bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical value of vascular endothelial growth factor and endostatin in urine for diagnosis of bladder cancer
Authors: Cheng Daye , Liang Bin , Li Yunhui 
Published: February 2018

Aims and background The aim of the study was to determine whether urinary VEGF and endostatin predict the presence of bladder cancer, and whether these noninvasive biomarkers provide clinically useful information in the bladder cancer patient as well. Methods and study design Voided urine samples were collected from 239 patients (109 bladder cancers, 81 urological disorders, 49 healthy controls). The urine levels of VEGF and endostatin were determined with the sandwich enzyme immunoassay technique. Results Urine levels of VEGF and endostatin were higher in patients with bladder cancer than those in patients with urological disorders and healthy controls (P <0.01). The difference between patients with urological disorder and healthy controls was significant only for VEGF (P <0.01). Urine level of VEGF was related to the tumor grade, and urine level of endostatin was related to tumor stage, tumor size and tumor number (P <0.05). The optimal cutoffs for VEGF and endostatin were calculated by the ROC curves as 860 pg/ml for VEGF, and 350 pg/ml for endostatin. The five-year survival rate was 60.0% in patients with low level of endostatin (<350 pg/ml) and 7.69% in patients with high level of endostatin (≥350 pg/ml) in the bladder cancer group. Patients with a high level of endostatin had a shorter survival time, whereas patients with a low level of endostatin had a longer survival time (P <0.05). Conclusions Urine levels of VEGF and endostatin may be a clinically useful aid in the diagnosis of bladder cancer, and endostatin but not VEGF is a supplementary prognostic marker for predicting tumor progression.
Percutaneous Computed Tomography-Guided Lung Biopsies: Preliminary Results using an Augmented Reality Navigation System
Authors: Grasso Rosario Francesco , Luppi Giacomo , Cazzato Roberto Luigi , Faiella Eliodoro , D'Agostino Francesco , Zobel Daniela Beomonte , De Lena Mario 
Published: February 2018

Aims and background “Augmented reality” is a technique to create a composite view by augmenting the real intervention field, visualized by the doctor, with additional information coming from a virtual volume generated using computed tomography (CT), magnetic resonance or ultrasound images previously acquired from the same patient. In the present study we verified the accuracy and validated the clinical use of an augmented reality navigation system produced to perform percutaneous CT-guided lung biopsies. Methods One hundred and eighty consecutive patients with solitary parenchymal lung lesions, enrolled using a nonrandom enrollment system, underwent percutaneous CT-guided aspiration and core biopsy using a traditional technique (group C, 90 patients) and navigation system assistance (group S, 90 patients). For each patient we recorded the largest lesion diameter, procedure time, overall number of CT scans, radiation dose, and complications. The entire experimental project was evaluated and approved by the local institutional review board (ethics committee). Results Each procedure was concluded successfully and a pathological diagnosis was reached in 96% of cases in group S and 90% of cases in group C. Procedure time, overall number of CT scans and incident x-ray radiation dose (CTDIvol) were significantly reduced in navigation system-assisted procedures (P <0.001; z = 5.64) compared with traditional CT-guided procedures. The percentage of procedural complications was 14% in group S and 17% in group C. Conclusion The augmented reality navigation system used in this study was a highly safe, technically reliable and effective support tool in percutaneous CT-guided lung biopsy, allowing to shorten the procedure time and reduce the incident x-ray radiation dose to patients and the rate of insufficient specimens. Furthermore, it has the potential to increase the number of procedures executed in the allocated time without increasing the number of complications.
Use of Luminex xMAP bead-based suspension array for detecting microRNA in NSCLC tissues and its clinical application
Authors: Wang Yanan , Shi Jinfang , Wu Yuanjian , Xu Weidong , Wang Qinxi , Zhang Jing , Jiang Min , Gu Guohao 
Published: February 2018

Background We measured the expression of microRNA (miRNA) in non-small cell lung cancer (NSCLC) tissues using the Luminex xMAP bead-based suspension array. We discuss the feasibility of employing this method to detect miRNA in NSCLC and explore its value as a high-throughput miRNA array. Methods We performed the methodological analysis of xMAP with oligoribonucleic acid references. We detected the expression of miR-21, miR, miR-31, miR-222, miR-145 and miR 40 NSCLC cancer tissues and adjacent normal tissues by xMAP bead-based suspension array. We selected miR-191 and miR-103 as the house-keeping genes (internal control). We also analyzed the relationship between xMAP and RT-PCR. Results The methodological analysis parameters of xMAP are quite good. The expression of miR-21, miR, miR-31 and miR-222 was higher in NSCLC tissues than in adjacent tissues, while the expression of miR-145 and miR-126 was lower in NSCLC tissues than in adjacent tissues. The expression of miR-145 and miR-126 decreased with disease progression. The intraassay and interassay coefficients of variation were lower in xMAP than in RT-PCR. xMAP proved cheaper and more flexible in detecting multiple miRNAs of one sample. Conclusions The Luminex xMAP bead-based suspension array for detecting miRNA has many advantages, such as allowing a smaller sample size (only 2 μL), no sample amplification, fast detection, high throughput, and flexible combination of multiple detection targets. The high throughput testing technology shows a great advantage in saving time and labor. We found that the Luminex xMAP bead-based suspension array is a good and feasible method for detecting miRNA expression with high-throughput technology.
Variation among Local Health Units in Follow-Up Care of Breast Cancer Patients in Emilia-Romagna, Italy
Authors: Leoni Maurizio , Sadacharan Radha , Louis Daniel , Falcini Fabio , Rabinowitz Carol , Cisbani Luca , De Palma Rossana , Yuen Elaine , Grilli Roberto 
Published: February 2018

Aims and background This study examines the patterns of follow-up care for breast cancer survivors in one region in Italy. Methods and study design This retrospective analysis included 10,024 surgically treated women, with incident cases of breast cancer in the years 2002–2005 who were alive 18 months after their incidence date. Rates of use of follow-up mammograms, abdominal echogram, bone scans and chest x-rays were estimated from administrative data and compared by Local Health Unit (LHU) of residence. Logistic regression analyses were performed to assess possible “overuse”, accounting for patient age, cancer stage, type of surgery and LHU of residence. Results A total of 7168 (72.1%) women received a mammogram within 18 months of their incidence date, while 6432 (64.2%) had an abdominal echogram, 3852 (38.4%) had a bone scan and 5231 (52.2%) had a chest x-ray. The rates of use of abdominal echograms, bone scans and chest x-rays were substantially higher in the population of breast cancer survivors than in the general female population. Taking account of patient age, cancer stage at diagnosis and type of surgery, multivariate analyses demonstrated significant variation in the use of these tests by LHU of residence. Conclusions The observed variation in the use of abdominal echograms, bone scans and chest x-rays supports the conclusion that there is substantial misuse of these tests in the population of postsurgical breast cancer patients in the Emilia-Romagna region in Italy. In the absence of a documented survival benefit, overtesting has both a human and financial cost. We recommend additional review of the methods of follow-up care in breast cancer patients in the LHUs of Emilia-Romagna, with the aim of developing, disseminating and evaluating the implementation of specific guidelines targeting primary care physicians and oncologists providing care to breast cancer survivors. Patient education materials may also help to reduce unnecessary testing.
First-Line Irinotecan Combined with 5-Fluorouracil and Leucovorin for High-Grade Metastatic Gastrointestinal Neuroendocrine Carcinoma
Authors: Du Zedong , Wang Yi , Zhou Yi , Wen Feng , Li Qiu 
Published: February 2018

Aim and background High-grade gastrointestinal neuroendocrine neoplasms, ie, poorly differentiated neuroendocrine carcinomas, with no effective therapeutic approaches, have a high ability to metastasize. Methods A review of the hospital information system was performed. Patients with histologically proven gastrointestinal neuroendocrine carcinoma who were treated with irinotecan combined with 5-fluorouracil and leucovorin in a first-line setting were eligible for analysis. We extracted information on age, sex, disease stage, laboratory findings, radiological findings, pathological findings, chemotherapy, effectiveness and adverse events of therapy, and outcomes. Results Eleven patients were included in the study. Partial response was observed in 7 patients. Median progression-free survival and overall survival were 6.5 (95% CI, 5.1–7.9) and 13.0 (95% CI, 9.8–16.2) months, respectively. No treatment-related deaths occurred. Conclusions The results demonstrated that irinotecan combined with 5-fluorouracil and leucovorin is an active regimen with acceptable toxicity for patients with metastatic high-grade gastointestinal neuroendocrine carcinoma that merits further investigation in prospective trials.
Reappraisal of Pretreatment Carcinoembryonic Antigen in Patients with Rectal Cancer Receiving Preoperative Chemoradiotherapy
Authors: Yeo Seung-Gu , Kim Dae Yong , Chang Hee Jin , Park Ji Won , Oh Jae Hwan , Kim Byung Chang , Baek Ji Yeon , Kim Sun Young , Kim Tae Hyun 
Published: February 2018

Aims and background The pretreatment serum carcinoembryonic antigen (CEA) level is an independent prognostic factor in colorectal cancer. We aimed to investigate the significance of CEA as a prognostic or predictive factor in rectal cancer patients receiving preoperative chemoradiotherapy (CRT). Methods and study design In total, 609 patients with locally advanced (cStage II-III) mid to distal rectal cancer who underwent preoperative CRT and radical surgery between 2001 and 2008 were analyzed retrospectively. Predictive factors for pathologic CRT response were determined using multivariate logistic regression. A prognostic factor analysis was performed using the log-rank test and Cox proportional hazards regression. Results Elevated CEA levels (>5 ng/mL) were observed in 201 (33.0%) patients at diagnosis. Following preoperative CRT, downstaging (ypStage 0-I) occurred in 255 (41.9%) patients, of whom 88 had pathologic complete tumor regression. Pretreatment CEA was significantly associated with pathologic CRT response in terms of downstaging and tumor regression grade, and was the most relevant predictive factor. After a median follow-up period of 60 months, the 5-year disease-free and overall survival rates were 76.2% and 84.6%, respectively. Prognostic factors independently associated with recurrence or survival included ypStage, circumferential resection margin, and histologic grade. Conclusions In patients with rectal cancer who received preoperative CRT, the pretreatment CEA level was a significant and independent predictor of pathologic CRT response. However, it may not be able to predict long-term outcomes independently of ypStage.
Can Hepatocellular Carcinoma (HCC) Produce Unconventional Metastases? Four Cases of Extrahepatic HCC
Authors: Piccirillo Mauro , Granata Vincenza , Albino Vittorio , Palaia Raffaele , Setola Sergio Venanzio , Petrillo Antonella , Tatangelo Fabiana , Botti Gerardo , Foggia Margherita , Izzo Francesco 
Published: February 2018

Aims and background Extrahepatic spread of hepatocellular carcinoma (HCC) diagnosed during the clinical course of the disease is not frequent; however, with the prolonged survival of HCC patients, the incidence of extrahepatic metastases seems to be increasing. Methods and study design We present four unusual cases of extrahepatic metastasis from HCC: the first concerns a patient who underwent a liver transplantation for HCC with cirrhosis and three years later developed metastases in the lung and the left orbit; the second is that of a patient who developed an extraperitoneal pararectal metastasis; in the third case a large osteolytic lesion developed on the left iliac bone, and in the fourth case we found an isolated metastasis in the left mandible. Results and conclusions These cases offer important information related to the unusual biology of isolated metastases from HCC after successful treatment of the primary cancer.
Fatigue, Quality of Life, and Mood States during Chemotherapy in Italian Cancer Patients
Authors: Annunziata Maria Antonietta , Muzzatti Barbara , Mella Sara , Bidoli Ettore 
Published: February 2018

Aims and background In cancer patients, fatigue interferes with the individual's functioning and quality of life (QoL). We investigated the association between fatigue and the main QoL dimensions and mood states as well as the main sociodemographic and clinical variables. Methods A total of 105 inpatients undergoing chemotherapy were administered the Revised Piper Fatigue Scale and the EORTC QLQ-C30 and POMS questionnaires, along with a form for collecting personal and clinical data. Results Compared with patients reporting lower fatigue levels, patients with higher levels showed worse functioning (P <0.001) in every QoL domain (i.e., physical, role, emotional, social, cognitive functioning, pain, and general health) as well as in the assessed mood states (depression-dejection, tension-anxiety, confusion-bewilderment). Moreover, both QoL and mood states in the subgroup reporting intermediate fatigue levels were worse than those of the subgroup with lower fatigue levels (P <0.02), except for emotional functioning, general health and QoL, and tension-anxiety. In addition, fatigue was significantly associated with gender, age, education, performance status, but not with marital status, survival rate of cancer type, and current chemotherapy cycle. Conclusions The associations observed between fatigue, the main QoL domains, and negative mood states call for further active interventions to prevent and reduce fatigue.
Association of Breast Cancer Subtypes and Body Mass Index
Authors: Petekkaya Ibrahim , Sahin Ugur , Gezgen Gamze , Solak Mustafa , Yuce Deniz , Dizdar Omer , Arslan Cagatay , Ayyildiz Veysel , Altundag Kadri 
Published: February 2018

Aims and background Breast cancer is a heterogeneous disease with various pathological and molecular subtypes. This study aims to determine the association between BMI and the distribution of breast cancer subtypes defined by estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor (HER2/neu) expression in pre- and postmenopausal breast cancers. Methods and study design A total of 1847 female breast cancer patients were involved. After the exclusion of 457 patients due to missing subtype information (n = 400) or benign histology (n = 57), 1390 were included in the analyses. The histological type of the tumor, ER and PR expression, HER2/neu with immunohistochemistry and HER2/neu gene evaluation with interphase fluorescence in situ hybridization (if necessary), age, body weight, height and menopausal status at diagnosis were investigated retrospectively. The patients were stratified as having a normal body weight if BMI was ≤24.9 kg/m2, as being overweight if BMI was between 25.0 and 29.9 kg/m2, and as being obese if BMI was ≥30.0 kg/m2. Results Median BMI was 28.7 kg/m2 (17.6–55.6) in the postmenopausal and 25.6 kg/m2 (16.4–51.1) in the premenopausal group ( P <0.001). BMI at diagnosis did not differ significantly between the molecular subtypes ( P = 0.12). Distribution of BMI strata was similar between the molecular subtypes both in pre- and postmenopausal breast cancer ( P = 0.24 and P = 0.99, respectively). Premenopausal women with a BMI of ≥25.0 kg/m2 showed a tendency towards ER– tumors when compared to premenopausal women with a BMI of <25.0 kg/m2 ( P = 0.009). Conclusions The risk of specific breast cancer subtypes may not be associated with BMI in pre- and postmenopausal breast cancer. However, obesity might be related to an increased risk of premenopausal hormone receptor-negative breast cancer. Further studies are needed for clarification of the probable mechanisms in the pathogenesis of premenopausal hormone receptor-negative breast cancer.
Phase II Trial of Combination Chemotherapy with Gemcitabine, 5-Fluorouracil and Cisplatin for Advanced Cancers of the Bile Duct, Gallbladder, and Ampulla of Vater
Authors: Sohn Byeong Seok , Yuh Young Jin , Kim Ki-hwan , Jeon Tae Joo , Kim Nam Sun , Kim Sung Rok 
Published: February 2018

Aims and background For advanced cancers of the bile duct, gallbladder and ampulla of Vater, there are only a few treatment options. We explored the efficacy of the combination of gemcitabine, 5-fluorouracil and cisplatin for advanced biliary cancers. Methods From September 2003 to April 2010, 28 patients with recurrent or metastatic biliary tract cancer were enrolled. A treatment regimen consisting of gemcitabine (800 mg/m2 at a fixed dose rate on days 1 and 8), 5-fluorouracil (1 g/m2/day continuous infusion for 4 days) and cisplatin (60 mg/m2 on day 2) was repeated every 3 weeks. Results One (3.6%) patient showed complete response, 8 (28.6%) partial response, 14 (50%) stable disease and 5 (17.9%) disease progression. Overall, the objective response rate was 32.1% (95% CI, 17.9–50.6%) and the disease control rate was 82.1% (95% CI, 64.4–92.1%). Median progression-free survival and overall survival were 7.6 months (95% CI, 5.5–9.7) and 11.2 months (95% CI, 6.8–15.5), respectively. G3/4 neutropenia was observed in 44 (24.3%) of 181 cycles and G3/4 thrombocytopenia in 48 (26.5%) of 181 cycles. There was no treatment-related mortality. Conclusions The combined regimen of gemcitabine, 5-fluorouracil and cisplatin has comparable activity for patients with advanced cancer of the bile duct, gallbladder and ampulla of Vater. Toxicity was tolerable but substantial.
Primary Radiotherapy with Endobronchial High-Dose-Rate Brachytherapy Boost for Inoperable Lung Cancer: Long-Term Results
Authors: Rochet Nathalie , Hauswald Henrik , Stoiber Eva Maria , Hensley Frank W , Becker Heinrich D , Debus Juergen , Lindel Katja 
Published: February 2018

Background To retrospectively evaluate the outcome of patients with inoperable non-small-cell lung cancer treated with primary external beam radiotherapy combined with high-dose-rate endobronchial brachytherapy boost. Patients and methods Between 1988 and 2005, 35 patients with non-small-cell lung cancer (stage I-III) ineligible for surgical resection and/or chemotherapy, were primarily treated with external beam radiotherapy with a median total dose of 50 Gy (range, 46–60). A median of 3 fractions high-dose-rate endobronchial brachytherapy was applied as a boost after external beam radiotherapy, the median total dose was 15 Gy (range, 8–20). High-dose-rate endobronchial brachytherapy was carried out with iridium-192 sources (370 GBq) and prescribed to 1 cm distance from the source axis. Results With a median follow-up of 26 months from the first fraction of high-dose-rate endobronchial brachytherapy, the 1-, 2- and 5-year overall (local progression-free) survival rates were 76% (76%), 61% (57%) and 28% (42%), respectively. Complete or partial remission rates 6 to 8 weeks after treatment were 57% and 17%, respectively. Significant prognostic favorable factors were a complete remission 6–8 weeks after treatment and a negative nodal status. In patients without mediastinal node involvement, a long-term local control could be achieved with 56% 5-year local progression-free survival. Common Toxicity Criteria grade 3 toxicities were hemoptysis (n = 2) and necrosis (n = 1). One fatal hemoptysis occurred in combination with a local tumor recurrence. Conclusions The combination of external beam radiotherapy with high-dose-rate endobronchial brachytherapy boost is an effective primary treatment with acceptable toxicity in patients with non-small-cell lung cancer ineligible for surgical resection and/or chemotherapy.
The Role of Mammography after Breast-Conserving Surgery and Adjuvant Chemotherapy
Authors: Ramella Sara , Ippolito Edy , Fiore Michele , Greco Carlo , Iurato Aurelia , Trodella Luca E , Floreno Barnaba , Di Donato Alessia , D'Angelillo Rolando M , Trodella Lucio 
Published: February 2018

Aims and background To investigate the impact of postchemotherapy mammography on radiotherapy timing and detection of early locoregional recurrences in breast cancer patients treated with breast-conserving surgery and adjuvant chemotherapy. Methods Bilateral mammography was performed before radiotherapy. Mammogram assessments were collected using the Breast Imaging Reporting and Data System (BI-RADS) scale. Differences in waiting times for radiotherapy between patients who needed further evaluation after mammograms and who did not were tested by the nonparametric Mann-Whitney U test. Results A total of 277 patients who underwent locoregional restaging after conservative surgery and adjuvant chemotherapy were evaluated. All patients had surgical margins greater than 2 mm. No locoregional recurrences were detected. Only in 2 patients (0.7%) did preradiotherapy mammograms reveal a contralateral breast cancer, which was histologically confirmed. After chemotherapy, the waiting times for radiotherapy were not different between patients who needed further imaging evaluation and patients who did not (34 days, 95% CI: 29–65 vs 38 days, 95% CI: 32–39; P = NS). Conclusion According to these data, postchemotherapy mammography detected a contralateral breast cancer in very few cases (0.7%); thus, even if performing these exams did not delay the start of radiotherapy, we believe that preradiotherapy mammograms are not necessary for patients undergoing adjuvant chemotherapy after breast-conserving surgery.