Predictive value of HER-2 and Topoisomerase IIalpha in response to primary doxorubicin in breast cancer

AimTo study the predictive role of HER-2 and Topoisomerase IIα (TOP2A) in response to primary doxorubicin.MethodsTwo hundred and thirty-two patients with operable breast cancer were treated with doxorubicin prior to surgery. ER, PgR, grade, Ki-67 and HER-2 status were prospectively assessed. HER-2 overexpression was evaluated with immunohistochemistry; positive cases were then studied for gene copy number of HER-2, TOP2A and chromosome 17 centromere by chromogenic in situ hybridisation. Clinical response was assessed by mammography. Pathological response was evaluated as the percentage of tumour replaced by changes due to chemotherapy.ResultsHER-2 amplification was associated with clinical response (p = 0.04). ER and PgR negativity, high Ki-67 and HER-2 amplification significantly correlated to pathological response (p < 0.05). Tumours with coamplification of HER-2 and TOP2A showed a higher percentage of pathological changes (p = 0.6). However, in the multivariate analysis for complete pathological response, ER negativity and high Ki-67 index were the only parameters that maintained statistical significance.ConclusionHER2 and Topoisomerase IIα amplification failed to show an association with pathological response to doxorubicin, whereas ER negativity and a high proliferation rate were predictive of complete pathological response to this regime.     

Plasma and dietary carotenoid, retinol and tocopherol levels and the risk of gastric adenocarcinomas in the European prospective investigation into cancer and nutrition

Despite declining incidence rates, gastric cancer (GC) is a major cause of death worldwide. Its aetiology may involve dietary antioxidant micronutrients such as carotenoids and tocopherols. The objective of this study was to determine the association of plasma levels of seven common carotenoids, their total plasma concentration, retinol and alpha- and gamma-tocopherol, with the risk of gastric adenocarcinoma in a case-control study nested within the European Prospective Investigation into Cancer and Nutrition (EPIC), a large cohort involving 10 countries. A secondary objective was to determine the association of total sum of carotenoids, retinol and alpha-tocopherol on GCs by anatomical subsite (cardia/noncardia) and histological subtype (diffuse/intestinal). Analytes were measured by high-performance liquid chromatography in prediagnostic plasma from 244 GC cases and 645 controls matched by age, gender, study centre and date of blood donation. Conditional logistic regression models adjusted by body mass index, total energy intake, smoking and Helicobacter pylori infection status were used to estimate relative cancer risks. After an average 3.2 years of follow-up, a negative association with GC risk was observed in the highest vs the lowest quartiles of plasma beta-cryptoxanthin (odds ratio (OR) = 0.53, 95% confidence intervals (CI) = 0.30-0.94, P(trend) = 0.006), zeaxanthin (OR = 0.39, 95% CI = 0.22-0.69, P(trend) = 0.005), retinol (OR = 0.55, 95% CI = 0.33-0.93, P(trend) = 0.005) and lipid-unadjusted alpha-tocopherol (OR = 0.59, 95% CI = 0.37-0.94, P(trend) = 0.022). For all analytes, no heterogeneity of risk estimates or significant associations were observed by anatomical subsite. In the diffuse histological subtype, an inverse association was observed with the highest vs lowest quartile of lipid-unadjusted alpha-tocopherol (OR = 0.26, 95% CI = 0.11-0.65, P(trend) = 0.003). These results show that higher plasma concentrations of some carotenoids, retinol and alpha-tocopherol are associated with reduced risk of GC.     

Trans obturator tape (TOT) for female stress incontinence. Experience with three years follow-up in 200 patients

ObjectiveTo evaluate the security and effectiveness of the TOT in the female incontinence surgical treatment according to our experience.Patient and MethodProspective study of 200 patients underwent TOT at Gynecology Unit of the Obstetrics and Gynecology Department in Barros Luco-Trudeau Hospital between January 2003 and October 2006. Polypropilene, macropore, mofilament mesh (Prolene) was used. The mean age was 52 years old, parity 3.ResultsThe mean surgical time of TOT was 15 minutes. In 184 (92%) patients obtained cure, 6 (3%) improvement and 10 (5%) fails. Three cases of bladder injury occurred (one perforation with the scissor and two with TOT needle during the learning phase). During the immediately postoperative time: one case of partial urethral obstruction, two cases of urinary infection and three with pain of the legs. During the delayed postoperative time a case of fail was observed after trauma.ConclusionAccording to our experience with 200 cases, the TOT appears as a safe and effective technique in the surgical treatment of the stress urinary incontinence.