DOI: 10.37421/1948-5956.2025.17.682
Ana Helena Willrich Rasera*, Cleverton Spautz, Iris Rabinovich, Ana Cléa Andrade, Cícero Urban, Karina Furlan Anselmi and Ana Paula Martins Sebastião
Introduction: In early-stage breast cancer, there is a constant search to identify which patients will benefit from chemotherapy. Among the most widely used genetic tests is Oncotype DX®, a validated prognostic marker. However, its high cost is still a major limitation. As a more financially viable alternative, the cell proliferation index determined by the Ki67 antigen is used. Objective: To evaluate the percentage of Ki67 expression and its relationship with the Oncotype DX® recurrence score in luminal breast carcinomas.
Methods: 79 Oncotype DX® results available in the last 5 years were analyzed and compared with the respective anatomopathological and immunohistochemical reports.
Results: The mean age was 56 years with tumors ≤ 2 cm (72.2%), with a predominance of carcinomas of no special type (73.4%) and tumor grade 2 (72.2%). Among patients under 50 years of age, intermediate risk was the most common (60.7%). In this group, the cutoff point for Ki67 by ROC curve adjustment was 37% (p=0.032), with sensitivity of 85.7% and specificity of 61.9%. In patients over 50 years of age, low risk was prevalent (70.6%). The cutoff point for Ki67 by ROC curve adjustment was 33% (p=0.040), with sensitivity of 93.3% and specificity of 41.7%. For these cutoff points, the kappa coefficient of agreement was estimated at 0.29.
Conclusions: Ki67 correlated with the Oncotype DX® recurrence score. The kappa index showed low agreement. The results suggest that Ki67 should not be used alone for therapeutic decision-making, but rather associated with clinical factors.
DOI: 10.37421/2376-1318.2024.13.345
Cholestatic jaundice as the initial symptom in patients with metastatic prostate cancer is extremely rare. Few cases only of paraneoplasic cholestatic jaundice associated with prostate cancer have been reported in the literature. We present a case of 57 years old patient who presented cholestatic jaundice revealing an underlying metastatic prostate cancer after detailed examinations including Computed Tomography (CT), Magnetic Resonance Imaging (MRI), Positon Emission Tomography (PET), and Endoscopic Retrograde Cholangiopancreatography (ERCP). Cholestatic jaundice may be brought on by malignancies via identified pathways (e.g., bile duct obstruction or widespread hepatic infiltration). Through an unknown pathogenetic mechanism, paraneoplastic syndromes connected to malignancy, particularly renal cell carcinoma (Stauffer's syndrome) and malignant lymphoproliferative disorders, can cause a reversible form of cholestasis. There have been two cases documented in the medical literature of prostate cancer that originally manifested as cholestatic jaundice without any clear reason (i.e., blockage or invasion). We describe a patient who had pruritus and cholestatic jaundice when they first arrived. The diagnosis of prostate cancer was made throughout the diagnostic process. Conjugated bilirubin and alkaline phosphatase levels significantly rose, but transaminase and glutamyltranspeptidase levels only slightly increased. No signs of extrahepatic biliary blockage or hepatic metastases were found, according to the findings of the necessary studies carried out while the patient was hospitalised.
DOI: 10.37421/2167-1168.2024.13.682
According to the NICPR in the year 2010, the average estimated prevalence of cancer was 25 lakhs and incidence was about 07 lakhs in India, there were 5.56 lakh deaths due to cancer. The study is based on data from NFHS (2015-16). Univariate and Bivariate analysis and Poisson regression models were used to establish an association between all independent predictors and outcome variable. Among both women and men, asthma and diabetes emerged as the main determinants for cancer prevalence. Women who smoke tobacco are 1.76 times significantly more likely to get cancer whereas in case of men who smoke are 2.65 times significantly more likely to get cancer. Among both women and men, non-vegetarian diet emerged to be important determinants for cancer prevalence i.e. (IRR=1.58, P<0.05) for women and (IRR=3.17, P<0.05) for men. Among women who are exposed to arsenic through groundwater are 1.81 times significantly more likely to get cancer. From the study, it has been found that asthma and diabetes among biological factors; tobacco and alcohol consumption, consumption of non-vegetarian food and arsenic exposure (only among women) among behavioral factors are the main determinants of cancer prevalence among both men and women in India.
Brian Carr*, Vito Guerra, Ümit Karaoğullarından, Hikmet Akkiz, Volkan Ince, Burak Isik and Sezai Yilmaz
DOI: 10.37421/2167-1168.2024.13.682
Introduction: Survival in patients with Hepatocellular Carcinoma (HCC) has been previously found to be worse with increase in tumor size, but also with increase in inflammation. To examine these issues separately, we aimed to study the influences on survival of various liver inflammation parameters in the whole cohort, and separately in patients with HCCs of defined Maximum Tumor Diameter (MTD).
Methods: A prospectively collected large database of Turkish HCC patients with documented survival was interrogated. Patients had baseline liver function tests and CT scans for tumor characteristics. Liver function and inflammation parameters included blood tests for levels of albumin, AST, GGT, ALKP, CRP, ESR and WBC.
Results: Survival was worse for patients with larger HCCs, including those with low or high serum AFP levels. Highest hazard ratios were found for patients with abnormal blood albumin (low) or AST (high) levels, regardless of AFP status. When patients were separately examined according to tumor size, only albumin and AST were significant for survival in patients with small <3cm tumors; whereas albumin, AST and ALKP were significant in patients with >3cm HCCs. Abnormal albumin or AST levels in different HCC size cohorts significantly related to percent patients with PVT, higher AFP or increased tumor focality, regardless of tumor size.
Results: Survival was worse for patients with larger HCCs, including those with low or high serum AFP levels. Highest hazard ratios were found for patients with abnormal blood albumin (low) or AST (high) levels, regardless of AFP status. When patients were separately examined according to tumor size, only albumin and AST were significant for survival in patients with small <3cm tumors; whereas albumin, AST and ALKP were significant in patients with >3cm HCCs. Abnormal albumin or AST levels in different HCC size cohorts significantly related to percent patients with PVT, higher AFP or increased tumor focality, regardless of tumor size.
Cancer Science & Therapy received 5332 citations as per Google Scholar report
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