1
|
Posso M, Corominas JM, Serrano L, Román M, Torá‐Rocamora I, Domingo L, Romero A, Quintana MJ, Vernet‐Tomas M, Baré M, Vidal C, Sánchez M, Saladié F, Natal C, Ferrer J, Servitja S, Sala M, Castells X. Biomarkers expression in benign breast diseases and risk of subsequent breast cancer: a case-control study. Cancer Med 2017; 6:1482-1489. [PMID: 28470951 PMCID: PMC5463091 DOI: 10.1002/cam4.1080] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Revised: 03/28/2017] [Accepted: 03/29/2017] [Indexed: 11/16/2022] Open
Abstract
Women with benign breast diseases (BBD) have a high risk of breast cancer. However, no biomarkers have been clearly established to predict cancer in these women. Our aim was to explore whether estrogen receptor (ER), progesterone receptor (PR), and Ki67 expression stratify risk of breast cancer in screened women with BBD. We conducted a nested case-control study. Women with breast cancer and prior BBDs (86 cases) were matched to women with prior BBDs who were free from breast cancer (172 controls). The matching factors were age at BBD diagnosis, type of BBD, and follow-up time since BBD diagnosis. ER, PR, and Ki67 expression were obtained from BBDs' specimens. Conditional logistic regression was used to estimate odds ratios (ORs), and 95% confidence intervals (CIs) of breast cancer risk according to ER, PR, and Ki67 expression. Women with >90% of ER expression had a higher risk of breast cancer (OR = 2.63; 95% CI: 1.26-5.51) than women with ≤70% of ER expression. Similarly, women with >80% of PR expression had a higher risk of breast cancer (OR = 2.22; 95% CI: 1.15-4.27) than women with ≤40% of PR expression. Women with proliferative disease and ≥1% of Ki67 expression had a nonsignificantly increased risk of breast cancer (OR = 1.16; 95% CI: 0.46-2.90) than women with <1% of Ki67 expression. A high expression of ER and PR in BBD is associated with an increased risk of subsequent breast cancer. In proliferative disease, high Ki67 expression may also have an increased risk. This information is helpful to better characterize BBD and is one more step toward personalizing the clinical management of these women.
Collapse
Affiliation(s)
- Margarita Posso
- Department of Epidemiology and EvaluationIMIM (Hospital del Mar Medical Research Institute)BarcelonaSpain
- Department of Clinical Epidemiology and Public HealthHospital de la Santa Creu i Sant Pau (IIB Sant Pau)BarcelonaSpain
| | - Josep M. Corominas
- Pathology DepartmentIMIM (Hospital del Mar Medical Research Institute)BarcelonaSpain
| | - Laia Serrano
- Pathology DepartmentIMIM (Hospital del Mar Medical Research Institute)BarcelonaSpain
| | - Marta Román
- Department of Epidemiology and EvaluationIMIM (Hospital del Mar Medical Research Institute)BarcelonaSpain
- Research Network on Health Services in Chronic Diseases (REDISSEC)BarcelonaSpain
| | - Isabel Torá‐Rocamora
- Department of Epidemiology and EvaluationIMIM (Hospital del Mar Medical Research Institute)BarcelonaSpain
- Research Network on Health Services in Chronic Diseases (REDISSEC)BarcelonaSpain
| | - Laia Domingo
- Department of Epidemiology and EvaluationIMIM (Hospital del Mar Medical Research Institute)BarcelonaSpain
- Research Network on Health Services in Chronic Diseases (REDISSEC)BarcelonaSpain
- Agency for Health Quality and Assessment of Catalonia (AQuAS)BarcelonaSpain
| | - Anabel Romero
- Department of Epidemiology and EvaluationIMIM (Hospital del Mar Medical Research Institute)BarcelonaSpain
- Research Network on Health Services in Chronic Diseases (REDISSEC)BarcelonaSpain
| | - María Jesús Quintana
- Department of Clinical Epidemiology and Public HealthHospital de la Santa Creu i Sant Pau (IIB Sant Pau)BarcelonaSpain
- CIBER of Epidemiology and Public Health (CIBERESP)BarcelonaSpain
| | - María Vernet‐Tomas
- Obstetrics and Gynecology DepartmentIMIM (Hospital del Mar Medical Research Institute)BarcelonaSpain
| | - Marisa Baré
- Clinical Epidemiology and Cancer ScreeningParc Taulí University HospitalBarcelonaSpain
| | - Carmen Vidal
- Cancer Prevention and Control ProgramCatalan Institute of OncologyBarcelonaSpain
| | - Mar Sánchez
- Direction General of Public HealthDepartment of HealthGovernment of CantabriaSantanderSpain
| | - Francina Saladié
- Breast Cancer Screening Program of TarragonaThe Foundation League for the Research and Prevention of CancerTarragonaSpain
| | - Carmen Natal
- Principality of Asturias Breast Cancer Screening ProgramPrincipality of AsturiasOviedoSpain
| | - Joana Ferrer
- Radiology DepartmentHospital de Santa CaterinaGironaSpain
| | - Sònia Servitja
- Oncology DepartmentIMIM (Hospital del Mar Medical Research Institute)BarcelonaSpain
| | - María Sala
- Department of Epidemiology and EvaluationIMIM (Hospital del Mar Medical Research Institute)BarcelonaSpain
- Research Network on Health Services in Chronic Diseases (REDISSEC)BarcelonaSpain
| | - Xavier Castells
- Department of Epidemiology and EvaluationIMIM (Hospital del Mar Medical Research Institute)BarcelonaSpain
- Research Network on Health Services in Chronic Diseases (REDISSEC)BarcelonaSpain
| | | |
Collapse
|
2
|
Nadal R, Ortega FG, Salido M, Lorente JA, Rodríguez-Rivera M, Delgado-Rodríguez M, Macià M, Fernández A, Corominas JM, García-Puche JL, Sánchez-Rovira P, Solé F, Serrano MJ. CD133 expression in circulating tumor cells from breast cancer patients: Potential role in resistance to chemotherapy. Int J Cancer 2013; 133:2398-407. [DOI: 10.1002/ijc.28263] [Citation(s) in RCA: 82] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2013] [Revised: 03/28/2013] [Accepted: 04/17/2013] [Indexed: 12/26/2022]
Affiliation(s)
| | - F. Gabriel. Ortega
- Centro Pfizer-Universidad de Granada; Junta de Andalucia. Centro de Genomica e Investigacion Oncologica; Granada; Spain
| | - Marta Salido
- Molecular Cytogenetics Laboratory; Pathology Department. Parc de Salut Mar-Hospital del Mar- IMIM-GRETNHE; Barcelona; Spain
| | | | - Maria Rodríguez-Rivera
- Molecular Cytogenetics Laboratory; Pathology Department. Parc de Salut Mar-Hospital del Mar- IMIM-GRETNHE; Barcelona; Spain
| | | | - Marta Macià
- Division of Preventive Medicine and Public Health; CIBERESP, University of Jaén; Jaén; Spain
| | - Ana Fernández
- Centro Pfizer-Universidad de Granada; Junta de Andalucia. Centro de Genomica e Investigacion Oncologica; Granada; Spain
| | - Josep M. Corominas
- Molecular Cytogenetics Laboratory; Pathology Department. Parc de Salut Mar-Hospital del Mar- IMIM-GRETNHE; Barcelona; Spain
| | - J. Luis García-Puche
- Centro Pfizer-Universidad de Granada; Junta de Andalucia. Centro de Genomica e Investigacion Oncologica; Granada; Spain
| | | | | | | |
Collapse
|
3
|
Carracedo A, Salido M, Corominas JM, Rojo F, Ferreira BI, Suela J, Tusquets I, Corzo C, Segura M, Espinet B, Cigudosa JC, Arumi M, Albanell J, Serrano S, Solé F. Are ER+PR+ and ER+PR- breast tumors genetically different? A CGH array study. Cancer Genet 2012; 205:138-46. [PMID: 22559974 DOI: 10.1016/j.cancergen.2012.01.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2011] [Revised: 12/03/2011] [Accepted: 01/03/2012] [Indexed: 11/29/2022]
Abstract
The estrogen receptor (ER) is a well-known predictor of breast cancer response to endocrine therapy. ER+ progesterone receptor (PR)- breast tumors have a poorer response to endocrine therapy and a more aggressive phenotype than ER+PR+ tumors. A comparative genomic hybridization array technique was used to examine 25 ER+PR+ and 23 ER+PR- tumors. Tissue microarrays composed of 50 ER+PR+ and 50 ER+PR- tumors were developed to validate the comparative genomic hybridization array results. The genes of interest were analyzed by fluorescence in situ hybridization. The ER+PR- group had a slightly different genomic profile when compared with ER+PR+ tumors. Chromosomes 17 and 20 contained the most overlapping gains, and chromosomes 3, 8, 9, 14, 17, 21, and 22 contained the most overlapping losses when compared with the ER+PR+ group. The gained regions, 17q23.2-q23.3 and 20q13.12, and the lost regions, 3p21.32-p12.3, 9pter-p13.2, 17pter-p12, and 21pter-q21.1, occurred at different alteration frequencies and were statistically significant in the ER+PR- tumors compared with the ER+PR+ tumors. ER+PR- breast tumors have a different genomic profile compared with ER+PR+ tumors. Differentially lost regions in the ER+PR- group included genes with tumor suppressor functions and genes involved in apoptosis, mitosis, angiogenesis, and cell spreading. Differentially gained regions included genes such as MAP3K3, RPS6KB1, and ZNF217. Amplification of these genes could contribute to resistance to apoptosis, increased activation of the PI3K/Akt/mTOR pathway, and the loss of PR in at least some ER+PR- tumors.
Collapse
Affiliation(s)
- Alma Carracedo
- Pathology Service, Molecular Cytogenetics Laboratory, Hospital del Mar, IMIM, Barcelona, Spain
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
4
|
Rojo F, García-Parra J, Zazo S, Tusquets I, Ferrer-Lozano J, Menendez S, Eroles P, Chamizo C, Servitja S, Ramírez-Merino N, Lobo F, Bellosillo B, Corominas JM, Yelamos J, Serrano S, Lluch A, Rovira A, Albanell J. Nuclear PARP-1 protein overexpression is associated with poor overall survival in early breast cancer. Ann Oncol 2012; 23:1156-1164. [PMID: 21908496 DOI: 10.1093/annonc/mdr361] [Citation(s) in RCA: 123] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/06/2023] Open
Abstract
BACKGROUND Poly(ADP-ribose)polymerase-1 (PARP-1) is a highly promising novel target in breast cancer. However, the expression of PARP-1 protein in breast cancer and its associations with outcome are yet poorly characterized. PATIENTS AND METHODS Quantitative expression of PARP-1 protein was assayed by a specific immunohistochemical signal intensity scanning assay in a range of normal to malignant breast lesions, including a series of patients (N = 330) with operable breast cancer to correlate with clinicopathological factors and long-term outcome. RESULTS PARP-1 was overexpressed in about a third of ductal carcinoma in situ and infiltrating breast carcinomas. PARP-1 protein overexpression was associated to higher tumor grade (P = 0.01), estrogen-negative tumors (P < 0.001) and triple-negative phenotype (P < 0.001). The hazard ratio (HR) for death in patients with PARP-1 overexpressing tumors was 7.24 (95% CI; 3.56-14.75). In a multivariate analysis, PARP-1 overexpression was an independent prognostic factor for both disease-free (HR 10.05; 95% CI 5.42-10.66) and overall survival (HR 1.82; 95% CI 1.32-2.52). CONCLUSIONS Nuclear PARP-1 is overexpressed during the malignant transformation of the breast, particularly in triple-negative tumors, and independently predicts poor prognosis in operable invasive breast cancer.
Collapse
MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Animals
- Biomarkers, Tumor/genetics
- Biomarkers, Tumor/metabolism
- Breast Neoplasms/diagnosis
- Breast Neoplasms/metabolism
- Breast Neoplasms/mortality
- Breast Neoplasms/pathology
- Carcinoma, Ductal, Breast/diagnosis
- Carcinoma, Ductal, Breast/metabolism
- Carcinoma, Ductal, Breast/mortality
- Carcinoma, Ductal, Breast/pathology
- Cell Nucleus/metabolism
- Cell Nucleus/pathology
- Cells, Cultured
- Disease Progression
- Embryo, Mammalian
- Female
- Gene Expression Regulation, Neoplastic/drug effects
- Humans
- Mice
- Mice, Knockout
- Middle Aged
- Neoplasm Invasiveness
- Neoplasm Staging
- Poly (ADP-Ribose) Polymerase-1
- Poly(ADP-ribose) Polymerase Inhibitors
- Poly(ADP-ribose) Polymerases/genetics
- Poly(ADP-ribose) Polymerases/metabolism
- Prognosis
- RNA, Small Interfering/pharmacology
- Survival Analysis
- Up-Regulation/drug effects
- Up-Regulation/genetics
Collapse
Affiliation(s)
- F Rojo
- Cancer Research Program, IMIM (Hospital del Mar Research Institute), Barcelona; Department of Pathology, Hospital del Mar, Barcelona; Department of Pathology, IIS-Fundación Jiménez Díaz, Madrid
| | - J García-Parra
- Cancer Research Program, IMIM (Hospital del Mar Research Institute), Barcelona; Medical Oncology Department, Hospital del Mar, Barcelona
| | - S Zazo
- Department of Pathology, IIS-Fundación Jiménez Díaz, Madrid
| | - I Tusquets
- Medical Oncology Department, Hospital del Mar, Barcelona
| | - J Ferrer-Lozano
- Department of Oncology and Hematology, Hospital Clinico Universitario, Valencia
| | - S Menendez
- Cancer Research Program, IMIM (Hospital del Mar Research Institute), Barcelona; Medical Oncology Department, Hospital del Mar, Barcelona
| | - P Eroles
- Department of Oncology and Hematology, Hospital Clinico Universitario, Valencia
| | - C Chamizo
- Department of Pathology, IIS-Fundación Jiménez Díaz, Madrid
| | - S Servitja
- Medical Oncology Department, Hospital del Mar, Barcelona
| | | | - F Lobo
- Department of Oncology, IIS-Fundación Jiménez Díaz, Madrid
| | - B Bellosillo
- Department of Pathology, Hospital del Mar, Barcelona
| | - J M Corominas
- Cancer Research Program, IMIM (Hospital del Mar Research Institute), Barcelona; Department of Pathology, Hospital del Mar, Barcelona; Department of Medicine, Autonomous University of Barcelona, Barcelona
| | - J Yelamos
- Cancer Research Program, IMIM (Hospital del Mar Research Institute), Barcelona; Immunology Department, Hospital del Mar, Barcelona
| | - S Serrano
- Department of Pathology, Hospital del Mar, Barcelona; Department of Medicine, Autonomous University of Barcelona, Barcelona
| | - A Lluch
- Department of Oncology and Hematology, Hospital Clinico Universitario, Valencia; Department of Medicine, Valencia Central University, Valencia, Spain
| | - A Rovira
- Cancer Research Program, IMIM (Hospital del Mar Research Institute), Barcelona; Medical Oncology Department, Hospital del Mar, Barcelona
| | - J Albanell
- Cancer Research Program, IMIM (Hospital del Mar Research Institute), Barcelona; Medical Oncology Department, Hospital del Mar, Barcelona; Department of Medicine, Autonomous University of Barcelona, Barcelona.
| |
Collapse
|
5
|
Albanell J, González A, Ruiz-Borrego M, Alba E, García-Saenz JA, Corominas JM, Burgues O, Furio V, Rojo A, Palacios J, Bermejo B, Martínez-García M, Limon ML, Muñoz AS, Martín M, Tusquets I, Rojo F, Colomer R, Faull I, Lluch A. Prospective transGEICAM study of the impact of the 21-gene Recurrence Score assay and traditional clinicopathological factors on adjuvant clinical decision making in women with estrogen receptor-positive (ER+) node-negative breast cancer. Ann Oncol 2012; 23:625-631. [PMID: 21652577 DOI: 10.1093/annonc/mdr278] [Citation(s) in RCA: 96] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND This study examined the impact of the Recurrence Score (RS) in Spanish breast cancer patients and explored the associations between clinicopathological markers and likelihood of change in treatment recommendations. PATIENTS AND METHODS Enrollment was offered consecutively to eligible women with estrogen receptor-positive; human epidermal growth factor receptor 2-negative, node-negative breast cancer. Oncologists recorded treatment recommendation and confidence in it before and after knowing the patient's RS. RESULTS Treatment recommendation changed in 32% of 107 patients enrolled: in 21% from chemohormonal (CHT) to hormonal therapy (HT) and in 11% from HT to CHT. RS was associated with the likelihood of change from HT to CHT (P < 0.001) and from CHT to HT (P < 0.001). Confidence of oncologists in treatment recommendations increased for 60% of cases. Higher tumor grade (P = 0.007) and a high proliferative index (Ki-67) (P = 0.023) were significantly associated with a greater chance of changing from HT to CHT, while positive progesterone receptor status (P = 0.002) with a greater probability of changing from CHT to HT. CONCLUSIONS Results from the first prospective European study are consistent with published experience and use of the RS as proposed in European clinical practice guidelines and provide evidence on how Oncotype DX and clinicopathological factors are complementary and patient selection may be improved.
Collapse
Affiliation(s)
- J Albanell
- Medical Oncology Service, Hospital del Mar, Barcelona; Cancer Research Program, IMIM (Hospital del Mar Research Institute), Barcelona; Department of Medicine, Autonomous University of Barcelona, Barcelona.
| | - A González
- Medical Oncology Service, MD Anderson, Madrid
| | - M Ruiz-Borrego
- Medical Oncology Service, Hospital Virgen del Rocío, Sevilla
| | - E Alba
- Medical Oncology Service, Hospital Virgen de la Victoria, Málaga
| | | | - J M Corominas
- Cancer Research Program, IMIM (Hospital del Mar Research Institute), Barcelona; Department of Medicine, Autonomous University of Barcelona, Barcelona; Pathology Service, Hospital del Mar, Barcelona
| | - O Burgues
- Pathology Service, Hospital Clínico, Valencia
| | - V Furio
- Pathology Service, Hospital Clínico, Madrid
| | - A Rojo
- Pathology Service, MD Anderson, Madrid
| | - J Palacios
- Pathology Service, Hospital Virgen del Rocío, Sevilla
| | - B Bermejo
- Department of Hematology and Oncology, Hospital Clínico de Valencia, Valencia
| | - M Martínez-García
- Medical Oncology Service, Hospital del Mar, Barcelona; Cancer Research Program, IMIM (Hospital del Mar Research Institute), Barcelona
| | - M L Limon
- Medical Oncology Service, Hospital Virgen del Rocío, Sevilla
| | - A S Muñoz
- Medical Oncology Service, Hospital Virgen de la Victoria, Málaga
| | - M Martín
- Medical Oncology Service, Hospital Gregorio Marañón Madrid, Madrid
| | - I Tusquets
- Medical Oncology Service, Hospital del Mar, Barcelona; Cancer Research Program, IMIM (Hospital del Mar Research Institute), Barcelona
| | - F Rojo
- Cancer Research Program, IMIM (Hospital del Mar Research Institute), Barcelona; Pathology Service, Fundación Jiménez Díaz, Madrid
| | - R Colomer
- Medical Oncology Service, MD Anderson, Madrid
| | | | - A Lluch
- Department of Hematology and Oncology, Hospital Clínico de Valencia, Valencia
| |
Collapse
|
6
|
Serrano MJ, Nadal R, Lorente JA, Salido M, Rodríguez R, Rodríguez M, Macià M, Sánchez-Rovira P, Corominas JM, González L, Vera L, Albanell J, Solé F. Circulating cancer cells in division in an early breast cancer patient. Ann Oncol 2011; 22:2150-2151. [PMID: 21743104 DOI: 10.1093/annonc/mdr322] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Affiliation(s)
- M J Serrano
- Pfizer-University of Granada-Andalusian Government Center of Genomics and Oncology (GENyO), Granada.
| | - R Nadal
- Molecular Cytogenetics Laboratory, Pathology Department, Parc de Salut Mar-Hospital del Mar, IMIM-GRETNHE, Barcelona
| | - J A Lorente
- Pfizer-University of Granada-Andalusian Government Center of Genomics and Oncology (GENyO), Granada; Laboratory of Genetic Identification-UGR, Department of Legal Medicine, University of Granada, Granada
| | - M Salido
- Molecular Cytogenetics Laboratory, Pathology Department, Parc de Salut Mar-Hospital del Mar, IMIM-GRETNHE, Barcelona
| | - R Rodríguez
- Laboratory of Genetic Identification, Department of Legal Medicine, University of Granada, Granada
| | - M Rodríguez
- Molecular Cytogenetics Laboratory, Pathology Department, Parc de Salut Mar-Hospital del Mar, IMIM-GRETNHE, Barcelona
| | - M Macià
- Oncology Department, Hospital del Mar-IMAS, Barcelona
| | - P Sánchez-Rovira
- Pfizer-University of Granada-Andalusian Government Center of Genomics and Oncology (GENyO), Granada; Medical Oncology Department, University Hospital, Jaén, Spain
| | - J M Corominas
- Molecular Cytogenetics Laboratory, Pathology Department, Parc de Salut Mar-Hospital del Mar, IMIM-GRETNHE, Barcelona
| | - L González
- Pfizer-University of Granada-Andalusian Government Center of Genomics and Oncology (GENyO), Granada
| | - L Vera
- Pfizer-University of Granada-Andalusian Government Center of Genomics and Oncology (GENyO), Granada
| | - J Albanell
- Oncology Department, Hospital del Mar-IMAS, Barcelona
| | - F Solé
- Molecular Cytogenetics Laboratory, Pathology Department, Parc de Salut Mar-Hospital del Mar, IMIM-GRETNHE, Barcelona
| |
Collapse
|
7
|
Parker LA, Porta M, Lumbreras B, López T, Guarner L, Hernández-Aguado I, Carrato A, Corominas JM, Rifà J, Fernandez E, Alguacil J, Malats N, Real FX. Clinical validity of detecting K-ras mutations for the diagnosis of exocrine pancreatic cancer: a prospective study in a clinically-relevant spectrum of patients. Eur J Epidemiol 2011; 26:229-36. [PMID: 21298467 DOI: 10.1007/s10654-011-9547-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2010] [Accepted: 01/20/2011] [Indexed: 12/22/2022]
Abstract
The diagnostic utility of detecting K-ras mutations for the diagnosis of exocrine pancreatic cancer (EPC) has not been properly studied, and few reports have analysed a clinically relevant spectrum of patients. The objective was to evaluate the clinical validity of detecting K-ras mutations in the diagnosis of EPC in a large sample of clinically relevant patients. We prospectively identified 374 patients in whom one of the following diagnoses was suspected at hospital admission: EPC, chronic pancreatitis, pancreatic cysts, and cancer of the extrahepatic biliary system. Mutations in the K-ras oncogene were analysed by PCR and artificial RFLP in 212 patients. The sensitivity and specificity of the K-ras mutational status for the diagnosis of EPC were 77.7% (95% CI: 69.2-84.8) and 78.0% (68.1-86.0), respectively. The diagnostic accuracy was hardly modified by sex and age. In patients with either mutated K-ras or CEA > 5 ng/ml, the sensitivity and specificity were 81.0% (72.9-87.6) and 62.6% (72.9-87.6), respectively. In patients with mutated K-ras and CEA > 5 ng/ml the sensitivity was markedly reduced. In comparisons with a variety of non-EPC patient groups sensitivity and specificity were both always greater than 75%. In this clinically relevant sample of patients the sensitivity and specificity of K-ras mutations were not sufficiently high for independent diagnostic use. However, it seems premature to rule out the utility of K-ras analysis in conjunction with other genetic and 'omics' technologies.
Collapse
Affiliation(s)
- Lucy A Parker
- Department of Public Health, Miguel Hernández University, Alicante, Spain
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
8
|
Carracedo A, Egervari K, Salido M, Rojo F, Corominas JM, Arumi M, Corzo C, Tusquets I, Espinet B, Rovira A, Albanell J, Szollosi Z, Serrano S, Solé F. FISH and immunohistochemical status of the hepatocyte growth factor receptor (c-Met) in 184 invasive breast tumors. Breast Cancer Res 2009; 11:402. [PMID: 19439036 PMCID: PMC2688943 DOI: 10.1186/bcr2239] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Affiliation(s)
- Alma Carracedo
- Servei de Patologia, Laboratori de Citogenètica Molecular, Hospital del Mar, IMAS, GRETNHE, IMIM, Barcelona, Spain
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
9
|
Abstract
Anticancer drug discovery and development in cancer are currently undergoing of fast transformation. The selection of a therapeutic and effective dose using conventional cytotoxic agents has been based on the consecution of the maximally tolerated dose. However, this principle does not apply for new targeted therapies, where the definition of the optimal biologic dose (OBD) should be preferred. The definition of OBD might be established based on pharmacokinetic endpoints and, ideally, on pharmacodynamic assays by demonstrating directly the biological effect on the target and its downstream molecules in normal or tumor tissues. Normal tissues, such as peripheral blood mononuclear cells, skin or mucosa, may be excellent surrogates for explore the exposure of a drug and the dynamic target inhibition in vivo. In addition, tumor pharmacodynamic assays may determine the biologic effects of a therapy because tumor cells respond in a different way to targeted drugs than normal tissues, and to identify biomarkers that would permit to predict the individual response. In conclusion, these studies provide demonstration of proof of concept for biological and molecular mechanisms of selected drug, to select the appropriate population to be treated, to help the interpretation of clinical data, to inform the identification of optimal dose and schedule, to evaluate the clinical response and to contribute to take decisions for final approval by authorities.
Collapse
Affiliation(s)
- F Rojo
- Department of Pathology. Hospital del Mar-IMAS. Barcelona, Spain.
| | | | | | | |
Collapse
|
10
|
Corzo C, Bellosillo B, Corominas JM, Salido M, Coll MD, Serrano S, Albanell J, Solé F, Tusquets I. Does polysomy of chromosome 17 have a role in ERBB2 and topoisomerase IIalpha expression? Gene, mRNA and protein expression: a comprehensive analysis. Tumour Biol 2007; 28:221-8. [PMID: 17717428 DOI: 10.1159/000107583] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2006] [Accepted: 03/27/2007] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES ERBB2 is an oncogene with prognostic and predictive value. Topoisomerase IIalpha is an enzyme encoding close to the ERBB2 oncogene, that represents a molecular target for anthracyclines. An indirect mechanism of increasing ERBB2 and topoisomerase IIalpha gene copy number is chromosome 17 polysomy. The aim of the present study was to clarify the implication of polysomy 17 in ERBB2 and topoisomerase IIalpha expression. In addition, we assessed the relation of ERBB2 and topoisomerase IIalpha gene dosage to mRNA and protein levels. METHODS We selected 83 cases diagnosed as invasive breast cancer. We analysed ERBB2 and topoisomerase IIalpha genes, mRNA and protein by fluorescence in situ hybridisation, real-time reverse-transcription polymerase chain reaction and immunohistochemistry. RESULTS We observed a progressive increase in mRNA expression from 0+ to 3+ and also a significant difference in the ERBB2 RNA levels between normal and amplified cases. We found that polysomy of chromosome 17 does not affect the ERBB2 expression and that topoisomerase IIalpha mRNA expression is not related to gene status. CONCLUSIONS Our results demonstrate that polysomy of chromosome 17 is not related to ERBB2 expression. Thereby, it is important to use centromeric probes to clearly discriminate between true ERBB2 gene amplification and polysomy of chromosome 17.
Collapse
MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Antigens, Neoplasm/biosynthesis
- Breast Neoplasms/genetics
- Breast Neoplasms/pathology
- Chromosomes, Human, Pair 17
- DNA Topoisomerases, Type II/biosynthesis
- DNA-Binding Proteins/biosynthesis
- Female
- Gene Expression Regulation, Enzymologic
- Gene Expression Regulation, Neoplastic
- Humans
- Immunohistochemistry
- In Situ Hybridization, Fluorescence
- Middle Aged
- RNA, Messenger/metabolism
- Receptor, ErbB-2/biosynthesis
Collapse
Affiliation(s)
- Cristina Corzo
- Servei d'Oncologia mèdica, Hospital del Mar, IMAS, Barcelona, Spain.
| | | | | | | | | | | | | | | | | |
Collapse
|
11
|
Crous-Bou M, Porta M, López T, Jariod M, Malats N, Alguacil J, Morales E, Fernandez E, Corominas JM, Carrato A, Guarner L, Real FX. Lifetime history of tobacco consumption and K-ras mutations in exocrine pancreatic cancer. Pancreas 2007; 35:135-41. [PMID: 17632319 DOI: 10.1097/mpa.0b013e31805d8fa4] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
OBJECTIVES We analyzed the relation between mutations in codon 12 of the K-ras oncogene and lifetime consumption of tobacco in patients with exocrine pancreatic cancer (EPC). METHODS Incident cases of EPC were prospectively identified and interviewed during hospital admission about smoking and other factors. Exact logistic regression was used to compare EPC cases (N = 107) with and without K-ras mutations (case-case study). RESULTS Mutated cases were nonsignificantly less likely to have been smokers than wild-type cases: the odds ratio adjusted by age and sex was 0.54 (95% confidence interval, 0.10-2.69; P = 0.613). With respect to never smokers, adjusted odds ratios for former and current smokers were 0.79 and 0.36, respectively (P = 0.193). Pack-years smoked, years of smoking, and cigarettes smoked per year also tended to be higher in nonmutated than in mutated cases. Neither age at onset of smoking nor the time between quitting and diagnosis were associated with K-ras. CONCLUSIONS Tobacco does not play a major part in the acquisition of K-ras mutations in the pancreatic epithelium. Although both smoking and K-ras mutations have important roles in the etiopathogenesis of EPC, the 2 processes may act independently.
Collapse
|
12
|
Morales E, Porta M, Vioque J, López T, Mendez MA, Pumarega J, Malats N, Crous-Bou M, Ngo J, Rifà J, Carrato A, Guarner L, Corominas JM, Real FX. Food and nutrient intakes and K-ras mutations in exocrine pancreatic cancer. J Epidemiol Community Health 2007; 61:641-9. [PMID: 17568059 PMCID: PMC2465759 DOI: 10.1136/jech.2007.060632] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/31/2007] [Indexed: 12/30/2022]
Abstract
BACKGROUND No studies have investigated the relation between K-ras mutations and dietary factors in exocrine pancreatic cancer (EPC), and fewer than 10 studies have done so in other neoplasms. PATIENTS AND METHODS Incident cases of EPC were prospectively identified, and interviewed face-to-face during hospital admission. Food and nutrient intakes were measured with a food frequency questionnaire. Logistic regression was used to compare EPC cases (n = 107) with and without K-ras mutations (case-case study). RESULTS K-ras mutations were more common among daily consumers of milk and other dairy products than among non-daily consumers: the odds ratio adjusted by total energy, age, sex, smoking, alcohol and coffee consumption (ORa) was 5.1 (95% CI 1.1 to 24.5, p = 0.040). For all dairy products, including butter, the ORa for the medium and upper tertiles of intake were 5.4 and 11.6, respectively (p for trend = 0.023). The ORa for regular coffee drinkers further adjusted by dairy consumption was 4.7 (95% CI 1.1 to 20.7, p = 0.043). K-ras mutated cases reported a lower intake of vitamin E (ORa = 0.2, p for trend = 0.036), polyunsaturated fats and omega 3 fatty acids (ORa = 0.2; p for trend <0.03). CONCLUSIONS Results support the hypothesis that in EPC exposure to specific dietary components or contaminants may influence the occurrence or persistence of K-ras mutations.
Collapse
Affiliation(s)
- Eva Morales
- Clinical & Molecular Epidemiology of Cancer Unit, Institut Municipal d'Investigació Mèdica (IMIM), Universitat Autònoma de Barcelona, Carrer del Dr Aiguader 88, E-08003 Barcelona, Spain
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
13
|
Ortiz-Zapater E, Peiró S, Roda O, Corominas JM, Aguilar S, Ampurdanés C, Real FX, Navarro P. Tissue plasminogen activator induces pancreatic cancer cell proliferation by a non-catalytic mechanism that requires extracellular signal-regulated kinase 1/2 activation through epidermal growth factor receptor and annexin A2. Am J Pathol 2007; 170:1573-84. [PMID: 17456763 PMCID: PMC1854952 DOI: 10.2353/ajpath.2007.060850] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Tissue plasminogen activator (tPA) is overexpressed in pancreatic ductal carcinoma and is involved in tumor progression. This effect is probably mediated through the activation of angiogenesis, cell invasion, and cell proliferation. Previous studies support the notion that the effects of tPA on cell invasion require its proteolytic activity. Here, we report the molecular mechanism responsible for the proliferative effects of tPA on pancreatic tumor cells. tPA activates the extracellular signal-regulated kinase 1/2 signaling pathway in a manner that is independent of its catalytic activity. We also show that at least two membrane receptors, epidermal growth factor receptor and annexin A2, which are overexpressed in pancreatic cancer, are involved in the transduction of tPA signaling in pancreatic tumors. This observation suggests the establishment of an amplification loop in tumor cell proliferation. Double immunofluorescence experiments showed co-localization of tPA/epidermal growth factor receptor and tPA/annexin A2 in pancreas cancer cells. These results add novel insights into the non-catalytic functions of tPA in cancer and the molecular mechanisms behind the effects of this protease on cell proliferation, including a role for epidermal growth factor receptor.
Collapse
Affiliation(s)
- Elena Ortiz-Zapater
- Unitat de Biologia Cel.lular i Molecular, Institut Municipal d'Investigació Mèdica, Barcelona, Spain
| | | | | | | | | | | | | | | |
Collapse
|
14
|
Conde P, Sarmiento LE, Parramon F, Corominas JM, Villalonga A. [Anaphylactic reaction to latex after surgery and release of the ischemic cuff]. REVISTA ESPANOLA DE ANESTESIOLOGIA Y REANIMACION 2006; 53:514-5. [PMID: 17125019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
|
15
|
Montagut C, Tusquets I, Ferrer B, Corominas JM, Bellosillo B, Campas C, Suarez M, Fabregat X, Campo E, Gascon P, Serrano S, Fernandez PL, Rovira A, Albanell J. Activation of nuclear factor-kappa B is linked to resistance to neoadjuvant chemotherapy in breast cancer patients. Endocr Relat Cancer 2006; 13:607-16. [PMID: 16728586 DOI: 10.1677/erc.1.01171] [Citation(s) in RCA: 74] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The nuclear factor (NF)-kappaB system is a promising anticancer target due to its role in oncogenesis and chemoresistance in preclinical models. To provide evidence in a clinical setting on the role of NF-kappaB in breast cancer, we aimed to study the value of basal NF-kappaB/p65 in predicting resistance to neoadjuvant chemotherapy, and to characterise the pharmacodynamic changes in NF-kappaB/p65 expression following chemotherapy in patients with locally advanced breast cancer. Pre- and post-chemotherapy tumour specimens from 51 breast cancer patients treated with anthracycline- and/or taxane-containing neoadjuvant chemotherapy were assayed by immunohistochemistry for NF-kappaB/p65 subcellular expression. We studied NF-kappaB/p65, a well-characterised member of the NF-kappaB family that undergoes nuclear translocation when NF-kappaB is activated. Activation of NF-kappaB (i.e. nuclear NF-kappaB/p65 staining in pre-therapy specimens) was linked to chemoresistance. Patients with NF-kappaB/p65 nuclear staining in pre-treatment samples had a 20% clinical response rate, while patients with undetected nuclear staining had a 91% response rate to chemotherapy (P = 0.002). Notably, four patients achieved a complete histological response and none of them had pre-treatment NF-kappaB/p65 nuclear staining. Moreover, the number of patients with NF-kappaB/p65 activation increased after chemotherapy exposure. It is concluded that NF-kappaB/p65 activation assayed by immunohistochemistry is a predictive factor of resistance to neoadjuvant chemotherapy in breast cancer patients. Moreover, NF-kappaB activation was inducible following chemotherapy in a proportion of breast cancer patients. These novel clinical findings strengthen the rationale for the use of NF-kappaB inhibitors to prevent or overcome chemoresistance in breast cancer.
Collapse
Affiliation(s)
- C Montagut
- Medical Oncology Department, Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Hospital Clinic, Barcelona 08035, Spain
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
16
|
Corzo C, Corominas JM, Tusquets I, Salido M, Bellet M, Fabregat X, Serrano S, Solé F. The MYC oncogene in breast cancer progression: from benign epithelium to invasive carcinoma. ACTA ACUST UNITED AC 2006; 165:151-6. [PMID: 16527609 DOI: 10.1016/j.cancergencyto.2005.08.013] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2005] [Revised: 08/03/2005] [Accepted: 08/09/2005] [Indexed: 01/23/2023]
Abstract
One hypothesis for breast cancer development suggests that breast carcinogenesis involves a progression of events leading from benign epithelium to hyperplasia (with or without atypia) to carcinoma in situ and then invasive carcinoma. The MYC gene (alias c-Myc) is a transcriptional regulator whose expression is strongly associated with cell proliferation and cell differentiation. The present study is a descriptive analysis of MYC status throughout the hypothesized stages of invasive ductal carcinoma progression. A tissue microarray (TMA) was constructed including representative selected areas (normal cells, hyperplasia, in situ carcinoma, and invasive carcinoma) from each of 15 patients. Fluorescence in situ hybridization (FISH) with the LSI c-MYC/CEN8/IgH probe was performed. Two cases displayed MYC amplification (13%), showing this amplification only in the invasive carcinoma zones selected. Five cases displayed polysomy of chromosome 8 (33%), detected only in ductal in situ and invasive zones selected. Benign lesions and normal adjacent cells were classified as normal. None of the hyperplasia specimens and normal specimens analyzed showed any alterations in MYC status or any aneusomies of chromosome 8. The presence of MYC amplification only in invasive cells suggests that the finding of MYC amplification could reflect an advanced tumor progression.
Collapse
Affiliation(s)
- Cristina Corzo
- Laboratori de Citogenètica i Biologia Molecular, Servei de Patologia, Hospital del Mar, IMAS, URTTS, PRBB, Pg. Maritim 25-29, 08003 Barcelona, Spain.
| | | | | | | | | | | | | | | |
Collapse
|
17
|
Porta M, Fabregat X, Malats N, Guarner L, Carrato A, de Miguel A, Ruiz L, Jariod M, Costafreda S, Coll S, Alguacil J, Corominas JM, Solà R, Salas A, Real FX. Exocrine pancreatic cancer: symptoms at presentation and their relation to tumour site and stage. Clin Transl Oncol 2005; 7:189-97. [PMID: 15960930 DOI: 10.1007/bf02712816] [Citation(s) in RCA: 168] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
INTRODUCTION The need to detect pancreatic cancer at earlier stages is undisputed. We recorded the signs and symptoms of patients presenting with exocrine pancreatic cancer and evaluated their association with clinical characteristics such as tumour site and disease stage. PATIENTS AND METHODS All patients (n = 185) with exocrine pancreatic cancer newly diagnosed at five general hospitals in Eastern Spain were prospectively recruited over 5 years. Symptoms were elicited through personal interviews and signs were recorded by the attending physician on admission. RESULTS At diagnosis, one third of tumours of the pancreas head were in stage I and another third in stage IV. None of the tumours of the body and tail were in stage I, and over 80% were in stage IV (p < 0.001) . At presentation, the most frequent symptoms were asthenia (86%), anorexia (85%), weight-loss (85%), abdominal pain (79%), and choluria (59%). Cholestatic symptoms were more common in tumours affecting only the pancreatic head (p < 0.001) . There was a clear trend toward more localized tumours with increasing numbers of cholestatic signs (p < 0.001) . Asthenia, anorexia and weight-loss were unrelated to stage. An increased symptom-to-diagnosis interval was associated with more advanced stage (p = 0.048). CONCLUSIONS Proper attention to signs and symptoms, especially cholestasis, may help identify patients with pancreatic cancer at an earlier stage. Results also provide a current picture of the semiology of pancreatic cancer which could be of use in studies on the potential of proteomic tests in the early detection of this neoplasm.
Collapse
Affiliation(s)
- Miquel Porta
- Unidad de Epidemiología Clinica y Molecular del Cáncer, Instituto Municipal de Investigación Médica, Universidad Autónoma de Barcelona, Carrer del Dr. Aiguader 80, 08005 Barcelona, Spain.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
18
|
Torres-Rodríguez JM, González MP, Corominas JM, Pujol RM. Successful Thermotherapy for a Subcutaneous Infection Due to Alternaria alternata in a Renal Transplant Recipient. ACTA ACUST UNITED AC 2005; 141:1171-3. [PMID: 16172326 DOI: 10.1001/archderm.141.9.1171-b] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
|
19
|
Barreiro E, de la Puente B, Minguella J, Corominas JM, Serrano S, Hussain SNA, Gea J. Oxidative Stress and Respiratory Muscle Dysfunction in Severe Chronic Obstructive Pulmonary Disease. Am J Respir Crit Care Med 2005; 171:1116-24. [PMID: 15735057 DOI: 10.1164/rccm.200407-887oc] [Citation(s) in RCA: 173] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
RATIONALE Oxidative stress is involved in the skeletal muscle dysfunction observed in patients with severe chronic obstructive pulmonary disease (COPD). We hypothesized that the diaphragms of such patients might generate greater levels of oxidants than those neutralized by antioxidants. OBJECTIVES To assess the levels of both oxidative and nitrosative stress and different antioxidants in the diaphragms of those patients, and to analyze potential relationships with lung and respiratory muscle dysfunctions. METHODS AND MEASUREMENTS We conducted a case-control study in which reactive carbonyl groups, hydroxynonenal-protein adducts, antioxidant enzyme levels, nitric oxide synthases, and 3-nitrotyrosine formation were detected using immunoblotting and immunhistochemistry in diaphragm specimens (thoracotomy) obtained from six patients with severe COPD, six patients with moderate COPD, and seven control subjects. MAIN RESULTS Diaphragms of patients with severe COPD showed both higher protein carbonyl groups and hydroxynonenal-protein adducts than control subjects. When only considering patients with COPD, negative correlations were found between carbonyl groups and airway obstruction, and between hydroxynonenal-protein adducts and respiratory muscle strength. Although diaphragmatic neuronal nitric oxide synthase did not differ among the three groups and no inducible nitric oxide synthase was detected in any muscle, muscle endothelial nitric oxide synthase was lower in patients with severe COPD than in control subjects. Muscle nitrotyrosine levels were similar in both patients with severe COPD and control subjects. CONCLUSIONS This study shows that oxidative stress rather than nitric oxide is likely to be involved in the respiratory muscle dysfunction in severe COPD.
Collapse
Affiliation(s)
- Esther Barreiro
- Muscle and Respiratory System Research Unit, Respiratory Medicine Department, IMIM-Hospital del Mar, Universidad Pompeu Fabra, C/Dr. Aiguader, 80, E-08003 Barcelona, Spain.
| | | | | | | | | | | | | |
Collapse
|
20
|
Salido M, Tusquets I, Corominas JM, Suarez M, Espinet B, Corzo C, Bellet M, Fabregat X, Serrano S, Solé F. Polysomy of chromosome 17 in breast cancer tumors showing an overexpression of ERBB2: a study of 175 cases using fluorescence in situ hybridization and immunohistochemistry. Breast Cancer Res 2005; 7:R267-73. [PMID: 15743507 PMCID: PMC1064140 DOI: 10.1186/bcr996] [Citation(s) in RCA: 66] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2004] [Revised: 11/08/2004] [Accepted: 01/05/2005] [Indexed: 12/31/2022] Open
Abstract
Introduction One of the most common genetic aberrations associated with breast cancer is the amplification and overexpression of the ERBB2 proto-oncogene located at chromosome 17, bands q12-21. The amplification/overexpression occurs in 25 to 30% of all breast cancers. In breast cancer, aneusomy of chromosome 17, either monosomy or polysomy, is frequently observed by conventional cytogenetics and fluorescence in situ hybridization (FISH). The aim of this study was to discover whether or not numerical aberrations on chromosome 17 have a correlation to the amplification or overexpression of the ERBB2 gene and to analyze their clinical implications in subgroups showing 2+ or 3+ positive scores by immunohistochemistry (IHC). Methods We used FISH on a series of 175 formalin-fixed paraffin-embedded breast carcinomas to detect ERBB2 amplification, using a dual-probe system for the simultaneous enumeration of the ERBB2 gene and the centromeric region of chromosome 17, as well as using IHC to detect overexpression. We analyzed clinical and pathological variables in a subgroup of patients with 2+ and 3+ IHC scores (147 patients), to describe any differences in clinicopathological characteristics between polysomic and non-polysomic cases with the use of the χ2 test. Results We found 13% of cases presenting polysomy, and three cases presented monosomy 17 (2%). According to the status of the ERBB2 gene, instances of polysomy 17 were more frequently observed in non-amplified cases than in FISH-amplified cases, suggesting that the mechanism for ERBB2 amplification is independent of polysomy 17. Polysomy 17 was detected in patients with 2+ and 3+ IHC scores. We found that nodal involvement was more frequent in polysomic than in non-polysomic cases (P = 0.046). Conclusions The determination of the copy number of chromosome 17 should be incorporated into the assesment of ERBB2 status. It might also be helpful to differentiate a subgroup of breast cancer patients with polysomy of chromosome 17 and overexpression of ERBB2 protein that probably have genetic and clinical differences.
Collapse
Affiliation(s)
- Marta Salido
- Laboratori de Citogenètica i Biologia Molecular, Servei de Patologia, Hospital del Mar, IMAS, Barcelona, Spain
- Escola de Citologia Hematològica S Woessner-IMAS, Hospital del Mar, IMAS-IMIM, Barcelona, Spain
- Unitat de Recerca translacional en tumors sòlids-IMAS, Barcelona, Spain
| | - Ignasi Tusquets
- Unitat de Recerca translacional en tumors sòlids-IMAS, Barcelona, Spain
- Servei d'Oncologia Mèdica, Hospital del Mar, IMAS, Barcelona, Spain
- Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Josep M Corominas
- Unitat de Recerca translacional en tumors sòlids-IMAS, Barcelona, Spain
- Universitat Autònoma de Barcelona, Barcelona, Spain
- Servei de Patologia, Hospital del Mar, IMAS, Barcelona, Spain
| | - Marta Suarez
- Unitat de Recerca translacional en tumors sòlids-IMAS, Barcelona, Spain
- Servei d'Oncologia Mèdica, Hospital del Mar, IMAS, Barcelona, Spain
| | - Blanca Espinet
- Laboratori de Citogenètica i Biologia Molecular, Servei de Patologia, Hospital del Mar, IMAS, Barcelona, Spain
- Escola de Citologia Hematològica S Woessner-IMAS, Hospital del Mar, IMAS-IMIM, Barcelona, Spain
| | - Cristina Corzo
- Laboratori de Citogenètica i Biologia Molecular, Servei de Patologia, Hospital del Mar, IMAS, Barcelona, Spain
- Unitat de Recerca translacional en tumors sòlids-IMAS, Barcelona, Spain
- Servei d'Oncologia Mèdica, Hospital del Mar, IMAS, Barcelona, Spain
- Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Meritxell Bellet
- Unitat de Recerca translacional en tumors sòlids-IMAS, Barcelona, Spain
- Servei d'Oncologia Mèdica, Hospital del Mar, IMAS, Barcelona, Spain
| | - Xavier Fabregat
- Unitat de Recerca translacional en tumors sòlids-IMAS, Barcelona, Spain
- Servei d'Oncologia Mèdica, Hospital del Mar, IMAS, Barcelona, Spain
| | - Sergi Serrano
- Universitat Autònoma de Barcelona, Barcelona, Spain
- Servei de Patologia, Hospital del Mar, IMAS, Barcelona, Spain
| | - Francesc Solé
- Laboratori de Citogenètica i Biologia Molecular, Servei de Patologia, Hospital del Mar, IMAS, Barcelona, Spain
- Escola de Citologia Hematològica S Woessner-IMAS, Hospital del Mar, IMAS-IMIM, Barcelona, Spain
- Unitat de Recerca translacional en tumors sòlids-IMAS, Barcelona, Spain
| |
Collapse
|
21
|
Aguilar S, Corominas JM, Malats N, Pereira JA, Dufresne M, Real FX, Navarro P. Tissue plasminogen activator in murine exocrine pancreas cancer: selective expression in ductal tumors and contribution to cancer progression. Am J Pathol 2004; 165:1129-39. [PMID: 15466380 PMCID: PMC1618622 DOI: 10.1016/s0002-9440(10)63374-3] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Tissue plasminogen activator (tPA) is absent from normal human pancreas and is expressed in 95% of human pancreatic adenocarcinomas. We have analyzed the expression of components of the tPA system in murine pancreatic tumors and the role of tPA in neoplastic progression. Transgenic mice expressing T antigen and c-myc under the control of the elastase promoter (Ela1-TAg and Ela1-myc, respectively) were used. tPA was undetectable in normal pancreas, acinar dysplasia, ductal complexes, and in all acinar tumors. By contrast, it was consistently detected in Ela1-myc tumors showing ductal differentiation. Crossing transgenic Ela1-myc with tPA-/- mice had no effect on the proportion of ductal tumors, indicating that tPA is not involved in the acinar-to-ductal transition. Ela1-myc:tPA-/- mice showed an increased survival in comparison to control mice. All ductal tumors, and none of the acinar tumors, overexpressed the tPA receptor annexin A2, suggesting its participation in the effects mediated by tPA. Our findings indicate that murine and human pancreatic ductal tumors share molecular alterations in the tPA system that may play a role in tumor progression.
Collapse
Affiliation(s)
- Susana Aguilar
- Unitat de Biologia Cellular i Molecular, Institut Municipal d'Investigació Mèdica, Dr. Aiguader, 80, 08003-Barcelona, Spain
| | | | | | | | | | | | | |
Collapse
|
22
|
Corzo C, Tusquets I, Suarez M, Fabregat X, Salido M, Solé F, Corominas JM, Serrano S. Intratumoral heterogeneity of HER2/neu and topoisomerase IIalpha in breast cancer: a case with clonal monosomy 17. ACTA ACUST UNITED AC 2004; 154:89-90. [PMID: 15381381 DOI: 10.1016/j.cancergencyto.2004.02.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
23
|
Barreiro E, Gea J, Corominas JM, Hussain SNA. Nitric oxide synthases and protein oxidation in the quadriceps femoris of patients with chronic obstructive pulmonary disease. Am J Respir Cell Mol Biol 2003; 29:771-8. [PMID: 12816735 DOI: 10.1165/rcmb.2003-0138oc] [Citation(s) in RCA: 105] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Skeletal muscle dysfunction contributes to poor exercise performance in patients with chronic obstructive pulmonary disease (COPD). Increased oxygen radicals and nitric oxide (NO) have been proposed as mechanisms. In this study, we assessed the levels of protein oxidation (carbonyl formation), lipid peroxidation (4-hydroxy-2-nonenal formation), catalase and Mn-superoxide dismutase (Mn-SOD) expressions, nitric oxide synthases (NOSs), and protein tyrosine nitration in quadriceps muscles of 12 patients with patients with COPD and 6 control subjects. Lipid peroxidation was elevated in muscles of patients with patients with COPD as compared with control subjects, but protein oxidation was not. Muscle Mn-SOD but not catalase protein expression was significantly higher (200%) in patients with patients with COPDas compared with control subjects. Expression of neuronal NOS and endothelial NOS isoforms did not differ between control subjects and patients with COPD, whereas no inducible NOS protein expression was detected in limb muscles of the two groups of subjects. In patients with COPD, neuronal NOS expression correlated negatively with the degree of the airway obstruction (%FEV1 predicted). 3-Nitrotyrosine levels were significantly elevated in muscles of patients with COPDas compared with control subjects, and correlated positively with nNOS protein levels. These results indicate the development of both oxidative and nitrosative stresses in the quadriceps of patients with COPD, suggesting their involvement in muscle dysfunction.
Collapse
Affiliation(s)
- Esther Barreiro
- Room L3.05, 687 Pine Ave. West, Montreal, PQ, H3A 1A1 Canada
| | | | | | | |
Collapse
|
24
|
Torres-Rodríguez JM, Morera Y, Baró T, Corominas JM, Castañeda E. Pathogenicity of Cryptococcus neoformans var. gattii in an immunocompetent mouse model. Med Mycol 2003; 41:59-63. [PMID: 12627805 DOI: 10.1080/mmy.41.1.59.63] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
The pathogenicity of two different genomic profiles of Cryptococcus neoformans var. gattii serotype B isolated from goats that died from cryptococcal pneumonia was assessed in an experimental model of immunocompetent mice. One strain of each randomly amplified polymorphic DNA (RAPD) profile (GR52 and GR56) and three reference C. neoformans isolates representing serotypes B, D and C were used. BALB/c male mice were inoculated by the intraperitoneal route with each strain. After 4 weeks of follow-up, the animals were sacrificed and autopsy specimens of testes, liver, spleen, kidney, lungs and brain were cultured and stained for histopathology. Although spontaneous mortality was only 2% (one animal), all mice except for those inoculated with serotype C showed positive cultures in almost one organ. The strain GR52 isolated from goat showed the highest rate of positive cultures (80%) followed by serotype D (77%). Serotype B reference strain and second goat strain GR56 were both isolated from 70% of samples. Serotype C was recovered in only 33% of organs, and never from brain or lung specimens. GR52 grew abundantly from all lung cultures, and yeast cells with large capsules were seen in histopathology inside the alveoli, peribronchial vessels and interalveolar spaces. They appeared to elicit no inflammatory response. We conclude that intraperitoneally inoculated C. neoformans var. gattii shows high virulence in this immunocompetent mouse model. Strain GR52 was highest in pathogenicity and had marked lung tropism. In contrast, the serotype C reference strain showed the lowest pathogenicity and seemed not to spread outside the abdominal viscera.
Collapse
Affiliation(s)
- J M Torres-Rodríguez
- Clinical and Experimental Mycology Research Group, (IMIM), Institut Municipal d'Assistència Sanitària, Barcelona, Spain.
| | | | | | | | | |
Collapse
|
25
|
Bayes-Genis A, Salido M, Solé Ristol F, Puig M, Brossa V, Campreciós M, Corominas JM, Mariñoso ML, Baró T, Vela MC, Serrano S, Padró JM, Bayes de Luna A, Cinca J. Host cell-derived cardiomyocytes in sex-mismatch cardiac allografts. Cardiovasc Res 2002; 56:404-10. [PMID: 12445881 DOI: 10.1016/s0008-6363(02)00597-7] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Mesenchymal precursor cells are able to respond to tissue signals and differentiate into a phenotype characteristic of mature cells of that tissue. We sought to investigate whether adult human cardiomyocytes can be derived from recipient precursor cells in sex-mismatched cardiac allografts. METHODS We studied four male patients who received hearts from female donors, and four female patients who received an allograft from a male donor. Four sex-matched transplant patients, two of each sex served as controls. Combined fluorescence in situ hybridization with probes specific for X- and Y-chromosomes and immunohistochemistry with alpha-actin was used to identify cardiac muscle cells 4 and 12 months after transplantation. Slides were examined with a fluorescence microscope to detect the presence of male cells with one X and one Y signal in the nucleus, and female cells containing two X signals. RESULTS Mature cardiomyocytes from the host (1-2%) were found in five endomyocardial biopsy specimens at 4 months, and in three specimens at 12 months. In addition, recipient cells negative for cytoplasmic alpha-actin were also identified (1-21% per slide). The number of infiltrating recipient cells was not associated with the degree of rejection of the sample or with the number of prior rejection episodes. Echocardiographic evaluation showed no improvement in cardiac performance in hearts from patients with more than 10% chimeric recipient cells. CONCLUSIONS Our data confirm the existence of mature cardiomyocytes derived from host cells, likely mesenchymal precursors, in the adult cardiac allograft in vivo.
Collapse
Affiliation(s)
- Antoni Bayes-Genis
- Servei de Cardiologia, Hospital de la Santa Creu i Sant Pau, C/San Antonio Ma Claret 167, 08025, Barcelona, Spain
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
26
|
Lloreta J, Ferrer D, Corominas JM, Pavesi M, Serrano S, Mackay B. Prediction of recurrence and nucleolar features in node-negative breast carcinoma, ductal type, grade II. An ultrastructural study. Virchows Arch 2002; 440:280-4. [PMID: 11889598 DOI: 10.1007/s004280100506] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2001] [Accepted: 06/13/2001] [Indexed: 10/27/2022]
Abstract
One-third of patients with node-negative breast carcinoma develop a local recurrence that will decisively influence their outcome. We conducted this quantitative ultrastructural study to determine the value of nucleolar features in predicting recurrence of node-negative breast carcinomas. Forty-three node-negative infiltrating duct carcinomas were examined by means of electron microscopy. The number of cells with three or more nucleoli (N3), percentage of nucleoli contacting the nuclear membrane (NC), patient age, tumor size, grading, treatment, follow-up time, development of recurrence, and status were recorded. There were no differences in patient age, tumor grade, or modality of surgical treatment. Significant differences were found among patients with and without recurrence for N3 ( P=0.02), NC ( P=0.01), and tumor size ( P=0.01). For N3, the positive predictive value (PPV) was 64.3, and the negative predictive value (NPV) was 72.4 (sensitivity=52.9%; specificity=80.8%; P=0.04). For NC, the PPV was 62.5, and the NPV was 74.1 (sensitivity=58.8%; specificity=76.9%; P=0.02). For tumor size, the PPV was 66.7, and the NPV was 64.9 (sensitivity=23.5%; specificity=92.3%; P not significant). Using logistic regression analysis, independent predictive value was shown for N3, NC, and tumor size. The number of nucleoli per cell and the number of cells with nucleoli in contact with the nuclear membrane have independent predictive value for the development of recurrence in lymph node-negative infiltrating duct carcinoma of the breast. Although electron microscopy is a highly accurate method, improving the precision of light microscopic techniques would allow more universal assessment of these nucleolar features.
Collapse
Affiliation(s)
- Josep Lloreta
- Department of Pathology, Hospital del Mar-IMAS-IMIM, Universitat Pompeu Fabra, Passeig Marítim 25--29, 08003 Barcelona, Spain.
| | | | | | | | | | | |
Collapse
|
27
|
Porta M, Malats N, Corominas JM, Rifà J, Piñol JL, Real FX. Generalizing molecular results arising from incomplete biological samples: expected bias and unexpected findings. Ann Epidemiol 2002; 12:7-14. [PMID: 11750234 DOI: 10.1016/s1047-2797(01)00267-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
PURPOSE In molecular epidemiology, obtaining biological samples for all subjects targeted for study is frequently hampered by ethical, clinical, and logistic factors. The extent to which the incompleteness of biological samples could cause bias is rarely analyzed in depth. Here we report some expected bias and some unexpected findings during a study on mutations in the K-ras gene in exocrine pancreatic cancer (EPC). METHODS In this case-case study, all patients registered with EPC between 1980 and 1990 at two general hospitals were retrospectively identified from the hospital tumor registries. Their clinical records were abstracted and paraffin-embedded samples retrieved from pathology records. DNA was amplified, and mutations in codon 12 of the K-ras gene were detected using the artificial RFLP technique. RESULTS Results on the mutations (RM) were obtained for 51 of the 149 cases of EPC (34.2%). There were no significant differences on the availability of RM by age, gender, and tumor stage at diagnosis, but RM were over five times more likely to be available from one of the hospitals. Subjects with RM were more likely to have received a treatment with curative intent (OR = 11.56, 95% CL: 2.88-46.36). The existence of RM was positively associated with the availability of information on alcohol use and family history of cancer. Subjects with RM tended to belong to higher occupational groups and to smoke less than subjects without RM. Unexpectedly--given that in EPC K-ras mutations have consistently been found unrelated to age, gender, tumor stage, and other clinical factors-, cases with a K-ras mutation were more likely than wild-type cases to have information on tobacco and alcohol use (OR = 3.29, p = .21), medical history (OR = 4.46, p = .41), and family history of cancer (OR = 4.80, p = .01). The relationship between completeness of clinical records and K-ras mutations among cases with RM could not be accounted by age, gender, and occupational group. CONCLUSIONS Simple tests of age and gender distributions among subjects with and without available clinical information and molecular results may not rule out selection and information bias. Studies using biologic specimens are even more in need than classic studies to explain clearly the process followed to include and exclude subjects. Additional caution is needed when generalizing molecular results arising from incomplete biological specimens.
Collapse
Affiliation(s)
- Miquel Porta
- Institut Municipal d'Investigació Mèdica, Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain.
| | | | | | | | | | | |
Collapse
|
28
|
Arén JJ, Aroles F, Bausili JM, Baxarias P, Benlloch R, Bernal J, Buisan L, Canudes E, Casanovas P, Castaño J, Canet J, Cochs J, Corominas JM, Cuenca J, Delgado J, Escolano F, Esparza F, Esquius E, Fargas X, Ferrer JM, Fuentes J, Gancedo VA, Gomar C, Guitart J, Hervás C, Jornet M, López R, Manubens E, Más-Marfan J, Mateu J, Miranda A, Miranda L, Montero A, Moral V, Oferil F, Ortiz M, Pacheco M, Pelegrí MD, Ruidebas J, Rull M, Sala X, Sintes MD, Soler E, Tomás A, Turón E, Villalonga A, Villar JM. [Survey of the deficit of anesthesiologists in Catalonia and analysis of the situation made by 47 department heads]. Rev Esp Anestesiol Reanim 2001; 48:45-8. [PMID: 11234610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
|
29
|
Porta M, Costafreda S, Malats N, Guarner L, Soler M, Gubern JM, García-Olivares E, Andreu M, Salas A, Corominas JM, Alguacil J, Carrato A, Rifà J, Real FX. Validity of the hospital discharge diagnosis in epidemiologic studies of biliopancreatic pathology. PANKRAS II Study Group. Eur J Epidemiol 2000; 16:533-41. [PMID: 11049097 DOI: 10.1023/a:1007692408457] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND The aim was to analyse the magnitude, direction and predictors of change in the main hospital discharge diagnosis (HDD) after a clinical expert review, among patients included in a multicentre molecular epidemiologic study of biliopancreatic diseases. METHODS A total of 602 patients with a suspicion diagnosis of pancreas cancer (PC), cancer of the extrahepatic biliary system (CEBS) or benign biliopancreatic pathologies (BPP) were prospectively recruited at five general hospitals. A structured form was used to collect information from medical records. A panel of experts revised all diagnostic information and established the main clinicopathological diagnosis (CPD) by consensus. RESULTS Of the 204 cases with a HDD of PC, 176 (86%) were deemed to have a CPD of PC, eight of CEBS, twelve a neoplasm of different origin, four BPP and four syndromic diagnoses. Thus, 28 cases (14%) were false positives. Of the 129 patients with a HDD of CEBS, 15 (12%) were false positives. Nine of the 396 cases with a HDD of non-PC (2%) had a CPD of PC (false negatives), whilst 14 of 471 patients with a HDD of non-CEBS (3%) were deemed to have CEBS. Overall, sensitivity and specificity of HDD for PC were, respectively, 95 and 93%, and for CEBS, 89 and 97%. Cytohistological confirmation and laparotomy were independent predictors of diagnostic change. CONCLUSIONS Validity of the HDD was high, but its association with some clinical variables suggests that sole reliance on HDD can significantly bias results, and highlights the need to review all HDDs. Alternatively, only patients at high risk of misdiagnosis could be reviewed: primarily, those lacking a cytohistological diagnosis or a laparotomy. No exclusions appear warranted solely on the basis of age, gender or tumour spread.
Collapse
Affiliation(s)
- M Porta
- Institut Municipal d'Investigació Mèdica, Universitat Autònoma de Barcelona, Spain.
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
30
|
Abstract
We report the case of an exuberant ulcerative angiomatoid nasal lesion in a cocaine abuser. The lesion was made up of polymorphous endothelial cells with occasional mitoses, arranged in a lobular pattern with infiltrative-looking areas. There were extensive areas of thrombosis with focal recanalization. Intravascular proliferation was not observed. The clinical, radiological, and histological features suggested hemangiosarcoma as the main differential diagnosis, but the lobular architecture of the lesion and the widespread thrombosis favoured the diagnosis of a benign reactive process.
Collapse
Affiliation(s)
- F Alameda
- Department of Pathology, Hospital del Mar, Autonomous University of Barcelona, Spain
| | | | | | | | | |
Collapse
|
31
|
Porta M, Malats N, Jariod M, Grimalt JO, Rifà J, Carrato A, Guarner L, Salas A, Santiago-Silva M, Corominas JM, Andreu M, Real FX. Serum concentrations of organochlorine compounds and K-ras mutations in exocrine pancreatic cancer. PANKRAS II Study Group. Lancet 1999; 354:2125-9. [PMID: 10609819 DOI: 10.1016/s0140-6736(99)04232-4] [Citation(s) in RCA: 134] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Organochlorine compounds such as 1,1,1-trichloro-2,2-bis(p-chlorophenyl)-ethane (p,p'-DDT), 1,1-dichloro-2,2-bis(p-chlorophenyl) ethylene (p,p'-DDE), and some polychlorinated biphenyls (PCBs) are carcinogenic to animals and possibly also to human beings. Occupational exposure to DDT may increase the risk of pancreas cancer. The high frequency of K-ras mutations in pancreatic cancer remains unexplained. We analysed the relation between serum concentrations of selected organochlorine compounds and mutations in codon 12 of the K-ras gene in patients with exocrine pancreatic cancer. METHODS Cases were prospectively identified in five hospitals. Mutations in K-ras were analysed by PCR and artificial restriction fragment length polymorphism. Cases of pancreatic cancer with wild-type K-ras (n=17) were frequency matched for age and sex to cases of pancreatic cancer with a K-ras mutation (n=34, case-case study). These 51 cases were further compared with 26 hospital controls (case-control comparison). Serum organochlorine concentrations were measured by high-resolution gas chromatography with electron-capture detection and negative ion chemical ionisation mass spectrometry. FINDINGS Serum concentrations of p,p'-DDT were significantly higher in pancreatic cancer cases with a K-ras mutation than in cases without a mutation (odds ratio for upper tertile 8.7 [95% CI 1.6-48.5], p for trend=0.005). For p,p'-DDE the corresponding figures were 5.3 (1.1-25.2, p for trend=0.031). These estimates held after adjusting for total lipids, other covariates, and total PCBs. A specific association was observed between a glycine to valine substitution at codon 12 and both p,p'-DDT and p,p'-DDE concentrations (odds ratio 15.9, p=0.044 and odds ratio 24.1, p=0.028; respectively). A similar pattern was shown for the major di-ortho-chlorinated PCBs (congeners 138, 153, and 180), even after adjustment for p,p'-DDE, but without a specific association with spectrum. Concentrations of p,p'-DDT and p,p'-DDE were similar among wild-type cases and controls, but significantly higher for K-ras mutated cases than for controls (p<0.01). INTERPRETATION Organochlorine compounds such as p,p'-DDT, p,p'-DDE, and some PCBs could play a part in the pathogenesis of exocrine pancreatic cancer through modulation of K-ras activation. The results require replication, but they suggest new roles for organochlorines in the development of several cancers in human beings.
Collapse
Affiliation(s)
- M Porta
- Institut Municipal d'Investigació Mèdica, Universitat Autònoma de Barcelona, Spain.
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
32
|
Porta M, Malats N, Guarner L, Carrato A, Rifà J, Salas A, Corominas JM, Andreu M, Real FX. Association between coffee drinking and K-ras mutations in exocrine pancreatic cancer. PANKRAS II Study Group. J Epidemiol Community Health 1999; 53:702-9. [PMID: 10656099 PMCID: PMC1756794 DOI: 10.1136/jech.53.11.702] [Citation(s) in RCA: 56] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
STUDY OBJECTIVE To analyse the relation between coffee consumption and mutations in the K-ras gene in exocrine pancreatic cancer. DESIGN Case-case study. Consumption of coffee among cases with the activating mutation in the K-ras gene was compared with that of cases without the mutation. SETTING AND PATIENTS All cases of pancreatic cancer newly diagnosed at five hospitals in Spain during three years were included in the PANKRAS II Study (n = 185, of whom 121 whose tissue was available for molecular analysis are the object of the present report). Over 88% were personally interviewed in hospital. DNA was amplified from paraffin wax embedded tissues, and mutations in codon 12 of K-ras were detected by the artificial RFLP technique. MAIN RESULTS Mutations were found in tumours from 94 of 121 patients (77.7%). Mutations were more common among regular coffee drinkers than among non-regular coffee drinkers (82.0% v 55.6%, p = 0.018, n = 107). The odds ratio adjusted by age, sex, smoking and alcohol drinking was 5.41 (95% CI 1.64, 17.78). The weekly intake of coffee was significantly higher among patients with a mutated tumour (mean of 14.5 cups/week v 8.8 among patients with a wild type tumour, p < 0.05). With respect to non-regular coffee drinkers, the odds ratio of a mutated tumour adjusted by age, sex, smoking and alcohol drinking was 3.26 for drinkers of 2-7 cups/week, 5.77 for drinkers of 8-14 cups/week and 9.99 for drinkers of > or = 15 cups/week (p < 0.01, test for trend). CONCLUSIONS Pancreatic cancer cases without activating mutations in the K-ras gene had drank significantly less coffee than cases with a mutation, with a significant dose response relation: the less they drank, the less likely their tumours were to harbour a mutation. In exocrine pancreatic cancer the K-ras gene may be activated less often among non-regular coffee drinkers than among regular drinkers. Caffeine, other coffee compounds or other factors with which coffee drinking is associated may modulate K-ras activation.
Collapse
Affiliation(s)
- M Porta
- Institut Municipal d'Investigació Mèdica, Barcelona, Spain
| | | | | | | | | | | | | | | | | |
Collapse
|
33
|
Abstract
Systemic infections caused by opportunistic fungi have shown an increased frequency in the past 10 years, particularly in immunocompromised patients. Hansenula anomala is an ascosporogenous yeast of the Ascomycetes class found in the skin, throat, and digestive tract transient normal flora. This study was conducted to compare the pathogenicity of H. anomala and Candida albicans in a model of immunocompromised mice. Thirty-eight Swiss mice were divided into two groups as follows: 30 animals received an intraperitoneal (i.p.) injection of cyclophosphamide (200 mg/kg) four days before the induction of infection with H. anomala (1 x 10(6) yeasts/mL), and 8 animals received 100 mg/kg of cyclophosphamide at 3-day intervals during 3 weeks before inoculation of 1 x 10(7) yeasts/mL. All animals were treated with amoxicillin/clavulanic acid (40 mg/kg) four days before induction of infection. A group of mice inoculated with C. albicans (ATCC 64548) served as control. Tissue samples from the lung, spleen, liver, and kidney for histological and mycologic studies were obtained at necropsy. In each animal, the number of viable yeasts per gram of kidney was determined. The organs most frequently infected by H. anomala were the kidneys and the liver (20%), and the lung (10%). However, in conditions of sustained immunosuppression, H. anomala was found in 65.5% of the organs examined. It is concluded that in an experimental model of immunocompromised mice, the pathogenicity of H. anomala was low.
Collapse
Affiliation(s)
- J R Cermeño-Vivas
- Department of Parasitology and Microbiology, Universidad de Oriente, Ciudad Bolívar, Venezuela
| | | | | | | |
Collapse
|
34
|
Abstract
Cells having a signet ring appearance can occur in mesenchymal, lymphoid, and other nonepithelial neoplasms. We report the case of an intestinal stromal tumor with smooth muscle differentiation and a prominent signet ring cell component. The presence of signet ring forms of smooth muscle cells in sections of paraffin-embedded tissue often contrasts with a lack of cytoplasmic spaces by electron microscopy, and the ultrastructural finding of signet ring-like areas in the present case can be attributed to the fact that the tissue for electron microscopy was retrieved from paraffin blocks where this peculiar artifact already existed. Ultrastructural examination of the signet ring-like areas suggests that they originated as retraction spaces which may have resulted from variations in intracellular tension forces related to the distribution of actin filaments.
Collapse
Affiliation(s)
- M D Ferrer
- Department of Pathology, Hospital del Mar-IMAS-IMIM, Facultat de Biologia Humana, Universitat Pompeu Fabra, Barcelona, Spain
| | | | | | | | | | | |
Collapse
|
35
|
Abstract
Clear cell meningioma (CCM) is a peculiar variant that differs from conventional meningioma in affecting younger patients, arising more often in spinal or cerebellopontine locations, and showing a higher recurrence rate. Classical meningothelial areas are scarce in these tumors and the differential diagnosis with other neoplasms, particularly metastatic carcinoma, is often difficult. We report a case of clear cell meningioma from the lumbosacral spine in which location, radiologic presentation, light microscopic appearance in initial sampling, and some of the ultrastructural findings were reminiscent of chordoma. The tumor cells were diffusely positive for vimentin and very focally positive for epithelial membrane antigen. Ultrastructural demonstration of interdigitating cell processes joined by numerous desmosomes confirmed the diagnosis of CCM.
Collapse
Affiliation(s)
- F Alameda
- Hospital del Mar-IMAS-IMIM, Autonomous University of Barcelona, Spain
| | | | | | | | | | | |
Collapse
|
36
|
Tomás S, Coll J, Reth P, Corominas JM. [Immunohistochemical study of inflammatory infiltrates in minor salivary glands in Sjögren's syndrome and other autoimmune diseases]. Med Clin (Barc) 1998; 111:681-6. [PMID: 9887430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
BACKGROUND A study of the phenotype, activation and adhesive cells factors and cytokines in minor salivary glands in patients with primary Sjögren's syndrome (pSS), secondary Sjögren's syndrome (sSS) and autoimmune diseases (AD) without Sjögren's syndrome. PATIENTS AND METHODS We have studied the minor salivary glands in 30 patients with pSS, 30 patients with sSS, 19 patients with AD without SS and 18 controls, using immunohistochemical techniques to analyze the molecular expression of CD3, CD4, CD8, CD20, CD25, CD14, CD56, CD11a, CDw50 (ICAM-3), HLA-DR, IL-1, TNF-alpha and IFN-gamma in lymphocytic infiltration and epithelial cells. RESULTS Phenotype features were similar in patients with pSS and sSS, except that CD20+ lymphocyte expression was significantly higher in the sSS group (p = 0.023). The patients affected by AD without SS had activated lymphocytes in minor salivary glands in a similar manner to patients affected by pSS and sSS. No significant differences were found in HLA-DR expression in epithelial cells. We found unusual CD25 expression in epithelial cells in patients with SS but not in patients with AD without SS. The differences between pSS and sSS are related to SS theoretical time development and to immunosuppressive treatments. CONCLUSIONS The immunohistochemical pattern of minor salivary glands is similar in patients with pSS and sSS. Patients with AD are likely to develop immunological changes in minor salivary glands attributable to activated lymphocytes.
Collapse
Affiliation(s)
- S Tomás
- Servicio de Medicina Interna, Hospital del Mar-IMIM, Universidad Autónoma de Barcelona, Barcelona
| | | | | | | |
Collapse
|
37
|
Pou-Serradell A, Vinyas-Gayà J, Corominas JM. [A 56-year-old man with weakness of the legs]. Rev Neurol 1998; 26:777-86. [PMID: 9634668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- A Pou-Serradell
- Societat Catalana de Neurologia, Mútua de Terrassa, Hospital del Mar. Barcelona, España
| | | | | |
Collapse
|
38
|
Abstract
The authors report a renal cell carcinoma composed largely of spindle cells of Fuhrman's nuclear grade II in which the bland appearance of the cells and low mitotic index were reminiscent of a benign or low-grade smooth muscle tumor. Keratin immunostaining was positive, but evidence of epithelial differentiation was obtained by electron microscopy. The tumor was an incidental finding and it did not invade the perirenal fat or the renal vein. Follow-up is only 24 months but the histological features suggest that the prognosis may be better than that of a classic sarcomatoid renal cell carcinoma.
Collapse
Affiliation(s)
- J Lloreta
- Department of Pathology, Hospital del Mar IMAS-IMIM, Autonomous University of Barcelona, Spain
| | | | | | | | | | | | | |
Collapse
|
39
|
Supervía A, Knobel H, Corominas JM, Díez A. [Multicentric plasma cell angiofollicular hyperplasia in a HIV-positive patient]. An Med Interna 1997; 14:648-9. [PMID: 9518037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
|
40
|
Lloreta J, Mariñoso ML, Corominas JM, Cañas MA, Serrano S. Medullary carcinoma of the breast: an ultrastructural morphometric study of nine cases. Ultrastruct Pathol 1997; 21:499-507. [PMID: 9355232 DOI: 10.3109/01913129709016366] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Ultrastructural and morphometric features of 10 medullary carcinomas of the breast (MC) were investigated. Cases with a long follow-up were selected by applying stringent histologic criteria. All tumors had a homogeneous appearance by light microscopy. Under transmission electron microscopy, they showed occasional intracellular lumen formation or keratinization. In one tumor squamous differentiation was prominent and diffuse. Tumors with lymph node metastases possessed over 40% more desmosomes than nonmetastatic tumors. The number of cells with three or more nucleoli per nuclear section was significantly higher in metastatic than in nonmetastatic tumors (p = .02). Classic cases of MC of the breast display a relatively uniform appearance. However, subtle differences can be identified between metastatic and nonmetastatic tumors by ultrastructural morphometry. Although these differences are not associated with changes in the outcome of patients in this study, they seem to bear some relationship to the peculiar behavior of MC.
Collapse
Affiliation(s)
- J Lloreta
- Department of Pathology, Hospital Universitari de Mar (IMAS-IMIM-Autonomous University of Barcelona, Spain
| | | | | | | | | |
Collapse
|
41
|
Malats N, Porta M, Corominas JM, Piñol JL, Rifà J, Real FX. Ki-ras mutations in exocrine pancreatic cancer: association with clinico-pathological characteristics and with tobacco and alcohol consumption. PANK-ras I Project Investigators. Int J Cancer 1997; 70:661-7. [PMID: 9096646 DOI: 10.1002/(sici)1097-0215(19970317)70:6<661::aid-ijc6>3.0.co;2-t] [Citation(s) in RCA: 45] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The aims of this study were (i) to assess the prevalence and spectrum of codon 12 Ki-ras mutations in patients diagnosed with exocrine pancreatic cancer (EPC) in 2 general hospitals between 1980 and 1990, (ii) to analyze the association of this genetic alteration with clinical and pathological characteristics, and (iii) to determine the association of Ki-ras mutations with tobacco and alcohol consumption. DNA was amplified from paraffin-embedded tissue samples and mutations in codon 12 of Ki-ras were detected using the artificial RFLP technique. Cox proportional-hazards regression and unconditional logistic regression were applied. Codon 12 Ki-ras mutations were detected in 30 of 51 cases for which molecular results were available. The amino-acid substitutions were Asp (8), Val (6), and Arg (3). A double mutation, including always a Val, was detected in 5 cases. None of the 4 nonductal pancreatic neoplasms were mutated. The mutation prevalence was 79% in metastases and 54% in primary tumors. The risk of a mutated tumor was 3 times higher in alcohol drinkers than in non-drinkers, and a linear trend was apparent. When age, gender, hospital, and tobacco and alcohol consumption were taken into account, a high risk for mutations was detected in patients who only smoked and in patients who only drank, but less so in patients who both smoked and drank. These results raise novel hypotheses regarding the role of tobacco and alcohol in EPC.
Collapse
Affiliation(s)
- N Malats
- Institut Municipal d'Investigació Mèdica, Hospital del Mar, Universitat Autònoma de Barcelona, Spain
| | | | | | | | | | | |
Collapse
|
42
|
Cardellach F, Corominas JM. [A 69-year-old woman with predominantly proximal muscle weakness for 6 years]. Med Clin (Barc) 1996; 107:107-14. [PMID: 8754499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Affiliation(s)
- F Cardellach
- Servicio de Medicina Interna General, Hospital Clínic i Provincial, Universidad de Barcelona
| | | |
Collapse
|
43
|
Abstract
The ultrastructural features of a case of severe hyperthyroid myopathy are presented. Along with the moderate increase in mitochondrial size and number usually observed in most patients with hyperthyroid myopathy, some of the skeletal muscle mitochondria in the present case also contained paracrystalline rectangular inclusions. This finding has not been previously reported in hyperthyroid myopathy and further supports the current view that mitochondrial abnormalities play a major role in the pathogenesis of muscle dysfunction in hyperthyroid patients.
Collapse
Affiliation(s)
- J Lloreta
- Department of Pathology, Hospital Universitari del Mar, Barcelona, Spain
| | | | | | | |
Collapse
|
44
|
Lloreta J, Orozco M, Gea J, Corominas JM, Serrano S. Selective diaphragmatic mitochondrial abnormalities in a patient with marked air flow obstruction. Ultrastruct Pathol 1996; 20:67-71. [PMID: 8789212 DOI: 10.3109/01913129609023240] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
There is increasing evidence that exercise overload induces changes in skeletal muscle structure and function. Recent studies suggest that muscle mitochondria could be involved either as the result or the origin of these changes. This study describes a case of a patient with marked air flow obstruction related to chronic obstructive pulmonary disease, in which large aggregates of mitochondria were found in diaphragm muscle fibers. Many of the mitochondria contained paracrystalline rectangular inclusions. Latissimus dorsi and intercostal muscles were also available for ultrastructural examination that showed, respectively, normal and moderately increased number of mitochondria with normal mitochondrial structure. This is the first known report of paracrystalline rectangular inclusions in respiratory skeletal muscle from a patient with chronic obstructive pulmonary disease.
Collapse
Affiliation(s)
- J Lloreta
- Department of Pathology, Hospital Universitari del Mar, Barcelona, Spain
| | | | | | | | | |
Collapse
|
45
|
Lloreta J, Serrano S, Corominas JM, Ferrés-Padró E. Polymorphous low-grade adenocarcinoma arising in the nasal cavities with an associated undifferentiated carcinoma. Ultrastruct Pathol 1995; 19:365-70. [PMID: 7483012 DOI: 10.3109/01913129509021908] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
A case of polymorphous low-grade adenocarcinoma arising in the right nasal cavity of a male patient with previous history of kidney transplantation is reported. The tumor contained extensive areas of undifferentiated carcinoma, probably arising from the low-grade component. This combination of findings has not been previously reported in this variety of salivary gland tumor.
Collapse
Affiliation(s)
- J Lloreta
- Servei de Patologia, Hospital Universitari del Mar, Barcelona, Spain
| | | | | | | |
Collapse
|
46
|
Malats N, Porta M, Piñol JL, Corominas JM, Rifà J, Real FX. Ki-ras mutations as a prognostic factor in extrahepatic bile system cancer. PANK-ras I Project Investigators. J Clin Oncol 1995; 13:1679-86. [PMID: 7602358 DOI: 10.1200/jco.1995.13.7.1679] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
PURPOSE To assess the prevalence and prognostic significance of Ki-ras codon 12 mutations in extrahepatic biliary system cancer (EBSC). PATIENTS AND METHODS Patients diagnosed with EBSC between 1980 and 1990 (N = 111) were selected from two hospitals. DNA was amplified from paraffin-embedded tissues and mutations in codon 12 of Ki-ras were detected using the artificial restriction fragment-length polymorphism (RFLP) technique. RESULTS Tissue was available from 68.5% of patients. The prevalence of mutations was 41%. There was no association between mutations and clinical and pathologic characteristics; however, mutations in Ki-ras were associated with survival, with a median survival duration of 7.7 months for patients with wild-type Ki-ras and 1.7 months for patients with mutated tumors (hazards ratio [HR] = 1.67; P = .075). Among patients with stage I to II tumors, the chance of dying of patients with the mutation was 7.8 times higher than that of patients without the mutation (P = .087); the corresponding HR for patients with stage III to IV disease was 2.9 (P = .003). After adjusting for age, tumor site, histology, differentiation, and stage, the HR for Ki-ras mutations was 2.12 (P = .026). CONCLUSION Ki-ras codon 12 mutations are an independent prognostic indicator in patients with EBSC. Mutation detection may be of help in the management of these patients.
Collapse
Affiliation(s)
- N Malats
- Departmetn of Epidemiology, Institut Municipal d'Investigació Mèdica, Barcelona, Spain
| | | | | | | | | | | |
Collapse
|
47
|
Orozco-Levi M, Gea J, Sauleda J, Corominas JM, Minguella J, Aran X, Broquetas JM. Structure of the latissimus dorsi muscle and respiratory function. J Appl Physiol (1985) 1995; 78:1132-9. [PMID: 7775307 DOI: 10.1152/jappl.1995.78.3.1132] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
The aim of this study was to evaluate whether respiratory function influences the structure of the latissimus dorsi muscle (LD). Twelve patients (58 +/- 10 yr) undergoing thoracotomy were studied. Lung and respiratory muscle function were evaluated before surgery. Patients showed a forced expired volume in 1 s (FEV1) of 67 +/- 16% of the reference value, an FEV1-forced vital capacity ratio of 69 +/- 9%, a maximal inspiratory pressure of 101 +/- 21% of the reference value, and a tension-time index of the diaphragm (TTdi) of 0.04 +/- 0.02. When patients were exposed to 8% CO2 breathing, TTdi increased to 0.06 +/- 0.03 (P < 0.05). The structural analysis of LD showed that 51 +/- 5% of the fibers were type I. The diameter was 56 +/- 9 microns for type I fibers and 61 +/- 9 microns for type II fibers, whereas the hypertrophy factor was 87 +/- 94 and 172 +/- 208 for type I and II fibers, respectively. Interestingly, the histogram distribution of the LD fibers was unimodal in two of the three individuals with normal lung function and bimodal (additional mode of hypertrophic fibers) in seven of the nine patients with chronic obstructive pulmonary disease. An inverse relationship was found between the %FEV1-forced vital capacity ratio and both the diameter of the fibers (type I: r = -0.773, P < 0.005; type II: r = -0.590, P < 0.05) and the hypertrophy factors (type I: r = -0.647, P < 0.05; type II: r = -0.575, P = 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
Collapse
Affiliation(s)
- M Orozco-Levi
- Servei de Pneumologia, Hospital del Mar, Universitat Autònoma de Barcelona, Spain
| | | | | | | | | | | | | |
Collapse
|
48
|
Affiliation(s)
- A Supervía
- Department of Internal Medicine, Hospital del Mar, Barcelona, Spain
| | | | | | | | | |
Collapse
|
49
|
Roquer J, Pomarol E, Corominas JM, Pou Serradell A. [Axillary skin biopsy: a reliable diagnostic test for Lafora's disease]. Neurologia 1994; 9:431-2. [PMID: 7811498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
|
50
|
Affiliation(s)
- O Bielsa
- Department of Urology, Hospital del Mar, Universitat Autonoma de Barcelona, Spain
| | | | | | | | | |
Collapse
|