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S P Balasubramanian

Publications and source records attributed to S P Balasubramanian.

At least 19 recordsLinked to original sources
PubMed2006

Interleukin gene polymorphisms and breast cancer: a case control study and systematic literature review.

BACKGROUND: Interleukins and cytokines play an important role in the pathogenesis of many solid cancers. Several single nucleotide polymorphisms (SNPs) identified in cytokine genes are thought to influence the expression or function of these proteins and many have been evaluated for their role in inflammatory disease and cancer predisposition. The aim of this study was to evaluate any role of specific SNPs in the interleukin genes IL1A, IL1B, IL1RN, IL4R, IL6 and IL10 in predisposition to breast cancer susceptibility and severity. METHODS: Candidate single nucleotide polymorphisms (SNPs) in key cytokine genes were genotyped in breast cancer patients and in appropriate healthy volunteers who were similar in age, race and sex. Genotyping was performed using a high throughput allelic discrimination method. Data on clinico-pathological details and survival were collected. A systematic review of Medline English literature was done to retrieve previous studies of these polymorphisms in breast cancer. RESULTS: None of the polymorphisms studied showed any overall predisposition to breast cancer susceptibility, severity or to time to death or occurrence of distant metastases. The results of the systematic review are summarised. CONCLUSION: Polymorphisms within key interleukin genes (IL1A, IL1B, IL1RN, IL4R, IL6 and IL10 do not appear to play a significant overall role in breast cancer susceptibility or severity.

Aged↗
PubMed2006

Ischemic vascular disease and solid cancers: opposing ends of the angiogenic spectrum?

Angiogenesis is a key pathway crucial to the patho-physiology of both vascular disease and solid cancer. In physiological conditions, a fine balance of pro- and anti-angiogenic factors is maintained as part of normal homeostatic mechanisms. It is widely accepted that excess angiogenesis influences the development or progression of tumours whilst insufficient angiogenesis may predispose to ischemic vascular disease. Although there are some factors, which predispose to both cancers and vascular disease, we believe there is a reasonable body of literature that suggests an inverse association between the two. We hypothesise that pro-angiogenic and anti-angiogenic phenotypes exist in the population. This may be due to a combination of underlying genetic variations and/or environmental factors. Pro-angiogenic phenotypes would have increased susceptibility to solid cancers and decreased predisposition to cardiovascular diseases and vice versa with the anti-angiogenic phenotypes. We propose that genetic and environmental factors causing a shift in the balance of angiogenesis will predispose individuals towards one group of pathologies while protecting them from another. Evaluation of this hypothesis will in the first instance involve carefully designed large population based observational studies to determine if an inverse relationship exists between the predisposition to ischemic vascular disease and the predisposition to solid cancer. Further detailed study of the pathways and underlying mechanisms of angiogenesis especially in disease states would facilitate better understanding of its regulation. Evaluation and validation of molecular markers that affect the 'angiogenesis pathway' may be helpful in determining the angiogenic potential of individual subjects. Determining where individuals lie along this spectrum may have a potential role in the prediction and stratification of risk of cancer and vascular disease. Modifying risk for patients at high risk of disease at the two opposing ends of the spectrum may then be possible by either lifestyle or dietary alterations or drugs targeting the angiogenic pathway.

Angiogenesis Inhibitors↗
PubMed2006

Expression of receptor activator of nuclear factor kappabeta ligand (RANKL) and tumour necrosis factor related, apoptosis inducing ligand (TRAIL) in breast cancer, and their relations with osteoprotegerin, oestrogen receptor, and clinicopathological variables.

BACKGROUND: Receptor activator of nuclear factor kappabeta ligand (RANKL) has an important role in bone remodelling, and tumour necrosis factor related, apoptosis inducing ligand (TRAIL) can induce apoptosis in cancer cells. Their functions are linked by their interactions with osteoprotegerin (OPG). OBJECTIVE: To investigate the expression of RANKL and TRAIL in a large series of unselected breast cancers and to analyse the relations between these expressions and the expression of OPG, oestrogen receptor, and clinicopathological variables. METHODS: 395 breast cancers were sampled into tissue microarrays and immunohistochemistry undertaken for RANKL and TRAIL. RESULTS: There was strong expression of RANKL in 14% of the cancers and strong expression of TRAIL in 30%. Expression of RANKL had a negative association with expression of oestrogen receptor (p = 0.036). Expression of TRAIL had a negative association with the Nottingham Prognostic Index (p = 0.021). There was a significant negative relation between expression of RANKL and TRAIL (p<0.005). Unsupervised cluster analysis produced a dendrogram that showed a clear division into two groups, and the expression of oestrogen receptor was significantly higher in one of those groups (p = 0.012). CONCLUSIONS: There is apparent loss of expression of RANKL in 86% of breast cancers; those tumours that retain expression tend to be oestrogen receptor negative and of a high histological grade. There is strong expression of TRAIL in 30% of breast cancers and these tend to be of better prognostic type. These results may be important in the processes of metastasis to bone and the apoptotic cell death pathway in cancer.

Apoptosis Regulatory Proteins↗
PubMed2006

Publication of surgical abstracts in full text: a retrospective cohort study.

INTRODUCTIONAbstracts presented at national and international scientific meetings are an important educational resource. However, the work is not peer reviewed and little is known about the quality or validity of the presented results and the fate of such abstracts.MATERIALS AND METHODSThis is a retrospective cohort study of abstracts presented to the 1997 annual meeting of the Association of Surgeons of Great Britain and Ireland. We examined the rates of full-text publication, time to publication, factors influencing publication, inconsistencies between presented and subsequently published manuscripts, and reasons for non-publication of abstracts.RESULTSOf the 241 abstracts presented, 136 (56.4%) were published at a median duration of 18 months. Multicentre studies had a greater tendency to subsequent publication and studies involving academic centres predicted publication in a high impact factor journal. Inconsistencies between presented and published abstracts were common and were significantly associated with delayed publication. Oral and poster presentations were equally likely to be published. Reasons for non-submission of presented abstracts included lack of time, low priority to publish, perceived methodological limitations, lack of novelty of findings and co-investigators leaving the organisation.CONCLUSIONSMore than half of the work presented at a national surgical meeting in the UK has been subsequently published. Various factors that influence the process of publication and remediable causes for non-publication have been identified.

Journal Article↗
PubMed2005

A randomized, controlled trial comparing lidocaine periprostatic nerve block, diclofenac suppository and both for transrectal ultrasound guided biopsy of prostate.

PURPOSE: Lidocaine periprostatic nerve block (PPNB) provides good procedural pain relief for transrectal ultrasound (TRUS) prostatic biopsy. However, post-procedural pain can be significant. The addition of diclofenac suppository (DS) to lidocaine PPNB might provide additional, particularly post-procedural pain relief. We assessed the procedural and post-procedural pain relief for TRUS biopsy provided by DS, and the combination of DS and lidocaine PPNB compared with lidocaine PPNB alone. MATERIALS AND METHODS: A total of 165 patients were randomized into 3 groups, namely group 1-lidocaine PPNB, group 2-DS and group 3-a combination of lidocaine PPNB and DS. In all patients 12 core biopsy was performed. Pain/discomfort at various intervals after the procedure was recorded on a visual analogue scale of 0 to 10 cm. RESULTS: Biopsy pain was significantly lower in patients who received lidocaine alone or in combination compared with DS alone (median 1.95, IQR 1.08 to 3.12, 3, IQR 1.25 to 5.47 and 1.8, IQR 0.85 to 3.0, respectively, p = 0.018), while evening pain scores were significantly lower in patients who received DS alone or in combination compared with that in patients who received lidocaine alone (median 1.25, IQR 0.38 to 3.0, 0.3, IQR 0.03 to 1.08 and 0.4, IQR 0 to 1.0, respectively, p = 0.001). There were no significant differences in pain/discomfort due to the probe (p = 0.107), that 1 hour after biopsy (p = 0.076) and that on the day after the procedure (p = 0.165). There were no significant differences in hemorrhagic or infective complications among the groups. CONCLUSIONS: The combination of lidocaine PPNB with DS provides additional pain relief during and after prostatic TRUS biopsy.

Aged↗
PubMed2004

Candidate gene polymorphisms in solid cancers.

Accumulation of information from scientific advances in genetics and biotechnology has accelerated research investigating the inherent individual variation in disease susceptibility and severity. Gene polymorphisms, in particular single nucleotide polymorphisms, are being evaluated for their role in multi-factorial diseases such as cancer and inflammation. Most surgical diseases are multi-factorial and a better understanding and utilization of the information gained from such studies by clinicians/surgeons is likely to favorably influence patient outcome. In this article, we illustrate the types of genetic variation and the complexities involved in their study and discuss their potential in predicting both the occurrence and outcomes of solid cancers.

Genetic Predisposition to Disease↗
PubMed2003

An audit of the management of soft tissue sarcoma within a health region in the UK.

AIMS: Soft tissue sarcomas are rare and heterogeneous tumours only occasionally seen by most individual clinicians. Early recognition, appropriate referral and timely investigations markedly improve outcomes. Our aim was to retrospectively assess the referral patterns, investigation, surgery and outcomes of patients with soft tissue sarcoma in the Trent region of the UK. METHODS: Two hundred and four patients with soft tissue sarcoma registered with the Trent Cancer Registry in 1995-1997 were first studied. Clinical details, tumour characteristics, presentation, management and follow-up were recorded from the case notes and analysed.A further group of 40 patients referred to a single cancer centre in 1999 were audited to establish whether there had been any improvements/changes over the 2 years, since the completion of the first audit. RESULTS: In the first audit, 49.5% were first referred to general surgeons and 16% to orthopaedic surgeons. Only 15% of patients fit for surgery were referred to a surgeon with a specialist sarcoma interest prior to definitive exploration. Of the deep tumours, 64% had a preoperative biopsy and only 68% had a scan before biopsy or definitive surgery. Tumour grade, completeness of excision and site of the sarcoma influenced survival. The second audit performed on patients treated in 1999 showed only a marginal improvement in management when compared to the first audit.

Abdominal Neoplasms↗
PubMed2003

Audit of compliance to adjuvant chemotherapy and radiotherapy guidelines in breast cancer in a cancer network.

The North Trent Cancer Network Breast Group in the United Kingdom revised its adjuvant treatment guidelines in breast cancer management in 1998. We aimed to check the compliance to the guidelines, 8 months after their introduction. Data were collected, retrospectively, from the medical records of patients with invasive breast cancer who underwent definitive surgery (in a 3-month period) in different cancer units and the cancer centre within the North Trent Cancer Network. The overall compliance to treatment guidelines was 82% (90% and 74% for chemotherapy and radiotherapy, respectively), which was similar across the network. In 5% of cases, compliance could not be determined. On case review, 22% of the non-compliant incidents were justified and 16% seemed to be due to variation in guideline interpretation. We discuss the possible reasons for non-compliance and show a need to periodically monitor compliance to adjuvant treatment guidelines.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed2002

Role of genetic polymorphisms in tumour angiogenesis.

Angiogenesis plays a crucial role in the development, growth and spread of solid tumours. Pro- and anti-angiogenic factors are abnormally expressed in tumours, influencing tumour angiogenesis, growth and progression. Polymorphisms in genes encoding angiogenic factors or their receptors may alter protein expression and/or activity. This article reviews the literature to determine the possible role of angiogenesis-related polymorphisms in cancer. Further research studies in this potentially crucial area of tumour biology are proposed.

Animals↗