1,720,980 research outputs found
Accuracy of serum HER2 and CA 15-3 together in early detection of breast cancer recurrence. A preliminary case-control study
No full textBackground: Breast cancer is the most common female cancer worldwide, and the 5-year recurrence rates range from 7% to 13%, according to the stage (I-III) of the disease. Because late detection of metastases can contribute to the failure of primary treatment, their early identification has a substantial impact on adequate therapy and prognosis. In this setting, several serum tumor markers (TM) and tissue-extracting prognostic factors have been tested. Unfortunately, none has shown such a sensitivity to be recommended as a routine test. Human epidermal growth factor receptor 2 (HER2) is a transmembrane glycoprotein with intracellular tyrosine kinase activity, that can also be measured in the blood. The monoclonal antibody of the cancer antigen (CA) 15-3 assay recognizes an epitope localized in a mucine glycoprotein encoded by the gene MUC1, and this protein is overexpressed in BC cells and shed into the bloodstream. The purpose of this study was to evaluate the usefulness of HER2 and CA 15-3 serum levels measurements in the early detection of cancer recurrence in women who underwent curative surgery for stage I-II BC invasive ductal carcinoma of the breast.
Materials and Methods: Nineteen women (median age 62 years, range 38-74) who underwent curative surgery for stage I-II BC and developed distant metastases during follow-up (cases) were enrolled in the study. Controls were 21 age- and stage-matched patients at the time of surgery, in whom a recurrence was excluded by whole body 18F-FDG-PET/CT. All patients had undergone serum HER2 and CA 15-3 measurements using two-site sandwich immunoassay and direct chemiluminescent technology. The cut-off limit was 32 U/mL and 15 ng/mL for CA 15-3 and HER2, respectively. The chi-squared test was used to compare results.
Results: The results (HER2 vs. CA 15-3) were the following: sensitivity 52.6% vs. 36.8% (p=0.022), specificity 81.0 vs. 76.2% (p=0.39), positive predictive value 71.4% (95% CI 45.3-88.3) vs. 58.3% (95% CI 31.9-80.7) (p=0.054), negative predictive value 65.4% (95% CI 46.2-80.6) vs. 57.1% (95% CI 39.1-73.5) (p=0.19), accuracy 67.5% vs. 57.5% (p=0.14). The prevalence was the same (47.5%). With the combination of CA 15-3 and HER2, the sensitivity, specificity and accuracy reached 63.1% (p=0.15), 85.7% (p=0.34), and 75.0% (p=0.21), respectively.
Conclusions: In the early detection of distant metastases in patients with BC, the sensitivity of both serum HER2 and CA 15-3 was low. HER2 was more sensitive than CA 15-3 (52.6% vs. 36.8%, p=0.02), but the combination of HER2 and CA 15-3 did not improve significantly (p=NS) the results, and thus is not recommended
Predictive value of serum HER2 and CA 15-3 in patients with HER2 positive breast cancer and relapse of the disease: Preliminary study.
No full textBackground: Cancer antigen (CA) 15-3 is encoded by the MUC1 gene. It is overexpressed in breastcancer (BC) tissue, and released into the bloodstream. The human-epidermal-growth-factor receptor 2 (HER2) is a transmembrane glycoprotein with intracellular tyrosine kinase activity, that can also be measured in the blood. The role of circulating HER2 and CA 15-3 as predictive markers of relapse of the disease and in monitoring therapy in patients with metastatic BC are not well defined. The aim of this study was to analyze, whether correlation exists between preoperative serum CA 15-3 and HER2, and relapse ofthe disease in patients who underwent surgery for tissue HER2 positive (HER2+) BC.
Materials and Methods: Data regarding a series of 12 women (median age 57 years, range 35-62 years) withstage I (pT1, N0-1mi, M0) tissue HER2+ BC (Group 1) who developed locoregional or distant metastases during follow-up were reviewed. Controls were 14 women with age- and stage-matched tissue HER2+ BC (Group 2) who did not developed relapse of the disease. All patients underwent preoperative CA 15-3 and HER2 serum levels measurement, by a two-site sandwich immunoassay using direct chemiluminescent technology, and enzyme-linked immunosorbent assay (ELISA), respectively. A serum CA 15-3 and HER2 concentration of 30 U/mL and 15 ng/mL were defined as the upper limit of normal, respectively. A p-value<0.05 was considered statistically significant.
Results: Overall, the mean preoperative CA 15-3 and HER2 levels were 26.0±10.8 U/mL and 18.5±9.3 ng/mL, respectively. CA 15-3 and HER2 were above the cut-off in 7 and 10 patients of Group 1, respectively. The sensitivity, specificity, positive predictive value (PPV), negative predictivevalue, and negative likelihood ratio weighted by prevalence were (CA15-3 vs.HER2) 0.78 vs. 0.77 (p=0.86), 0.70 vs. 0.85 (p=0.011), 0.58 vs. 0.83 (p<0.001), 0.85 vs. 0.78 (p=0.20), and 0.17 vs. 0.27 (p=0.08), respectively. A weak correlation between CA 15-3 and HER2 (R=0.46, p=0.05) was found. There was nosignificant relationship between age of the patients, CA 15-3 (R=-0.28, p=0.25) or HER2 (R=0.02, p=0.92).
Conclusions: In patients with HER2+ stage I BC, baseline serum CA 15-3 and HER2 are independent of age. Both have low sensitivity in detecting primary tumor, but the specificity and PPV of HER2 were significantly higher than that of CA 15-3. These serum markers do not condition the therapeutic decision-making of patients, but are useful as prognostic factor in patients who will develop locoregional or distant metastases during follow-up.
References: Lumachi F et al. Curr Med Chem 20: 596-604, 2013
Proteomics as a Guide for Personalized Adjuvant Chemotherapy in Patients with Early Breast Cancer
No full textProteomics allows for better understanding of the function and regulation of cancer cells mediated by intra-and extracellular signaling networks. Integrating such information with clinicopathological characteristics of the tumor may lead to either detection of disease biomarkers useful to differentiate high-from low-risk patients, or to identification of new drug targets. Adjuvant chemotherapy is currently a personalized treatment strategy, especially for breast cancer (BC) patients, and the risk assessment of each patient influences its use because the benefit strictly correlates with the level of risk. Luminal A BCs are endocrine therapy (ET)-sensitive but exhibit low sensitivity to chemotherapy, while luminal B cancers, according to the Ki-67 proliferation rate may require for chemotherapy in addition to ET, and HER2-positive tumors derive benefit from adjuvant chemotherapy containing an anthracycline, a taxane and trastuzumab for one year. Triple-negative BCs have a high degree of genomic instability exhibiting a more aggressive clinical course with respect to other types of BC, and the anthracycline-taxane regimen constitutes the standard approach. Studies considering the use of targeted approaches (drugs), including poly (ADP-ribose) polymerase (PARP-1), vascular endothelial growth factor (VEGF), epidermal growth factor receptor (EGFR) inhibitors, or EFGR and HER2 blockers, are still under evaluation. In the genomic era, promising new targeted-therapies are worthy of further investigation, and mTOR inhibitors have been used for patients with high-risk ER-positive and HER2-negative tumors. In the near future, genetic and molecular profiling of BC will help to better-categorize patients, determine the choice of chemotherapy in low-risk, or intensify the treatment in high-risk cancer patients, eventually revealing new targeted agents
Quality-of-life after breast surgery in patients with breast cancer who underwent axillary lymph node dissection using harmonic dissection devices.
No full textBackground: Axillary node dissection (ALND) is still required in patients with breast cancer (BC) but unfortunately, it can cause some complications, such as increased amount of drainage and seroma formation, which subsequently worsen their quality-of-life (QoL). The aim of this study was to evaluate whether the use of a harmonic dissection device (HDD), which reduces the risk of complications, can improve the short-term postoperative QoL of patients who underwent breast surgery.
Methods: Sixty-eight women (median age 60, range 34-67 years) undergoing curative surgery for primary pT1-2 BC were enrolled in the study. The patients were randomly divided into two groups according to whether or not a HDD was used (Group 1, N=32; Group 2, N=36, respectively). Health-related QoL was measured with the Medical Outcomes Study Short Form (MOS-SF-36).
Results: Age, body mass index (BMI), tumor stage, number of the removed nodes, type of surgery did not differ (p=NS) between groups. The total output of drainage was significantly reduced in Group 1, and also the formation of seromas was reduced in number. The results of the MOS-S-36 are shown in the Table.
Conclusions: In patients undergoing ALND for BC the use of a HDD reduces some postoperative complications, such as output of drainage and seroma formation. However, these benefits have a limited impact on QoL of patients, since a few parameters of the MOS-SF-36 form improve significantly
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Dispelling the Myths Behind First-author Citation Counts
Full text linkWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
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