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A Katalinic

Publications and source records attributed to A Katalinic.

At least 73 records · Page 4Linked to original sources
PubMed1997

Interleukin-6 expression after renal transplantation.

BACKGROUND: Interleukin-6 (IL-6) is an inflammatory cytokine that plays a role in transplant rejection. We tested the hypothesis that IL-6 levels in serum or urine could be of value in predicting acute and chronic allograft rejection. Furthermore, we examined whether or not such levels reflected IL-6 expression in the kidney. METHODS: We measured IL-6 and IL-6 soluble receptor (IL-6sR) in serum and urine of 145 transplant patients and 20 normal controls. In parallel, we studied 108 renal biopsies. IL-6 was measured with a bioassay system using an IL-6 dependent cell line. IL-6sR was measured with enzyme-linked immunosorbent assay. The biopsies were examined for IL-6 and IL-6 receptor (IL-6R) expression with immunohistochemistry. RESULTS: Rejection episodes occurring within 2 months of transplantation were accompanied by elevated IL-6 concentrations in serum (17 +/- 4.8 pg/ml, P < 0.05) and urine (114 +/- 27 pg/ml, P < 0.005), compared to controls. These values returned towards baseline (0-5 pg/ml) after successful rejection treatment. The sensitivity of urine measurements was much higher (93%) than serum (54%). The specificity in serum (70%) and urine (60%) was reduced by infection, acute tubular necrosis, and antithymocyte globulin treatment. Serum and urine IL-6sR values did not correlate with rejection. In biopsy tissue, IL-6 and IL-6R were both elevated during rejection. Especially, mononuclear cells within the interstitial infiltrate stained positive. However, the amount of IL-6 positive cells did not correlate with peripheral IL-6 concentrations. CONCLUSIONS: Urine but not serum IL-6 values are sensitive indicators of rejection; however, they are confounded by infection, acute tubular necrosis, and certain antirejection treatments. These features limit their usefulness.

Acute Disease↗
PubMed1997

Influence of season on manifestation of schizophrenic subtypes.

In the modern classification systems ICD-10 and DSM-III-R, the term seasonality has been given a separate significance in the diagnostic categorization of affective disorders. Its definition is oriented not merely to the increased seasonal prevalence in the autumn and winter months, but also to symptoms that do not occur in nonseasonal attacks. To date, research work on seasonality in schizophrenia has concentrated on birth seasonality, while no results based on large populations of patients have yet become available on the manifestation seasonality of schizophrenic subtypes. Within the framework of a retrospective study carried out in the period between 1983 and 1995, involving 2, 119 patients suffering from recurrent attacks of schizophrenia, seasonal manifestations were recorded in accordance with the criteria defined in DSM-III-R. It was found that the two subtypes of paranoid hallucinatory and schizoaffective psychoses met the criterion of seasonality significantly more frequently than did the subtypes disorganized and catatonic disorders. In addition, seasonal courses within the groups just mentioned clearly differed from the nonseasonal forms in terms of their symptomatology.

Adult↗
PubMed1997

Procalcitonin--influence of temperature, storage, anticoagulation and arterial or venous asservation of blood samples on procalcitonin concentrations.

In this study we have analysed the influence of temperature and time of storage and of repeated freezing on procalcitonin plasma concentrations ex vivo. We have also analysed the difference of procalcitonin concentrations in arterial or venous blood samples and the influence of different anticoagulation techniques on procalcitonin concentrations (serum, EDTA-, lithium-heparin- or citrate plasma). At room temperature (25 degrees C) a loss of procalcitonin plasma concentrations of 6.4% +/- 2.6% (mean, 2 standard error of the mean) after 3 hours (4.6% +/- 5.2% at 4 degrees C) and 12.3% +/- 3.1% after 24 hours occurred (6.3% +/- 5.0% at 4 degrees C, n = 17 each). Comparing the procalcitonin concentrations of blood samples with different anticoagulants (n = 24 each), there was only a significant difference between procalcitonin concentrations in heparinized plasma and serum (+ 7.6%, difference of the mean). There was no significant influence of the blood sampling technique (arterial or venous line) and of repeated freezing/thawing cycles (up to 3 times) on the procalcitonin concentrations measured. Although the difference of sampling and storage of the blood on procalcitonin concentrations is not significant, multiple factors may act synergistically on the result of procalcitonin measurement. To keep variations of ex vivo conditions as minimal as possible, a standardized technique of anticoagulation, time and temperature of storage is recommended, e.g. the use of EDTA-plasma and storage at room temperature, when samples are measured within 4 hours after blood drawing.

Anticoagulants↗
PubMed1997

The prediction of lymph node metastases in colorectal cancer by expression of the nucleoside diphosphate kinase/nm23-H1 and histopathological variables.

OBJECTIVE: To ascertain the risk of locoregional lymph node metastases from colorectal cancer, we compared microscopic pathological characteristics of the primary tumor with the expression of the nm23-H1 protein. METHODS: The nm23-H1 expression of 100 colorectal carcinomas and corresponding non-neoplastic mucosa was analyzed immunohistochemically at the time of primary curative surgery (R0 resection). Conventional histopathological factors (depth of infiltration, grade of differentiation, invasion of lymph vessels or veins) that are proven indicators for metastatic involvement of locoregional lymph nodes were examined in all cases. RESULTS: Of 45 tumors with lymph node metastases, 42 (93%) had a low nm23-H1 expression whereas only 35 (78%) were of high-risk histology (G3, G4, or lymphatic invasion). Therefore, nm23-H1 expression within the primary tumor indicated the lymph node status with a sensitivity of 93% and a negative predictive value of 92%. The classic pathohistological factors (high risk vs low risk) had a sensitivity of 78% and a negative predictive value of 77%, respectively. CONCLUSION: Reduced expression of nm23-H1 within primary colorectal carcinomas could serve as an additional independent marker in estimating the nodal metastatic potential of these tumors.

Antigens, Neoplasm↗
PubMed1997

[Nasal CPAP therapy of obstructive sleep apnea syndrome with expiratory pressure reduction: a prospective randomized study of acceptance of treatment during therapy initiation].

It is often difficult to achieve adequate acceptance of nasal continuous positive airway pressure (CPAP) therapy by patients with OSA. Many patients find it particularly inconvenient to expire against the treatment pressure. With this in mind, we have attempted to improve acceptance of CPAP therapy by using a bilevel system that reduces the treatment pressure during expiration. 52 patients were randomized either to initial treatment with CPAP therapy followed by bilevel treatment, or to treatment in reversed order. During bilevel therapy the ratio of inspiratory to expiratory pressure was fixed at 1:0.6. After each treatment the patients were interviewed on the basis of visual analogue scales to establish their subjective evaluation of such parameters as general well-being, quality of sleep, comparison of the respective treatment pressures, and possible preference for one of the two systems for long-term treatment. The minimal effective inspiratory treatment pressure during bilevel therapy (IPAP) and the minimal effective CPAP pressure were closely correlated (r = 0.89). There was no difference between the apnoea hypopnoea indices during CPAP therapy as compared with bilevel therapy. Most patients (57%) felt the treatment pressure with the bilevel system to be lower (p = 0.048). There were no differences in patients' well-being early in the morning, or in their assessment of sleep quality. The majority of patients (52%) preferred bilevel therapy for long term treatment, while 38% preferred CPAP therapy (n.s.). In a subgroup of 13 patients with a treatment pressure of > or = 10 mbar during CPAP therapy 10 patients (77%) gave preference to the bilevel system (n.s.). In a considerable number of patients the acceptance of treatment can be improved by using a bilevel system for initiation of nasal positive pressure therapy.

Adult↗
PubMed1996

[Survey of alcohol drinking and results of studies of alcoholism biological markers within the scope of a neurologic occupational medicine study of industrial workers].

As part of a combined neurological and occupational-medical study about potentially neurotoxic agents consumption of alcohol of the probationers as possible influential factor on the nervous system was evaluated. Therefore an injury of industrial workers of different nationalities was performed about the individual alcohol consumption combined with an investigation about so-called alcoholism-markers [gamma-Glutamyltranferase (gGT), mean corpuscular erythrocytes volume (MCV) and Carbohydrate-deficient Transferrin (CDT)]. It was the aim of the study, to give an overview of the amount of alcohol consumption in male industrial workers - and to examine, to what extent connections exist between alcoholism markers and the amount of individual alcohol consumption. We found a high percentage of probationers with alcohol abstinence (53%). The test persons with anamnestic alcohol consumption indicated a mean alcohol consumption of 33,7 g per day (6 to 240 g/d). A significant correlation between changes of laboratory markers and amount of alcohol consumption could only be found for CDT. In addition there was a correlation of CDT with gGT and MCV and of gGT with MCV, but with very small correlation coefficients. After multiple logistic regression and establishing of a prediction model of the consumption of alcohol under knowledge of laboratory results an assignment of the probationers to the respective group (abstinents and/or consumers of alcohol) was not successful with sufficient safety. According to our data in a normal collective a determination of laboratory parameters, which are discussed as alcoholism markers, does not contribute to better delimitation of abstinent living and alcohol drinking persons and to a better knowledge of the amount of alcohol consumption.

Alanine Transaminase↗
PubMed1996

[Technical and clinical success with extracorporeal shockwave lithotripsy in pancreatic duct calculi].

BACKGROUND: Chronic pancreatitis is often complicated by concrements obstructing the main pancreatic duct. Duct obstruction is discussed as potential mechanism responsible for recurrent and persistent pain. PATIENTS AND METHODS: 75 symptomatic patients (15 female, 60 male; 46 +/- 12 years) with stones in the main pancreatic duct (solitary n = 23; multiple n = 52) primarily not endoscopically extractable even after sphincterotomy of the pancreatic orifice were treated by means of a piezoelectric lithotripter (Piezolith 2500). Fragmentation and stone clearance were documented by ERP. The clinical benefit was evaluated in 35 patients (9 female, 26 male; 45 +/- 12 years) followed up meanwhile for more than 12 (29 +/- 14) months. RESULTS: After 3 +/- 2 (1 to 10) ESWL-sessions/patient the concrements were fragmented successfully in 80% of the patients. Focussing of the stones was achieved sonographically (15%), fluoroscopically (45%) or using both imaging techniques (40%). In total, 61% of the patients became stone free, 44% spontaneously, in further 17% all remaining fragments could be removed endoscopically. In 39% of the patients only a partial extraction was achieved. Severe complications due to shockwave application did not occur. The majority of the patients (stonefree n = 22, remaining fragments n = 13) followed up > or = 12 months kept free of pain (51%) or reported on pain relief (26%). Nine patients developed 13 recurrent calculi, which were again treated successfully by interventional measures in 8/9 patients. CONCLUSIONS: The data confirm the value of extracorporeal shockwave lithotripsy as an important tool in the interventional therapy of chronic pancreatitis. Even if recurrent calculi may occur, the majority of patients will experience at least a medium-term profit by those measures due to pain relief.

Adult↗
PubMed1996

Prognostic value of ploidy and proliferation markers in renal cell carcinoma.

BACKGROUND: The prognosis for patients with renal cell carcinoma depends mainly on pathological stage and grade of the tumor at the time of surgery. Cellular proliferation may prove to be another measure for predicting biologic aggressiveness and, therefore, the prognosis. METHODS: The authors compared four different methods to assess proliferation in a series of 87 curatively resected (R0) renal cell carcinomas: flow cytometry analysis (FCM), silver-stained nucleolar organizer regions (AgNOR), and immunohistochemical assessment of the MIB-1 (Ki-67) antigen, and proliferating cell nuclear antigen (PCNA). The results obtained were compared with pathologic stage (according to the International Union Against Cancer [UICC]) and grade with disease-related survival rate; finally, we assessed whether the methods led to similar results. RESULTS: In each carcinoma examined, we could demonstrate MIB-1, PCNA, and AgNOR dots in varied proportions. Statistical correlations were seen between the tumor grade, the rate of nuclear positivity for MIB-1 and PCNA, and the number of AgNOR dots. Additionally, the MIB-1 index was significantly higher in more advanced tumor stages. A good correlation between MIB-1 and AgNOR as well as for PCNA was found. In univariate survival analysis, tumor stage and grade, MIB-1 and PCNA index, and mean AgNOR number were related significantly to patient survival. On multivariate Cox disease-related survival analysis, stage of disease and MIB-1 were significant independent prognostic factors. Flow cytometry was not related to prognosis nor to other examined parameters. CONCLUSIONS: These results indicated that MIB-1 immunostaining is an additional prognostic parameter for patient outcome. MIB-1 and PCNA immunostaining, as well as AgNOR, demonstrated good correlations among themselves. We failed to establish flow cytometry as a method to predict proliferative capacity or prognosis in renal cell carcinoma patients.

Antigens, Nuclear↗
PubMed1996

Growth and pubertal development in patients with meningomyelocele: a retrospective analysis.

Our retrospective analysis of growth and pubertal development includes 109 children and adults with meningomyelocele (MMC) (52 M, 57 F) aged 3.2-21.0 years (median 8.9 years). Anthropometric data, growth-retarding factors and data on pubertal development were analysed in comparison to the normal population using standards from Prader et al. (1). The results (mean +/- SD) were as follows. Fifty patients (46.8%) had short stature (height SDS for chronological age (SDS CA) < -2). The supine length was influenced by the level of the lesion (height SDS CA: > or = L2 -3.13 +/- 1.62, < or = S2 -0.46 +/- 1.27), ambulatory status, skeletal deformities and pubertal stage. The mean adult height (n = 15, age 16.1-21.0 years) measured 141.3 cm for women (height SDS CA -3.83 +/- 1.79) and 159.2 cm for men (height SDS CA -2.27 +/- 1.81). In 82.6% of the subjects (n = 90), arm spans were within the normal range. Reduced arm spans (SDS < -2) as found in 19 patients (17.4%) with short stature (mean height SDS CA -3.29 +/- 1.29) may be caused by factors other than neurological lesions and skeletal deformities, and require further endocrinological studies. Out of 27 pubertal patients, central precocious puberty was diagnosed in five girls. The stages of puberty in MMC girls developed earlier than expected for the age-related group.

Adolescent↗
PubMed1996

Heel spur: radiation therapy for refractory pain--results with three treatment concepts.

PURPOSE: To evaluate radiation therapy (RT) to treat refractory pain in plantar heel spur. MATERIALS AND METHODS: From 1984 to 1994, 141 patients with refractory painful plantar heel spur (170 heels, because of bilateral disease) underwent RT. Quantitative criteria were used to evaluate heel pain and ankle function prior to RT, 6-12 weeks after RT, and at last follow-up (median, 4 years). Patients were divided into three treatment groups: group A (n = 72 heels [two courses, 1.0-Gy fractions, 12-Gy total RT dose]), group B1 (n = 50 heels [one course, 0.3-Gy fractions, 3-Gy total dose]), and group B2 (n = 48 heels [one course, 0.5-Gy fractions, 5-Gy total dose]). RESULTS: At last follow-up, complete pain relief was achieved in 48 (67%) of 72 group A heels and in 71 (72%) of 98 group B heels. Statistically significant (P < .05) differences between groups were found for insufficient pain relief (< 80%) in patients in whom the response time after RT was longer than 4 weeks or in whom pain recurred during follow-up. The best results were achieved with the 5-Gy total RT dose (P < .05). Prognostic factors for complete pain relief were acute pain and short duration of pain prior to RT. The prognostic factor for insufficient pain relief was total RT dose. CONCLUSION: Refractory heel pain is effectively treated with RT, which should be considered a primary treatment approach rather than a last resort.

Adult↗
PubMed1996

[Radiotherapy of plantar heel spurs: indications, technique, clinical results at different dose concepts].

BACKGROUND: In a retrospective study the efficacy of orthovoltage radiotherapy for refractory painful plantar heel spur was analyzed for 3 different radiation dose concepts. PATIENTS AND METHODS: From 1.1 1984 through 1.3.1994, 182 patients with refractory painful heel symptoms and radiologically proven plantar heel spur received radiotherapy. A total of 141 patients and 170 heels (due to double-sided symptoms) were completely documented in long-term follow-up. Clearly defined semi-quantitative criteria (9-point score) were used to analyze heel pain and ankle function prior to RT, 6 to 12 weeks post-radiation, and at last follow-up. The treatment outcome, i.e. (un)favourable response, of 3 radiation dose concepts were compared: Group A (n = 72 heels) received 12 Gy total radiation dose in 3 fractions per week and 2 series (6 x 1 Gy per series) separated by 6 weeks; group B (n = 98 heels) received 3 Gy total radiation dose in 10 fractions of 0.3 Gy (n = 50) or 5 Gy (10 x 0.5 Gy) (n = 48) with conventional fractionation in 1 series. RESULTS: Radiotherapy was very effective: at last follow-up 67% (group A) and 71% (group B) remained completely free of pain. The rate of "complete pain relief" (i.e. free of any pain symptoms) was not different between the 3 radiation concepts. However, significant differences were observed with regard to "incomplete or insufficient pain relief", i.e. a subjective pain relief of less than 80%, a delayed pain relief after more than 4 weeks or a relapse of pain symptoms in long-term follow-up. More favourable results were achieved in patients receiving 5 Gy or 12 Gy total dose, while patients with 3 Gy total dose had significantly worse results. Prognostic factors for "complete pain relief" were short duration of pain symptoms and acute pain symptoms prior to radiotherapy; with regard to "in-complete or insufficient pain relief" the total dose was found to be a prognostic parameter. CONCLUSIONS: Patients with refractory heel pain can yield a high response to radiotherapy even after failing various conventional treatments previously. Thus, radiotherapy should not be solely regarded as a last resort due to its low costs and high efficacy at low radiation doses.

Adult↗
PubMed1996

[Water-filtered infrared-A-hyperthermia combined with radiotherapy in advanced and recurrent tumors. Initial results of a multicenter phase I-II study].

BACKGROUND: Water-filtered infrared-A-radiation (IR/A-HT) can be used to heat superficial malignant tumors. A prospective multicenter phase I-II study was conducted to evaluate toxicity and efficacy of IR/A-HT combined with external beam radiotherapy (RT). PATIENTS, MATERIAL AND METHODS: From December 1991 to June 1994, a total of 53 patients with 58 malignant lesions were entered in the study. There were 14 primary, 36 recurrent and 8 metastatic tumors which were located in the head and neck region (14), chest wall (31), abdominal wall (2) and the extremities (11). The mean tumor volume was 100 cm3. IR/A-HT was applied 1 to 2 times per week with up to 3 IR/A-HT-radiators directly before or after external RT for 1 hour at 40.5 to 44 degrees C. Temperatures were controlled at various locations at the skin surface and invasively at depth. RESULTS: IR/A-HT was well tolerated: in 31 (53%) lesions acute (pain, pulse or blood pressure changes, increased skin reaction etc.) and in 25 (43%) chronic side-effects (atrophy, telangiectasis, fibrosis etc.) were noted; usually the toxicity was minor and temporary. At 3 months FU, 32 (55%) lesions achieved a local CR and 19 (35%) a PR; at 12 months FU, 25 (43%) had persistent CR; 16 patients (18 lesions) were deceased and 3 (4 lesions) not yet in FU. In univariate analysis the following prognostic factors for CR at 3 or 12 months FU were found: Karnofsky, metastatic status, tumor size, total RT-dose, thermal parameters T min(av) and T mean. For acute toxicity maximum temperature Tmax(av) was prognostically decisive. Significant differences were also found when considering the "quality of the HT-application". The microwave technique was superior to the infrared-A-HT-technique with regard to the penetration depth of energy deposition. CONCLUSIONS: Water-filtered infrared-A-radiation can be safely and effectively applied to heat localized superficial tumors (up to 1 cm depth). To increase the area of HT application multiple infrared-A-radiators have to be combined. A multi-element-system is in progress.

Abdominal Muscles↗
PubMed1995

Expression of nm23-H1 predicts lymph node involvement in colorectal carcinoma.

PURPOSE: Reduced expression of the metastasis suppressor gene nm23-H1 has previously been correlated with high tumor metastatic potential and fatal clinical outcome in some tumors (e.g., breast). For colorectal carcinomas, the findings are equivocal. METHODS: We have used a monoclonal antibody against nm23-H1 to investigate the expression in colorectal carcinomas at the time of primary curative surgery (R0 resection) to assess if there was any relation between nm23-H1 expression and stage or histologic grade at the time of primary tumor removal. RESULTS: Of 100 colorectal carcinomas studied (Stages I, II, and III according UICC, all resected curatively), nm23-H1 immunoreactivity was weak in 41 (41 percent), moderate in 24 (24 percent), and strong in 35 (35 percent) cases. The grade of positivity against nm23-H1 was significantly lower in advanced stages of the disease (Stages II or III) (P < 0.001, chi-squared = 52.8). In tumors with low or weak immunoreactivity against nm23-H1, frequency of lymph node metastases was significantly higher compared with those with moderate or strong staining (P < 0.001; chi-squared = 50.58). Therefore, with a sensitivity of 93 percent and a specificity of 58 percent, low nm23-H1 immunoreactivity of the primary tumor, assessed at the time of surgery, is an indicator of the presence of lymph node metastases. CONCLUSIONS: Immunohisto-chemical evaluation of nm23-H1 in the primary tumor or in a biopsy is a useful predictor of stage of disease and presence of lymph node metastases in colorectal carcinomas and may have clinical significance, e.g., in predicting optimal therapeutic regimes.

Biomarkers, Tumor↗
PubMed1994

Piezoelectric shock wave lithotripsy of pancreatic duct stones.

OBJECTIVES: The efficacy of extracorporeal piezoelectric shock wave lithotripsy in patients with obstructing pancreatic duct stones was investigated. METHODS: Fifty patients suffering from chronic pancreatitis and obstructing pancreatolithiasis were treated by ESWL (Piezolith 2500). Shock wave treatment was administered, inasmuch as the stones were not extractable by initially applied endoscopic measures. RESULTS: A total of 119 (2.4 +/- 1.4, range 1-7) lithotripsy sessions were conducted; only mild sedation/analgesia was used. Optimum targeting of the concrements in the shock wave focus was achieved in 17 (14%) treatment sessions with ultrasonography only; it was achieved in 65 (55%) cases by fluoroscopy and, in further 37 (31%) sessions by using both localization systems. Stone fragmentation was successful in 43 (86%) patients. Nineteen (38%) patients achieved spontaneous stone discharge after shock wave lithotripsy. In 11 (22%) cases, it was possible to remove all fragments endoscopically; residual fragments remained in 20 (40%) patients. Severe complications attributable to shock wave application did not occur. During follow-up, six patients had to be referred to surgery; two male patients died of specific diabetic complications and pleural mesothelioma, respectively. Thirty-five (90%) of 39 patients whose conditions were followed for 2-50 (20 +/- 14) months reported improvement of their pain sensations. Six (15%) patients required endoscopic treatment, including ESWL in five of those patients, to be repeated due to recurrent formation of calculi in the main pancreatic duct, which was again successful in five of the six patients. CONCLUSIONS: Piezoelectric shock wave lithotripsy offers a basis for safe and effective fragmentation of pancreatic stones and facilitates endoscopic procedures. Most of the patients with obstructing pancreatic stones became stonefree and showed a significant reduction of pain.

Calculi↗
PubMedDate not supplied

Counselling on cryopreservation of pronucleated oocytes.

The German Embryo Protection Law permits only the cryopreservation of supernumerary pronuclear stage eggs. Data are needed to counsel patients about their individual benefits from this procedure. All fresh embryo transfer cycles performed from January 1994 until December 1998 in which supernumerary pronucleate eggs were cryopreserved (n = 557) were analysed retrospectively, together with data from all subsequent cycles involving transfers of frozen-thawed pronucleate eggs (n = 420) from January 1994 until June 2001. The additional cumulative pregnancy rate per fresh cycle was 11.5%. This rate depended on the number of embryos per transfer, i.e. 1.9, 8.2 and 13.0% respectively when one, two or three embryos were transferred (P < 0.05). A strong correlation was found between the numbers of cryopreserved pronucleate eggs and pregnancy rates, of 9.3, 10.5 and 17.1% when 1-3, 4-6, or at least 7 pronucleate eggs were available respectively. Additional benefit in terms of this rate from cryopreservation for a patient with and without a pregnancy in the fresh embryo transfer cycles was 5.3 and 12.7% respectively. It is concluded that higher pregnancy rates in cycles involving cryopreserved eggs for patients who did not become pregnant in fresh transfer cycles reveals the disadvantage of the German Embryo Protection Law, which does not allow embryo selection. Therefore, cryopreservation of pronucleate eggs with a higher developmental potential is possible. The total pregnancy rate could be raised from 28.0 to 35.5% per fresh transfer cycle.

Age Factors↗
PubMedDate not supplied

[Relation of breast cancer tumour stage and the degree of registration in a population-based cancer registry].

UNLABELLED: Population-based cancer registries provide a large database of cancer cases which can be used for evaluation of cancer epidemiological and care-related questions. In particular, the latest projects in breast cancer screening and quality assured breast cancer diagnostics represent appropriate databases in the use of cancer registry data for further evaluation. For breast cancer the tumour stage distribution is a well suited, early available indicator for evaluating such interventions. The problem in using data from cancer registries occurs with the rather long time period until registration can be completed (up to 3 years). Thus, early usage of cancer registry data remains rather questionable. AIM OF THE STUDY: This analysis aims to show whether the distribution of breast cancer tumour stage depends on the completeness of registration and whether a valid estimate of the tumour stage distribution is possible at an early stage, on the basis of a not fully completed registration. METHODS: The cancer registry records all new cancer cases of the Federal State of Schleswig-Holstein. For the period from 1998 to the beginning of 2003 all breast cancer cases and their tumour stage distribution were extracted at three-month' intervals. Completeness of registration for each date was estimated on the basis of cancer data from the Federal State of Saarland. The expected number of breast cancer cases for Schleswig-Holstein was set to 100%. RESULTS: In total, 7,418 patients with new breast cancer were analysed. Already at a degree of 50% of registration a stable distribution of tumour stage could be observed. For example, the variability of the T1-category (tumour size < or = 2 cm) showed a maximum of three per cent in the range from 50% up to 100% completeness. Also for lymph nodes and distant metastases just a small degree of variability from one to three per cent points could be shown. A 75% completeness of breast cancer registration was established about six months after the end of the year of diagnosis. Complete registration could only be reached significantly later, approximately after two years. CONCLUSION: For the cancer registry of Schleswig-Holstein a significant relation of the tumour stage distribution in the degree of registration could not be detected. A stable distribution could be shown with a completeness of 50-75%. Hence, it appears to be methodically justified to analyse the tumour stage of breast cancer data with sufficient validity with a completeness of 75 %. The tumour stage distribution can be used as an early indicator (about six months after the end of the year of diagnosis) for evaluation of projects like mammography screening, quality management or research on medical care.

Breast↗
PubMedDate not supplied

The prognostic significance of c-erbB-2 serum protein in metastatic breast cancer.

The relationship between c-erbB-2 serum positivity and prognosis was evaluated in 80 patients with metastatic breast cancer. Using 120 fmol/ml as a cutoff level, elevated concentrations were found in 31 patients (38.8%) at the time of detection of metastases. Menopausal status, steroid receptor status, site of recurrence, initial tumor size, initial degree of nodal involvement as well as relapse-free interval were unrelated to c-erbB-2 serum positivity. In addition, no association could be found between adjuvant chemotherapy and positive c-erbB-2 concentrations. Patients with elevated c-erbB-2 levels showed a lower response rate (including complete remission, partial remission, no change) to first-line therapy than those with normal levels (29 vs. 59%, p < 0.01). The median survival time after relapse was 12 months (CI: 3-22 months) for the c-erbB-2-negative patients and only 6 months (CI: 3-8 months) for the c-erbB-2-positive group (p < 0.01). In the multivariate analysis, while c-erbB-2 levels at the time of primary surgery had no significant impact on survival in metastatic breast cancer, serum c-erbB-2 turned out to be the strongest factor for predicting survival after relapse.

Adult↗