BACKGROUND Helicobacter pylori(H.pylori)is a spiral-shaped bacterium responsible for the development of chronic gastritis,gastric ulcer,gastric cancer(GC),and MALTlymphoma of the stomach.H.pylori can be present in the...BACKGROUND Helicobacter pylori(H.pylori)is a spiral-shaped bacterium responsible for the development of chronic gastritis,gastric ulcer,gastric cancer(GC),and MALTlymphoma of the stomach.H.pylori can be present in the gastric mucosa(GM)in both spiral and coccoid forms.However,it is not known whether the severity of GM contamination by various vegetative forms of H.pylori is associated with clinical and morphological characteristics and long-term results of GC treatment.AIM To establish the features of H.pylori infection in patients with GC and their correlations with clinical and morphological characteristics of diseases and long-term results of treatment.METHODS Of 109 patients with GC were included in a prospective cohort study.H.pylori in the GM and tumor was determined by rapid urease test and by immunohistochemically using the antibody to H.pylori.The results obtained were compared with the clinical and morphological characteristics and prognosis of GC.Statistical analysis was performed using the Statistica 10.0 software.RESULTS H.pylori was detected in the adjacent to the tumor GM in 84.5%of cases,of which a high degree of contamination was noted in 50.4%of the samples.Coccoid forms of H.pylori were detected in 93.4%of infected patients,and only coccoid-in 68.9%.It was found that a high degree of GM contamination by the coccoid forms of H.pylori was observed significantly more often in diffuse type of GC(P=0.024),in poorly differentiated GC(P=0.011),in stage T3-4(P=0.04)and in N1(P=0.011).In cases of moderate and marked concentrations of H.pylori in GM,a decrease in 10-year relapse free and overall survival from 55.6%to 26.3%was observed(P=0.02 and P=0.07,respectively).The relationship between the severity of the GM contamination by the spiral-shaped forms of H.pylori and the clinical and morphological characteristics and prognosis of GC was not revealed.CONCLUSION The data obtained indicates that H.pylori may be associated not only with induction but also with the progression of GC.展开更多
<strong>Background:</strong> <span style="font-family:Verdana;">Breast cancer (BC) is considered the most common women cancer worldwide. </span><span style="font-family:Verdan...<strong>Background:</strong> <span style="font-family:Verdana;">Breast cancer (BC) is considered the most common women cancer worldwide. </span><span style="font-family:Verdana;">The main clinicopathological prognostic factors are tumor size, lymph node status and estrogen/progesterone (ER/PR) receptor status</span><span style="font-family:Verdana;">.</span><span style="font-family:Verdana;"> In addition, some factors are both prognostic and predictive as ER/PR receptors and HER2/neu overexpression. </span><span style="font-family:Verdana;">Axillary lymph node status is the most important prognostic factor for breast cancer. Node negative breast cancer patients had the best 5-year overall survival (OS) of 82.8% compared to 73%, 45.7%, and 28.4% for patients with 1</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">-</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">3, 4</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">-</span><span style="font-family:;" "=""> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">12, and ≥13 positive nodes, respectively. </span><span style="font-family:Verdana;">The aim of this study was</span><span style="font-family:Verdana;"> to determine the association between different clinicopathological features and </span><span style="font-family:Verdana;">development</span><span style="font-family:Verdana;"> of metastasis in a group of Egyptian women with early breast cancer</span></span><span style="font-family:Verdana;">,</span><span style="font-family:;" "=""><span style="font-family:Verdana;"> also, to assess patients’ Relapse-free survival (DFS) and OS and their correlation with different clinicopathological features. </span><b><span style="font-family:Verdana;">Patients and Methods: </span></b><span style="font-family:Verdana;">We retrospectively reviewed the files of breast cancer patients who were treated and </span><span style="font-family:Verdana;">followed-up</span><span style="font-family:Verdana;"> at the clinical oncology department and surgical oncology unit, Alexandria Main University Hospital during the period from January 2014 to December 2017. A total of 1848 breast cancer cases were presented during this </span><span style="font-family:Verdana;">period of time</span><span style="font-family:Verdana;">. 141 out of the 1848 patients developed metastasis from breast cancer during follow-up. Among the 141 patients, only 102 had adequate clinical, pathological, treatment </span><span style="font-family:Verdana;">and</span><span style="font-family:Verdana;"> follow-up data enough for analysis and were included in our study. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">The number of patients who developed distant metastasis from breast cancer during the study period (metachronous metastasis) ranges from 17</span></span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">-</span><span style="font-family:;" "=""> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">31 cases/year. All the study patients had documented metastatic disease constituting 102 out of 1848 collected patients representing about 5.5%. The median time for </span><span style="font-family:Verdana;">development</span><span style="font-family:Verdana;"> of metastasis from the initial diagnosis among the 102 studied patients was 17.88 months. Seventy-two out of 102 cases had </span><span style="font-family:Verdana;">distant</span><span style="font-family:Verdana;"> recurrence. There was </span></span><span style="font-family:Verdana;">a </span><span style="font-family:Verdana;">significant</span><span style="font-family:;" "=""><span style="font-family:Verdana;"> correlation between DFS and tumor size, grade, number of lymph nodes involved </span><span style="font-family:Verdana;">and</span><span style="font-family:Verdana;"> hormone receptor (ER and PR) status. Age, tumor grade, tumor size </span><span style="font-family:Verdana;">and</span><span style="font-family:Verdana;"> Her2 status had </span></span><span style="font-family:Verdana;">a </span><span style="font-family:Verdana;">significant</span><span style="font-family:;" "=""><span style="font-family:Verdana;"> impact on the OS. </span><b><span style="font-family:Verdana;">Conclusion: </span></b><span style="font-family:Verdana;">The clinicopathological characteristics of the primary tumor are important for predicting the risk of metastasis among early breast cancer patients and determining their prognosis.</span></span>展开更多
BACKGROUND Approximately 30%of patients with localized prostate cancer(PCa)who undergo radical prostatectomy will develop biochemical recurrence.In these patients,the only potentially curative treatment is postoperati...BACKGROUND Approximately 30%of patients with localized prostate cancer(PCa)who undergo radical prostatectomy will develop biochemical recurrence.In these patients,the only potentially curative treatment is postoperative radiotherapy(PORT)with or without hormone therapy.However,the optimal radiotherapy dose is unknown due to the limited data available.AIM To determine whether the postoperative radiotherapy dose influences biochemical failure-free survival(BFFS)in patients with PCa.METHODS Retrospective analysis of patients who underwent radical prostatectomy for PCa followed by PORT-either adjuvant radiotherapy(ART)or salvage radiotherapy(SRT)-between April 2002 and July 2015.From 2002 to 2010,the prescribed radiation dose to the surgical bed was 66-70 Gy in fractions of 2 Gy;from 2010 until July 2015,the prescribed dose was 70-72 Gy.Patients were grouped into three categories according to the total dose administered:66-68 Gy,70 Gy,and 72 Gy.The primary endpoint was BFFS,defined as the post-radiotherapy prostatespecific antigen(PSA)nadir+0.2 ng/mL.Secondary endpoints were overall survival(OS),cancer-specific survival(CSS),and metastasis-free survival(MFS;based on conventional imaging tests).Treatment-related genitourinary(GU)and gastrointestinal(GI)toxicity was evaluated according to Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer criteria.Finally,we aimed to identify potential prognostic factors.BFFS,OS,CSS,and MFS were calculated with the Kaplan-Meier method and the log-rank test.Univariate and multivariate Cox regression models were performed to explore between-group differences in survival outcome measures.RESULTS A total of 301 consecutive patients were included.Of these,93(33.6%)received ART and 186(66.4%)SRT;22 patients were excluded due to residual macroscopic disease or local recurrence in the surgical bed.In this subgroup(n=93),43 patients(46.2%)were Gleason score(GS)≤6,44(47.3%)GS 7,and 6(6.5%)GS≥8;clinical stage was cT1 in 51(54.8%),cT2 in 35(39.3%),and cT3 in one patient(1.1%);PSA was<10 ng/mL in 58(63%)patients,10-20 ng/mL in 28(30.6%),and≥20 ng/mL in 6(6.4%)patients.No differences were found in BFFS in this patient subset versus the entire cohort of patients(P=0.66).At a median follow-up of 113 months(range,4-233),5-and 10-year BFFS rates were 78.8%and 73.7%,respectively,with OS rates of 93.3%and 81.4%.The 5-year BFFS rates in three groups were as follows:69.6%(66-68 Gy),80.5%(70 Gy)and 82.6%(72 Gy)(P=0.12):the corresponding 10-year rates were 63.9%,72.9%,and 82.6%(P=0.12),respectively.No significant between-group differences were observed in MFS,CSS,or OS.On the univariate analysis,the following variables were significantly associated with BFFS:PSA at diagnosis;clinical stage(cT1 vs cT2);GS at diagnosis;treatment indication(ART vs SRT);pre-RT PSA levels;and RT dose 66-68 Gy vs.72 Gy(HR:2.05;95%CI:1.02-4.02,P=0.04).On the multivariate analysis,the following variables remained significant:biopsy GS(HR:2.85;95%CI:1.83-4.43,P<0.001);clinical stage(HR:2.31;95%CI:1.47-4.43,P=0.01);and treatment indication(HR:4.11;95%CI:2.06-8.17,P<0.001).Acute grade(G)1 GU toxicity was observed in 11(20.4%),17(19.8%),and 3(8.3%)patients in each group(66-68 Gy,70 Gy and 72 Gy),respectively(P=0.295).Acute G2 toxicity was observed in 2(3.7%),4(4.7%)and 2(5.6%)patients,respectively(P=0.949).Acute G1 GI toxicity was observed in 16(29.6%),23(26.7%)and 2(5.6%)patients in each group,respectively(P=0.011).Acute G2 GI toxicity was observed in 2(3.7%),6(6.9%)and 1(2.8%)patients,respectively(P=0.278).No cases of acute G3 GI toxicity were observed.CONCLUSION The findings of this retrospective study suggest that postoperative radiotherapy dose intensification in PCa is not superior to conventional radiotherapy treatment.展开更多
文摘BACKGROUND Helicobacter pylori(H.pylori)is a spiral-shaped bacterium responsible for the development of chronic gastritis,gastric ulcer,gastric cancer(GC),and MALTlymphoma of the stomach.H.pylori can be present in the gastric mucosa(GM)in both spiral and coccoid forms.However,it is not known whether the severity of GM contamination by various vegetative forms of H.pylori is associated with clinical and morphological characteristics and long-term results of GC treatment.AIM To establish the features of H.pylori infection in patients with GC and their correlations with clinical and morphological characteristics of diseases and long-term results of treatment.METHODS Of 109 patients with GC were included in a prospective cohort study.H.pylori in the GM and tumor was determined by rapid urease test and by immunohistochemically using the antibody to H.pylori.The results obtained were compared with the clinical and morphological characteristics and prognosis of GC.Statistical analysis was performed using the Statistica 10.0 software.RESULTS H.pylori was detected in the adjacent to the tumor GM in 84.5%of cases,of which a high degree of contamination was noted in 50.4%of the samples.Coccoid forms of H.pylori were detected in 93.4%of infected patients,and only coccoid-in 68.9%.It was found that a high degree of GM contamination by the coccoid forms of H.pylori was observed significantly more often in diffuse type of GC(P=0.024),in poorly differentiated GC(P=0.011),in stage T3-4(P=0.04)and in N1(P=0.011).In cases of moderate and marked concentrations of H.pylori in GM,a decrease in 10-year relapse free and overall survival from 55.6%to 26.3%was observed(P=0.02 and P=0.07,respectively).The relationship between the severity of the GM contamination by the spiral-shaped forms of H.pylori and the clinical and morphological characteristics and prognosis of GC was not revealed.CONCLUSION The data obtained indicates that H.pylori may be associated not only with induction but also with the progression of GC.
文摘<strong>Background:</strong> <span style="font-family:Verdana;">Breast cancer (BC) is considered the most common women cancer worldwide. </span><span style="font-family:Verdana;">The main clinicopathological prognostic factors are tumor size, lymph node status and estrogen/progesterone (ER/PR) receptor status</span><span style="font-family:Verdana;">.</span><span style="font-family:Verdana;"> In addition, some factors are both prognostic and predictive as ER/PR receptors and HER2/neu overexpression. </span><span style="font-family:Verdana;">Axillary lymph node status is the most important prognostic factor for breast cancer. Node negative breast cancer patients had the best 5-year overall survival (OS) of 82.8% compared to 73%, 45.7%, and 28.4% for patients with 1</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">-</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">3, 4</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">-</span><span style="font-family:;" "=""> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">12, and ≥13 positive nodes, respectively. </span><span style="font-family:Verdana;">The aim of this study was</span><span style="font-family:Verdana;"> to determine the association between different clinicopathological features and </span><span style="font-family:Verdana;">development</span><span style="font-family:Verdana;"> of metastasis in a group of Egyptian women with early breast cancer</span></span><span style="font-family:Verdana;">,</span><span style="font-family:;" "=""><span style="font-family:Verdana;"> also, to assess patients’ Relapse-free survival (DFS) and OS and their correlation with different clinicopathological features. </span><b><span style="font-family:Verdana;">Patients and Methods: </span></b><span style="font-family:Verdana;">We retrospectively reviewed the files of breast cancer patients who were treated and </span><span style="font-family:Verdana;">followed-up</span><span style="font-family:Verdana;"> at the clinical oncology department and surgical oncology unit, Alexandria Main University Hospital during the period from January 2014 to December 2017. A total of 1848 breast cancer cases were presented during this </span><span style="font-family:Verdana;">period of time</span><span style="font-family:Verdana;">. 141 out of the 1848 patients developed metastasis from breast cancer during follow-up. Among the 141 patients, only 102 had adequate clinical, pathological, treatment </span><span style="font-family:Verdana;">and</span><span style="font-family:Verdana;"> follow-up data enough for analysis and were included in our study. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">The number of patients who developed distant metastasis from breast cancer during the study period (metachronous metastasis) ranges from 17</span></span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">-</span><span style="font-family:;" "=""> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">31 cases/year. All the study patients had documented metastatic disease constituting 102 out of 1848 collected patients representing about 5.5%. The median time for </span><span style="font-family:Verdana;">development</span><span style="font-family:Verdana;"> of metastasis from the initial diagnosis among the 102 studied patients was 17.88 months. Seventy-two out of 102 cases had </span><span style="font-family:Verdana;">distant</span><span style="font-family:Verdana;"> recurrence. There was </span></span><span style="font-family:Verdana;">a </span><span style="font-family:Verdana;">significant</span><span style="font-family:;" "=""><span style="font-family:Verdana;"> correlation between DFS and tumor size, grade, number of lymph nodes involved </span><span style="font-family:Verdana;">and</span><span style="font-family:Verdana;"> hormone receptor (ER and PR) status. Age, tumor grade, tumor size </span><span style="font-family:Verdana;">and</span><span style="font-family:Verdana;"> Her2 status had </span></span><span style="font-family:Verdana;">a </span><span style="font-family:Verdana;">significant</span><span style="font-family:;" "=""><span style="font-family:Verdana;"> impact on the OS. </span><b><span style="font-family:Verdana;">Conclusion: </span></b><span style="font-family:Verdana;">The clinicopathological characteristics of the primary tumor are important for predicting the risk of metastasis among early breast cancer patients and determining their prognosis.</span></span>
文摘BACKGROUND Approximately 30%of patients with localized prostate cancer(PCa)who undergo radical prostatectomy will develop biochemical recurrence.In these patients,the only potentially curative treatment is postoperative radiotherapy(PORT)with or without hormone therapy.However,the optimal radiotherapy dose is unknown due to the limited data available.AIM To determine whether the postoperative radiotherapy dose influences biochemical failure-free survival(BFFS)in patients with PCa.METHODS Retrospective analysis of patients who underwent radical prostatectomy for PCa followed by PORT-either adjuvant radiotherapy(ART)or salvage radiotherapy(SRT)-between April 2002 and July 2015.From 2002 to 2010,the prescribed radiation dose to the surgical bed was 66-70 Gy in fractions of 2 Gy;from 2010 until July 2015,the prescribed dose was 70-72 Gy.Patients were grouped into three categories according to the total dose administered:66-68 Gy,70 Gy,and 72 Gy.The primary endpoint was BFFS,defined as the post-radiotherapy prostatespecific antigen(PSA)nadir+0.2 ng/mL.Secondary endpoints were overall survival(OS),cancer-specific survival(CSS),and metastasis-free survival(MFS;based on conventional imaging tests).Treatment-related genitourinary(GU)and gastrointestinal(GI)toxicity was evaluated according to Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer criteria.Finally,we aimed to identify potential prognostic factors.BFFS,OS,CSS,and MFS were calculated with the Kaplan-Meier method and the log-rank test.Univariate and multivariate Cox regression models were performed to explore between-group differences in survival outcome measures.RESULTS A total of 301 consecutive patients were included.Of these,93(33.6%)received ART and 186(66.4%)SRT;22 patients were excluded due to residual macroscopic disease or local recurrence in the surgical bed.In this subgroup(n=93),43 patients(46.2%)were Gleason score(GS)≤6,44(47.3%)GS 7,and 6(6.5%)GS≥8;clinical stage was cT1 in 51(54.8%),cT2 in 35(39.3%),and cT3 in one patient(1.1%);PSA was<10 ng/mL in 58(63%)patients,10-20 ng/mL in 28(30.6%),and≥20 ng/mL in 6(6.4%)patients.No differences were found in BFFS in this patient subset versus the entire cohort of patients(P=0.66).At a median follow-up of 113 months(range,4-233),5-and 10-year BFFS rates were 78.8%and 73.7%,respectively,with OS rates of 93.3%and 81.4%.The 5-year BFFS rates in three groups were as follows:69.6%(66-68 Gy),80.5%(70 Gy)and 82.6%(72 Gy)(P=0.12):the corresponding 10-year rates were 63.9%,72.9%,and 82.6%(P=0.12),respectively.No significant between-group differences were observed in MFS,CSS,or OS.On the univariate analysis,the following variables were significantly associated with BFFS:PSA at diagnosis;clinical stage(cT1 vs cT2);GS at diagnosis;treatment indication(ART vs SRT);pre-RT PSA levels;and RT dose 66-68 Gy vs.72 Gy(HR:2.05;95%CI:1.02-4.02,P=0.04).On the multivariate analysis,the following variables remained significant:biopsy GS(HR:2.85;95%CI:1.83-4.43,P<0.001);clinical stage(HR:2.31;95%CI:1.47-4.43,P=0.01);and treatment indication(HR:4.11;95%CI:2.06-8.17,P<0.001).Acute grade(G)1 GU toxicity was observed in 11(20.4%),17(19.8%),and 3(8.3%)patients in each group(66-68 Gy,70 Gy and 72 Gy),respectively(P=0.295).Acute G2 toxicity was observed in 2(3.7%),4(4.7%)and 2(5.6%)patients,respectively(P=0.949).Acute G1 GI toxicity was observed in 16(29.6%),23(26.7%)and 2(5.6%)patients in each group,respectively(P=0.011).Acute G2 GI toxicity was observed in 2(3.7%),6(6.9%)and 1(2.8%)patients,respectively(P=0.278).No cases of acute G3 GI toxicity were observed.CONCLUSION The findings of this retrospective study suggest that postoperative radiotherapy dose intensification in PCa is not superior to conventional radiotherapy treatment.
