bluuebunny/crossref_metadata_2025_split huggingface dataset:
Breast Cancer Takes up 99mTc Bombesin. A Preliminary Report
Authors: Scopinaro F , Varvarigou A , Ussof W , De Vincentis G , Archimandritis S , Evangelatos G , Corleto V , Pulcini A , Capoccetti F , Remediani S , Massa R 
Published: April 2018

Background Several tumors including lung, prostate, ovarian, colon, and exocrine pancreatic cancer show receptors for the amphibian neurotransmitter and growth factor bombesin (BN) and its mammalian counterparts gastrin-releasing peptide and neuromedin B. Also breast cancer has been reported to show such receptors: the presence of BN receptors in primary breast cancer has been demonstrated on cultured cells and by autoradiography on breast tissue samples. Authors who have studied BN receptors in breast cancer do not agree on their frequency in primary cancer, but indicate that 100% of metastatic breast cancers show such receptors. Methods We examined three primary breast cancer patients with 99mTc BN and 99mTc sestamibi one week before surgery. One of them showed axillary node invasion. The same acquisition technique was used for breast and chest imaging with both radiopharmaceuticals, whereas total body images were acquired only with 99mTc BN. Also the administered radioactivity was different: 20 mCi of 99mTc sestamibi and 5-8 mCi of 99mTc BN. Dynamic images were acquired for 20 mins after iv injection with the patient in ventral decubitus and the gamma camera positioned in lateral view, as is generally done in Khakhali's prone scintimammography. Anterior chest images were acquired for 30 mins. Prone scintimammography was performed one hour after administration of both tracers. ROIs were drawn on tumors and surrounding breast with the same technique in order to calculate the tumor to breast ratio (T/B). In addition, total body scan was performed one hour and three hours after 99mTc BN administration. All three patients underwent breast conserving surgery with lymphadenectomy. Postoperative pathologic assessment showed the following T and N stages in the three patients: T1bN0, T1cN0. and T1cN1. Results All three cancers were imaged with both tracers. The T/B of 99mTc BN was always higher than that of 99mTc sestamibi. Chest uptake was always much higher with 99mTc sestamibi than with 99mTc BN. Comparison between 99mTc BN and 99mTc sestamibi images gave other intriguing results: in the N1 patient both tracers clearly imaged the invaded node, but on the 99mTc BN image the primary tumor was larger than on the 99mTc sestamibi image and the node was smaller. It is known that 99mTc BN is not taken up by vessels and inflammatory tissue. The time activity curves of the two tracers were significantly different in all patients, with an increase in 99mTc BN uptake in the first three to five minutes, followed by a less sharp uprise of the curve, quite similar to a plateau. Conclusions Our first impression is that 99mTc BN is a useful breast cancer seeking agent and very promising for lymph node staging.
Sentinel Lymph Node Detection by Lymphoscintigraphy in Malignant Melanoma
Authors: Caprio MG , Carbone G , Bracigliano A , Acampa W , Mainolfi C , Molea G , Salvatore M 
Published: April 2018

Aims and Background Sentinel lymph node (SLN) detection is currently employed in patients with malignant melanoma (MM) to spare them unnecessary lymph node dissection. Methods and Study Design We investigated 241 patients (130 men and 111 women, median age, 50 years (range, 14-92)) with MM (192 before and 51 after surgical biopsy); two of them had more than one melanoma lesion. In each patient approx. 10 MBq of 99mTc Nanocoll in 0.1 mL (Nycomed Amersham Sorin; particle size range, 3-80 nm) was injected intradermally around the MM lesion or surgical scar. Dynamic acquisition was performed for 20 minutes (20 frames/min) and the study was concluded within four hours of injection. Using an external radioactive marker, the skin over the SLN was marked with China ink. Results 294 SLNs were scintigraphically identified: 117 in the inguinal region, 147 in the axillae, four in the submandibular region, three in the laterocervical region and 23 at other sites. In two patients no drainage was detected. In 43 patients more than one sentinel node was identified. In 13 patients with lesions located in the trunk the tracer drained towards multiple lymph node stations or unexpected lymph nodes (nine cases). Histology and immunohistochemistry diagnosed MM in 25 SLNs; 19 were positive for metastasis with hematoxylin-eosin staining, five with Hmb45 and one with CD68 immunostaining. All 25 detected lymphatic basins were excised. In nine of these basins there was metastatic involvement of at least one other lymph node besides the SLN. During follow-up, which ranged from six to 86 months, metastatic disease was found in only one patient with a histologically negative SLN six months after surgery. Conclusions This study confirms the utility of scintigraphic SLN detection in patients with MM. In most of the cases the procedure led the surgeon to evaluate the drainage area, which is unpredictable for lesions in the trunk and may be difficult to delineate using only patent blue dye. Furthermore, in approximately 10% of cases we observed dual drainage from individual lesions, mainly those located on the trunk. We will proceed to compare the results obtained during follow-up with those of an investigational group of patients with melanoma who were not subjected to lymphoscintigraphy for SLN detection in order to obtain well-founded information on the prognostic value of this technique.
Surgical Approach to Cervical Lymph Node Metastasis in Differentiated Thyroid Cancer
Authors: Goss M , D'Amico S , Mobiglia A , Sargiotto A , Deandrea M 
Published: April 2018

Background Precautionary locoregional lymph node dissection in thyroid carcinomas for diagnostic and/or staging purposes is useless both in differentiated (papillary and follicular) and undifferentiated forms. It is only indicated in medullary carcinomas because of their frequent spread to regional lymph nodes. The objective of lymphadenectomy is to contain tumor spread; however, the procedure may be associated with intraoperative complications and postoperative sequelae. In order to improve the therapeutic management of patients with thyroid carcinoma, diagnostic scintigraphy with 201Tl or 99mTc-sestamibi is used in the advanced and undifferentiated forms of this tumor. Methods We have treated a woman submitted three years previously to total thyroidectomy for papillary carcinoma (pT3) without subsequent radiometabolic treatment. On physical examination we noticed a swelling on the left side of the neck. The lesion was confirmed by ultrasonography, CT scan, and scintigraphic examination with 99mTc-sestamibi 24 hours before planned lymphadenectomy. During the surgical procedure we performed radiodetection to localize metastatic lesions. Results Intraoperative radiodetection may help to identify residual disease, which is often difficult to trace in the presence of post-surgical fibrosis. In our patient, histological examination of the removed tissue specimens demonstrated that intraoperative radiolocalization had been highly accurate. The eradication of residual disease was confirmed by scintigraphic follow-up after 12 months. Discussion and conclusions Scintigraphy with 99mTc-sestamibi has been proposed as a means to localize metastatic spread and possible residual disease after a supposedly radical thyroidectomy. Surgical eradication of all residual tumor guarantees the best disease control without having to resort to radiometabolic therapy. This approach will reduce the incidence of iatrogenic comorbidity and consequently improve the patients' quality of life.
Sentinel Lymph Node Analysis in Squamous Carcinoma of the Oral Cavity and Oropharynx
Authors: Pastore A , Turetta GD , Tarabini A , Turetta D , Feggi L , Pelucchi S 
Published: April 2018

Aims The aim of our study was to evaluate the usefulness and applicability of sentinel lymph node (SLN) identification in NO carcinomas of the oral cavity and oropharynx. Study design We carried out a prospective evaluation of SLN identification in 20 patients with oral cavity or oropharynx carcinomas with no clinical evidence of lymph node metastases. Methods Peritumoral infiltration with technetium-99-labeled nanocolloid followed by lymphoscintigrapy was carried out approximately 18 hours prior to surgery. A vital dye was injected intraoperatively and the SLN was identified with the aid of a gamma probe. All patients underwent routine neck dissection. Results While multiple radioactive nodes were generally identified on lymphoscintigraphy, the number of nodes ranging from one to five with variable degrees of uptake, intraoperative gamma probe scanning allowed the identification of a single more radioactive lymph node in 19 of the 20 patients. In only one patient did this method lead to the identification of two equally highly radioactive SLNs, with no uptake in the remaining nodes. All SLNs were ipsilateral to the neoplastic lesion. In 15 cases the SLN was tumor negative and so were the remaining nodes obtained by comprehensive neck dissection. In five cases the SLN was the only lymph node containing micrometastasis among those obtained by dissection. There were no instances of node positivity not involving the SLN. Conclusions Sentinel lymph node identification in ENT surgery may indicate intraoperatively if node metastases are present, thereby avoiding overtreatment in a substantial proportion of patients with NO carcinomas of the oral cavity or oropharynx.
A Simplified Procedure for Continuous Intraoperative External Monitoring of Systemic Leakage during Isolated Limb Perfusion
Authors: Casara D , Rubello D , Pilati PL , Scalerta R , Foletto M , Rossi CR 
Published: April 2018

Aims Isolated limb perfusion (ILP) with high doses of an alkylating agent alone or in combination with tumor necrosis factor (TNF) in hyperthermic conditions (HAP) has been proposed for the treatment of locoregional tumors. A critical step in ILP/HAP is accurate monitoring of systemic leakage to prevent the toxic effects of chemotherapy, and in particular of TNF. Ten percent systemic leakage from the perfusion circuit is considered the maximum acceptable leakage. In this study we report our experience of a new leakage monitoring system. Materials and methods This new simplified procedure is based on the use of 99mTc-labeled soluble human serum albumin (HSA) and a hand-held gamma probe as detector. The procedure consists of the following steps: 1) A standardized 99mTc-HSA dose of 0.5 MBq/kg body weight is injected into the perfusion circuit before chemotherapy/TNF perfusion, and a hand-held gamma probe (IGP) is placed over the precordial area in a zone that was marked on the skin during a simulation test; 2) 48-72 hours before ILP/HAP a complete simulation test is performed with a 99mTc-HSA dose corresponding to 10% of the total dose calculated for the patient's body weight; 3) during the simulation test the maximum countrate zone on the precordial area is detected by IGP and marked on the patient's skin; 4) a 60-min curve of effective 99mTc-HSA radioactivity decay (physical and biological) is calculated and fitted; 5) to compare external counting with the effective circulating radioactivity, patient blood samples and circuit blood samples are taken every five minutes during ILP/HAP and measured by a laboratory gamma counter and very convenient thanks to the favorable characteristics of IGP. The placed in the operating room. Results External counting with a hand-held gamma probe was easy to perform time/activity curves obtained during simulation tests showed a regular and constant effective decay with a mean decay rate of 30% at 60 minutes compared to baseline values. The external measurements obtained by IGP proved to be well correlated with blood samples measured in vitro by a laboratory gamma counter. The results of this procedure, in particular the data of the simulation test for each patient, allowed us to correct the limit of 10% maximum leakage during ILP/HAP in accordance with the time/activity curve. Conclusions Although 99mTc-HSA has some unfavorable characteristics, it offers many advantages over 131I-HSA. The procedure proposed by us, which was based on the use of an IGP and 99mTc-HAS at a standardized dose of 0.5 MBq/kg body weight and on an individual simulation test for each patient performed 48 hours before ILP/HAP, proved to be simple and accurate in monitoring systemic leakage during ILP/HAP anticancer therapy.
Colorectal Cancer in Korea: Characteristics and Trends
Authors: Kim Dong-Wan , Bang Yung-Jue , Heo Dae Seog , Kim Noe Kyeong 
Published: April 2018

Aims and Background Colorectal cancer is the fourth leading cause of malignancy in Korea. However, there have been few reports concerning the clinical or pathological characteristics of patients in this area. The aim of this study was to examine the characteristics and trends of colorectal cancer in Korea. Methods The 1,468 patients with a histologic diagnoses of colorectal cancer between 1990 and 1997 at the Seoul National University Hospital, Seoul, Korea, were retrospectively examined. The data source was the medical record database of the Hospital. Results The mean age at diagnosis was younger than in Western countries (57.4 years for colon cancer and 55.6 years for rectal cancer). Rectal cancer was found to be more frequent than colon cancer. However, the proportion of colon cancer has been steadily increasing with time. The changes in the colon-to-rectal ratio mainly arose from an increase in left-sided colon cancer. Moderately differentiated adenocarcinoma was also increasing. Colon cancer patients demonstrated a more advanced stage than the rectal cancer patients. Surgery was performed in 93.7% of the patients as a first course of treatment. Conclusions The characteristics of Korean colorectal cancer patients were remarkably different from those seen in Western countries in age and primary tumor site distribution. However, the differences were less evident with time. A nationwide population-based registry is required to confirm the results of the study.
Survival after Pleural Malignant Mesothelioma a Population-based Study in Italy
Authors: Magnani Corrado , Viscomi Silvia , Dalmasso Paola , Ivaldi Cristiana , Mirabelli Dario , Terracini Benedetto 
Published: April 2018

Aims and Background The study analyzed survival after malignant mesothelioma in the population-based Registry of Malignant Mesothelioma of Piedmont (NW Italy, 4.5 million total population). It focused on possible differences related to period of diagnosis a proxy of changes in diagnostic or therapeutic procedures. Methods Cases were actively searched in pathology units and files of hospital admissions and discharges. In 1990-1998, 693 incident cases were diagnosed in residents in the region: 590 of them had a histologic diagnosis of pleural mesothelioma in life and were included in the study. Vital status was ascertained at the municipality of residence as of January 1, 2000. Results Fifty-eight cases were alive (9.8%) and 20 were lost (3.6%) at the end of the follow-up. Median survival was 0.71 years (95% Cl, 0.64-0.78). Cumulative survival was 35.9% at 1 year (95% Cl, 32.0-39.8) and 14.2% at 2 years (95% Cl, 11.2-17.1). Survival was associated to age (longer survival for younger subjects at diagnosis; P <0.0001) and to histology (longer survival for epithelial mesothelioma, shorter for fibrous and intermediate for mixed or unspecified types; P <0.0001). There was no difference in survival for period of diagnosis. The results were confirmed in multivariate analyses. Analyses according to type of hospital (with vs without thoracic surgery) did not show any statistically significant difference. Discussion The study on survival after malignant mesothelioma is the second largest of the three population-based studies in the world, which showed results similar to ours. Survival measured in published clinical series ranged between 18.4% and 57.6% at 1 year for pleural and 24.1% and 33.8% for peritoneal mesothelioma. The most striking effect of the present study was the absence of improvement in survival with period of diagnosis. Either there was no change in treatment efficacy or the effect was limited to small subgroups and could not be noticed when the analysis included larger categories.
Folfox 2 Regimen in Heavily Pretreated Patients with Advanced Colorectal Cancer
Authors: Luppi Gabriele , Zanelli Francesca , Di Stasi Antonio , Bertolini Federica , Pifferi Micol 
Published: April 2018

Aims and Background To determine the efficacy and safety of the FOLFOX 2 regimen in patients with pretreated advanced colorectal cancer. Methods In this single-arm phase II study, 28 patients with heavily pretreated advanced colorectal cancer received the following drug combination: oxaliplatin (100 mg/m2 for 2 hrs on day 1), folinic acid (250 mg/m2 for 2 hrs on day 1) and 5-filuorouracil (1500 mg/m2 for 22 hrs continuous infusion on days 1 and 2) every 2 weeks (one cycle). The treatment was continued until unacceptable toxicity occurred or at most for 10 cycles. Results Nine patients (32%) had a partial response and 5 (18%) stable disease, with a median duration of tumor control of 24 weeks (range, 8-44). The median survival of patients with a partial response or stable disease was 32 weeks (range, 12-52), whereas the median overall survival was 32 weeks (range, 8-72). A clinical benefit was achieved in 32% (9/21) of the patients. Severe (grade 3-4) non-hematological toxicity included diarrhea (1 patient), nausea/vomiting (7%) and peripheral neuropathy (1 patient). Severe hematological toxicities were rare (4%). Conclusions Our phase II study confirmed the therapeutic effectiveness and safety of the FOLFOX 2 regimen in pretreated advanced colorectal cancer patients.
Determining the Sensitivity of Transrectal Ultrasonography on a Consecutive Series of Prostate Cancers in a Clinical and Screening Setting
Authors: Ciatto Stefano , Bonardi Rita , Lombardi Claudio , Zappa Marco , Gervasi Ginetta 
Published: April 2018

Purpose To evaluate the sensitivity at transrectal ultrasonography (TRUS) for prostate cancer. Material A consecutive series of 170 prostate cancers identified by matching local cancer registry and TRUS archives at the Centro per lo Studio e la Prevenzione Oncologica of Florence. Method TRUS sensitivity was determined as the ratio of TRUS positive to total prostate cancers occurring at different intervals from TRUS date. Univariate and multivariate analyses of sensitivity determinants were performed. Results Sensitivity at 6 months, 1, 2 and 3 years after the test was 94.1% (95% Cl, 90-98), 89.8% (95% Cl, 85-95), 80.4% (95% Cl, 74-87) and 74.1% (95% Cl, 68-81%), respectively. A higher sensitivity (statistically significant) of TRUS was observed only if digital rectal examination was suspicious, whereas no association to sensitivity was observed for age, prostate-specific antigen or prostate-specific antigen density. Conclusions The study provided a reliable estimate of TRUS sensitivity, particularly reliable being checked against a cancer registry: observed sensitivity was high, at least of the same magnitude of other cancer screening tests. TRUS, which is known to allow for considerable diagnostic anticipation and is more specific than prostate-specific antigen, might still be considered for its contribution to a screening approach.
Conventional Pap Smear and Liquid-based Cervical Cytology Smear: Comparison from the Same Patient
Authors: Confortini Massimo , Bulgaresi Paolo , Cariaggi Maria Paola , Carozzi Francesca Maria , Cecchini Silvia , Cipparrone Ida , Maddau Cristina , Rossi Riccardo , Troni Grazia Maria , Zappa Marco , Ciatto Stefano 
Published: April 2018

Background The results of blind reading of smears obtained with liquid-based cytology in patients previously screened by conventional cytology were compared. Material and methods Cases selected for the study were a consecutive series of 99 subjects undergoing colposcopy within the screening program of the Florence District. The Pap test samples were processed utilizing the Thin Prep 2000 (Cytyc Corporation, Boxborough, MA). The liquid-base cytology smears were randomly admixed and read by seven expert cytologists with more than 15 years of experience in Pap smear reading. For each case, a consensus diagnosis was created and considered as the definitive diagnosis. Cytologic reports in conventional and liquid-based cytology smears were compared by the κ statistic to evaluate diagnostic agreement. Results The study showed that the conventional and liquid-based cytology provide comparable cytologic reports and that the latter is not less sensitive than the former in detecting CIN2+ lesions of the cervix. Discussion Such evidence suggests the feasibility of randomized studies comparing the two methods, which are needed before adopting liquid-based cytology as the current method when screening for cervical cancer.
Correlation between Laminin and Cathepsin D Expressions in Breast Carcinoma
Authors: Zheng Wei-Qiang , Looi Lai-Meng , Cheah Phaik-Leng 
Published: April 2018

Aims and Background Laminin is a major glycoprotein component of basement membrane which is an important barrier to tumor cells which must be breached before metastatic spread can occur. Proteolytic enzymes play an important role in mediating the passage of cancer cells through the basement membrane(BM) and extracellular matrix. We have compared the patterns of laminin and cathepsin D (CD) expressions in a range of benign and malignant breast lesions to better understand the process of tumor progression. Methods One hundred and sixty-two cases of breast samples comprising 18 fibroadenomas, 22 cases of fibrocystic disease, 96 cases of invasive ductal carcinoma and 26 carcinomas with intraductal components were evaluated for laminin and cathepsin D expressions by immunohistochemical staining. Results The prevalence of CD positivity in both neoplastic and stromal cell components were significantly higher in higher histological grade tumors compared to lower grades (P <0.01). Various severity of BM disruption correlated with histological grade of the carcinomas (P <0.001). There was a negative correlation between the laminin expression and CD presence. Conclusions It was confirmed that in a process of cancer cell invasion and metastasis, it could be necessary with the basement membrane disruption by proteinase secreted by cancer cells and especially by stroma cells of cancer.