German translation and external validation of the Radboud Skills Questionnaire in patients suffering from Complex Regional Pain Syndrome 1

Background  

Patients suffering from Complex Regional Pain Syndrome commonly complain of substantial limitations in their activities of daily living. The Radboud Skills Questionnaire measures alterations in the level of disability of patients with Complex Regional Pain Syndrome, but this instrument is currently not available in German. The goals of our study were to translate the Dutch Radboud Skills Questionnaire into German and to assess its external criterion validity with the German version of the Disabilities of the Arm, Shoulder and Hand Questionnaire.     

Is periprostatic adipose tissue associated with aggressive tumor biology in prostate cancer?

The prevalence of overweight and obesity and their health-related problems have been increasing.Obesity is increasingly recognized as a risk factor in different types of cancer in humans.The mechanisms supporting the link between obesity and cancer development have not been fully understood.Leptin,a circulating cytokine produced by adipocytes,may influence prostate cancer(PCa)progression in different ways.Body mass index seems to be an unreliable predictor for the development of PCa,but its influence on progression and poor oncological outcomes seems to be clear.Given the fact that abdominal fat is the most metabolically active fat,with different metabolic and paracrine effects,related anthropometric measurements may lead to a better estimation of PCa risk.Metabolically active periprostatic abdominal fat may also play an important role in releasing cytokines and growth factors that may promote tumor cell proliferation or even create a favorable environment for aggressive tumor biology.Different imaging measurements,e.g.,periprostatic adipose tissue(PPAT)thickness,may be significant predictors of PCa.Several genes in the PPAT of obese men have been identified to contribute to chronic immuno-inflammatory responses which eventually lead to cell cycle alterationwith oncological potential.In vitro studies showed the importance of PCa and its interaction with its microenvironment particularly in patients with aggressive PCa.Different types of cytokines,such as interleukin-6,may promote a tumorigenic microenvironment.This article endeavors to review the current literature on the association of PPAT with aggressive tumor biology in PCa.     

The predictive impact of body mass index on the efficacy of extended adjuvant endocrine treatment with anastrozole in postmenopausal patients with breast cancer: an analysis of the randomised ABCSG-6a trial

Background:

We investigated whether body mass index (BMI) can be used as a predictive parameter indicating patients who benefit from extended aromatase inhibitor (AI) treatment.

Methods:

The ABCSG-6a trial re-randomised event-free postmenopausal hormone receptor-positive patients from the ABCSG-6 trial to receive either 3 additional years of endocrine therapy using anastrozole vs nil. In this retrospective analysis, we investigated the prognostic and predictive impact of BMI on disease outcome and safety.

Results:

In all, 634 patients (177 normal weight, 307 overweight, and 150 obese) patients were included in this analysis. Normal weight patients with additional 3 years of anastrozole halved their risk of disease recurrence (disease-free survival (DFS) HR 0.48; P=0.02) and death (HR 0.45; P=0.06) and had only a fifth of the risk of distant metastases (HR 0.22; P=0.05) compared with normal weight patients without any further treatment. In contrast, overweight+obese patients derived no benefit from additional 3 years of anastrozole (DFS HR 0.93; P=0.68; distant recurrence-free survival HR 0.91; P=0.78; and OS HR 0.9; P=0.68). The possible predictive impact of BMI on extended endocrine treatment could be strengthened by a Cox regression interaction model between BMI and treatment (P=0.07).

Conclusion:

Body mass index may be used to predict outcome benefit of extended AI treatment in patients with receptor-positive breast cancer.     

Correlation of body mass index and menopausal status with the intra-tumoral estrogen system in invasive breast cancer

Objective. Obesity increases breast cancer risk in post-menopausal women. This is, in part, due to elevated non-glandular aromatase activity, resulting in higher estradiol serum levels. We tested the hypothesis that obesity and menopausal status influence the intra-tumoral estrogen system of breast cancer tissue.

Design. Breast cancer tissue and fasting serum were collected from 26 female patients. After microdissection of the frozen samples, RNA was isolated, and expression of estrogen receptor (ER)α, ERβ1, ERβ2, ERβ5, CYP19 aromatase and steroid sulfatase was measured on mRNA level by means of real time RT-PCR. Fasting estradiol serum levels were analysed by ELISA.

Results. Post-menopausal women older than 70 years exhibited a significantly higher expression both of steroid sulfatase and ERα than did pre-menopausal women younger than 50 years. We identified a significant positive correlation between body mass index (BMI) and lymphovascular/vascular invasion. A significant inverse correlation between ERα and ERβ2 expression was identified in invasive breast cancer tissue irrespective of BMI or menopausal status.

Conclusion. In conclusion, we report an association between menopausal status – but not BMI – and the intra-tumoral expression of steroid sulfatase and ERα. Our observation that BMI was associated with invasiveness supports the hypothesis that metabolic factors are able to affect essential features of breast cancer.     

Causality and functional relevance of BRCA1 and BRCA2 pathogenic variants in non-high-grade serous ovarian carcinomas

The identification of causal BRCA1/2 pathogenic variants (PVs) in epithelial ovarian carcinoma (EOC) aids the selection of patients for genetic counselling and treatment decision-making. Current recommendations therefore stress sequencing of all EOCs, regardless of histotype. Although it is recognised that BRCA1/2 PVs cluster in high-grade serous ovarian carcinomas (HGSOC), this view is largely unsubstantiated by detailed analysis. Here, we aimed to analyse the results of BRCA1/2 tumour sequencing in a centrally revised, consecutive, prospective series including all EOC histotypes. Sequencing of n = 946 EOCs revealed BRCA1/2 PVs in 125 samples (13%), only eight of which were found in non-HGSOC histotypes. Specifically, BRCA1/2 PVs were identified in high-grade endometrioid (3/20; 15%), low-grade endometrioid (1/40; 2.5%), low-grade serous (3/67; 4.5%), and clear cell (1/64; 1.6%) EOCs. No PVs were identified in any mucinous ovarian carcinomas tested. By re-evaluation and using loss of heterozygosity and homologous recombination deficiency analyses, we then assessed: (1) whether the eight ‘anomalous’ cases were potentially histologically misclassified and (2) whether the identified variants were likely causal in carcinogenesis. The first ‘anomalous’ non-HGSOC with a BRCA1/2 PV proved to be a misdiagnosed HGSOC. Next, germline BRCA2 variants, found in two p53-abnormal high-grade endometrioid tumours, showed substantial evidence supporting causality. One additional, likely causal variant, found in a p53-wildtype low-grade serous ovarian carcinoma, was of somatic origin. The remaining cases showed retention of the BRCA1/2 wildtype allele, suggestive of non-causal secondary passenger variants. We conclude that likely causal BRCA1/2 variants are present in high-grade endometrioid tumours but are absent from the other EOC histotypes tested. Although the findings require validation, these results seem to justify a transition from universal to histotype-directed sequencing. Furthermore, in-depth functional analysis of tumours harbouring BRCA1/2 variants combined with detailed revision of cancer histotypes can serve as a model in other BRCA1/2-related cancers. © 2023 The Authors. The Journal of Pathology published by John Wiley & Sons Ltd on behalf of The Pathological Society of Great Britain and Ireland.     

B超诊断老年性白内障及合并症价值

０引言老年性白内障严重影响着老年人的生活质量．手术是根治本病的最佳方法．现将我院１９９８－０１～１９９８－１１经Ｂ超检查并经手术证实的１２９例,共２５８只眼,２２３只老年性白内障的结果及声像图特点报告如下．旨在探讨Ｂ超在诊断该病中的应用价值及对手术的...