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L Piana

Publications and source records attributed to L Piana.

At least 19 recordsLinked to original sources

c-myc gene amplification in selected node-negative breast cancer patients correlates with high rate of early relapse.

In breast cancers with histologically negative axillary nodes selected for high frequency of recurrence, the amplification of c-myc, erbB-2 and int-2 genes was found to concern, respectively 25% (16/65), 31% (25/81) and 14% (10/70) of tumours. Their relation with tumour progression expressed by relapse-free survival is reported. Using univariate analyses, c-myc amplified tumours showed significant association with early (30-month period after diagnosis) (P = 0.0013) and intermediate (50-month period after diagnosis) (P = 0.0398) risks of recurrence. In contrast, only a trend towards higher relapse was observed in erbB-2 amplified breast cancers with respect to later events (occurring over the first 30-month period). Multivariate analyses indicated that c-myc amplification is an independent prognostic factor stronger than oestrogen receptor status and tumour size to define a high risk subset in node-negative patients selected for high frequency of recurrence.

Adult

Correlation of nucleolar organizer regions and nuclear morphometry assessed by automatic image analysis in breast cancer with aneuploidy, K167 immunostaining, histopathologic grade and lymph node involvement.

Silver-stained nucleolar organizer regions (AgNORs) in human breast carcinoma were studied using a computer-assisted system of image analysis. Standardized, automatic measurements of 7 morphometric parameters (area, perimeter, shape factor, bend energy, angle, and small and large diameters) performed on paraffin sections and cell imprint were compared and correlated with nuclear morphometry, histopathological grading, tumor growth fraction, (monoclonal Ki67-immunostaining), DNA nuclear content (stoechiometric Feulgen staining) and axillary lymph node invasion. The major findings were as follows: (i) variations in AgNORs and nuclear parameters were correlated, (ii) the ratio of AgNOR area/nuclear area was significantly different in low and high grade tumors, (iii) mean AgNOR parameter values increased significantly with the tumor growth fraction and tumor hyperploidy and were significantly higher in patients with axillary lymph node metastases and (iv) AgNOR evaluation was more accurate for cell preparations than for tissue sections.

Antibodies, Monoclonal

[Colposcopy in gynecologic cancers. Retrospective study of 192 examinations].

One hundred and ninety two colposcopic examinations carried out on 183 patients of whom 140 had carcinoma of the cervix, 26 carcinoma of the endometrium and 17 carcinoma of the ovaries were analysed in order to assess the value of colposcopy in patients with gynaecological cancer. The mean distance from the edge of the anus that was looked at was 45 cms--the range being from--130. Out of all the systematic examinations that were carried out before any treatment was started, 103 were for cervical cancer and among these invasion of the rectal mucosa was found in two cases (1.9%). Twelve cases of external pressure on the rectum and 9 cases of recto-colic polyadenomata (8.7%) of which one was malignant. Out of the 14 colposcopies that were carried out for carcinoma of the endometrium one case of rectal invasion was found and one case of external compression. In the 12 cases of cancer of the ovary 2 were found to have recto-colic spread, 1 external compression and 1 malignant polyadenoma. All these cases of spread to the rectum and colon were diagnosed in advanced cases (stage III or IV). In the 63 examinations carried out on follow-up the most common warning sign was a rectal discharge and the most commonly found lesion in the rectum was actinomycotic inflammation of the rectum. The 5 cases of recurrence in the rectum expressed themselves most often by the rectal syndrome.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult

Inflammatory carcinoma of the breast.

Inflammatory breast carcinoma has to be defined by accurate clinical and pathological criteria. The prognosis is very poor and improvements made by chemotherapy are limited to the increase in the disease-free period and overall survival for a few months.

Adult

Association between breast cancer and family malignancies.

In a case-control study, the relationship between a family history of cancer of the breast, ovary, colon, uterus or prostate and the risk of breast cancer was investigated. The data consisted of family histories from 495 breast cancer cases and 785 controls aged 20-56 years. A positive association was found between the occurrence of breast cancer and a history of breast cancer in the families of the subjects affected. This relationship increased linearly with both the degree of kinship of the affected relatives and with their number. The risk of breast cancer associated with other types of cancer in the family was not significantly different from unity.

Adult

Oral contraceptives and breast cancer: a French case-control study.

The relationship between the risk of breast cancer and oral contraceptive use was investigated in a case-control study conducted in France between 1983 and 1987 in five public hospitals. Some 464 cases aged 25 to 56 years and 542 matched controls were interviewed about their history of the use of oral contraceptives (OC). Results are given for the entire population and for the subgroup of 358 and 379 premenopausal cases and controls. The multivariate relative risk estimate, for ever user, was 1.5 (p less than 0.01) in the whole group as well as in the premenopausal subgroup (p less than 0.02). However, there was no evidence that the effect varied appreciably according to duration of use, age at first use, use before first full-term pregnancy (FFTP) and time since first or last use. The risk was not altered for any particular brand of OC. We conclude that, because of the widespread attention given to the relationship between OC use and breast cancer, information bias might be responsible for part of the excess in risk observed among OC ever users.

Adenocarcinoma

The relation between seborrheic keratoses and malignant solid tumours. A case-control study.

In order to establish whether or not here is an association between cancer and intense growth of seborrheic keratosis, the so-called Leser-Trelat sign, we conducted a case control study in which the number and features of seborrheic keratosis in 82 patients with recent solid tumours, were compared with 82 age- and sex-matched controls. Neither numbers nor features of seborrheic keratosis differed significantly in patients and controls. Eruptive seborrheic keratosis was noted in only one patient and one control. This study showed that solid malignancies are not generally associated with an increase in the number or size of seborrheic keratosis lesions, thus suggesting that they are not controlled by a hypothetical secretion of growth factors by tumours. Our results suggest that Leser-Trelat is either a coincidence, or at most a very rare sign of unusual types of cancer. We also showed that multiple cherry angiomas, previously reported to be a paraneoplastic sign, are not regularly associated with solid tumours.

Adult

[Lumbo-aortic lymphadenectomy in ovarian cancers].

Systematic lumbo-aortic lymphadenectomy has revealed the importance of lymphatic dissemination of ovarian cancers: the incidence of lumbo-aortic metastases reported in the literature is high (15 to 25% of so-called early stages, false stage I and II). An exact staging assessment is an essential prognostic factor; underestimation of apparently early stages leads to insufficient treatment, reducing the long-term survival rate. The correlation with intraperitoneal extension, the degree of differentiation and the histological type is only partial. Retroperitoneal lymph node invasion has a prognostic significance at each stage. Lastly, lumbo-aortic lymphadenectomy appears to provide a specific therapeutic benefit as part of maximal tumour reduction surgery.

Female

Image cytometry of aneuploidy, growth fraction (MoAb Ki-67) and hormone receptors (ER, PR) immunocytochemical assays in breast carcinomas.

DNA nuclear content was assessed in human breast carcinomas (n = 132) using image cytometry. Optical density histograms of Feulgen stained cell imprints from fresh tissue samples, subsequently frozen for immunocytochemical assays, were determined by the SAMBA system and used for the DNA index, the ploidy balance (PB) and the proliferation index (PI) computation. The three parameters were correlated to (i) histological data (tumour grade, vascular and/or lymph node invasion) and to (ii) growth fraction (Ki67), hormone receptor antigenic sites (ER, PR) and intramedullar (bone marrow) biopsies and anti-KL1-positive epithelial cells. It was shown that 57% of breast carcinomas were aneuploid. Aneuploidy PI significantly correlated to the criteria of poor prognosis such as high tumour grade, vascular and lymphatic invasion and to increased Ki67-positive cells, and the absence of or low ER and PR. Since image cytometry is easy to handle and perfectly suitable for current diagnostic practice in pathology departments, particularly for tumour cell ploidy assessment and standardized analysis of immunostaining procedures with morphological control of the preparation, we conclude that image cytometry, as performed with the SAMBA, must be regarded as a relevant tool for prognosis evaluation and therapy guidance in individual patients.

Aneuploidy

[Surgical treatment of ovarian cystadenocarcinoma].

Ovarian cystadenocarcinoma should be dealt with by surgeons well-trained in abdominal and pelvis surgery. The initial laparotomy has a dual purpose: to determine the tumoral stage after detailed evaluation of the lesions, and to remove all or most of the tumoral tissue. This is easy in localized cancers, but difficult, or even impossible, in the majority of stage III cancers. Radical surgery of stage III cancers has not yet been proven to influence the long-term survival. When surgical evaluation and excision have been unsatisfactory at the first laparotomy, another operation through a midline incision is justified before initiating an adjuvant treatment. This "second look" laparotomy is the best way to evaluate a tumoral residue after chemotherapy. In the absence of effective second-line therapy, the operation does not seem to improve the patient's comfort or survival, and it should be reserved to second-line therapeutic trials. Similarly, the surgical treatment of occlusive lesions due to recurrent cancer does not seem to influence the patient's comfort or survival.

Cystadenocarcinoma

[Growth fraction (Ki67), ploidy balance and proliferation index in tumors of the urogenital tract and breast].

The practical applications of computer-assisted image analysis systems are multiple in oncology. The computerized system of image analysis referred to as SAMBA (TITN) is particularly relevant to analyse coloured images resulting from immunostaining or histochemical procedures assessed either on tissue sections of any type or cytological preparations (imprints, smears). The SAMBA analysis of positive Ki67 surfaces in tissue sections from breast, endometrial, ovarian, cervical or urinary bladder samples enables a multiparametric evaluation of the growth fraction (GF) in intraepithelial, borderline or invasive proliferations. Moreover, the SAMBA analysis after Feulgen staining procedures provides a parametric evaluation of the nuclei densitometry and morphological features and of the chromatin texture, which serve to compute the ploidy balance (BP) and the proliferation index (PI). In benign tumors, GF and PI are low and tumor cells are diploid with an overall high positive PB values. In malignant tumors, GF, PI and the percentage of aneuploid cells increase with tumor grade and stage whereas PB decreases. In borderline proliferations, FC, PI and PB intermediate values are recorded. These new criteria of prognosis should be assessed routinely in pathology departments and the results from these new investigations are likely to be soon implicated in the selection of patient therapy.

Antigens, Surface

[Role of surgery in the strategy of primary local and regional treatment of stage I and II cancer of the endometrium].

Having seen 192 cases of cancer of the endometrium treated at the Institute Paoli-Calmettes between the years 1975 and 1980, the authors have been able to evaluate the place of surgery in the planning of treatment of Stage I and II cases. They hold that: Laparatomy is well tolerated, in 90% of cases of Stage I, 88% of cases of Stage II, 70% of older than 70 years of age and 79% of patients who have some wasting there was no operative mortality. The need to re-explore Stage I and Stage II cases surgically (14%) especially when invasion of the ovaries had not been recognized before histological examination exists. The bad influence of the 5 year survival rate of histological grade 3 or where the myometrium was deeply invaded or where the pelvic lymph nodes were invaded. Studying this personal series and other series found is the literature shows that there is no great value in clearing the pelvis of lymph nodes in order to plan the post-surgical treatment. This is because generally lymph node involvement in the pelvis is associated with other factors that are unfavourable prognostically and these factors can be determined more easily than by removing the lymph nodes. They are, grade 3, invasion of the cervix, positive peritoneal cytology and when the myometrium has been invaded more than 50%. It was only in two cases out of 122 that study of the lymph nodes of the pelvis altered the treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

Brachytherapy