health, and its incidence is showing an increasing trend in recent years. The deep researchs of pathogenesis and typing of endometrial carcinoma are aimed at finding new effective treatment methods, in which the proposal of cancer stem cell concept has offer new therapeutic strategy for oncotherapy. Cancer stem cells are defined as a subset of cancer cells with abilities of self-renewal, unlimited proliferation, multipotential differentiation and high tumorigenicity. Current emerging evidences indicate that the cancer stem cells are likely responsible for the development, progression, metastasis and recurrence of endometrial carcinoma. These may be the main reasons for the poor prognosis. According to the endometrial cancer stem cell surface markers (such as CD133, CD44, etc.) or cell biological characteristics (such as side population cell sorting), cancer stem cells are separated and purified. In addition, using high expression of ALDH1 and Musashi-1 in endometrial cancer stem cells to identify cancer stem cells in the tumor tissues, which provides the probability of radical curing cancers through the targeted killing of cancer stem cells. This review is a report of literatures of the sources and characters of cancer stem cells, and their special surface markers in endometrial carcinoma. [ABSTRACT FROM AUTHOR]

Objectives Although the glycoprotein group tumor marker CA 19-9 has been detected in both serum and urine of bladder cancer patients, information about their comparative role in screening of low grade transitional cell carcinoma (LGTCC) and high grade transitional cell carcinoma (HGTCC) is rare. Materials and Methods In this study we measured both the urinary and serum levels of CA 19-9 in 35 LGTCC and 20 HGTCC patients by ELISA and determined the cut off value of both urinary and serum CA 19-9 levels by receiver operator characteristic curve (ROC) for both patient groups. Odds ratio (OR) for CA 19-9 was analyzed with its range at 95% confidence interval to analyze the role of this tumor marker as a screening parameter for both of these cancer types. Results For urinary CA 19-9 the OR was 20.16 with an interval of 4.91-82.71 whereas for the serum CA 19-9 it was 7.5 with an interval of 2.28-24.62. Conclusions From these data we suggest that urinary CA 19-9 is a better screening parameter with optimum sensitivity and specificity than its serum counterpart for diagnosis of low grade and early stages of transitional cell carcinoma of urinary bladder. Furthermore, it can be suggested that urinary CA 19-9 can be used as better prognostic marker for LGTCC than its serum counterpart.

The development of leukemia and lymphomas is related to the increase in inflammatory process modulators. These, in turn, have divergent actions on the neoplastic process. Populations of T cells have different roles in the neoplastic environment; while interferon-gamma positive T cells have antitumor activity, the FoxP3+interleukin-10 positive population present a pro-tumor activity. Simultaneously, the inflammatory process promotes the mobilization of fatty acids from the cell membrane to produce lipid mediators, which also participate of the inflammatory response. Eicosapentaenoic (EPA) and docosahexaenoic (DHA) omega-3 fatty acids, when incorporated in the plasmatic membrane, decrease the arachidonic acid (AA) metabolism and the production of eicosanoids derived from it. Thus, an alternative family of lipid mediators are produced that are often less inflammatory than those produced from arachidonic acid. Fatty acids can also influence the production of peptide mediators such as cytokines, and the expression of transcription factors, which can determine the production patterns of eicosanoids and cytokines as well as cell differentiation. Due to these properties, the objective of this literature review was to investigate studies published over the last 15 years on the effects of using omega-3 fatty acids on inflammatory markers in leukemia and lymphomas.

PURPOSE: Tumor markers are substances found in blood and other biological fluids if tumor is present in the body. They can be produced by tumor itself or can be results of cancer - body relation. They may be used in the follow-up of cancer patients to identify tumor recurrence. Pre-treatment levels have prognostic tool and could signalize persistence of minimal residual disease despite radical surgery. METHODS: We operated on 52 patients with upper GI malignancy (32 with gastric cancer and 20 with pancreatic cancer). Blood samples were taken before surgery and peritoneal samples immediately after laparotomy before any manipulation with tumor. All samples were examined by standard biochemical technique and the level was compared with a stage of the disease. RESULTS: Patients suffering from gastric carcinoma of stage I and II had higher level of both markers in sera then in the peritoneal cavity, however most of them were within physiological range. Patients in stage III and IV had average marker levels in the peritoneal cavity higher than in sera. Number of positive findings was increasing according to the stage of the disease. The peritoneal levels of both markers varied extremely in higher stages. In patients suffering from pancreatic carcinoma the CEA levels both in sera and peritoneal cavity were parallel but peritoneal levels were slightly higher in stages III and IV. Ca 19 - 9 was more sensitive for pancreatic cancer. The percentage of positive findings was higher in sera but the level of Ca 19 - 9 was higher in the peritoneal cavity. The number of positive findings again correlated with the stage of the disease. CONCLUSIONS: Levels of tumor markers in sera could signalize inoperability of tumor (Ca 19 - 9 in cases of pancreatic carcinoma); peritoneal levels could predict R1 resection especially in gastric cancer patients and risk of early peritoneal recurrence of the disease. Difference between the levels in the peritoneum and sera may signalize the route of dissemination (hematogenous and intraperitoneal).OBJETIVO: Os marcadores tumorais são substâncias encontradas no sangue e outros fluidos biológicos em pacientes com doenças oncológicas. São produzidos pelo próprio tumor ou ser resultado da interação entre o tumor e o organismo. Podem ser usados no seguimento de pacientes com câncer para identificar recidiva tumoral. Os níveis pré-tratamento têm valor prognóstico e podem sinalizar persistência de doença residual mínima após cirurgia radical.. MÉTODOS: Foram operados 52 pacientes com tumores do trato gastroinstestinal superior (32 com câncer do estômago e 20 do pâncreas). Amostras sanguineas foram colhidas no préoperatório e amostras peritoneais imediatamente após a laparotomia, antes de qualquer manipulação do tumor. Todas as amostras foram examinadas bioquímicamente e os resultados foram comparados entre si e em face ao progresso da doença. RESULTADOS: Os pacientes com câncer de estômago nos estadios I e II apresentaram níveis sanguineos mais elevados de ambos os marcadores tumorais do que no peritônio, mas a maioria dos valores encontrava-se dentro dos limites fisiológicos. Já nos estadios III e IV os níveis dos marcadores tumorais foram mais elevados no peritônio do que no sangue. O número de exames positivos aumentou de acordo com o estadio da doença. Nos estádios avançados, observou-se elevada variabilidade nos níveis de ambos os marcadores analisados no peritônio. Os doentes com carcinoma de pâncreas tiveram níveis de CEA semelhantes no sangue e no peritônio, mas os níveis peritoneais foram ligeiramente mais elevados nos estadios III e IV. Ca 19 - 9 foi muito mais sensível para o câncer do pâncreas. A porcentagem de exames positivos foi mais elevada no sangue, mas o níveis do Ca19-9 foram mais elevados no peritônio.A porcentagem de exames positivos também teve correlação com o estadio da doença. CONCLUSÕES: Os níveis de marcadores tumorais no sangue podem indicar inoperabilidade do tumor. No peritônio podem indicar o tipo de ressecção, especialmente nos doentes com câncer gástrico, e o risco de recidiva peritoneal precoce. A diferença entre os níveis no peritônio e sangue podem sinalizar a via de disseminação, hematogênica ou intra-peritoneal.

INTRODUÇÃO: O N-metil-N-nitrosourea (MNU) tem ação cancerígena direta, induzindo tumores em várias espécies em uma variedade de órgãos, incluindo o estômago de ratos. Tratamento do MNU na água de beber por 25-42 semanas, seletivamente, induz carcinoma gástrico glandular de ratos F344 e camundongos C3H. OBJETIVO: Estabelecer um modelo experimental para indução seletiva de câncer no estômago glandular de ratos Wistar com MNU. MÉTODOS: Um total de 48 ratos Wistar machos com oito semanas, foram utilizados no presente estudo. MNU (Sigma-Aldrich) foi dissolvido em DMSO e liberada água potável ad libitum por um período variando de 16 a 70 semanas. Após 16 semanas, quatro ratos foram selecionados aleatoriamente e mortos. Depois, de seis em seis semanas, quatro animais também foram mortos até 70 semanas. RESULTADOS: A taxa de sobrevivência foi superior a 90%. Ocorreu a indução de dois adenocarcinomas, um carcinoma espinocelular e um sarcoma. A incidência de adenocarcinoma gástrico foi de 4,5% (0,5 a 15). CONCLUSÕES: O modelo experimental de carcinogênese gástrica em ratos Wistar, utilizando MNU dissolvido na água, não mostrou viabilidade prática neste estudo, devido à baixa taxa de adenocarcinoma gástrico que ocorreu.BACKGROUND: The N-methyl-N-nitrosourea (MNU) is a direct acting carcinogen, inducing tumors in several species in a variety of organs, including stomach of rats. Treatment of MNU in the drinking water for 25-42 weeks selectively induced glandular gastric carcinoma in F344 rats and C3H mice. AIM: To establish an experimental model for selective MNU induction of glandular stomach cancer in Wistar rats. METHODS: A total of 48 males eight-week-old Wistar rats were used in the present study. MNU (Sigma-Aldrich) was dissolved in DMSO and provided as the drinking water ad libitum for a period ranging from 16 to 70 weeks. After 16 weeks, four rats were randomly selected and killed. After every six weeks four animals were killed until 70 weeks. RESULTS: Survival rate was higher than 90%. It had the induction of two adenocarcinomas, one squamous cell carcinoma and one sarcoma. The incidence of gastric adenocarcinoma was 4.5% (0.5 to 15). CONCLUSIONS: The experimental model of gastric carcinogenesis in Wistar rats, using MNU dissolved in water, showed not practice viability in this study due to the low rate of gastric adenocarcinoma.

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Background/Aim. Unknown primary tumors represent a heterogeneous group of malignancies that are indicative of ominous prognosis. Cancer of unknown primary site (CUP) is defined as the lack of any detectable primary site after full evaluation, and accounts for approximately 3-5% of all newly diagnosed patients with malignancies. The aim of this report was to present the prognostic and predictive value of 8 serum tumor markers in this group of patients. Methods. The study involved 63 patients. On histological examination, all the patients were presented with metastatic tumors whose primary site (origin) could not be detected with noninvasive diagnostic techniques. Following the routine light microscopy, all histological findings were classified into one of the following three groups: plano-cellular carcinoma - 8 patients; adenocarcinoma - 33 patients; unclassifiable (undifferentiated) carcinoma - 22 patients. In all the cases we evaluated 8 serum tumor markers: alpha-fetoproteins (AFP), chronic gonadotrophin beta submit, human (beta-HCG), neuron specific enolase (NSE), marker of malignant ovarian tumors (CA 125), prostate-specific antigene (PSA), marker of malignant brest tumor (CA 15-3), marker of malignant pancreas tumor and gastrointestinal tumor (Ca 19-9), carcinoembryonic antigen (CEA) at the time of diagnosis. The patients on chemotherapy had the markers determined after the third and sixth chemocycle, i.e. at the time of illness progression observation, if present. The patients responding to chemotherapy with complete response (CR), partial response (PR) or stable disease (SD) had the markers determined after three-month periods until the time of relapse or progression. Chemotherapy was applied in 32 patients (20 females and 12 males), aged 29-70 years, who met the inclusion criteria. The following chemotherapy regimen was used: doxorubicin 50mg/m2 (day 1), cisplatin 60mg/m2 (day 1), and etoposide 120 mg/m2 (days 1-3). The period between two chemotherapy cycles was three weeks, and maximum five weeks in the case of prolonged hematological toxicity. Results. Most commonly elevated were NSE values (82.54%), while AFP values were least commonly elevated (11.11%). Average survival time was 17.89 months (95%CI 12.96; 22.83). The probability of 24 months' survival was 0.228. The group of 32 patients treated with chemotherapy had 12 (37.5%) fatal outcomes in the observed period (72 months). Average survival time was 26.6 months (95% CI 19.5; 33.7). Average tumor marker values before and after the chemotherapy were significantly lower for NSE and CA 125. Survival was significantly better in cases of NSE and CA 125 decrease of more than 20%. Conclusion. Increased values of serum tumor markers are very often in CUP. The tumors show nonspecific overexpression of tumor markers. The NSE and CA 125 levels show good correlation with response to the given chemotherapy. However, a routine evaluation of commonly used serum tumor markers has not been proven of any prognostic and predictive assistance.

PURPOSE: To compare histopathological variables and staging in colorectal adenocarcinoma cases with CEA and CA 242 in peripheral and mesenteric blood. METHODS: In 169 individuals underwent surgery for colorectal cancer, CEA and CA 242 were analyzed and compared to mesenteric and peripheral blood and correlated with macroscopic tumor's morphology and size, degree of cell differentiation, venous, neural and lymphatic involvement and TNM classification. RESULTS: There was a difference between the mesenteric (M) and peripheral (P) serum levels of CEA (p=0.020). Higher levels of markers were correlated with venous invasion CEA (P) p=0.013, CEA (M) p=0.05, CA 242 (M) p=0.005 and CA 242 (P) p=0.038; with advanced staging CEA (P) < CEA (M) (p < 0.05); CA 242 (P) < CA 242 (M) (p < 0.05); and with greater dimensions CEA (P) < CEA (M) (p < 0.001); CA 242 (P) < CA 242 (M) (p < 0.001). CA 242 became higher with neural invasion (P): p=0.014, (M): p=0.003). CONCLUSIONS: There were higher mesenteric than peripheral levels of CEA. Both mesenteric and peripheral levels of CEA and CA 242 were higher in neoplasm with venous involvement, greater diameter and advanced stages. There was a correlation between CA 242 and neural invasion.OBJETIVO: Comparar variáveis histopatológicas e graus de estadiamento do adenocarcinoma colorretal com níveis sanguíneos periféricos e mesentéricos de CEA e CA-242. MÉTODOS: Em 169 doentes submetidos ao tratamento cirúrgico por adenocarcinoma colorretal, CEA e CA-242 foram analisados e comparados quanto aos níveis sanguíneos periféricos e mesentéricos e correlacionados com o tamanho e a morfologia macroscópica do tumor, grau de diferenciação celular, invasões venosa, linfática, neural e a classificação TNM. RESULTADOS: Verificou-se diferença significante entre o nível sérico mesentérico e periférico de CEA (p= 0,02). Níveis séricos mais elevados dos marcadores foram observados e correlacionados com invasão venosa, CEA (P) p=0,013, CEA(M), p=0,05, CA-242 (M) p=0,005 e CA-242 (P) p=0,038. Grau de estadiamento TNM avançado foi associado com CEA(P) < CEA(M) p

PURPOSE: To analyze the expression of metalloproteinase-1, metalloproteinase-7 and vascular endothelial growth factor (VEGF) in colorectal adenocarcinoma, and to correlate these with the clinical-pathological prognostic factors. METHODS: Tumor tissue from 82 patients was fixed in formalin and embedded in paraffin blocks. These samples were analyzed by means of the streptavidin-biotin immunohistochemical method, using the tissue microarray technique. Marker positivity was evaluated using categorical scores that determined cutoff percentages of stained tumor cells. Protein tissue expression was correlated with the variables of degree of cell differentiation, staging, disease-free interval, recurrence, survival and specific mortality. The Fisher exact and Kaplan-Meier tests were used to assess associations between the markers and the study variables. The log-rank and Wilcoxon tests were used to assess the significance of differences between curves of disease-free interval and survival. RESULTS: All tumors were positive for metalloproteinase-1; 50 (61%) were positive and 32 (39%) were negative for metalloproteinase-7; and 60 (74.1%) were positive and 21 (25.9%) were negative for VEGF. Correlation of marker expression, both in groups and individually, did not show statistical significance in relation to the degree of cell differentiation, staging, disease-free interval, survival or specific mortality. Recurrence showed a statistically significant correlation with positive expression of the three markers, when analyzed as a group (p = 0.038). CONCLUSION: The associated expression of metalloproteinase-1, metalloproteinase-7 and VEGF in colorectal adenocarcinoma is related to the incidence of disease recurrence.OBJETIVO: Analisar as expressões da metaloproteinase-1, metaloproteinase-7 e do fator de crescimento endotelial vascular no adenocarcinoma colorretal e correlacionar com os fatores prognósticos clínico-patológicos. MÉTODOS: Foram analisados tecidos fixados em formol e dispostos em blocos de parafina dos tumores de 82 pacientes, por imunohistoquímica, pelo método da estreptavidina-biotina, usando-se a técnica de arranjo em matriz de amostras teciduais (tissue microarray). Na avaliação da positividade dos marcadores foi utilizado um escore categórico, que predeterminou o valor de corte na percentagem de células coradas do tumor. As expressões teciduais das proteínas foram correlacionadas com as varáveis representadas pelo grau de diferenciação celular, estadiamento, tempo livre de doença, recidiva, sobrevida e mortalidade específica. Foram empregados os testes exato de Fisher e de Kaplan-Meier para verificar as associações dos marcadores com as varáveis estudadas. Para testar a significância das diferenças entre as curvas do tempo livre de doença e da sobrevida foram utilizados os testes de longrank e Wilcoxon. RESULTADOS: A metaloproteinase-1 foi positiva em todos os tumores. A metaloproteinase-7 foi positiva em 50 (61%) e negativa em 32 (39%) tumores. O fator de crescimento endotelial vascular foi positivo em 60 (74,1%) e negativo em 21 (25,9%) tumores. A correlação das expressões dos marcadores realizada separadamente e em conjunto não apresentou significância estatística com o grau de diferenciação celular, estadiamento, tempo livre de doença, sobrevida e mortalidade específica. A recidiva apresentou correlação estatística significante com a expressão positiva dos três marcadores, quando foram analisados em conjunto (p = 0,038). CONCLUSÃO: As expressões associadas da metaloproteinase-1, metaloproteinase-7 e do fator de crescimento endotelial vascular no adenocarcinoma colorretal se relacionam com a incidência de recidiva da doença.

O propósito da imuno-histoquímica é reconhecer antígenos e assim identificar e classificar células específicas dentro de uma população celular morfologicamente heterogênea (ou aparentemente homogênea). A visualização do complexo antígeno-anticorpo é possível pela adição de um fluorocromo conjugado ao anticorpo, que pode então ser observado ao microscópio, ou alternativamente uma enzima, cujo produto de reação pode igualmente ser visualizado. A imuno-histoquímica pode ser aplicada na rotina diagnóstica complementar do câncer de pulmão para a identificação de marcadores biológicos diagnósticos e prognósticos. Os painéis imuno-histoquímicos mínimos necessários para a complementação diagnóstica serão discutidos nesta revisão.The role of immunohistochemistry is to recognize antigens and, consequently, to identify and classify specific cells within a cell population whose morphology is heterogenous or apparently homogenous. The visualization of the antigen-antibody complex is made possible through the addition of either a fluorochrome conjugate or an enzyme to the antibody, which is then viewed under microscopy. Immunohistochemistry can be used in the routine diagnosis of lung cancer, in order to identify biological markers (diagnostic and prognostic). The essential immunohistochemistry panels will be discussed in this review.

OBJETIVO: avaliar características clínicas, patológicas e moleculares de carcinomas mamários em mulheres muito jovens em comparação a tumores de mulheres na pós-menopausa. MÉTODOS: foram selecionados 106 casos de câncer de mama de mulheres jovens e 130 casos de mulheres pós-menopausa. Foram analisados dados clínicos (idade ao diagnóstico, estadiamento, ocorrência de metástases, tempo de sobrevida global e livre de doença), anátomo-patológicos (tamanho do tumor, tipo e grau histológico do tumor primário) e marcadores moleculares (receptores de estrógeno e progesterona, HER2, p53, p63, citoqueratinas 5 e 14 e EGFR) com uso da imunoistoquímica empregando microarranjo de tecido. Foi analisada a relação entre as características clínico-patológicas, imunoistoquímicas e de sobrevidas global e livre de doença. RESULTADOS: as pacientes muito jovens apresentaram maior frequência de nuliparidade (p=0,03), maior diâmetro dos tumores (pPURPOSE: the objective of this study was to evaluate the clinical, pathological and molecular characteristics in very young women and postmenopausal women with breast cancer. METHODS: we selected 106 cases of breast cancer of very young women (

BACKGROUND: Determining levels of tumor markers in peritoneal washing enables likelihood of peritoneal recurrence to be ascertained in patients with high marker levels, thereby allowing provision of more accurate adjuvant treatment and postoperative follow up. AIM: To analyze the relationship between levels of tumor marker CA72-4 in serum and peritoneal washing, and morphological aspects of gastric carcinoma. METHOD: This study analyzed 32 consecutively-operated patients with gastric carcinoma, who underwent subtotal, total or palliative gastrectomy. The variables studied were CA72-4 levels in serum and peritoneal washing, lesion site, stage, degree of cell differentiation, operation performed, and number of extirpated and involvement lymph nodes. Of the 32 patient sample, 21 (65.6%) were male and 11 (34.4%) female. Mean age was 62.6 ± 14.2 years (29 to 91 years). Following anesthetic induction, peripherical venous blood was collected through percutaneous punction of an upper limb vein. After the procedure, 50 mL of physiologic solution at 37ºC was introduced into the cul-de-sac. A 10 mL volume of this liquid was aspirated from the cavity and the peritoneal washing tested for CA72-4 levels. Normal values for CA72-4 levels in serum were considered 7U/mL, whilst for the peritoneal washing normal levels were 0.61 U/mL. RESULTS: Mean pre-operative serum levels for CA72-4 were 6.55 U/mL ± 15.30 (0.3 to 75.30 U/mL) whilst the mean level of CA72-4 in peritoneal washing was 8.50 U/mL ± 26.72 (0.3 to 142.00 U/mL); correlation between these levels was significant. Lymph nodes involvement by the gastric carcinoma correlated significantly with higher CA72-4 levels in both serum and peritoneal wash. There was no statistically significant correlation between serum level of CA72-4 and invasion into serosa by the gastric carcinoma. There was however, significant correlation between peritoneal washing levels of CA72-4 and involvement of serosa by gastric carcinoma. There was also a significant correlation between more advanced stages of gastric carcinoma and higher levels of CA72-4 in the peritoneal washing, although serum levels of CA72-4 and more advanced stage of gastric neoplasia showed no significant correlation. Degrees of cellular differentiation in the gastric carcinoma did not differ significantly with CA72-4 levels in serum or peritoneal washing. CONCLUSION: High levels of CA72-4 in peritoneal washing correlated significantly with lymph node metastasis and serosa involvement by the neoplasia, and also with more advanced stage of gastric carcinoma. The levels of CA72-4 in the blood correlated significantly with lymph node involvement by the gastric carcinoma, but not with serosa invasion or more advanced stage of neoplasia.RACIONAL: A determinação dos níveis de marcadores tumorais no lavado peritonial apresenta a possibilidade de indicar tendência à recidiva peritonial nos doentes com níveis elevados, o que pode indicar tratamento adjuvante e seguimento pós-operatório mais acurado. OBJETIVO: Analisar a relação entre os níveis do marcador tumoral CA72-4 no sangue e no lavado peritonial e os aspectos morfológicos do carcinoma gástrico. MÉTODO: Foram analisados 32 doentes operados consecutivamente, com carcinoma gástrico e submetidos a gastrectomia subtotal, total ou paliativa. Foram estudadas as seguintes variáveis: nível sérico e no lavado peritonial do CA72-4, localização da lesão, estádio, grau de diferenciação celular, operação realizada, e número de linfonodos extirpados e acometidos. Dos 32 doentes do estudo, 21 (65,6%) eram homens e 11 (34,4%) mulheres. A média de idade foi de 62,6 ± 14,2 anos (29 a 91 anos). Logo após a indução anestésica, o sangue venoso periférico foi coletado por punção percutânea de veia do membro superior. Após o término da operação, 50 mL de solução fisiológica aquecida a 37ºC foi derramado no fundo de saco. Desse líquido, foi aspirado o volume de 10 mL e encaminhado para a determinação do nível do CA72-4 no lavado peritonial. Para o nível sérico do CA72-4 foram considerados normais os valores < a 7 U/mL e elevados os valores > que 7 U/mL. Para o nível no lavado peritonial do CA72-4 foram considerados normais os valores < 0,61 U/mL, e alterados os valores > que 0,61 U/mL. RESULTADOS: média do nível sérico do CA72-4 no pré-operatório foi de 6,55 U/mL ± 15,30 (0,3 a 75,30 U/mL) e a média do nível do CA72-4 no lavado peritonial foi de 8,60 U/mL ± 26,72 (0,3 a 142,00 U/mL); a correlação entre esses níveis foi significativa. O acometimento linfonodal pelo carcinoma gástrico correlacionou-se significantemente com os níveis mais elevados do CA72-4 sérico e peritonial. Não houve diferença significativa entre o nível sérico do CA72-4 e a invasão da serosa do estômago pelo carcinoma gástrico. Houve correlação significante entre os níveis do CA72-4 no lavado peritonial e o acometimento da serosa do estômago pelo carcinoma gástrico. Houve diferença significante entre o estádio mais avançado do carcinoma gástrico e o nível mais elevado do CA72-4 no lavado peritonial, porém o nível sérico do CA72-4 e o estádio mais avançado da neoplasia gástrica não mostraram correlação significante. Os diferentes graus de diferenciação celular do carcinoma gástrico não mostraram diferenças significantes com os níveis do CA72-4 no sangue e no lavado peritonial. CONCLUSÕES: O nível aumentado do CA72-4 no lavado peritonial correlacionou-se significantemente com o acometimento linfonodal e da serosa gástrica pela neoplasia e com estádio mais avançado do carcinoma gástrico. O nível sérico do CA72-4 correlacionou-se significantemente com o acometimento linfonodal pelo carcinoma gástrico, porém não mostrou correlação com a invasão da serosa do órgão e com o estádio mais avançado da neoplasia.

BACKGROUND: Colorectal cancer is the sixth most common tumor and the fifth in mortality in Brazil. Molecular markers have been associated with disease prognosis, especially in relation to therapeutic response and overall survival rates. Among these, microsatellite instability has been extensively studied. Microsatellite stability status is usually determined by comparison of normal and tumoral tissues from the same patient and instability is characterized by the difference in the PCR-amplification profile of these tissues at a given locus. Usually, a panel of five markers is used for this purpose. Two of them (BAT-25 and BAT-26) are considered monomorphic in populations of European origin. AIM: To analyse the frequency of constitutive polymorphic variation at BAT-25 and BAT-26 loci in a sample of individuals from Southern Brazil. METHODS: Two-hundred and sixteen healthy and unrelated individuals were analised to assess the frequency of allelic variation at the BAT-25 and BAT-26 loci in DNA extracted from peripheral blood. Analysis was done by polymerase chain reaction - single strand conformation polymorphism (PCR-SSCP). RESULTS: From the sample of patients studied, 7% and 6% of the patients had possible constitutive allelic variation at the BAT-25 and BAT-26 loci, respectively. CONCLUSIONS: These results indicate that significant constitutive allelic variation of these loci does occur in heterogeneous populations such as ours, and reinforce the importance of comparative studies between tumoral and corresponding normal tissue to determine microsatellite stability status and correctly identify microsatellite instability in selected populations.RACIONAL: No Brasil, o câncer colorretal é o sexto tumor em freqüência e o quinto em mortalidade. Marcadores moleculares têm sido associados com o prognóstico da doença, especialmente em relação à resposta terapêutica e taxa de sobrevida. Dentre eles, a instabilidade de microssatélites tem sido amplamente estudada. O estado de instabilidade de microssatélites é usualmente determinado pela comparação entre tecido tumoral e tecido normal correspondente de um mesmo paciente e a instabilidade se caracteriza pela diferença no perfil do produto de amplificação por PCR destes tecidos em um determinado locus. Usualmente, é utilizado um painel de cinco marcadores para este propósito. Dois deles (BAT-25 e BAT-26) são considerados monomórficos em populações de origem européia. OBJETIVO: Analisar a freqüência de variação constitutiva nos loci BAT-25 e BAT-26 em amostra de indivíduos do sul do Brasil. MÉTODOS: Duzentos e dezesseis indivíduos saudáveis e não relacionados foram analisados para determinar a freqüência de variação alélica nestes loci. O rastreamento de variantes alélicas foi feito por "polymerase chain reaction - single strand conformation polymorphism" (PCR-SSCP). RESULTADOS: Observou-se possível variação alélica constitutiva em 7% e 6% dos pacientes nos loci BAT-25 e BAT-26, respectivamente. CONCLUSÃO: Estes resultados indicam que há significativa variação alélica constitucional nos loci BAT-25 e BAT-26 em grupos selecionados, como nesta amostra de indivíduos brasileiros, e reforça a importância de estudos comparativos entre tecido tumoral e o tecido normal correspondente para identificar instabilidade de microssatélites em populações determinadas.

Backgrounnd/Aim. Study of the association between Epstein-Barr virus (EBV) and the tumors of the nasopharynx renders an opportunity to introduce causal treatment. Already have been proven the anti-EBV (anti-Epstein-Barr nucleus antigene) antibodies in the blood serum of the patients infected with EBV, while over 91% of the patients with nasopharyngeal malignant tumors also have a detectable anti-EBV marker. The aim of this research was to determine if there were anti-EBV antibodies in the serum of the patients with the already verified nasopharyngeal malignant tumors, and, if there were, to determine the quantitative ratio to the values in the serum of the healthy controls. Methods. The study involved 74 individuals in the period from 1994−2001 divided into four groups: group A counting 11 patients with undifferentiated carcinome of nasopharyngeal type (UCNT); group B counting 25 patients with UCNT Xray treated at least three years before the onset of the study; group C including 28 healthy subjecets (blood donors), and the group D with 10 patients with planocellular nasopharyngeal carcinoma. Serologic diagnostics of the patients serum was performed using the techniques of Reedman and Klein for the detection of anti-EBV antibodies in the serum. Results. The presence of the statistically significantly higher values of the mean geometric titer (MGT) of the anti- EBNA antibodies was determined in 36 patients with histologically verified UCNT as compared with the control groups including 10 patients with planocellular carcinomas of the nasopharynx and 28 blood donors. Presented were anti-EBNA titers with 95% confidence interval for any participants according to the Hoo clinical classification of nasopharyngeal tumors, as well as according to the fact if they had been radiotreated within the previous three years. Conclusion. The results of this study confirm the conclusions of the recent literature on the possible etiopathogenesis of nasopharyngeal tumors and the use of viral anti-EBNA antibodies as viral markers in the diagnostics of UCNT diseases. .

Heat shock protein 70 (Hsp70) is frequently found on the plasma membrane of a large number of malignant tumors including non-small cell lung cancer (NSCLC) and gets released into the blood circulation in lipid vesicles. On the one hand a membrane (m)Hsp70-positive phenotype correlates with a high aggressiveness of the tumor, on the other hand, mHsp70 serves as a target for natural killer (NK) cells that had been pre-stimulated with Hsp70-peptide TKD plus low dose interleukin-2 (TKD/IL-2). Following activation, NK cells show an up-regulated expression of activatory C-type lectin receptors, such as CD94/NKG2C, NKG2D and natural cytotoxicity receptors (NCRs; NKp44, NKp46, NKp30) and thereby gain the capacity to kill mHsp70-positive tumor cells. With respect to these results, the efficacy of ex vivo TKD/IL-2 stimulated, autologous NK cells is currently tested in a proof-of-concept phase II clinical trial in patients with squamous cell NSCLC after RCT at the TUM. Inclusion criteria are histological proven, non-resectable NSCLC in stage IIIA/IIIB, clinical responses to RCT and a mHsp70-positive tumor phenotype. The mHsp70 status is determined in the serum of patients using the lipHsp70 ELISA test which enables the quantification of liposomal and free Hsp70. Squamous cell and adeno NSCLC patients had significantly higher serum Hsp70 levels than healthy controls. A significant correlation of serum Hsp70 levels with the gross tumor volume (GTV) was shown for adeno and squamous cell NSCLC. However, significantly elevated ratios of activated CD69+/CD94+ NK cells that are associated with low serum Hsp70 levels were observed only in patients with squamous cell lung cancer. These data might provide a first hint that the innate immune system might get activated by soluble Hsp70 in squamous cell but not adeno NSCLC.

The upstream stimulatory factors (USFs) are regulators of important cellular processes. Both USF1 and USF2 are supposed to have major roles in metabolism, tissue protection and tumor development. However, the knowledge about the mechanisms that control the function of USFs, in particular in tissue protection and cancer, is limited. Phosphorylation is a versatile tool to regulate protein functions. Thereby, phosphorylation can positively or negatively affect different aspects of transcription factor function including protein stability, protein-protein interaction, cellular localisation or DNA binding. The present review aims to summarize the current knowledge about the regulation of USFs by direct phosphorylation and the consequences for USF functions in tissue protection and cancer.

OBJETIVO: Diversos marcadores têm se mostrados promissórios como preditores do diagnóstico e prognóstico do mesotelioma maligno (MM). MÉTODO: Mediante estudo morfométrico e inmunomarcação de componentes estromais (calretinina, CEA, Leu-M1 e trombomodulina) e nucleares (p53 e Ki-67), avaliamos a sobrevida após o diagnóstico de 58 pacientes com tumores malignos de pleura. RESULTADOS: O padrão histológico típico do mesotelioma maligno foi encontrado em 50 casos e o padrão atípico em 8 casos. Imunohistoquimicamente foram confirmados 40 casos como sendo mesoteliomas, 11 como adenocarcimonas e 7 casos do padrão atípico não puderam ser classificados. A análise multivariavel do Cox demonstrou a coexistência de um maior fator de risco de morte (476.2), nos pacientes com idade avançada, subtipo histológico bifásico e componentes de expressão nuclear. CONCLUSÃO: A calretinina foi o marcador inmunohistoquímico (IHQ) mais útil para o diagnóstico do mesotelioma e o CEA para o de adenocarcinoma. A quantificação por IHQ da trombomodulina foi fundamental na diferenciação do mesotelioma quando este foi positivo tanto para calretinina e como para o CEA. A informação prognostica mais valiosa foi a fornecida pela análise rotineira histopatológica do tipo histológico tumoral. Um ponto importante, divisor natural, foi a idade com uma media de 55 anos e 30.5% de componentes nucleares de marcação IHQ, separando os pacientes em dois grupos: pacientes com uma sobrevivência curta contra pacientes com uma sobrevivência mais longa que a esperada. Assim, a análise histopatológica oferece uma arma poderosa e de elevado potencial para guiar no tratamento adjuvante de quimioterápicos após a retirada cirúrgica do mesotelioma.OBJECTIVE: Various markers have shown promise as diagnostic markers and prognostic predictors in malignant mesothelioma (MM). METHODS: Through morphometric and immunological studies of markers in stromal components (calretinin, CEA, Leu-M1 and thrombomodulin) and nuclear components (p53 and Ki-67), we evaluated post-diagnosis survival in 58 patients with MM. RESULTS: The histologic pattern of the MM was typical in 50 cases and atypical in 8. Through immunohistochemistry, we confirmed 40 cases of mesothelioma and 11 cases of adenocarcinoma, although we were unable to classify 7 of the 8 cases presenting atypical histologic patterns. Cox multivariate analysis revealed that the risk factor for death was higher (476.2) among patients of advanced age, presenting the biphasic subtype and testing positive for components expressed at the nuclear level. CONCLUSION: The most useful immunohistochemical markers were was calretinin (for mesothelioma) and CEA (for adenocarcinoma). Immunohistochemical quantification of thrombomodulin facilitated the diagnosis of mesothelioma in patients testing positive for both calretinin and CEA. The most useful prognostic information was that provided by the routine histopathological analysis of the tumor type. It is of note that the combination of a mean age of 55 years and 30.5% immunohistochemical markers in nuclear components created a natural dividing point between patients in which survival was shorter than expected and those in which it was longer than expected. Therefore, histopathological analysis offers a powerful weapon with great potential to inform decisions regarding the use of adjuvant chemotherapy after surgical excision of a mesothelioma.

Objective: To explore the clinical value of HE4 detection in the screening of endometrial carcinoma (EC) in atypical endometrial hyperplasia (AEH) patients diagnosed with curettage pathology. Methods: Between January 2011 and December 2014, the blood specimens were collected from the patients subjected to total hysterectomy with a preoperative biopsy diagnosis of AEH in Tianjin Central Hospital of Gynecology Obstetrics. Serum levels of HE4, CA125 and CA199 were detected by the electro-chemiluminescent immunoassay. According to the postoperative pathology, patients were divided into EC group and AEH group, and the differences of the tumor markers in the two groups were analyzed. Evaluate the diagnosis accuracy of the tumor markers by the area under the curve of receiver operating characteristic (ROC-AUC). Results: 31 cases were diagnosed with postoperative EC in all the 118 preoperative atypical endometrial hyperplasia patients. Their serum level of HE4, CA125 and CA199 were 73.4 pmol/L, 31.4 kU/L and 23.3 kU/L. 87 were still AEH after the operation, the serum level of above tumor marker were 44.3 pmol/L, 17.0 kU/L and 19.0 kU/L. The median levels of HE4, CA125 in EC group were significantly higher than those in AEH group, the difference was statistically significant (P＜0.05), while the CA199 level in the two groups was not statistically different (P＞0.05). The ROC-AUC of HE4 and CA125 were 0.785 and 0.706 respectively. The AUC and sensitivity of joint detection were 0.867 and 76.6%. Conclusions院Serum HE4 and CA125 levels in EC group were significantly higher than those in AEH group. Combined detection of HE4 and CA125 is helpful to discriminate EC in patients with a preoperative diagnosis of AEH. [ABSTRACT FROM AUTHOR]

About 90% of all breast cancers can be considered as sporadic, without inherited gene alteration. The rest of breast cancers (about 5 to 10%) are considered hereditary, most commonly caused by alterations of BRCA1/2 tumor suppressor genes. Lifetime risks for breast and ovarian cancers are increased among BRCA1/2 mutation carriers - 4 to 8 and 10 to 20 fold higher respectively. Due to the small proportion of hereditary form of disease, as well as to the high cost, BRCA testing is not screening test for general population. It is addressed to selected part of population that fit to recommended criteria. Full coding region sequencing of both genes is "gold standard" for detection of BRCA mutation. Concerning BRCA testing in Serbia, complete or partial sequencing of BRCA1/2 coding region was performed in 60 samples. The presence of 4 BRCA1 known mutations, previously detected elsewhere, has been shown: 185delAG, C61G, 3447del4 and 5382insC (detected twice). In BRCA1 gene, exon 16, an unclassified variant M1652I was found. Polymorphic variants in BRCA1 (8 polymorphisms) and BRCA2 (5 polymorphisms) genes were also detected. The majority of found BRCA1 and BRCA2 polymorphic variants are the missense ones and their influence on breast/ovarian cancer risk in our population has to be proved. Identification of BRCA mutations carriers and establishment of spectra and frequency of BRCA mutations should enable introduction of BRCA1/2 testing into the clinical practice of Serbia. .

PURPOSE: To analyze the correlation between p53 and bcl-2 expression and colorectal adenocarcinoma staging and prognosis. METHODS: This was a retrospective series of 125 colorectal adenocarcinoma patients (67 women and 58 men; ages 30-87 years) who underwent surgery with curative intent. The mean follow-up was 28.5 months (range: 2-96 months). TNM staging, tumor recurrence, survival and cancer-related mortality were analyzed. Immunoreactivity was evaluated using DO7 (Dako) for p53 and K492 (Dako) for bcl-2. Tumors with accumulation of staining for cytoplasmic bcl-2 or nuclear p53 in more than 10% of cells were considered positive. Statistical analysis utilized Pearson chi-squared, log-rank and Wilcoxon tests, and Kaplan-Meier survival estimation (significance level: p

Racional - O tratamento e o prognóstico dos pacientes com câncer gástrico dependem, principalmente, do estádio clínico. Os marcadores tumorais séricos e do lavado peritonial podem auxiliar a avaliar o risco de recurrência da doença. Casuística e Métodos - Quarenta pacientes com câncer gástrico (11 estádio I ou II e 29 estádio III ou IV) e 24 com doença benigna foram estudados prospectivamente. Todos os doentes foram submetidos a laparotomia. O sangue e o lavado peritonial foram colhidos durante o ato cirúrgico, antes da retirada do tumor, para determinação dos marcadores CEA e CA72-4. Resultados - Vinte e cinco por cento e 47,5% dos pacientes com câncer gástrico apresentam elevação dos níveis séricos de CEA e CA72-4. Através das curvas ROC definiram-se os valores de corte dos marcadores no lavado peritonial. Através destas curvas, observaram-se que 60% e 57,5% apresentavam CEA e CA72-4 elevado, respectivamente no grupo com câncer gástrico. Os valores de CEA e CA72-4 foram maiores nos pacientes estádios III e IV. No lavado peritonial, os níveis de CEA foram maiores nos doentes com tumores T3-4. Os valores de CA72-4 no lavado peritonial diferenciaram o grupo controle do grupo com câncer gástrico. Conclusão - O CA72-4 foi o marcador sérico mais sensível no diagnóstico de câncer gástrico. Entretanto, no lavado peritonial, o marcador mais sensível foi o CEA. Os valores de CEA foram superiores nos tumores que ultrapassam a serosa e inferiores nos tumores que se restringem a mucosa e muscular.Background - The treatment and the prognosis of gastric cancer patients depends mainly on clinical stage. Serum and peritoneal tumoral markers levels can be helpful to evaluate individual risk for recurrence. Aims - To evaluate the sensibility of the tumoral markers in the serum and in the peritoneal washing on diagnosis of gastric cancer. Patients and Methods - Forty patients with adenocarcinoma of the stomach (11 stage I or II and 29 III or IV) and 24 patients with benign diseases were studied prospectively. All of them were submitted to laparotomy. Blood and peritoneal washed was collected during surgery before tumoral resection, for determination of CEA and CA72-4. Results - CEA and CA 72-4 serum levels were elevated in 25% and 47,5% respectively. Through the curves ROC, we defined the cut-off values for the markers in washed peritoneal fluid. Through these values CEA and CA72-4 rose in 60% and 57.5% respectively. The values of CEA and of CA 72-4 in the serum and in washed peritoneal fluid were higher in cancer patients stage III and IV. CEA levels in the peritoneal washed fluid were higher in the patients with tumor T3-4. Washed peritoneal CA72-4 differed the control group from the cancer group. Conclusion - CA72-4 was the most sensitive marker in the serum of the patients with gastric cancer. Otherwise in the washing peritoneal fluid the most sensitive marker was CEA. These levels were higher in patients with surpass the serosa and lower in patients with mucosa or muscular tumors.

Background. Carcinoid tumors are distinct neuroendocrine neoplasms commonly located within the gastrointestinal tract and bronchopulmonary system. The aim of this case report was to present a patient with carcinoid tumor of the ovary as a less common form of this neoplasm. Case report. A 49 year old woman was admitted to the hospital with symptoms of diarrhea and abdominal pain and suspicion of neuroendocrine neoplasm, 4 month after bilateral salpingo-oophorectomy and total hysterectomy for ovarian tumor. Pathological diagnosis was typical for carcinoid tumor. At admission the patient had slightly eleveated levels of tumor marker CA 125 and highly elevated levels of 5- HIAA. Abdominal CT showed suspicious rest tumor in the pelvis. Relaparotomy was done and retroperitoneal fibrosis was found. Six months after the intervention the levels of 5-HIAA and CA 125 were normal, and NMR of the abdomen showed no signs of rest tumor. Conclusion. Carcinoid tumor of the ovary is rare form of ovarian tumors and less than 0.1% had malignant potential. Surgical therapy associated with a long-term follow up was the treatment of choice. Consideration of unusual sites of carcinoid tumors facilitates appropriate diagnosis and treatment.

Over the last decade, we have gained new insight into the pathophysiology of pancreatic cancer cachexia. Unfortunately, its treatment is complex and remains a challenge. Pancreatic cancer cachexia is a multifactorial syndrome characterized by uncompensated adipose tissue and skeletal muscle loss in the setting of anorexia that leads to progressive functional impairment. This paper will review the current concepts of pancreatic cancer cachexia, its assessment and pathophysiology as well as current and future treatments. The successful management of pancreatic cancer cachexia will likely require a multimodal approach that includes nutritional support and combination pharmaceutical interventions.

Introduction. Gastrointestinal stromal tumors are the most common mesenchymal tumors of the digestive tract. Leiomyosarcomas of the gastrointestinal tract are rare mesenchymal neoplasms which grossly and histologically resemble gastrointestinal stromal tumors. They may be differentiated from gastrointestinal stromal tumors by using immunohistochemistry and they are typically positive for α smooth muscle actin and desmin and negative for c-kit, CD34 and DOG1.1. They often express calponin and h-caldesmon. Case Report. We present a case of a 59-year-old male with anemia, weight loss, intermittent abdominal pain and right abdominal mass. Colonoscopy revealed an exophytic ulcerated neoplastic mass in the ascending colon and abdominal computed tomography scan showed an ill-defined heterogeneous tumor mass which surrounded almost the whole ascending colon. The patient underwent right hemicolectomy and partial resection of ileum. Histopathological examination revealed a leiomyosarcoma composed of atypical spindle cells positive for α smooth muscle actin, desmin and vimentin, and negative for c-kit, CD34, S100 and neuron specific enolase. The patient is alive 8 months after the operation, undergoing chemotherapy. Conclusion. We have concluded that the multimodal approach comprising chemotherapy and complete surgical resection controls the leiomyosarcomas. [ABSTRACT FROM AUTHOR]

Introduction. The systems of energy in surgery are applied in order to achieve better and more effective performing of procedures. Whereas various energy sources, including electricity, ultrasound, laser and argon gas, may be used, the fundamental principle involves tissue necrosis and hemostasis by heating. Electro Surgery. Electro Surgery is a surgical technique by which surgical procedures are performed by focused heating of the tissue using devices based on high-frequency currents. It represents one of the most frequently used energy systems in laparoscopy. Ultrasound Energy. The basic principle of operation of the ultrasound surgical instruments is the usage of low-frequency mechanic vibrations (ultrasound energy within the range of 20-60 kHz) for cutting and coagulation of tissue. Laser. Laser is the abbreviation for Light Amplification by Stimulated Emission of Radiation, aimed at increasing light by stimulated emission of radiation and it is the name of the instrument which generates coherent beam of light. Argon Plasma Coagulation. It has been in use since 1991 for endoscopic hemostasis. It uses highfrequency electric current and ionized gas argon. The successful application of devices depends on the type of surgical procedure, training of the surgeon and his knowledge about the device. Surgeons do not agree on the choice of device which would be optimal for a certain procedure. Conclusion. The whole team in the operating room must have the basic knowledge of the way an energy system works so as to provide a safe and effective treatment of patients. The advantages and shortcomings of different systems of energy have to be taken into account while we use a special mode. [ABSTRACT FROM AUTHOR]

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Voltage-dependent K+ channels (Kv) are involved in a number of physiological processes, including immunomodulation, cell volume regulation, apoptosis as well as differentiation. Some Kv channels participate in the proliferation and migration of normal and tumour cells, contributing to metastasis. Altered expression of Kv1.3 and Kv1.5 channels has been found in several types of tumours and cancer cells. In general, while the expression of Kv1.3 apparently exhibits no clear pattern, Kv1.5 is induced in many of the analyzed metastatic tissues. Interestingly, evidence indicates that Kv1.5 channel shows inversed correlation with malignancy in some gliomas and non-Hodgkin’s lymphomas. However, Kv1.3 and Kv1.5 are similarly remodelled in some cancers. For instance, expression of Kv1.3 and Kv1.5 correlates with a certain grade of tumorigenicity in muscle sarcomas. Differential remodelling of Kv1.3 and Kv1.5 expression in human cancers may indicate their role in tumour growth and their importance as potential tumour markers. However, despite of this increasing body of information, which considers Kv1.3 and Kv1.5 as emerging tumoral markers, further research must be performed to reach any conclusion. In this review, we summarize what it has been lately documented about Kv1.3 and Kv1.5 channels in human cancer.

By combining the expertise of clinical neuroscience, the aim of neuro-oncology is to optimize diagnostic planning and therapy of primary brain tumors in an interdisciplinary setting together with radio-oncology and medical oncology. High-end imaging frequently allows brain tumors to be diagnosed preoperatively with respect to tumor entity and even tumor malignancy grade. Moreover, neuroimaging is indispensable for guidance of biopsy resection and monitoring of therapy. Surgical resection of intracranial lesions with preservation of neurological function is increasingly feasible. Tools to achieve this goal are, for example neuronavigation, functional magnetic resonance imaging (fMRI), tractography, intraoperative cortical stimulation and precise intraoperative definition of tumor margins by virtue of various techniques. In addition to classical histopathological diagnosis and tumor classification, modern neuropathology is supplemented by molecular characterization of brain tumors in order to provide clinicians with prognostic and predictive (of therapy) markers, such as codeletion of chromosomes 1p and 19q in anaplastic gliomas and O6-methylguanine-DNA methyltransferase (MGMT) promoter methylation in glioblastomas. Although this is not yet individualized tumor therapy, the increasingly more detailed analysis of the molecular pathogenesis of an individual glioma will eventually lead to specific pharmacological blockade of disturbed intracellular pathways in individual patients. This article gives an overview of the state of the art of interdisciplinary neuro-oncology whereby part 1 deals with the diagnostics and surgical therapy of primary brain tumors and part 2 describes the medical therapy of primary brain tumors. [ABSTRACT FROM AUTHOR]

Purpose: Since there are no proven tumor markers that reflect the course of gastric cancer, carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9) are commonly used alternatives. However, the degree of progression that corresponds to an increase in these markers, and the values of these markers at different cancer stages, remains unclear. Materials and Methods: This study enrolled 1,733 gastric cancer patients who underwent surgery and whose pre-operative CEA and CA19-9 levels were known. Survival curves and mean values of the two markers were compared according to the degree of cancer progression: serosa-unexposed (SU), serosa-exposed (SE), direct invasion (DI), localized seeding (P1), and extensive seeding (P2). Results: The 5-year overall survival rates at each stage differed significantly, except between DI and P1 patients (17.1% vs. 10.5%, P=0.344). The mean CEA values in SU, SE, DI, P1, and P2 patients were 5.80, 5.48, 13.36, 8.06, and 22.82, respectively. The CA19-9 values for these patients were 49.40, 38.97, 101.67, 73.77, and 98.57, respectively. The increase in CEA in P2 patients was statistically significant (P=0.002), and the increases in CA19-9 in DI and P2 patients were significant (P=0.025, 0.007, respectively). There was a fair correlation between the two markers in P2 patients (r=0.494, P<0.001). Conclusions: CA19-9 can be used to assess DI of gastric cancer into adjacent organs. Both markers are useful for predicting the presence of extensive peritoneal seeding. [ABSTRACT FROM AUTHOR]