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Biomedical subjects

G Gasparini

Publications and source records attributed to G Gasparini.

At least 217 records · Page 12Linked to original sources
PubMedDate not supplied

Left atrial overload can be used to estimate mitral regurgitant volume.

This study was conducted to assess the accuracy of the estimated mitral regurgitant volume using both the left atrial filling volume and the systolic component of pulmonary vein flow expressed as the percent of its total. Since mitral regurgitation fills the left atrial chamber, the variation in atrial volume during ventricular systole has been proposed as a means to evaluate the severity of regurgitation. Although the correlation with invasive grading of mitral regurgitation is good, there is an unacceptable overlap among grades caused by the absence of information concerning pulmonary vein flow, which enters the left atrium while regurgitation occurs. The Doppler regurgitant volume, or Dp-RVol (mitral stroke volume minus aortic stroke volume) was quantified in 74 patients with any degree and etiology of mitral regurgitation. Atrial volumes were measured from the four-chamber apical view (biplane area-length method). The systolic time-velocity integral of pulmonary vein flow was expressed as the percent of the total (PVs%) (systolic-diastolic) time-velocity integral. These parameters were subjected to multivariate analysis and a regression equation was obtained. The equation was subsequently applied to a group of 31 patients without mitral regurgitation, as evaluated by color Doppler or continuous-wave Doppler and to the overall population (105 patients) in order to estimate the mitral regurgitant volume. In 74 patients with mitral regurgitation, the Doppler regurgitant volume was univariately correlated with the left atrial filling volume (r= 0.74; p<0.0001) and the systolic pulmonary vein velocity integral expressed as the percent of the total (r=0.67; p<0.0001). In multiple regression analysis, the combination of atrial filling and the pulmonary vein velocity integral provided the more accurate estimation of the regurgitant volume (R2=0.84; standard error of the estimate [SEE], 13.9 mL; p<0.0001; Dp-RVol equals 7.84+[1.08*left atrial filling volume] 2 [0.839*PVs%]). In 31 patients with no mitral regurgitation detected by color Doppler or continuous wave Doppler the estimated regurgitant volume was 4.3±6.6 mL. In the overall population the estimated regurgitant volume and the Doppler regurgitant volume correlated well with each other (R2=0.85; SEE, 11.5 mL; p<0.0001). The equation was 100% sensitive and 98% specific in detecting a regurgitant volume higher than 55 mL. The combination of the atrial filling volume and the systolic pulmonary vein time-velocity integral expressed as the percent of the total allows reliable estimation of the regurgitant volume in patients with mitral regurgitation. (c)2001 CHF, Inc.

Journal Article↗
PubMedDate not supplied

Clinical management of a case of recurrent apocrine gland carcinoma of the scalp: efficacy of a chemotherapy schedule with methotrexate and bleomycin.

Apocrine carcinoma of the skin is a rare tumor. Wide surgical excision with complete removal of the neoplasm is the standard therapy and this appears to offer the best chance of cure. Radiotherapy may be used in case of local relapse or regional lymph node involvement. Systemic chemotherapy has not proved to be effective in the treatment of this tumor. We report on a 46-year-old woman with a recurrent apocrine carcinoma of the scalp that had previously been treated with surgery, radiotherapy and chemotherapy (Al-Saraff schedule). The patient was responsive to a second-line systemic chemotherapy regimen consisting of a weekly combination of methotrexate and bleomycin, and achieved long-term progression-free survival.

Antineoplastic Combined Chemotherapy Protocols↗
PubMedDate not supplied

Therapeutic strategies to improve the efficacy of oxaliplatin in gastrointestinal tumors.

The pharmacological characteristics of oxaliplatin make it one of the better chemotherapeutics to be combined with novel molecular-targeted anticancer treatments for the therapy of gastrointestinal tumors. The purposes of this review article are to report the preliminary data of combined therapy of oxaliplatin with inhibitors of angiogenesis or epidermal growth factor receptor and to suggest novel oxaliplatin-based therapeutic strategies. It is hypothesized that well designed, personalized, molecular-based treatments may improve the efficacy of oxaliplatin for the treatment of colorectal, gastric and pancreatic cancer. It is mandatory to rationalize such an approach by adequate determination of predictive surrogate biomarkers of response related to the targets in each single tumor against which therapy is aimed, using standardized assays and quality control.

Animals↗
PubMedDate not supplied

Sequential adjuvant hormone therapy in postmenopausal breast cancer: rationale and clinical results.

For the past 15 years tamoxifen has been the standard adjuvant hormone therapy for women with early-stage breast cancer and estrogen receptor (ER)-positive tumors, irrespective of nodal status and other clinicopathological parameters. Recent studies provided evidence that the optimal duration of tamoxifen treatment is 5 years. Based on the positive clinical results obtained with the administration of aromatase inhibitors (AIs) in the metastatic setting, several controlled clinical trials have evaluated the efficacy and side effects of AIs versus standard tamoxifen also as adjuvant therapy in postmenopausal breast cancer patients. The results of the above studies, suggest a therapeutic advantage of AIs over tamoxifen with regard to relapse-free survival and the risk of metachronous contralateral breast cancer. We review the rationale and the available clinical data on initial or sequential hormone treatment with AIs and we propose a novel scenario for possible therapeutic strategies based on the clinicopathological characteristics of the patients and on the biology of each single tumor.

Antineoplastic Agents, Hormonal↗
PubMedDate not supplied

Assessment of tumor vascularization: immunohistochemical and non-invasive methods.

Growth of solid tumors beyond a certain mass is dependent on the vascular bed from pre-existing host vasculature. The process of angiogenesis is essential not only for primary tumor growth but also for metastasis. The number of microvessels within the invasive component of a primary tumor reflects the degree of tumor angiogenesis. At present the most widely used method to assess neovascularization is the quantitation of intratumoral microvessel density (IMD) by immunohistochemical methods in which specific markers for endothelial cells are employed. In this paper we analyze the different methods used to assess IMD, as well as their advantages and potential methodological pitfalls. Several studies have shown a close correlation between IMD, tumor growth and the occurrence of metastasis, suggesting that IMD is a prognostic indicator of clinical relevance. Furthermore, preliminary studies suggest that determination of angiogenesis may predict responsiveness to some forms of conventional anticancer therapy. Although the histological microvessel density technique is the current gold standard to characterize tumor angiogenesis, it may not be the ideal tool for clinical purposes because it needs to be performed on biopsy material and does not assess the functional pathways involved in the angiogenic activity of tumors. Non-invasive assessment of tumor vascularity is possible in vivo by means of Doppler sonography, dynamic contrast-enhanced magnetic resonance imaging (MRI) and positron emission tomography (PET). These methods may be preferable to histological assay because they are non-invasive, survey the entire tumor, reflect both anatomic and physiologic characteristics, and may be useful to monitor the activity of antiangiogenic therapies.

Animals↗
PubMedDate not supplied

Clinical relevance of vascular endothelial growth factor and thymidine phosphorylase in patients with node-positive breast cancer treated with either adjuvant chemotherapy or hormone therapy.

PURPOSE: To determine the role of the two angiogenic peptides, vascular endothelial growth factor (VEGF) and thymidine phosphorylase (TP) (the latter also being a target enzyme for cytotoxicity of 5-fluorouracil and methotrexate), and conventional prognostic factors in predicting relapse-free survival (RFS) and overall survival (OS) probabilities in two cohorts of patients with node-positive breast cancer (NPBC) treated with either adjuvant chemotherapy (CMF [cyclophosphamide, methotrexate, 5-fluorouracil] schedule) or hormone therapy (tamoxifen). PATIENTS AND METHODS: We studied two groups of 137 and 164 patients with NPBC, median follow-up of 72 months for both, treated with adjuvant chemotherapy or hormone therapy, respectively. The cytosolic levels of VEGF and TP were determined in the primary tumor by original immunometric methods. The association between VEGF and TP and of these angiogenic peptides with other prognostic indicators were tested by using the Spearman correlation coefficient (for continuous variables) or the Kolmogorov-Smirnov test (for dichotomous variables). Results of the clinical outcome were analyzed by both univariate and multivariate (for RFS only) Cox regression models in which VEGF and TP were treated as continuous variables. RESULTS: In the CMF group, the concentrations of VEGF and TP ranged from 5.8 to 7798 pg/mg of protein (median, 87.5 pg/mg) and from 1.2 to 904 U/mg (median, 138.2 U/mg), respectively. There was no significant association between the two angiogenic peptides. VEGF was not associated with any other variable, whereas TP showed a positive association with age and an inverse association with the number of involved nodes. In the tamoxifen group, the concentrations of VEGF (5.9-2482; median, 79.3 pg/mg protein) and TP (6.1-1542; median, 146.5 U/mg) were similar to those of the CMF group, and the two angiogenic peptides were not correlated. VEGF was positively associated with age and was inversely associated with estrogen receptor and progesterone receptor, whereas TP was not associated with any other variable. Univariate analysis in the CMF group showed that VEGF and TP were significantly predictive of both RFS and OS. Likewise, the number of involved axillary nodes was significantly associated with both RFS and OS. Univariate analysis in the tamoxifen group showed that TP did not significantly influence either RFS or OS. On the contrary, VEGF levels were significantly predictive of both RFS and OS, as were the number of involved nodes, estrogen receptor concentrations, and progesterone receptor concentration. In the multivariate analysis on RFS in the CMF group, VEGF, TP, their first-order interaction term, and age were significant and independent predictive factors. In the tamoxifen group, only VEGF and the number of involved nodes were significant and independent predictive factors. DISCUSSION: The results of our study suggest that high levels of TP and low levels of VEGF characterize the patients with NPBC treated with adjuvant CMF who have the highest likelihood of favorable outcome. Low levels of VEGF and the presence of less than three involved axillary nodes characterize the patients with NPBC treated with adjuvant tamoxifen who have the highest likelihood of favorable outcome. This information may be useful to plan future studies to better select the patients with NPBC for conventional adjuvant treatments as well as to monitor the efficacy of novel therapeutic strategies of adjuvant therapy based on inhibition of angiogenesis.

Adult↗
PubMedDate not supplied

Angiosuppression and chemotherapy: strategies aimed at their integration in cancer patients.

A number of antiangiogenic agents have been developed as pharmaceuticals and are currently being tested in clinical studies. Potential strategies to enhance the activity of angiogenesis inhibitors could be to combine them, or better still, to administer them either sequentially or concurrently with cytotoxic drugs. Chemotherapy would be a more appropriate initial choice for patients with advanced disease since cytostatic agents can induce a fast regression of the tumor and cancer-related symptoms. Antiangiogenic treatment could be used after chemotherapy in patients who achieve disease remission to prolong the time to progression, the symptom-free interval and the overall survival. Antiangiogenic treatment is likely to attain an important role in the adjuvant setting. In fact, it could be used for prolonged periods after radical surgery to maintain dormancy of residual tumor cells. In spite of these promising preclinical data, several points need to be clarified before the initiation of clinical trials. In fact, certain misconceptions may interfere with their optimum design and result analysis.

Angiogenesis Inhibitors↗
PubMedDate not supplied

Coagulation factor XIII, endothelial damage and systemic sclerosis.

In the blood coagulation process, Factor XIII (F XIII) is responsible for the stabilization of the fibrin clot. The hypothesized ability of this blood coagulation factor to affect collagen synthesis and degradation led to its use in the treatment of scleroderma. However, the complex mechanism of action of F XIII remains unclear. The aim of our study was to assess possible effects of F XIII on endothelial damage, regarded as an early pathogenic event in systemic sclerosis (SSc). Thus, we measured plasma levels of von Willebrand factor antigen (vWF:Ag), a marker of endothelial cell injury, in 22 patients with SSc, 9 of whom were treated with F XIII and 13 who do not receive the drug. The plasma concentration of F XIII has also been analyzed. Interestingly, the vWF:Ag plasma levels within the group of SSc patients treated with F XIII were significantly lower than those of untreated SSc individuals (p < 0. 02). On the other hand, the highest mean value of vWF:Ag was found in a subset of untreated subjects having SSc with severe lung involvement, supporting a strict relationship between elevated levels of vWF:Ag and severity of the disease. In contrast, plasma concentration of F XIII resulted normal in all but 3 SSc patients, ruling out a deficiency of this blood coagulation factor as promoting the occurrence of SSc. These preliminary findings seem to support the hypothesis that F XIII may play an improving role on endothelial damage, other than the initially suggested action on collagen metabolism, in SSc.

Adult↗
PubMedDate not supplied

[Dental and skeletal malformations: 434 cases of II and III dental skeletal class. Our experience and review of the literature].

BACKGROUND: This study tests the patients who underwent to orthognatic surgery to compare the perioperatory treatment and the results with what related by international bibliography. METHODS: We have made a retrospective analysis on 434 patients affected by dentalskeletal malformations and surgically treated at the Department of Maxillo-Facial Surgery of the University of Rome "La Sapienza", from 1-1-1988 to 31-12-1997. We have examined these data: clinical evaluation of patient, pre and post-surgical orthodontic treatment, minimum age for surgical correction, surgical technique, use of osseus-synthesis with wire or RIF for mobile segment osseus stabilization, use of reference articular plaque and the possible association of additional surgical technique during the same time of maxillomandibular correction. We have made in all patients orthognatic surgery, which consist in osteotomy Le Fort I for upper jaw and sagittal osteotomy for mandible. RESULTS: In 25 patients was necessary remove the plaques and the screws which have made an infection. In 15 patients we have executed a subsequent operation for relapse of the dentalskeletal malformation. In other patients we have got a good functional and aesthetical result. CONCLUSIONS: From our study result that an exact presurgical analysis and a correct orthodontic-surgical treatment have permitted to obtain a good functional and aesthetical result in all patients.

Abnormalities, Multiple↗
PubMedDate not supplied

Validation of blood collection procedures for the determination of circulating vascular endothelial growth factor (VEGF) in different blood compartments.

AIMS OF THE STUDY: Studies on circulating VEGF have reported mixed results, possibly due to a lack of standardization of the pre-analytical phase. The aim of our investigation was to standardize the sampling procedure for the determination of VEGF in different blood fractions. BASIC PROCEDURES: We evaluated various clotting times for obtaining serum in 30 subjects, as well as different procedures for the preparation of plasma Edinburgh anticoagulant mixture (EDTA, PGE1, theophylline) and CTAD. VEGF was also assayed in lysed whole blood. In vitro platelet activation was monitored by measuring the levels of PF4. VEGF and PF4 were measured using commercially available enzyme-linked immunoassays. MAIN FINDINGS: Clotting time increased the release of VEGF, which reached a plateau between 2 and 4 hours. The percent increase of VEGF at 2 hours ranged from 118% to 4,515% (median 327%) compared to samples centrifuged within 10 min from withdrawal. VEGF was not different and PF4 was very low or undetectable in Edinburgh plasma and CTAD plasma, while it was significantly higher in sodium citrate plasma. VEGF in CTAD plasma was not correlated with platelet count or leukocytes. Serum VEGF did not correlate with the leukocyte number, but it correlated significantly with the platelet count. PRINCIPAL CONCLUSIONS: The procedures for sample collection described above are highly standardized and easy to perform in a routine setting. We therefore suggest systematic evaluation of VEGF in CTAD plasma, in serum (clotting for 2 hours at room temperature) and in whole blood, until prospective controlled clinical studies will have clarified in which blood compartment(s) VEGF provides clinically relevant information.

Biomarkers, Tumor↗
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Post surgical modification of facial divergency in 40 patients with mandibular prognathism.

With a Le Fort type I and sagittal-bilateral surgery in a single time is usually impossible to solve problems of divergency and maxillary-mandibular prognathism in patients with tooth-skeletric III class. According to the Authors, in these patients, to plan an efficient surgical correction treatment, is suitable to analyse, before surgery, not only all data of maxillary-mandibular protrusion but also those of facial divergency.

Adolescent↗
PubMedDate not supplied

Human articular cartilage in osteoarthrosis. I. The matrix. Transmission electron microscopic study.

The present research has been carried out with the aim of contributing to the understanding of morphological changes in human articular cartilage during osteoarthrosis and to evaluate the usefulness of TEM in this application. Only the matrix was examined in this first phase of study. Fragments from the femoral head of 20 patients subjected total hip arthroplasis, were studied by TEM after treatment with current procedures. The images obtained were considered observing the division of cartilage into superficial, intermediate and deep layers. Patients were divided according to the gravity of their clinical conditions. The least severe forms of pathology seem to involve only the superficial layer, which quickly loses the lamina splendens and may be affected by rarefactions of the matrix, which becomes fissured, while the deep layers are only slightly involved. During the later stages, the pathology progresses with irregularity of disposition and size of the collagen fibres and an increase in the number and size of fissures. The intermediate layer shows architectural disorder in the collagen fibres, even reaching the deep layer. The interfibrillar distance appears greater. As pathology progresses, the superficial layer tends to disappear, while the successive layers undergo progressive alteration in disposition and size of the collagen fibres. Globular aggregations of various dimensions and electron density similar to collagen are present in the deep layer.

Aged↗
PubMedDate not supplied

Relationship of the epidermal growth factor-receptor to the growth fraction (Ki-67 antibody) and the flow cytometric S-phase as cell kinetics parameters, in human mammary carcinomas.

Epidermal growth factor (EGF) has been shown to have a mitogenic effect on some breast cancer cells lines in vitro. The growth of the subclass of human breast tumors which expresses the specific receptor for EGF seems to be mediated by autocrine mechanisms rather than steroid hormones. The expression of EGF-receptor, as detected by an immunocytochemical method, was compared with the Growth Fraction (GF) by the Ki-67 monoclonal antibody and the S-phase content as tumor proliferative activity indexes, and with DNA ploidy and some pathologic features in 86 stage I-II breast carcinomas. Overall 52 out of 86 (60%) of the tumors were EGF-receptor positive. There was no correlation between the cell kinetics parameters and the EGF-receptor status, suggesting that its expression may be unrelated to the proliferative activity of the tumor in these clinical stages and that the EGF-receptor GF and S-phase may be independent variables in breast cancer. In our series 57% of tumors were DNA aneuploid and only a trend was found towards EGF-receptor positivity (P = 0.08). There was no correlation between EGF-receptor expression and grading or node-status. The overall picture is that of an independent relationship between EGF-receptor with the cell kinetics parameters and ploidy, confirming the complex and heterogeneous biology of breast carcinoma. These results suggest the possibility of better recognition of subsets of patients with diverse tumor aggressiveness, combining together EGF-receptor status, cell kinetics and ploidy, with a better stratification for treatment options.

Antibodies, Monoclonal↗
PubMedDate not supplied

Conservative surgery and irradiation (QUART) in the treatment of 243 stage I-II breast cancer patients.

From 1980 to 1987, 243 evaluable patients with pT1, pT2 (less than 3 centimeters in diameter), N0, M0, invasive breast cancer were treated with "quadrantectomy" with axillary dissection followed by electron beam radiation therapy (QUART) at the St. Bortolo Hospital, Vicenza. Stage II patients received adjuvant chemotherapy (CMF) if preperimenopausal or hormonotherapy (tamoxifen) if postmenopausal. The median follow-up was 54 months (26 to 116 months). The 4.5-year overall survival (OS) and disease-free survival (DFS) were respectively 91% and 85%; the 10-year actuarially estimated OS and DFS was 77%. Thirty-three patients relapsed, 11 of whom had local recurrence, and 23 developed distant metastases. A significantly longer OS and DFS were observed in stage I versus stage II (p = 0.0008) and in pT1 versus pT2 (p = 0.001) tumors. No difference was found regarding menopausal status and histotype. The local control of disease was very high (95.5%), with a significantly higher local recurrence rate in premenopausal women compared to postmenopausal (10/117 versus 1/126; p = 0.009). Tumor size did not influence the frequency of local recurrence. No major complications occurred but a significantly higher rate of reversible radiation-pneumonitis occurred in patients treated with higher energies of electrons (17 to 20 MeV) compared with lower (6 to 13 MeV) (33/177 versus 7/66; p less than 0.05). Cosmetic results were judged as excellent in 20%, satisfactory in 68%, unsatisfactory in 6% and not evaluable in 6% of cases. We conclude first, that small pT2 breast carcinomas may also be safely treated with QUART, second, that the electron beam is a radiotherapeutic technique able to produce a good cosmetic result and to assure a satisfactory local control and, finally, that the use of tamoxifen in postmenopausal stage II breast carcinomas is safe and easy to combine with radiotherapy in the conservative management of early breast cancer due to the lower toxic effects, compared to those observed in premenopausal women treated with chemotherapy.

Aged↗
PubMedDate not supplied

Breast cancer cell kinetics: immunocytochemical determination of growth fractions by monoclonal antibody Ki-67 and correlation with flow cytometric S-phase and with some features of tumor aggressiveness.

In operable breast cancer, cell kinetics can be utilized in the prediction of the clinical outcome of patients. The discovery of monoclonal antibodies recognizing antigens related to cell proliferation has permitted the assessment of cell kinetics by rapid and practical immunocytochemical methods. It is claimed that the Ki-67 mouse monoclonal antibody recognizes an antigen expressed in proliferating cells but not present in quiescent (G0) cells. To study the relationship between Ki-67 score and DNA flow cytometric S-Phase Fraction (SPF), the latter being one of the most widely used methods to assess cell kinetics, we compared these two techniques of measurement in 122 breast carcinomas using both for each specimen. In this series 90% of tumors were Ki-67 positive, with a median value of 7.5% (range 1% to 70%). DNA flow cytometric analysis revealed that 69 tumors (57%) were aneuploid, whereas 53 were diploid. The median SPF value was 8% for diploid and 15% for aneuploid tumors (range 2% to 32%). Ki-67 scores were significantly higher in the DNA aneuploid compared to the diploid carcinomas (p = 0.015). Overall, a good correlation was found between Ki-67 and SPF values both in diploid (r = 0.60) and in aneuploid (r = 0.38) tumors. High Ki-67 scores were associated with the presence of axillary lymph node metastases (p = 0.0023) and poor histologic differentiation (p = 0.0028). Menopausal status, tumor size and peritumoral vessel invasion were unrelated to the Ki-67 score. Over-expression of the Epidermal Growth Factor receptor (EGF-r) and the c-erbB-2 oncogene were not correlated with Ki-67 staining. In conclusion, in this study Ki-67 immunostaining correlated with other indices of cell proliferation (SPF and Grade) and with some features of tumor aggressiveness (DNA aneuploidy and lymph node metastases) but seemed to be independent of some biological markers (EGR-r and c-erbB-2). Since the major objective for assessing proliferative status in Stage I-II breast carcinoma is to determine prognosis, it will have to be evaluated whether the determination of the Growth Fraction has comparable or even greater prognostic value than other cell kinetics markers.

Aneuploidy↗
PubMedDate not supplied

A pharmacological rationale for neoadjuvant chemotherapy with adriamycin in locally advanced breast cancer.

Some locally advanced neoplastic diseases (i.e. head and neck cancer, breast cancer and osteogenic sarcoma), benefit from neoadjuvant chemotherapy with a resultant enhanced operability and a longer disease-free survival. The pharmacological study of the tissue distribution of adriamycin in patients affected by locally advanced breast cancer has shown a preferable tropism of the drug toward the primary tumor and axillary lymph nodes. Median concentrations of the drug in the tumor were: 9.68 micrograms/gr at 30 minutes, 8.71 micrograms/gr at 24 hours and 6.44 micrograms/gr at 48 hours. Median concentration in lymph nodes at 48 hours was 10.80 in normal and 16.62 in metastatic. Lower concentrations were found at 48 hours in the mammary gland (mean 1.72 micrograms/gr), skin (mean 0.59 micrograms/gr) and in muscle tissue (mean 1.83 micrograms/gr in normal and 2.41 micrograms/gr in metastatic). As regards acute toxicity, we observed that grade II-III leukopenia was associated with longer plasmatic T1/2 beta (3 out of 6 patients) and that grade II mucositis was related to high plasma AUC values (3 out of 6 patients). Nausea and vomiting and alopecia seem to be unrelated to plasma pharmacokinetics parameters. After a median follow-up of 36 months it is suggestive that high drug concentrations in carcinoma and in metastatic lymph nodes may be predictive of longer disease-free survival and overall survival. These data give a further rationale for the use of polychemotherapies containing adriamycin in the pre-operative treatment of locally advanced breast cancer.

Aged↗
PubMedDate not supplied

Characterization of node-negative breast cancer by clinico-pathologic and biologic factors.

About 30% of node-negative breast cancer (NNBC) patients relapse and about 20-25% die after local treatment. This is a heterogenous disease and at present no single factor completely distinguishes those patients destined to have a recurrence and to die, for whom an adjuvant treatment seems indicated. With the objective of subdividing NNBC into different prognostic groups, we studied the expression and relationship of eight factors related both to the clinico-pathologic characteristics and to the tumor biology in 78 consecutive patients: menopausal status, tumor size, grading (G), intratumoral vascular invasion (IVI) steroid hormonal receptors, proliferative rate and epidermal growth factor receptor (EGFr) expression. The frequencies of the risk factors examined were: pre- or perimenopausal status in 29.5%, tumor size greater than 2 cm (pT2) in 28%, GIII in 45%, IVI in 13% estrogen receptor (ER)-negative in 43% and progesterone receptor (PgR)-negative in 60%. There were 23% high proliferating (Ki-67 antibody greater than 20%) and 54% EGFr positive tumors. The distribution of the above risk factors in each tumor were: no factor in 4%; one in 15%; two in 30%; three in 23%; four in 14%; five in 8%; six in 2%; seven in 4% and no case had the sum of all the factors. The mean distribution value was of two per case. Twenty-eight percent of patients had more than the sum of four factors. A significant correlation was observed among: premenopausal status with G III (61% vs 45% in postmenopausal status; p less than 0.05), premenopausal status with ER-negative tumors (65 vs 29% in postmenopasual; p less than 0.05) and between the lack of expression of the two hormonal receptors (overall agreement of 77; p less than 0.05). The prognostic value of these findings needs to be verified with an adequate follow-up.

Adult↗