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Bacinschi X, Popescu GC, Zgura A, Gales L, Rodica A, Mercan A, Serban D, Haineala B, Toma L, Iliescu L. A Real-World Study to Compare the Safety and Efficacy of Paritaprevir/Ombitasvir/Ritonavir and Dasabuvir, with or without Ribavirin, in 587 Patients with Chronic Hepatitis C at the Fundeni Clinical Institute, Bucharest, Romania. Med Sci Monit 2022; 28:e936706. [PMID: 35787600 PMCID: PMC9270854 DOI: 10.12659/msm.936706] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background In the European Union, a tablet with fixed doses of ombitasvir, paritaprevir, and ritonavir combined with dasabuvir is an authorized treatment for patients with chronic hepatitis C virus (HCV) infection. Ribavirin is a broad-spectrum antiviral used in several treatment regimens for patients with HCV infection. This real-world study aimed to compare the safety and efficacy of ombitasvir, paritaprevir, and ritonavir combined with dasabuvir, with or without ribavirin, in 587 patients with chronic hepatitis C attending the Fundeni Clinical Institute, Bucharest, Romania. Material/Methods This is an observational prospective study including 315 patients with F4 degree of fibrosis and compensated cirrhosis, 185 patients with F3 fibrosis, and 83 patients with F2 fibrosis. Liver fibrosis was evaluated by liver biopsy or Fibromax. Efficacy was defined as undetectable HCV-RNA at 12 weeks after the end of treatment. In terms of safety, we monitored the development of adverse reactions, liver cytolysis, cholestasis, and hematologic disorders. Results Of the 587 patients, 2 patients with B-cell lymphoma died during therapy. In total, 3/585 patients (0.51%) did not achieve sustained virologic response. Common adverse effects were nausea and asthenia (especially in patients with other medical treatments; P=0.03 and P=0.04, respectively) and anemia in patients who received ribavirin (P<0.01). None of the patients discontinued antiviral treatment. Patients with kidney transplant or end-stage kidney disease did not receive or discontinued ribavirin. Conclusions Ombitasvir, paritaprevir, and ritonavir combined with dasabuvir, with or without ribavirin had an efficacy rate of over 99% in HCV genotype 1b infection. We report no serious adverse reactions.
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Affiliation(s)
- Xenia Bacinschi
- Department of Oncology-Radiotherapy, Alexandru Trestioreanu Institute of Oncology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Gabriel Cristian Popescu
- General Surgery Department, Bagdasar Arseni Clinical Emergency Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Anca Zgura
- Department of Oncology-Radiotherapy, Alexandru Trestioreanu Institute of Oncology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Laurentia Gales
- Department of Oncology-Radiotherapy, Alexandru Trestioreanu Institute of Oncology, Carol Davila University of Medicine and Pharmacy, Bucharest, Russian Federation
| | - Anghel Rodica
- Department of Oncology-Radiotherapy, Alexandru Trestioreanu Institute of Oncology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Adriana Mercan
- Department of Internal Medicine, Fundeni Clinical Institute, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Dragos Serban
- Department of General Surgery, Emergency University Bucharest Romania, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Bogdan Haineala
- Department of Urology, Fundeni Clinical Institute, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Letitia Toma
- Department of Internal Medicine, Fundeni Clinical Institute, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Laura Iliescu
- Department of Internal Medicine, Fundeni Clinical Institute, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
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Badiu DC, Zgura A, Mehedintu C, Haineala B, Anghel R, Bacinschi X. The Role of Programmed Cell Death Receptor 1 in Lung Cancer. In Vivo 2022; 36:1007-1012. [PMID: 35241563 DOI: 10.21873/invivo.12794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 12/14/2021] [Accepted: 12/22/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM Lung cancer is the most common cancer worldwide. Cancer immunotherapy is the activation of the immune system against cancer. The latest method of immunotherapy involves immune checkpoint inhibitors. Increased levels of programmed death ligand 1 (PD-L1) expression were observed on non-small-cell lung cancer. The association between PD-L1 expression and clinicopathological characteristics in lung cancer is still unclear. PATIENTS AND METHODS This is a cross-sectional, observational study that evaluated a sample of 41 lung cancer patients diagnosed between March 2019 and December 2020. PD-L1 tumor expression is described as a percentage. RESULTS Patients were diagnosed with non-microcellular lung cancer and aged 37 to 87 years. Most patients were diagnosed with adenocarcinoma. According to the analysis, the average age of patients with negative PD-L1 tumors was 65.6 years, and of those with positive PD-L1 tumors was 63.6 years. The average value of the tumor proportion score for males was 26.97%, and for females 25.55%. CONCLUSION No correlation was found between PD-L1 tumor expression and the age and sex of patients.
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Affiliation(s)
- Dumitru Cristinel Badiu
- General Surgery Department, "Bagdasar Arseni" Clinical Emergency Hospital, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - Anca Zgura
- Department of Obstetrics-Radiotherapy, Prof. Dr. Alexandru Trestioreanu Institute of Oncology, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania;
| | - Claudia Mehedintu
- Department of Obstetrics and Gynecology, Malaxa Clinical Hospital, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - Bogdan Haineala
- Department of Urology, "Fundeni" Clinical Institute, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - Rodica Anghel
- Department of Obstetrics-Radiotherapy, Prof. Dr. Alexandru Trestioreanu Institute of Oncology, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - Xenia Bacinschi
- Department of Obstetrics-Radiotherapy, Prof. Dr. Alexandru Trestioreanu Institute of Oncology, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
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Cristinel Badiu D, Popescu GC, Zgura A, Mercan Stanciu A, Dodot MD, Mehedintu C, Toma L, Razvan S, Bacinschi X, Haineala B. A Prospective Observational Study of 42 Patients with COVID-19 infection and a History of Hepatitis C Virus Infection and Thyroid Disease with Follow-Up Thyroid Function and Autoantibody Testing. Med Sci Monit 2021; 27:e935075. [PMID: 34969944 PMCID: PMC8725341 DOI: 10.12659/msm.935075] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background Thyroiditis is an important extrahepatic association in chronic hepatitis C virus (HCV) infection. There have been reports of an association between SARS-CoV-2 infection and the onset or re-activation of autoimmune hypothyroidism. Therefore, we performed this prospective observational study of 42 patients with COVID-19 infection and a history of hepatitis C virus infection and thyroid disease with follow-up thyroid function and autoantibody testing. Material/Methods From April 2020 to October 2020, we performed a prospective observational study of patients with cured hepatitis C virus (HCV) infection and documented thyroid disease who became infected with SARS-CoV-2 (confirmed by SARS-CoV-2 RNA detection via reverse-transcription polymerase chain reaction [RT-PCT] from the upper respiratory tract, both nasal and pharyngeal swabs). Evaluation at 1 and 3 months after SARS-CoV-2 infection included serum determination of antithyroid antibodies (anti-thyroglobulin [anti-Tg] and antithyroid peroxidase [ATPO]), thyroid-stimulating hormone (TSH), free thyroxine (fT4), free triiodothyronine (fT3), and evaluation of thyroid medication, with dose adjustment if required. Results One-month follow-up showed that both patients with autoimmune thyroiditis as well as patients without antibodies had increased ATPO levels. Also, levels of TSH, fT3, and fT4 were significantly decreased. At 3-month follow-up, levels of ATPO were decreased in all patient groups and the levels of thyroid hormones increased to normal values. Conclusions This study supports previous reports of an association between SARS-CoV-2 infection and thyroid dysfunction associated with thyroid autoantibodies. Thyroid function tests may be considered as part of the laboratory work-up in patients with COVID-19.
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Affiliation(s)
- Dumitru Cristinel Badiu
- Department of General Surgery, Bagdasar Arseni Clinical Emergency Hospital, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - Gabriel Cristian Popescu
- Department of General Surgery, Bagdasar Arseni Clinical Emergency Hospital, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - Anca Zgura
- Department of Oncology-Radiotherapy, Prof. Dr. Alexandru Trestioreanu Institute of Oncology, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - Adriana Mercan Stanciu
- Department of Internal Medicine II, "Fundeni" Clinical Institute, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - Mihai Daniel Dodot
- Department of Internal Medicine II, "Fundeni" Clinical Institute, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - Claudia Mehedintu
- "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - Letitia Toma
- Department of Internal Medicine II, "Fundeni" Clinical Institute, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - Simu Razvan
- Department of Internal Medicine II, "Fundeni" Clinical Institute, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - Xenia Bacinschi
- Department of Oncology-Radiotherapy, Prof. Dr. Alexandru Trestioreanu Institute of Oncology, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - Bogdan Haineala
- Department of Urology, "Fundeni" Clinical Institute, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
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Guler-Margaritis S, Mercan-Stanciu A, Toma L, Rusie D, Isac T, Dodot M, Zgura A, Bacalbasa N, Haineala B, Badiu DC, Serban D, Iliescu EL. COVID-19 Mid-term Impact on Hepatocellular Carcinoma in Patients With Hepatitis C Chronic Infection. In Vivo 2021; 35:3377-3383. [PMID: 34697172 DOI: 10.21873/invivo.12636] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Revised: 08/20/2021] [Accepted: 08/23/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM Liver injury has been frequently reported in association with SARS-CoV-2 infection, but data are still lacking regarding the impact of pre-existing liver damage and neoplasia on SARS-CoV-2 infection outcome and vice-versa. This study aimed to assess the effects of SARS-CoV-2 infection on hepatocellular carcinoma (HCC) in chronic hepatitis C virus (HCV) infected patients, both in therapeutic-naïve and patients treated with direct acting antivirals. PATIENTS AND METHODS We conducted a retrospective cohort study on 21 patients with a personal history of HCV infection, that have been diagnosed with different forms of HCC and who were subsequently infected with SARS-CoV-2. Patients were monitored by liver function tests, tumoral markers, blood cell count, and coagulation profile periodically. RESULTS Solitary HCC nodules were predominant among the subjects who achieved sustained virologic response, while multinodular and infiltrative patterns were mostly prevalent among the treatment-naïve group. Most patients had mild and moderate COVID-19 infections. CONCLUSION Within the current global pandemic crisis, cancer patients are highly vulnerable and in need of constant monitoring. Among patients with HCC, the ones with cured HCV infection may be at a lower risk of fatality than those with active HCV infection, when diagnosed with SARS-CoV-2 infection.
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Affiliation(s)
- Silviu Guler-Margaritis
- Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.,Department of Urology, Fundeni Clinical Institute, Bucharest, Romania
| | - Adriana Mercan-Stanciu
- Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.,Department of Internal Medicine II, Fundeni Clinical Institute, Bucharest, Romania
| | - Letitia Toma
- Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.,Department of Internal Medicine II, Fundeni Clinical Institute, Bucharest, Romania
| | - Daniel Rusie
- Department of General Surgery, Clinical Emergency Hospital, Bucharest, Romania
| | - Teodora Isac
- Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.,Department of Internal Medicine II, Fundeni Clinical Institute, Bucharest, Romania
| | - Mihai Dodot
- Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.,Department of Internal Medicine II, Fundeni Clinical Institute, Bucharest, Romania
| | - Anca Zgura
- Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.,Department of Oncology-Radiotherapy, "Prof Dr Alexandru Trestioreanu" Institute of Oncology, Bucharest, Romania
| | - Nicolae Bacalbasa
- Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Bogdan Haineala
- Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.,Department of Urology, Fundeni Clinical Institute, Bucharest, Romania
| | - Dumitru Cristinel Badiu
- Carol Davila University of Medicine and Pharmacy, Bucharest, Romania; .,General Surgery Department, Bagdasar Arseni Clinical Emergency Hospital, Bucharest, Romania
| | - Dragos Serban
- Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.,Department of Surgery, University Emergency Hospital, Bucharest, Romania
| | - Elena Laura Iliescu
- Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.,Department of Internal Medicine II, Fundeni Clinical Institute, Bucharest, Romania
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Badiu DC, Zgura A, Gales L, Iliescu L, Anghel R, Haineala B. Modulation of Immune System - Strategy in the Treatment of Breast Cancer. In Vivo 2021; 35:2889-2894. [PMID: 34410983 DOI: 10.21873/invivo.12578] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Revised: 06/24/2021] [Accepted: 07/16/2021] [Indexed: 01/28/2023]
Abstract
BACKGROUND/AIM In women, breast cancer is the most commonly diagnosed cancer type and at the same time the main cause of cancer-related death. Many mechanisms are involved in the tumor microenvironment to restrict the anti-tumor activity by the immune system. Identification of novel prognostic tools based on immunological data could make significant impact in developing innovative immunotherapy strategies that will restore the anti-tumor immune system efficacy. PATIENTS AND METHODS The study was performed on patients diagnosed with breast cancer, who were divided into two groups depending on the expression of HER2. For the studied group, first we described the infiltrate inflammatory on slides stained with haematoxylin eosin (HE) and in the second part we used flow cytometry in order to measure the percentage of T lymphocytes from the peripheral blood before and after breast cancer treatment. RESULTS High presence of tumor-infiltrating lymphocytes (TILs) was associated with prognostic improvement, better disease-free survival, distant disease-free survival and overall survival. In breast cancer, the presence of TILs predicts the full pathological response rate (pCR) after neoadjuvant chemotherapy. TILs are one of the best examples of the strict relationship existing between natural defence and carcinogenesis. CONCLUSION Modulation of the immune system is a promising strategy in the treatment of breast cancer, especially in triple-negative and HER2-positive molecular subtypes, the most immunogenic subtypes with a poor prognosis.
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Affiliation(s)
- Dumitru Cristinel Badiu
- General Surgery Department, Bagdasar Arseni Clinical Emergency Hospital, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - Anca Zgura
- Department of Oncology-Radiotherapy, Prof. Dr. Alexandru Trestioreanu Institute of Oncology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania;
| | - Laurentia Gales
- Department of Oncology-Radiotherapy, Prof. Dr. Alexandru Trestioreanu Institute of Oncology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Laura Iliescu
- Department of Internal Medicine II, Fundeni Clinical Institute, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Rodica Anghel
- Department of Oncology-Radiotherapy, Prof. Dr. Alexandru Trestioreanu Institute of Oncology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Bogdan Haineala
- Department of Urology, "Fundeni" Clinical Institute, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
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Haineala B, Zgura A, Diaconu C, Mehedintu C, Bacinschi X, Anghel RM. Long-term Response After Stopping Immunotherapy in a Patient With Metastatic Renal Cancer. In Vivo 2021; 35:1805-1810. [PMID: 33910866 DOI: 10.21873/invivo.12441] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 02/20/2021] [Accepted: 03/01/2021] [Indexed: 01/05/2023]
Abstract
BACKGROUND/AIM Kidney cancers account for about 2% of human malignancies. In recent decades, the incidence of this cancer type has gradually increased, mainly due to advances in imaging. The metastatic potential of these cancers is significant: a quarter of patients will immediately present with metastases and more than one third of patients treated with nephrectomy for a localized disease will develop metastases during their course. In total, more than half of patients will suffer from the consequences of metastasis. The median survival at this stage is only thirteen months, so the therapeutic challenge is immense. CASE REPORT The present case report describes a case of left renal clear cell carcinoma with brain, lung, right adrenal, bone and lymph node metastases in a 55-year-old male. The patient received only one line of anticancer treatment with sunitinib, which could not be continued due to haemorrhagic manifestations in brain metastases. The treatment was changed with immunotherapy which showed its effect even if it was stopped due to the patient wishes in the context of the COVID-19 epidemic. CONCLUSION Immunotherapy opens the doors to a new era in treatment of metastatic renal cancer and shows efficiency even after it has been stopped.
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Affiliation(s)
- Bogdan Haineala
- Department of Urology, "Fundeni" Clinical Institute, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - Anca Zgura
- Department of Oncology-Radiotherapy, "Prof. Dr. Alexandru Trestioreanu" Institute of Oncology, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania;
| | - Camelia Diaconu
- Department of Internal Medicine, Clinical Emergency Hospital of Bucharest, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - Claudia Mehedintu
- Department of Obstetrics and Gynecology, Malaxa Clinical Hospital, Bucharest, Romania
| | - Xenia Bacinschi
- Department of Oncology-Radiotherapy, "Prof. Dr. Alexandru Trestioreanu" Institute of Oncology, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - Rodica Maricela Anghel
- Department of Oncology-Radiotherapy, "Prof. Dr. Alexandru Trestioreanu" Institute of Oncology, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
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Haineala B, Zgura A, Badiu DC, Iliescu L, Anghel RM, Bacinschi XE. Lung Cancer, Covid-19 Infections and Chemotherapy. In Vivo 2021; 35:1877-1880. [PMID: 33910875 DOI: 10.21873/invivo.12450] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 03/24/2021] [Accepted: 03/26/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND/AIM The Covid-19 epidemic has severely strained health care systems across the globe. The impacts are multiple especially for patients cared for cancer. The Covid-19 epidemic has several impacts on the management of lung cancer patients. The aim of this work was to summarize the available epidemiological data on patients diagnosed with lung cancer infected with Covid-19 and describe the different strategies to improve the management of these patients by summarizing the recommendations in this area. PATIENTS AND METHODS The Teravolt cohort is an observational multicenter registry, including patients with non-small cell cancer, small cell cancer or mesothelioma but also epithelial tumors and a diagnosis of Covid-19. The Theravolt registry indicates an unexpectedly high mortality rate in patients with thoracic malignancies with COVID-19. RESULTS Between March 26 and April 12, 2020, 200 patients treated in 8 countries were included. They had a performance status (PS) of 0-1 in 72% of cases, were smokers or ex-smokers in 81% of cases, had non-small cell cancer (76% of cases), were under treatment in 74% of cases, and the majority were first-line cases (57%). The hospitalization rate was 76% and the mortality rate 33%; only 10% of patients with criteria for intensive care hospitalization were admitted to the intensive care. CONCLUSION Data presented in this registry suggest a high mortality in patients with thoracic cancer and Covid-19. Therofere, the importance to create a safe healthcare system during Covid-19 pandemic is underlined along with the need for essential effective clinical service delivery to patients with lung cancer.
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Affiliation(s)
- Bogdan Haineala
- Department of Urology, "Fundeni" Clinical Institute, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - Anca Zgura
- Department of Oncology-Radiotherapy, "Prof. Dr. Alexandru Trestioreanu" Institute of Oncology, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania;
| | - Dumitru Cristinel Badiu
- General Surgery Department, "Prof. Dr. Bagdasar Arseni" Clinical Emergency Hospital, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - Laura Iliescu
- II Department of Internal Medicine, "Fundeni" Clinical Institute, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - Rodica Maricela Anghel
- Department of Oncology-Radiotherapy, "Prof. Dr. Alexandru Trestioreanu" Institute of Oncology, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - Xenia Elena Bacinschi
- Department of Oncology-Radiotherapy, "Prof. Dr. Alexandru Trestioreanu" Institute of Oncology, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
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Bacinschi X, Zgura AF, Mercan-Stanciu A, Grasu M, Herlea V, Toma L, Dodot M, Martiniuc A, Anghel R, Haineala B. Management of Diagnosis and Treatment in a Case of Fibrolamellar Carcinoma. Cancer Diagn Progn 2021; 1:23-28. [PMID: 35399695 PMCID: PMC8962773 DOI: 10.21873/cdp.10004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 03/05/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND/AIM Fibrolamellar carcinoma is a rare primary hepatic malignancy that has recently been recognized as a distinct clinical entity, highly different from the well-known hepatocellular carcinoma. This report describes the clinical and paraclinical aspects of the fibrolamellar carcinoma, emphasizing its particularities. CASE REPORT A 30-year-old patient presented to the hospital with nonspecific symptoms and weight loss, with imaging findings showing abdominal and mediastinal masses. Multiple biopsies were performed, leading to a diagnosis of metastatic fibrolamellar carcinoma. Given the extent of the disease, systemic drug treatment was administered, although prognosis was poor with tumor growth, resulting in biliary duct invasion. CONCLUSION Fibrolamellar carcinoma is a rare type of malignancy, with a difficult differential diagnosis in which imaging techniques are important but for which biopsy remains the gold standard. The prognosis depends on tumor extent and may include surgical methods or chemotherapy.
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Affiliation(s)
- Xenia Bacinschi
- Department of Oncology-Radiotherapy, Prof. Dr. Alexandru Trestioreanu Institute of Oncology,Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Anca Florina Zgura
- Department of Oncology-Radiotherapy, Prof. Dr. Alexandru Trestioreanu Institute of Oncology,Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Adriana Mercan-Stanciu
- Department of Internal Medicine II, Fundeni Clinical Institute,Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Mugur Grasu
- Department of Interventional Radiology, Fundeni Clinical Institute,Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Vlad Herlea
- Department of Pathology, Fundeni Clinical Institute, Bucharest, Romania
| | - Letitia Toma
- Department of Internal Medicine II, Fundeni Clinical Institute,Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Mihai Dodot
- Department of Internal Medicine II, Fundeni Clinical Institute,Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Alexandru Martiniuc
- Department of General Surgery, Fundeni Clinical Institute,Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Rodica Anghel
- Department of Oncology-Radiotherapy, Prof. Dr. Alexandru Trestioreanu Institute of Oncology,Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Bogdan Haineala
- Department of Internal Medicine II, Fundeni Clinical Institute,Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
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Bacinschi X, Saptefrati O, Zgura A, Iliescu L, Haineala B, Bratila E, Mehedintu C, Petca RC, Petca A, Barac RI, Anghel R. Evaluation of Biochemical Markers Correlated with Breast Cancer Young Patients. Rev Chim 2020. [DOI: 10.37358/rc.20.8.8298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Breast cancer ranks first in women in terms incidence and mortality in the world. In Romania its frequency continues to increase and now is the most common cancer in the women. Despite therapeutic advances, there is still severe cancer with heavy sequelae both physical and mental. It`s even harder to accept or even reject when it comes to a young women. For a long time, breast cancer was linked to a more or less old age. However, in the recent literature, breast cancer is on the rise more observed in a young population, its frequency is estimated at 7% all cases of breast cancer. Breast cancer diagnosed in young patients tends to be more aggressive than the rest of the cases. In this paper, we present the results of a study that included 59 women presenting primary invasive breast carcinomas selected from the database of the Institute of Oncology Bucharest in which clinical follow-up data cover long intervals of time (2014 - 2019) and whose histological pieces met technical conditions optimal for extended immunohistochemical processing. The available material resources allowed the completion of a complete analyzes in all cases in relation to the immunohistochemical examination . The correlation between the expression of each of the antibodies was calculated using Pearson correlation coefficient.
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Zgura A, Gales L, Haineala B, Bratila E, Mehedintu C, Barac RI, Berceanu C, Andreescu CV, Brinduse LA, Ionescu A, Anghel R. Immune Effects of Transtuzumab in HER2 Positive Breast Cancer. Rev Chim 2019. [DOI: 10.37358/rc.19.8.7428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The immune system could mediate the antitumor activity of several anticancer treatments. Several chemotherapy compounds, including anthracyclines and oxaliplatin, induce immunogenic cell death that in turn activates the antitumor immune response. Trastuzumab induces antibody-dependant cell-mediated cytotoxicity. On the basis of this background, immune markers have recently been the focus of intense translational research to predict and monitor the efficacy of treatments. Gene expression arrays and immunohistochemistry have assessed immune activation and infiltration by macrophages, natural killer, and T and B lymphocytes. In this paper we present the results of a study that included 22 patients diagnosed with Her2 positive breast cancer undergoing treatment with Transtuzumab.
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Zgura A, Gales L, Haineala B, Bratila E, Mehedintu C, Andreescu CV, Berceanu C, Petca A, Barac RI, Ionescu A, Anghe R. Correlations Between Known Prognostic Markers and Tumor - infiltrating Lymphocytes in Breast Cancer. Rev Chim 2019. [DOI: 10.37358/rc.19.7.7340] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The presence of tumor-infiltrating lymphocytes (TILs) is associated with a favorable long-term outcome in breast cancer. The main objective of this study was to show that there is a correlation between known prognostic and predictive factors and TILs. We retrospectively identified 56 patients with human epidermal growth factor receptor-2 (HER2 +, n = 22) and HER2 negative (HER2-, n = 34) breast cancer diagnosed between 2012 and 2018 at the Institute of Oncology Prof. Dr. Alexandru Trestioreanu, Bucharest. Hematoxylin-eosin-stained slides of these paired samples were evaluated for stromal TILs. The present study reports that TILs can be used as a clinically useful biomarker that has the ability to stratify HER2 negative and HER2 positive patients in prognostic function, bringing relevant information in addition to the established prognostic factors.
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Zgura A, Gales L, Bratila E, Mehedintu C, Haineala B, Barac RI, Popa AR, Buhas C, Berceanu C, Andreescu CV, Anghel R. Variation of the T Lymphocytes According to Treatment in Breast Cancer. Rev Chim 2019. [DOI: 10.37358/rc.19.5.7186] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Breast cancer is a multifaceted disease whose varied phenotype recapitulates only partially the biological complexity. At present, there are new approaches to the diagnosis and treatment of this form of cancer, but research should also focus on identifying and implementing other individual prognostic factors, factors that may lead to improved clinical decision making with regard to the patient, in order to establish an individualized treatment.
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Duca AE, Dincă O, Pahomi-Nicolae CL, Neguț AC, Streinu-Cercel A, Săndulescu O, Haineala B, Margaritis S, Munteanu M, Ilie AE, Soica MA, Streinu-Cercel A. A complicated case of osteodiscitis and retroperitoneal abscesses in an immunosuppressed patient. BMC Infect Dis 2014. [PMCID: PMC4240107 DOI: 10.1186/1471-2334-14-s7-p2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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14
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Sinescu I, Surcel C, Mirvald C, Chibelean C, Gingu C, Harza M, Cerempei V, Haineala B, Iordache A, Savu C. UP-01.182 Tuberous Sclerosis with Cutaneous Phenotype: Clinical Particularities. Urology 2011. [DOI: 10.1016/j.urology.2011.07.733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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Voinea S, Harza M, Gingu C, Iordache A, Dudu C, Manea I, Pavel C, Haineala B, Sinescu I. POS-03.80: Large and sphere-shaped prostate affects the periprostatic nerve block anesthesia. Urology 2007. [DOI: 10.1016/j.urology.2007.06.971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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