bluuebunny/crossref_metadata_2025_split huggingface dataset:
Expression of Cystatin C in Human Esophageal Cancer
Authors: Zeng Qinghong , Zhao Yonggang , Yang Yuxian , Zheng Guiyu , Wang Gefei , Zhang Peng , Cui Youhong , Su Shaobo , Li Kangsheng 
Published: February 2018

Aims and background Cystatin C is a member of the cysteine protease inhibitors and its function is to decrease protease activity. A recent study showed that it was aberrantly expressed in many malignant tumors in association with tumor invasion and metastasis. We attempted to detect its expression in esophageal cancer tissues and adjacent reparative normal tissues. Methods and design Samples of cancers and non-cancerous esophageal tissues were obtained as matched pairs from 30 surgery patients with esophageal cancer and paraffin embedded. The expression of cystatin C in tissues was investigated by immunohistochemistry. Fisher's exact test was used to analyze the relationship between esophageal cancer tissues and adjacent normal tissues. Furthermore, mRNA was extracted, and reverse transcriptase polymerase chain reaction was performed. Results The intensity of cystatin C immunostaining in tumor tissues was increased compared to that of adjacent normal tissues. mRNA expression of the cystatin C gene was greater in esophageal cancer than in normal tissues (P <0.05). Conclusions Our results indicate that cystatin C may play an important role in the pathogenesis and metastasis of esophageal cancer.
Successful Treatment with GEMOX in Patient with Metastatic Pancreatic Adenosquamous Carcinoma
Authors: Aurilio Gaetano , Macarulla Teresa , Ramos Javier Francisco , Fazio Nicola , Nolè Franco , Iglesias Carmela 
Published: February 2018

Background Pancreatic adenosquamous carcinoma (PASC) is a rare subtype of pancreatic cancer characterized by a dual histological component and aggressive behavior. This form is not well known, its histogenesis is uncertain, and there are different opinions on the diagnostic histopathological criteria. The differential diagnosis with more common ductal adenocarcinoma, squamous cell carcinoma, squamous or adenosquamous metastases is complex. The available therapies do not improve the poor prognosis and it is difficult to find long-term survivors (more than 1 year), even after demolitive surgery with complementary therapies. Case report We report a case of advanced PASC with excellent progression-free survival and overall survival, 20 months and 29 months, respectively. Furthermore, an almost complete response was obtained to first-line chemotherapy with gemcitabine/oxaliplatin (GEMOX) followed by maintenance gemcitabine. Conclusion GEMOX followed by gemcitabine as maintenance could be an effective treatment for this pancreatic entity. Further reports are needed to confirm this outcome.
Concurrence of UGT1A Polymorphism and End-Stage Renal Disease Leads to Severe Toxicities of Irinotecan in a Patient with Metastatic Colon Cancer
Authors: Huang Sung-Hao , Chao Yee , Wu Ying-Ying , Luo Jiing-Chyuan , Kao Chien-Hui , Yen Sang-Hue , Li Chung-Pin 
Published: February 2018

Aims and background Colorectal cancer is one of the most common malignancies in the world, and irinotecan (CPT-11) is useful in its treatment. However, the safety and pharmacokinetics of irinotecan in dialysis patients with metastatic colorectal cancer are unclear. Case report We report the case of a 74-year-old man receiving chronic hemodialysis who had metastatic colorectal cancer. Palliative chemotherapy with irinotecan (80 mg/m2 weekly) was administered after hemodialysis. Blood samples were collected before and 1.5, 3, 6, 9, and 15 hours after administration of irinotecan. The peak serum concentrations (Cmax) of irinotecan and SN-38 in this patient were 1, 480 and 17.8 ng/mL, respectively, which were similar to the reported values in patients with normal renal function after a similar dose of irinotecan (75 mg/m2). The area under the serum concentration-time curve (AUC0-∞) was 8, 240 ng×h/mL for irinotecan and 619 ng×h/mL for SN-38. The AUC0-∞ for SN-38 was markedly higher than that for patients with normal renal function. Sequencing analysis of the UGT1A genes found that the patient had variant alleles of UGT1A1*28, UGT1A1*60 and UGT1A9*22, which may lead to decreased glucuronidation and excretion of SN-38, and may account for increased irinotecan-related toxicity. The patient developed febrile grade 4 neutropenia on day 7 after chemotherapy and died of septic shock on day 14. Conclusions UGT1A polymorphisms and renal failure may lead to accumulation of SN-38, which may have played a role in the death of this patient. Irinotecan should be used cautiously in dialysis patients with metastatic colorectal cancer and screening for UGT1A polymorphisms may help in identifying patients with lower SN-38 glucuronidation rates and greater susceptibility to irinotecan-induced toxicity.
The interaction between antioxidant status and cervical cancer: A case control study
Authors: Demirci Senem , Ozsaran Zeynep , Celik Handan Ak , Aras Arif Bulent , Aydin Hikmet Hakan 
Published: February 2018

Aims and background To compare the antioxidant status of cervical cancer patients with healthy controls and to assess the antioxidant levels before and after radiotherapy or radiochemotherapy Methods and study design Antioxidant levels (glutathione, glutathione peroxidase, superoxide dismutase, and malondialdehyde) were measured in 35 patients with cervical cancer and 35 age-matched healthy controls. Blood samples were collected twice (before and after treatment) from cervical cancer patients and once from healthy control subjects. Results In the patient group, pre-radiotherapy glutathione and glutathione peroxidase levels were significantly lower (P<0.01 and P<0.0001, respectively) than the control group. Pre-radiotherapy levels of superoxide dismutase were significantly higher in cancer patients (P<0.01). In general, no difference was observed between pre- and post-radiotherapy antioxidant levels in cancer patients. However, when post-radiotherapy glutathione levels were analyzed, patients who did not respond to treatment had significantly higher levels than those who did respond (P <0.01). Conclusions Levels of antioxidants significantly differed between the patients with cervical cancer and the controls, and no change in antioxidant levels was observed after treatment. Moreover, further studies evaluating the predictive value of glutathione levels on treatment response are warranted.
Laparoscopic-assisted total gastrectomy for adenocarcinoma in a western country: Safety and oncological issues
Authors: Fiscon Valentino , Portale Giuseppe , Migliorini Giovanni , Frigo Flavio 
Published: February 2018

Background Laparoscopic total gastrectomy for adenocarcinoma is a widely diffused operation in eastern countries, but there are only a few reports from western centers. We assessed a single surgeon's experience at a single, nonacademic, community hospital. Methods Short-term outcome of patients undergoing laparoscopic total gastrectomy for adenocarcinoma (June 2005-March 2010) was assessed. Results Fourteen patients (5 males, 9 females; median age, 66.8 years [interquartile range, 59.7–71.8]) underwent laparoscopic total gastrectomy. The median operative time was 240 min. There were five stage 1 patients, five stage 2, and four stage 3; R0 resection was obtained in all 14 patients, and the median number of lymph nodes retrieved was 38. Mortality and overall morbidity rates were 0% and 35.7%, respectively. Conclusions The outcomes of laparoscopic total gastrectomy for adenocarcinoma performed by a well-trained laparoscopic surgeon working in a community hospital are good in terms of safety for the patients and response to the oncological criteria used in open surgery.
Evaluation of lymphatic compensation by lymphoscintigraphy in the postoperative period of breast cancer surgery with axillary dissection
Authors: De Rezende Laura Ferreira , Pedras Felipe Villela , Ramos Celso Dario , Gurgel Maria Salete Costa 
Published: February 2018

Objective To evaluate postoperative lymphatic compensation in the upper limb after mastectomy with axillary dissection. Subjects and methods Twenty-three patients who underwent lymphoscintigraphy before and 60 days after surgery were enrolled from September 2006 to June 2007, in Campinas, Brazil. Protocol examination consisted in static imaging of each upper limb in semi-flexion and thoracic imaging after 10 min and 1 and 2 hr after subcutaneous injection of 1 mCi (37 MBq) of 99mTc dextran into the dorsum of the hand. A comparative analysis was made of hepatic uptake of the radiopharmaceutical, velocity of axillary lymph node visualization (I, visible at 10 min; II, at 1 hr; III, at 2 hr; IV, not visible) and degree (intensity) of uptake (a, marked; b, moderate; c, mild; d, absent) before and 60 days after surgery. Results In the preoperative period, 3 (13%) patients were considered to have an optimal pattern (Ia) and 2 (9%) showed total involvement (IVd). Compared to velocity in the postoperative period, 9 (39%) patients showed no difference, 5 (22%) improved, 9 (39%) became worse, and one was considerably worse. Regarding the degree, 10 (43%) patients showed no difference, 9 (39%) became worse, and 4 (17%) improved. Regarding classification, 2 (9%) patients had an optimal lymphatic pattern (Ia) and 3 (13%) had total involvement (IVd). No patient presented decreased hepatic uptake after surgical treatment. Conclusions The study found relevant changes in preoperative and postoperative lymphoscintigraphy, demonstrating the existence of functional differences in the lymphatic system of the upper limb. Alterations in lymphatic drainage pattern may already be perceived 60 days postoperatively, as can signs of lymphovenous anastomoses.
Pharmacogenetics of escitalopram and mental adaptation to cancer in palliative care: Report of 18 cases
Authors: Schillani Giulia , Capozzo Maria Anna , Era Daniel , De Vanna Maurizio , Grassi Luigi , Conte Maria Anna , Giraldi Tullio 
Published: February 2018

Aims and background In palliative care, few data are available on the diagnosis and treatment of mood disorders and of difficulties of mental adaptation to cancer for patients in the advanced phases of the disease. SSRI antidepressants are the treatment of choice; the 5-HTTLPR genetic polymorphism of the serotonin transporter (SERT) has been shown in psychiatry to significantly determine the therapeutic response and the incidence of adverse effects. The aim of the present investigation has been therefore to examine the effects of the SSRI antidepressant escitalopram, also considering 5-HTTLPR, on depression, anxiety and mental adaptation to cancer in palliative care. Methods and study design Eighteen consecutive depressed patients with different forms of advanced cancer admitted to the Hospice Ass 6 of S. Vito al Tagliamento (Pordenone, Italy) were genotyped for the “s” and “l” variants of 5-HTTLPR and were treated with escitalopram. Their response after two weeks of treatment was psycho-metrically evaluated. Results Treatment with escitalopram significantly decreased anxiety scores on the Hospital Anxiety and Depression Scale (HADS) (P = 0.006) as well as anxious preoccupation (P = 0.007) and hopelessness-helplessness (P = 0.017) scores on the Mini Mental Adjustment to Cancer (Mini-MAC) scale. When patients were stratified by SERT genotype, HADS anxiety was significantly decreased in patients carrying the “s/s” and “s/l” variants (P = 0.024), whereas those with an “l/l” genotype displayed a significant reduction of Mini-MAC anxious preoccupation (P = 0.018). Conclusions The results of this study indicate that the use of SSRI antidepressants is effective in the palliative care of cancer patients, and their action affects not only depression but also the patients' mental adaptation to the disease. These results encourage further examination of these drugs in a larger cohort of patients. The significant contribution of pharmacogenetics indicates the possibility of personalized treatment with SSRIs in palliative care.
An investigation into the combined effect of static magnetic fields and different anticancer drugs on K562 cell membranes
Authors: Liu Ying , Qi Hao , Sun Run-Guang , Chen Wen-Fang 
Published: February 2018

Aims and background Cell membranes were shown to be sensitive to and affected by static magnetic fields (SMF). Methods Cells were treated with four anticancer drugs followed by treatment with a combination of drugs and SMF. Individual cells were examined using atomic force microscopy (AFM). The drugs were taxol (alkaloid), doxorubicin (anthracycline), cisplatin (platinum compound) and cyclophosphamide (alkylating agent). Results Holes were observed in cells exposed to SMF but not in control groups. The number, size and shape of the holes were dependent on the drug type, SMF parameters and the duration of exposure. Conclusions The results suggest that the application of a SMF could alter membrane permeability, increasing the flow of the anticancer drugs. This may be one of the reasons why SMF can strengthen the effect of anticancer drugs. Observations were also made of the effect of using different anticancer drugs. For example, the effect of SMF combined with taxol or cyclophosphamide on the cells was additive while the effect of SMF combined with cisplatin or doxorubicin was synergistic. The target sites of cisplatin and doxorubicin are nucleic acids; continued research is required into this important area to ascertain the effect of SMF on nucleic acids.
Low-dose epirubicin inhibits ezrin-mediated metastatic behavior of breast cancer cells
Authors: Ma Li , Liu Yue-Ping , Geng Cui-Zhi , Xing Ling-Xiao , Zhang Xiang-Hong 
Published: February 2018

Aims and background Overexpression of ezrin contributes to the progression and invasiveness of several human cancers; however, its role in breast cancer metastasis has not been investigated in detail. Methods Ezrin expression in tissue samples from patients with invasive ductal carcinoma of the breast was detected by immunohistochemistry. Ezrin expression in a breast cancer cell line was evaluated using Western blot and RT-PCR. Results Elevated expression of ezrin was associated with lymph node metastasis and poor prognosis in patients with invasive ductal carcinoma. Ezrin expression was related to the invasiveness of breast cancer cells in vitro. Low-dose epirubicin inhibited the migration of breast cancer cells in a concentration-dependent manner without promoting cytotoxicity in vitro and decreased the expression of ezrin in a concentration-dependent manner. Conclusions Low-dose epirubicin may be antimetastatic without promoting cytotoxic effects and could serve as a target for the development of therapeutics for breast carcinoma.
Evidence of interval cancer proportional incidence and review from mammography screening programs in Italy
Authors: Ciatto Stefano , Bernardi Daniela , Caumo Francesca 
Published: February 2018

Purpose To summarize the existing evidence on the proportional incidence and review of interval cancers, as reported by Italian screening programs. Material and methods Literature search of published reports on: a) proportional incidence, determined according to breast cancers expected in the absnce of screening and estimated on the basis of patients/year at risk and age-specific incidence; and b) review of screening mammograms preceding interval cancers. Results were compared with European Commission recommended standards. Results Evidence on proportional incidence or review of interval cancers was reported by 37 and 24 local health unit programs, respectively. Compared to European Commission standards, 94% and 87% of programs complied at first interval cancers survey with recommended standards for proportional incidence or screening error rate at review, respectively. Two programs initially below acceptable standards reached satisfactory results at repeat evaluation over time. Conclusions Although they are a minority (20%) of all local health unit programs, which suggests a possible selection bias, Italian surveys reporting data on the proportional incidence or review of interval cancers show an overall good performance. Interval cancer survey appears feasible in any program and should become a routine procedure within the national quality control system.
Use of metronomic chemotherapy in oncology: Results from a national Italian survey
Authors: Collovà Elena , Sebastiani Federica , De Matteis Elisabetta , Generali Daniele , Aurilio Gaetano , Boccardo Francesco , Crispino Sergio , Cruciani Giorgio 
Published: February 2018

Aims and background Metronomic chemotherapy refers to the administration of low doses of cytotoxic agents over a prolonged period of time with no or only short drug-free intervals. It is designed to overcome acquired tumor resistance to chemotherapy and reduce neo-angiogenesis despite a lower toxicity than with standard chemotherapy. The role of metronomic chemotherapy remains controversial, and its optimal therapeutic use has not yet been defined. Methods and study design The present survey was designed as a short questionnaire and was sent to the medical oncologists registered with Medikey, a national database listing all the Italian oncology specialists linked with the Italian Council of Medical Oncology Hospital Consultants (Collegio Italiano Primari Oncologi Medici Ospedalieri, CIPOMO) and the Italian Association of Medical Oncology (Associazione Italiana di Oncologia Medica, AIOM). The questionnaire was completed on a voluntary basis and it was totally anonymous. Results The questionnaire was sent to 3,289 oncologists, and 191 (5.8%) actively participated in the survey. Seventy-two percent of responders declared that they had administered a regimen of metronomic chemotherapy at least once. Metronomic chemotherapy is commonly used in advanced breast cancer patients, and inmost cases it was prescribed after failure of at least two lines of treatment. Oral agents such as cyclophosphamide, capecitabine, methotrexate and vinorelbine were the most commonly prescribed drugs. Nearly 60% of responders was believed to have significantly less toxicity with metronomic chemotherapy than with standard chemotherapy. Conclusions The sample of oncologists who participated in the survey is small but it appears to be representative of the Italian medical oncology community. The answers to the questionnaire indicate a significant interest in metronomic chemotherapy, which is apparently widely prescribed. This is the first large national survey on the use of metronomic chemotherapy. Considering the results, larger research on metronomic chemotherapy is strongly warranted.
Trimodality treatment in patients with superior sulcus tumors: Hopes and realities
Authors: Kocak Zafer , Saynak Mert , Uygun Kazim , Yoruk Yener , Ozen Alaattin , Sut Necdet , Altiay Gundeniz , Caloglu Murat , Karamustafaoglu Altemur , Usta Ufuk , Karagol Hakan , Hatipoglu Osman N 
Published: February 2018

Aims and background In late 2001 at our institution, we started offering induction radiochemotherapy as a treatment option for superior sulcus tumors. Our aim was to evaluate treatment choices and outcome in this patient group treated over the past 7 years at our institution. Methods The records of 34 patients were retrospectively reviewed and 33 were assessable for the analysis. Results Twenty of 28 patients with M0 disease had operable disease. The induction radiochemotherapy for superior sulcus tumors was possible in about two-thirds (14/20) of the cases with operable disease, with only one-third (5/14) of these having undergone surgery. The most common reason for not proceeding to surgery following induction radiochemotherapy was patient refusal (n = 5). The median follow-up of all 33 patients was 17 months. In curatively treated patients with (n = 11) or without surgery (n = 15), the median overall survival time was 26 months (range, 10–26) and 26 months (range, 7–71), respectively (P = 0.534). Local-regional and/or distant failure developed in 20 of 26 patients treated curatively. In patients treated with the trimodality regimen (n = 5), no local-regional failure was observed, and distant failure occurred in one case. Conclusions The trimodality treatment was possible in 25% of cases with operable disease due to the high rate of patient refusal to proceed to surgery following induction radiochemotherapy. No difference in survival was observed between patients treated with surgery and those treated with radiochemotherapy only because of a limited follow-up. So, the benefit of additional surgery is not clear, and a longer follow-up is needed before final conclusions can be drawn.
Primary small cell carcinoma of the breast: Report of seven cases and review of the literature
Authors: Kanat Ozkan , Kilickap Saadetin , Korkmaz Taner , Oven Bala Basak Ustaalioglu , Canhoroz Mustafa , Cubukcu Erdem , Tolunay Sahsine , Evrensel Turkkan , Manavoglu Osman 
Published: February 2018

Aims and background The aim of the study was to analyze the clinicopathological characteristics, treatment modalities, and clinical outcome of patients with primary small cell carcinoma of the breast. Methods Fifty-three cases of primary small cell carcinoma of the breast were identified; 7 cases in this series and 46 from the English-language medical literature. Results There were 52 females and 1 male. The mean age was 53 years. Tumor size ranged from 1 to 18 cm (mean, 4.53). Axillary node metastasis was present in 61.7%. Only one patient had distant metastases at presentation. The presence of hormone receptors was reported in 24.5% of the tumors. Modified radical mastectomy was the most common surgical procedure and was performed in 50.9% of the patients. Adjuvant radiotherapy was administered to 39.6% of the patients, and 69.8% underwent chemotherapy. Thirteen percent of patients received adjuvant tamoxifen therapy. The mean follow-up was 20.75 months (range, 3–60), and 10 of 53 cases (18.9%) died of metastatic disease. Conclusions The prognosis of primary small cell carcinoma of the breast largely depends on the initial stage of the disease. Multimodality treatment including surgery, radiotherapy and chemotherapy seems to be the most appropriate strategy for early disease. Chemotherapy is usually unsuccessful in treating metastatic disease.