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Department of Surgery, Rutgers Cancer Institute of New Jersey, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA
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Department of Genetics, Yeshiva University Albert Einstein College of Medicine, Bronx, New York, USA
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Medicine, Albert Einstein College of Bronx, New York
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Medicine, Albert Einstein College of Bronx, New York
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understanding of their pathogenesis would be of high significance in developing new therapeutic approaches. The immune system and tumor cells have dynamic interactions ( Dunn et al. 2004 , Grivennikov et al. 2010 , Schreiber et al. 2011 ), which play
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potential prognostic relevance of Rac expression in human tumors has not been investigated yet. In the present study, we have analyzed Rac protein expression in benign secretory epithelium, high-grade prostatic intraepithelium neoplasia (HG-PIN), and
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Introduction Obesity is a major public health problem with rapidly increasing rates worldwide. It is characterized by a chronic low-grade inflammatory condition in adipose tissue (AT) ( Ouchi et al. 2011 ). In obesity, the AT expansion
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Originating from cells of the diffuse endocrine system the endocrine tumours of the gut and the pancreatic tract are rare entities characterized by a common phenotypic aspect and producing several bioactive substances including growth factors. Two major categories are identified: well-differentiated and poorly differentiated tumours. The clinical behaviour varies ranging from benign to low grade malignant for well-differentiated tumours/carcinomas to high grade malignant for poorly differentiated carcinomas. The two major categories of well-differentiated and poorly differentiated tumours display distinct phenotypes and genetic backgrounds possibly supporting distinct histogenesis. Genetic abnormalities associated with either induction or progression of tumours may vary depending on the site of origin.
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Apoptosis is a frequent phenomenon in breast cancer and it can be detected by light microscopy in conventional histopathological sections or by special staining techniques. The number of apoptotic cells as a percentage of cells present, or the number of apoptotic cells per square millimetre of neoplastic tissue, is usually described as the apoptotic index (AI). In breast cancer, the AI is not related to tumour size, axillary lymph node metastasis or distant metastasis at diagnosis. It is greater in invasive ductal carcinomas than in other histological types. High AI is also related to high histological grade, high nuclear grade, comedo-type necrosis, lack of tubule formation, and dense infiltration of the tumour by lymphocytes. Sex steroid receptor-negative tumours have greater AIs than the sex steroid receptor-positive ones. Aneuploid breast cancers with high S-phase fractions (SPFs) also have high AI values compared with diploid tumours with low SPFs. p53-Positive breast cancers have high AIs, whereas tumours that are Bcl-2 positive have low AIs. The AI shows a strong positive correlation to all direct or indirect indicators of cell proliferation, such as mitotic index and Ki67 immunolabelling. Univariate survival analyses show that a high AI is linked with unfavourable disease outcome in axillary lymph node-negative and -positive breast cancer, but multivariate analyses indicate that AI is not an independent prognostic factor. In conclusion, a high AI is related to malignant cellular features and indicators of invasiveness and cell proliferation in breast cancer.
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Abstract
The course of untreated or only palliatively treated prostate cancer was studied in two large unselected populations. The first population comprised 514 patients (mean age 74 years at diagnosis) who were all followed to death and represented patients in different stages and grades at diagnosis. The second population included 490 men (mean age 68 years at diagnosis) with newly detected prostate cancer diagnosed during 1960 to 1980 and who survived for at least 10 years after diagnosis. Of the patients with stage MO at diagnosis 50% ultimately died of prostate cancer. In early stage prostate cancer most deaths during the first 10 years were due to unrelated causes while prostate cancer was the dominant cause of death after 10 years. All the different stages and grades had an almost straight-falling cause-specific survival curve and all curves ended close to zero after 25 years. This means that prostate cancer deaths continue to occur as long as there are patients at risk and in none of the groups examined did the risk decline after a certain time. When a comparison was made with other studies on deferred treatment (corresponding subgroups were extracted) very similar results were found. However, the overall impression of the results looked very different when follow-up was extended from 10 to 25 years. Apart from a high mortality, a high morbidity was also found in patients who died from prostate cancer; this was significantly higher than in those who died of unrelated diseases. Patients at stage M0 at diagnosis who ultimately died had more frequent problems with local tumour growth than those who were at stage M1 at diagnosis. Early prostate cancer is usually a very slow-growing disease but it has a malignant potential and if the host lives long enough he will be at high risk for prostate cancer death irrespective of stage or grade at diagnosis.
Endocrine-Related Cancer (1996) 3 147-155
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Department of Hematology and Medical Oncology, Department of Pathology and Laboratory Medicine, Emory Winship Cancer Institute, Department of Surgery, Department of Medicine, Department of Oncology, Emory University School of Medicine, Atlanta, Georgia 30322, USA
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epidemiological studies have linked high levels of plasma leptin with increased risk for breast carcinogenesis, but a direct link between leptin signaling and breast cancer was first established in a clinical study showing that leptin receptors were not detectable
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ABSTRACT
Epidermal growth factor receptor (EGFR) and estrogen receptor (ER) status were immunohistochemically evaluated in 80 primary ductal breast carcinomas. The comparison between EGFR status and tumor grading, tumor size, lymph node involvement and age of patients was performed. EGFR expression was found in 87.5% of carcinoma samples and 46.3% of tumors were positive for ER staining. The inverse relationship between EGFR and ER expression was confirmed and it was evident that a high concentration of EGFR exceeding 25% of a tissue section may inhibit or significantly limit the ability to express ERs. EGFR presence was significantly associated with poorly differentiated tumors. No correlation was found between EGFR positivity and tumor size, lymph node involvement or age of patients. Our results indicate that EGFR status does not seem to be a valuable independent prognostic indicator, but that the combination of EGFR positivity (above 25% of a tissue section) accompanied by a low or undetectable level of ER expression should be considered as a potential marker of a poor prognosis in patients with ductal breast carcinoma.
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Ovarian cancer accounts for 5% of all cancer deaths in Western countries and is the most frequent cause of gynaecologic cancer mortality. The incidence varies with age between 1% and 14% with a peak rate in the eighth decade, and in the majority of cases, the disease has already spread beyond the pelvic cavity at time of diagnosis. Although in the last decades the introduction of cisplatin-based chemotherapy resulted in an improvement of patient survival, the percentage of recurrent disease is high even in those patients who achieve a complete response to chemotherapy, so that more than 80% of patients with advanced stage of disease die within 5 years (Copeland & Gershenson 1986). At present the prognostic characterisation of ovarian cancer patients, based on clinico-pathological parameters, such as stage, histology, grade and residual tumour after surgery, seems to be inadequate, since patients with similar clinico- pathological characteristics often experienced different clinical outcome. Therefore, the identification of biological factors related to tumour aggressiveness could be relevant in order to identify patients with different prognosis and chance to respond to chemotherapy, thus allowing the selection, at time of initial diagnosis, of high risk patients needing more aggressive therapy or alternative treatment, and a closer follow-up. Among the biological parameters proposed as possible prognostic factors in ovarian cancer much attention has been focused on endocrine factors and especially on steroid hormones and their receptors. Although several epidemiological and in vitro evidences have demonstrated that, similarly to breast and endometrial cancer, ovarian cancer cell biology could be influenced by the biochemical pathways promoted by the interaction of estrogens and progesterone with their specific receptors (ER, PR) conflicting data have been reported about the possible clinical role of ER and PR in this neoplasm. This review is aimed: a) to summarise the informations about the influence of steroid hormones and their receptors in the biology of ovarian cancer in in vitro models as well as in primary tumours;b) to investigate the association of steroid hormone receptor expression with the clinico-pathological parameters and the clinical outcome in ovarian cancer patients.c) to report the data of the literature about the rationale and the results of endocrine therapy in ovarian cancer.
