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Biomedical subjects

G A Degenshein

Publications and source records attributed to G A Degenshein.

At least 19 recordsLinked to original sources
PubMed1988

Relationship of estrogen and progesterone receptors to prognosis in breast cancer.

To ascertain the role of estrogen (ER) and progesterone (PR) receptors as prognostic indicators of resectable breast cancer, the records of 204 patients were analyzed whose receptor studies were done at the Maimonides Medical Center from 1975 to 1983. All patients had radical or modified radical mastectomies and did not show any evidence of distant metastases at the time of operation. Median follow-up was 37 months. An additional 117 patients received some form of adjuvant therapy, mainly chemotherapy, and were analyzed separately. Life table analysis using the log rank test for measuring significance, and a Cox multivariate analysis was performed. At 48 months, 22% of the ER positive (ER+) group versus 33% of the ER negative (ER-) group had recurred as compared to 16% and 35% for the PR+ versus PR- groups, respectively. Life table analysis of the disease free interval (DFI) showed that the difference between the ER+ and ER- groups was not significant (p greater than 0.1), while the difference in DFI between the PR+ and PR- groups was significant (p less than 0.05). Multivariate analysis revealed that the most important factors in predicting the DFI were nodal status (p less than 0.001), tumor size (p less than 0.025), and progesterone receptor status (p less than 0.05). Estrogen receptor status was not found to be significant. In conclusion, PR- patients have a shorter DFI than PR+ patients and that PR status is a more valuable predictor of DFI than ER status.

Aged↗
PubMed1980

The value of progesterone receptor assays in the management of advanced breast cancer.

Estrogen and progesterone receptor determinations were performed on 518 specimens at the Surgical Research Laboratory of the Maimonides Medical Center. Of these, 41% were ERP and PgRP positive; 17% were ERP positive and PgRP negative; 38% were ERP negative and PgRP negative, and 3.9% were ERP negative, PgRP positive. Sixty-two patients with advanced breast cancer were treated with either an endocrine ablative procedure or with antihormonal therapy. In the two treatment groups the overall response rate when both receptors were positive was 79%, with a higher percentage of responders in the endocrine ablative group (88% vs. 69%). In addition, a greater duration of response was achieved in those patients treated with endocrine ablation. The overall predictability of response was achieved in those patients treated with endocrine ablation. The overall predictability of response or failure to hormonal therapy is 91% if the progesterone receptor alone is utilized to select treatment and an endocrine ablative procedure is performed. The predictability of response based on the estrogen receptors presence or absence is 70%.

Adult↗
PubMed1980

Histochemical assay of estrogen and progesterone receptors in breast cancer: correlation with biochemical assays and patients' response to endocrine therapies.

Estrogen (ER) and progesterone (PgR) receptors were assayed by histochemistry in primary, recurrent, and metastatic breast cancer. Ligand-conjugates composed of 17 beta-estradiol and 11 alpha-hydroxyprogesterone covalently linked to bovine serum albumin and labelled with fluorescein isothiocyanate were employed. Results were compared with those of conventional biochemical receptor assays and correlated for ER in 92% of 314 tumors and for PgR in 86% of 86 specimens. ER and PgR determinations by both assay systems were correlated with clinical response to various endocrine therapies in 40 women with Stage IV disease. The histochemical assay enabled successful prediction of response in 80% of cases including eight which could not be fully analyzed biochemically.

Adrenalectomy↗
PubMed1980

The role of progesterone receptors in the management of advanced breast cancer.

The identification of steroid receptors in human breast cancer tissues has provided biochemical markers to predict hormone responsiveness. Analysis of tumors from 328 patients for the estrogen receptor protein (ERP) revealed significant levels in 225 patients (68%). Fifty-five patients with advanced disease were subjected to hormonal manipulation. Thirty patients underwent ablative surgery consisting of adrenalectomy or adrenalectomy and oophorectomy. Twenty-five patients were treated with additive therapy utilizing the new antiestrogen Tamoxifen. The ECOG criteria for an objective response were applied to all patients. Fifteen of the 24 estrogen receptor-positive patients (63%) subjected to endocrine ablation responded. Eleven of twenty (55%) ERP-positive patients responded to Tamoxifen therapy. Only one ERP-negative patient responded in the total group. Simultaneous analysis of these same specimens for the progesterone receptor protein (PgRP) revealed that 151 patients were ERP and PgRP positive (46%); 74 (23%) were ERP positive and PgRP negative; 90 (27%) were ERP and PgRP negative, and 13 (4%) were ERP negative and PgRP positive. In the two treatment groups the overall response rate when both receptors were positive was 77% with a higher percentage of responders in the endocrine ablative group (88% vs. 64%). In addition, a greater duration of response was achieved in those patients treated with endocrine ablation.

Adrenalectomy↗
PubMed1979

Hormone relationships in breast cancer: the role of receptor-binding proteins.

The introduction of receptor protein studies as markers for hormone dependence of breast carcinomas has had a profound effect on the management of advanced disease. All breast carcinomas, regardless of stage, should have receptor binding protein studies for estrogen and progesterone by the sucrose gradient method or by the dextran-coated charcoal method as a good alternative. A simpler test is needed. In cases of primary advanced disease or in recurrent disease, receptor binding protein studies effectively identify the subgroup of hormone-dependent tumors that should be managed by surgical hormone ablation or endocrine manipulation. These tests are even more effective in identifying patients that should not receive hormone therapy and respond better to chemotherapy. In primary, potentially surgically curable disease, receptor studies may serve as a therapeutic guide to adjuvant hormone or chemotherapy. In all breast cancers, ER and PgR receptor studies should be performed and the information should be stored for possible future use. If possible, tisssue should be stored in a freezer in anticipation of future tests and for confirmation of hormone dependence in the event of recurrence.

Adult↗
PubMed1979

A histochemical technique for evaluation of progesterone receptors in breast cancer.

A histochemical method for the detection and localization of progesterone receptors in human breast cancer has been developed employing a fluorescein labeled conjugate of bovine serum albumin linked to a progestin as the binding hormone. Considerable tumor cell receptor heterogeneity was apparent and nuclear binding was frequently noted. The results of the new assay correlated with those obtained by dextran-coated charcoal assay in 91 per cent of specimens.

Breast Neoplasms↗
PubMed1978

Immunofluorescent detection of estrogen receptors in breast cancer. Comparison with dextran-coated charcoal and sucrose gradient assays.

Biopsy specimens from 106 women with primary operable, recurrent or metastatic breast cancer were analyzed in a double blind study designed to compare the results of a new fluorescent antibody method for detection of estrogen receptors with estrogen receptors measured biochemically with dextran-coated charcoal and sucrose gradient assay techniques. Assay results correlated in 89.4% of tumors analyzed, and molecular receptor forms (8S and 4S) were accurately predicted in 94.7% of neoplasms studied. Divergent results most often occurred in specimens sparsely populated with malignant cells. The new technique permitted recognition of possible sources of false negative results such as necrosis, absence of tumor and, on occasion, estrogen bound in vivo. It was possible to analyze by the immunofluorescence method two specimens of insufficient size for biochemical assay.

Breast Neoplasms↗
PubMed1977

Endotoxin and bacteria in portal blood.

In order to determine whether endotoxin is normally found in the portal system, intraoperative samples of portal and peripheral blood were drawn from 34 consecutive elective abdominal surgery patients. The limulus lysate test was used to detect endotoxin. Ninety-seven per cent of patients had a positive limulus test in portal blood. Twelve of these patients were tested for portal bacteremia and only one showed growth. Four patients also had systemic endotoxemia. Three of these had liver disease and one had a gram-negative sepsis. This study demonstrates that endotoxin is a normal constituent of portal venous blood in man and does not represent a pathological process. It is suggested that the Kupffer cells of the liver normally protect the systemic circulation from endotoxin, and that endotoxin is present in systemic blood only when liver function is impaired or gram-negative bacteremia is present.

Adenocarcinoma↗
PubMed1976

Simultaneous perforation of a gastric and a duodenal ulcer.

This is a case report of simultaneous perforation of a gastric and duodenal ulcer. Perusal of the literature shows the rarity of this occurrence. Consideration is given to the difficulty of handling such a case in the presence of severe generalized peritonitis and the precarious condition of the patient.

Aged↗