PubMed Health⌕ Search

Biomedical subjects

M Díez

Publications and source records attributed to M Díez.

43 records · Page 3Linked to original sources

Prognostic value of flow cytometric DNA analysis in non-small-cell lung cancer: rationale of sequential processing of frozen and paraffin-embedded tissue.

The objective of this study was to determine the prognostic information provided by flow cytometric DNA analysis in non-small-cell lung cancer. Lung samples of 132 consecutive patients submitted to surgery were prospectively processed. When no aneuploid populations were detected in fresh frozen samples, the process continued as a second step in paraffin-embedded tissue, consuming all the tumor available. The influence of ploidy on the postoperative outcome was studied by both a univariate and a multivariate analysis. Aneuploidy was found in 81 patients (61.4%). Fourteen patients showed no aneuploidy in fresh frozen samples; and only after further analysis in paraffin-embedded tissue was abnormal DNA detected. Overall, the 36-month survival was 69% for the diploid group and 24% for the aneuploid group (p = 0.0006). Including subjects submitted to complete tumor removal (stages I, II, and IIIA) in a multivariate analysis adjusted for TNM stage and histologic type, bearers of aneuploid tumors exhibited a higher risk of relapse (hazard ratio 2.65; CI 95% 1.5-4.66;p = 0.004) or death (hazard ratio 2.17; CI 95% 1.08-4.39;p = 0.032) than patients with diploid tumors. DNA ploidy resulted an independent prognostic factor of survival and tumor relapse in completely resected non-small-cell lung cancer. Sequential analysis of fresh and paraffin-embedded samples can help avoid the bias due to intratumoral DNA content heterogeneity. DNA ploidy could be an useful parameter in any future multifactorial analysis of outcome in such tumors.

Aneuploidy↗

[Epidermal growth factor receptor in non-small cell cancer of the lung].

In this study we determined the concentration of epidermic growth factor receptors (EGFr) in non-small cell carcinoma of the lung (NSCCL) and analyzed its relation to the anatomical, pathological and clinical factors of these neoplasms. The concentration of EGFr in 62 tumor tissue samples was 9.9 +/- 14 fmol/mg, higher than that found in 14 tissue samples from cases of spontaneous pneumothorax (3.9 +/- 3.6 fmol/mg) (p = 0.005). EGFr concentration in lung tissue with no signs of neoplasm was 6.5 +/- 10 fmol/mg. In 21 (33%) cases of NSCCL the concentration exceeded the normal threshold of 10 fmol/mg. EGFr concentration was higher in cases of epidermoid carcinoma than in other tissue samples (p = 0.042). No significant association was found between EGFr levels and status of tumor node metastasis, degree of differentiation and mitotic index. The probability of remaining free of tumor recurrence and of survival after 24 months among patients whose tumoral EGFr concentration was below 10 fmol/mg was 34 and 40%, respectively. The rates for patients with concentrations that exceeded the threshold were 20% (p = 0.32) and 25% (p = 0.26), respectively. The results seem to indicate that the study of EGFr concentration alone does not yield practically important information for the management of patients with NSCCL who have undergone surgery. The concentration of EGFr marks degree of differentiation in NSCCL and has prognostic implications derived from its association with other factors.

Adenocarcinoma↗

Tumor markers in pancreatic cancer: a comparative clinical study between CEA, CA 19-9 and CA 50.

Seventy-eight patients were evaluated to ascertain the usefulness of markers CA 19-9 and CA 50 in diagnosing pancreatic cancer, using a less specific marker (CEA) as reference. Three groups were considered: a) 36 controls; b) 22 patients with benign obstructive jaundice; c) 20 patients with pancreatic cancer. Preoperative blood samples were obtained to ascertain CEA (E.I.A.), CA 19-9 (R.I.A.) and CA 50 (T.R.-F.I.A.). Serum concentrations of the various markers were significantly higher for patients with pancreatic cancer in comparison with the other groups, at cut-offs of 10 ng/ml (CEA), 100 ng/ml (CA 19-9) and 170 U/ml (CA 50). The sensitivity of CA 19-9 (94%) and CA 50 (88%) was much greater than that of CEA (30%). The specificity of the three markers in patients with pancreatic cancer, with respect to the control group, was 100% and this figure is reduced with respect to the group suffering from benign obstructive jaundice (CEA: 90%; CA 19-9: 88% and CA 50: 87%). Diagnostic results (sensitivity, specificity, positive predictive value (P.P.V.) and negative predictive value (N.P.V.] did not significantly increase with respect to CA 19-9 and CA 50 when considered individually. It is concluded that the serum concentrations of CA 19-9 and CA 50 showed high sensitivity and specificity as markers of pancreatic cancer with respect to the other groups, pointing towards clinical routine clinical use of both markers. In addition, a comparative study of the literature has been made and prospects for short-term development and concrete applications for early and reliable diagnosis have been highlighted.

Aged↗

P53 protein expression in gastric adenocarcinoma. Negative predictor of survival after postoperative adjuvant chemotherapy.

BACKGROUND: The aim of the present study was to evaluate the influence of p53 protein on the survival of patients undergoing radical gastrectomy and postoperative adjuvant chemotherapy for gastric cancer. PATIENTS AND METHODS: It was a retrospective study of 46 patients with gastric adenocarcinoma (Stage II and III of the Japanese staging system). Alypatients were treated by curative radical gastrectomy with regional lymphadenectomy plus adjuvant chemotherapy. This regime included Mitomycin (20 mg one hour before surgery, followed by 10 mg the day after) and Fluorinated Pyrimidine (UFT) (400 mg/m2/day orally) (started four weeks after operation, and continued for one year). Immunohistochemical expression of p53 protein was determined on tumor samples from the removed specimens. The influence of p53 on survival was assessed in a Cox's proportional hazard regression analysis. RESULTS: Sixteen tumors (34.7%) manifested nuclear overexpression of p53 protein. Patients with p53-negative tumors showed higher cumulative survival at 4 years follow-up than patients with p53-positive tumors (82% versus 45%) (p < 0.01). Multivariate analysis identified p53 overexpression as a negative independent predictive factor (hazard ratio: 11.15) (95% CI: 1.93-64.42). Multivariate analysis performed on patients with Stage III tumors, separately, confirmed the predictive effect of p53 overexpression. CONCLUSION: The results suggest that postoperative adjuvant chemotherapy acted differently in p53-positive than in p53-negative gastric tumors. Absence of p53 overexpression is associated to longer survival when adjuvant therapy is administered.

Adenocarcinoma↗