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C Markopoulos

Publications and source records attributed to C Markopoulos.

At least 55 records · Page 3Linked to original sources

99mTc Tetrofosmin imaging in breast tumours.

Eighty-five women, 18 to 80 years of age, with palpable breast lumps were studied 1-4 days before surgery in order to evaluate 99mTc Tetrofosmin imaging for the detection of malignant breast tumours. Intravenous injection of 99mTc Tetrofosmin was followed by 3 min planar images at 5-60 min postinjection. In the latter 57 patients, planar imaging was preceded by a dynamic study of 20x5 sec images. The myocardium was always included in the field of the left breast. Count rates in suspicious areas were compared with normal tissue areas in the same and the opposite breast and with myocardial counts. Data analysis showed that 77 of the 85 scan results were in agreement with the histological findings; six scans were false negative and two false positive for malignancy. The sensitivity of the method was 90.32% and the specificity 91.30%, with a positive predictive value of 96.55%. We conclude that breast scanning with 99mTc Tetrofosmin may play an important role in the detection of breast malignancies.

Adolescent↗

Mucoepidermoid carcinoma of the breast.

Mucoepidermoid carcinomas are very rare breast tumors. The morphology of this breast tumour is similar to its counterpart in the salivary gland. The first two cases reported were low-grade and neither patient had metastatic disease. Furthermore, none of the five patients with low-grade mucoepidermoid carcinoma reported by Fisher had axillary lymph node involvement and were alive with no evidence of disease 4 to 10 years after diagnosis and were considered of probable favourable prognosis. A high grade form of mucoepidermoid cancer might occur in the breast as it does in the salivary gland. All high-grade variant cases published had demonstrable lymph node or distant metastases and rapidly fatal outcomes. This report describes a case of high-grade mucoepidermoid carcinoma of the breast with a disease-free interval of 5 years, despite of unfavourable histologic features at the time of diagnosis.

Adult↗

Alterations of p16-pRb pathway and chromosome locus 9p21-22 in sporadic invasive breast carcinomas.

The p16-pRb pathway represents a vital cell-cycle checkpoint. In the present study we investigated the alterations of this G1-phase protein pathway using immunohistochemical and molecular methods in a series of 55 breast carcinomas and correlated the findings with clinicopathological features of the patients. Furthermore, we examined its relationship with the status of the chromosomal region 9p21-22 performing a deletion map analysis because there are indications that, in addition to CDKN2 and MTS2/p15(INK4B) tumor suppressor genes (TSGs), this area harbors other TSG(s). Aberrant expression (Ab) of p16 and pRb was observed in 26 (47%) and 16 (29%) of the carcinomas, respectively. A statistical trend pointing out an inverse relationship between p16 and pRb expression was found (p = 0.079). Analysis of the region that encodes for p16 by deletion mapping, a PCR-based methylation assay and PCR-SSCP, revealed that deletions and transcriptional silencing by methylation might represent the main mechanisms of CDKN2/p16(INK4A) inactivation in breast carcinomas. The results of deletion mapping also suggest that another TSG(s) may reside at the 9p21-22 area particularly at the D9S162 loci and that co-deletion of this putative gene with CDKN2/p16(INK4A) may play a role in breast carcinogenesis. In addition, microsatellite instability (MI), a marker of replication error phenotype (RER+), was observed with a frequency of 16% in the area examined and was inversely related with loss of heterozygosity (LOH). Interestingly, most cases with MI at the region encoding for p16 were aggregated in a subgroup of breast carcinomas with no other obvious genetic and/or epigenetic CDKN2/p16(INK4A) alterations. We speculate that there is an additional mechanism of CDKN2/p16(INK4A) inactivation. The relationship of p16 protein level pRb, status, the p16-pRb combined immunoprofiles, and the microsatellite alterations detected at the 9p21-22 locus with the patients' clinicopathological parameters revealed two significant correlations: one between normal pRb expression and lymph node involvement (p = 0.0263), and the other between microsatellite alterations (LOH and or MI) and tumor size (p = 9.2 x 10(-3)). In view of the heterogenous nature of breast cancer, we suggest that in a significant proportion of breast carcinomas, deregulation of the p16-pRb pathway in association with another, as-yet unidentified, TSG(s) of the 9p21-22 region may play a role in initiating or progressing the oncogenic procedure, while in other subgroups, alternative molecules may play this role.

Adult↗

DNA ploidy and pS2 protein expression in breast cancer.

The DNA content of ductal breast carcinomas of varying histological grade was measured using static image cytometry and correlated with pS2 expression in the tumour cells. Our study was performed on imprint of surgical biopsies of 60 women with ductal breast cancer. A statistically significant difference was observed between pS2+ expression and grade of malignancy (P < 0.001). The percentage of euploid tumours significantly decreased from grade I to grade II to grade III (P = 0.01). The percentage of aneuploid tumours increased from pS2+ to pS2- breast tumours (P < 0.001). These findings may be indicative of pS2 and DNA ploidy alterations and tumour aggressiveness.

Aneuploidy↗

DNA content and p53 protein expression in ductal breast cancer.

The DNA content of 85 ductal breast cancers of different histological grades was evaluated using static cytometry and correlated with immunocytochemical expression of p53 protein in tumour cells in cytological material. A statistically significant difference was observed between p53 protein expression and grade of malignancy (P < 0.001). The percentage of euploid tumours significantly decreased from grade I through grade II to grade III tumours (P < 0.001). Clonal DNA heterogeneity was observed in 26.6% of cases analysed and was correlated with p53 protein expression (P < 0.001). These changes probably reflect genomic alterations which may affect potential malignancy of breast cancer.

Adult↗

Sex hormones in postmenopausal women with breast cancer on tamoxifen.

In 42 postmenopausal women with breast cancer aged 48-85 (mean age 62.4) years, the blood sex hormone levels were measured before and after 6 months of tamoxifen administration (20 mg daily). Follicle-stimulating hormone and luteinizing hormone levels decreased after tamoxifen administration (p < 0.001), but remained in the postmenopausal range, oestradiol levels increased (p < 0.05), sex hormone binding globulin levels increased (p < 0.001), testosterone levels remained stable (p > 0.1), free testosterone levels decreased (p < 0.001), delta4-androstenedione, 17-hydroxyprogesterone, and dehydroepiandrosterone sulfate levels remained unchanged (p > 0.1), and basal prolactin levels and their response to thyrotrophin-releasing hormone injection decreased significantly (p < 0.001) after tamoxifen therapy. It is concluded that tamoxifen has many and diverse effects on sex hormone levels, and its adverse effects do not affect the biological status of the patient, except perhaps for oestradiol, that increases in some cases, whose possible effect must be studied.

Aged↗

[Experiences with surgical therapy of hepatic echinococcosis].

Between January 1984 and December 1990, 56 patients with hydatid liver disease were treated surgically at our Department. Diagnosis was made by using clinical criteria, serology and imaging techniques. Most frequent clinical symptom was abdominal pain or local discomfort (38 patients, 68%). Plain X-ray of the abdomen was helpful in 20 patients (36%), liver ultrasound in 53 (93%) and computerised tumorgraphy in 56 patients, (100%). The immunoelectrophoresis test of "arc 5" was sensitive in 51 patients (91%). Thirty patients (53%) underwent partial resection and omentoplasty, 17 patients (30%) underwent external drainage, two cystic resection (3%), one left lateral lobectomy (2%) and six (11%) underwent omentoplasty and T-tube insertion. Fatal complications did not occur. Four patients developed hepatic abscess (7%), three wound infection (5%), one bowel obstruction (2%) and in five instances (8%) drainage was maintained for more than three months. Of the 49 patients available for follow-up (87%), three (6%) developed recurrent disease.

Adult↗

Application of the learning vector quantizer to the classification of breast lesions.

OBJECTIVE: To investigate the potential of the learning vector quantization (LVQ) neural network for the discrimination of benign from malignant breast lesions. STUDY DESIGN: Using a custom image analysis system on Giemsa-stained smears, 25 parameters describing the size, shape and texture of the cell nucleus were measured. Three thousand nuclei from a total of 9,356 were selected as a training set for the neural network, and the whole data set was used for testing. An additional 238 cells from 16 cases without final cytologic diagnoses were evaluated by the system. The total number of cells (9,594) was collected from 100 patients (68 carcinomas and 32 benign lesions). RESULTS: Cytologic examination of the cases gave two false positive and two false negative results. However, in eight cases of ductal breast carcinoma and in eight cases of benign lesions, histologic confirmation was necessary in order to confirm the cytologic diagnosis. Application of the LVQ permitted correct classification of 87.41% of the cells. Classification at the patient level by using a hypothesis test for proportion with a hypothesis value equal to 50% permitted the correct diagnosis in 98% of patients. CONCLUSION: These results indicate that the use of neural networks combined with image morphometry and statistical techniques may offer useful information about the potential for malignancy, improving the diagnostic accuracy of fine needle aspiration of breast lesions.

Breast↗

Bilateral Paget's disease of the breast.

A rare case of metachronous bilateral Paget's disease of the nipple is presented. The occasional failure of routine follow-up to detect certain tumours until biologically advanced and the value of patient observations are mentioned.

Breast Neoplasms↗

Relationship of epidermal growth factor receptor (EGFR), proliferating cell nuclear antigen (PCNA) and vimentin expression and various prognostic factors in breast cancer patients.

Cytologic specimens (FNA) from 42 primary invasive ductal breast carcinomas and 22 matched specimens of cancer tissue were tested for EGFR status, PCNA index and vimentin expression by immunocytochemical staining, using an Extravidin-Biotin method, and their relationship with various prognostic factors was investigated. EGFR positivity, high PC10 score and vimentin positivity were significantly correlated with high histologic grade. The coordinate expression of EGFR, PCNA and vimentin was significantly associated with ER-negative breast carcinomas. A positive trend was observed between high proliferating tumours and EGFR expression. EGFR status and PCNA index were not correlated with axillary lymph node involvement, tumour size, age and menopausal status. Vimentin was preferentially expressed in tumours, with lymph node metastases. Co-expression of EGFR, PCNA and vimentin was determined in most cases. These data suggest that EGFR status, PCNA index and vimentin expression may be important for the prediction of biologically aggressive tumours.

Adult↗

DNA ploidy and vimentin expression in primary breast cancer.

The DNA content of 50 breast cancers of varying tumour type, grade and stage was measured using static image cytometry, and correlated with vimentin expression in the tumour cells. A tendency to increased vimentin expression and aneuploidy was observed in high grade and late stage tumours. A statistically significant difference was observed in DNA index and ploidy balance between grade 1 and grades 2 and 3 carcinomas (P < 0.05) and between grade I and stage II carcinomas (P < 0.05). There was a significant difference in the expression of vimentin between grades 1, 2, 3 (P < 0.001), and stages I, II, and III ductal carcinomas (P < 0.05). No significant difference was observed in the proliferation index and the degree of hyperploidy (P > 0.05) Clonal heterogeneity was observed in 25% of breast carcinomas, and was associated with increased vimentin expression. These changes may be indicative of genomic alteration and tumour aggressiveness.

Biomarkers, Tumor↗

Hamartomas of the breast.

Hamartomas of the breast are rare tumor-like lesions composed of ducts, lobules, fat, and fibrous tissue. The clinical and pathologic findings of six cases of patients ranging in age from 19 to 63 years are reported. Diagnosis is difficult, and we emphasize that fine needle aspiration and cytology of the smears is not diagnostic for hamartomas.

Adult↗

Expression of alpha-thymosins in human tissues in normal and abnormal growth.

Radioimmunoassays specific for the N and C termini of human prothymosin alpha and the N terminus of human parathymosin alpha were employed for the measurement of the levels of alpha-thymosins in human thymus, spleen, and liver during normal growth and intestine and breast in malignant growth. A differential expression of the two alpha-thymosins was observed in thymus (prothymosin alpha-rich) and liver (parathymosin alpha-rich). A decline in the levels of both alpha-thymosins was found with age, with prothymosin alpha in thymus showing the sharpest change (15- to 30-fold). The levels of both alpha-thymosins were higher in malignant tissues as compared with healthy ones. In breast cancer, in particular, the mean increase for prothymosin alpha and parathymosin alpha was 17.9- and 11.5-fold, respectively. The major crossreactive material was characterized in all cases as intact prothymosin alpha and parathymosin alpha. These results suggest an in vivo relationship of the expression of alpha-thymosins with the human tissue cell proliferation activity.

Adolescent↗

Obstructive colonic cancer.

The records of 121 patients with obstructing cancer of the colon were reviewed. About one-third of the patients had metastatic disease at the time of operation. Primary resection and anastomosis of the intestine was performed for most cancers of the ascending or transverse colon. Hartmann's procedure was performed in most patients with cancer of the sigmoid colon and rectum. Wound infection occurred in 20 patients (16.5%) and anastomotic leakage in six (4.9%). The operative mortality rate was 14.9%. The 5-year survival rate was 13.5%. Acute colonic obstruction is associated with high morbidity and mortality. The high incidence of advanced disease, advanced age, delay in tumour excision and unprepared bowel are some of the factors resulting in the poor prognosis of these patients.

Acute Disease↗

Bilateral breast cancer.

Seventy-eight confirmed cases of second primary breast cancer in the contralateral breast were encountered over a 22-year period in 1332 women with invasive breast cancer treated in our department. Tumors were grouped into those simultaneously detected in both breasts or within 6 months of each other (synchronous, 1.6%) and those detected within more than 6 months (metachronous, 4.2%). The mean interval between metachronous cancers was 117 months. Patients with bilateral tumors were more likely to have a family history of breast cancer than those with unilateral disease. Women with metachronous tumors tended to be younger when diagnosed with the first carcinoma as compared with those having unilateral or synchronous bilateral cancers. No differences were noticed in size and lymph node status between the first or second tumor of bilateral cases in comparison to patients with unilateral disease. Significantly more (P < 0.05) first metachronous tumors were found to be lobular invasive cancers. Histopathologic type of the first tumor was the same as the second in 62.8 per cent of all cases. Concordance of estrogen receptor status between bilateral tumors was 71.4 per cent. Our results indicate that the risk of developing, a contralateral breast cancer is related to the patient's age, family history of breast cancer, and lobular histology of the tumor.

Adult↗