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At least 145 records · Page 8Linked to original sources
PubMed2003

DNA cytometric features in biopsies of TaT1 urothelial cell cancer predict recurrence and stage progression more accurately than stage, grade, or treatment modality.

OBJECTIVES: To compare retrospectively the predictive value for recurrence and stage progression of DNA ploidy and S-phase fraction by flow cytometry and highly automated ultrafast image cytometry (ICM) in biopsies of TaT1 urothelial cell carcinomas (UCCs) of the urinary bladder with stage, grade, other pathologic features, and treatment. METHODS: Three experienced pathologists reviewed the stage and grade of 228 UCCs; 193 (85%) consensus cases were analyzed further. We had enough material for single-cell suspensions for both flow cytometry and ICM in 183 cases (94.8%). The 2001 European Society for Analytical Cellular Pathology standards for DNA ICM were followed. The predictive value of DNA features, classic prognosticators (stage, grade, carcinoma in situ, multicentricity), and treatment modality for recurrence and stage progression were analyzed with univariate (Kaplan-Meier) survival and multivariate (Cox model) regression analysis. Ta and T1 cases were analyzed separately. RESULTS: Of the 228 cases, 88 (51.5%) recurred and 13 (7.6%) progressed. On univariate analysis, most of the DNA features studied were statistically significant. Treatment modality and grade were only prognostic for progression (not for recurrence) and only in Ta cases. On multivariate analysis, DNA ICM features performed best; the strongest recurrence predictor for Ta UCC was a DNA index (DI) of 1.0 versus all others, and for T1 UCC, a DI of less than 1.3 versus 1.3 or greater. The best stage progression predictor for Ta UCCs was a DI of 1.0 plus an S-phase fraction of less than 10%, and for T1 UCCs, a DI of less than 1.3 versus 1.3 or greater. With multivariate analysis, sex, age, grade, carcinoma in situ, multicentricity, and treatment modality were excluded once the DNA ICM features were selected. CONCLUSIONS: DNA image cytometric features predict recurrence and stage progression in TaT1 UCC biopsies more accurately than classic prognostic factors, independent of treatment modality.

Aged↗
PubMed2000

Emotional suppression: can it predict cancer outcome in women with suspicious screening mammograms?

BACKGROUND: Previous studies have implicated emotional suppression, in particular suppression of anger, in the onset and progression of breast cancer. Many of these studies used non-standardized measures and failed to control for the effects of age and/or possible knowledge of diagnosis. The present study aimed to avoid these methodological errors in investigating the relationship of emotional suppression to a diagnosis of breast cancer in a large mammography screened population. METHOD: Data were collected from 1151 women with suspicious mammograms recalled to a breast screening programme. Prior to multidisciplinary assessment women were asked to complete the Courtauld Emotional Control Scale. Imaging assessment outcome data and biopsy results were collected. RESULTS: Fifteen per cent of this population subsequently were diagnosed with breast cancer. There were no significant associations between a cancer outcome and emotional suppression before or after the highly significant effect of age was taken into account. CONCLUSIONS: These results suggest that suppression of emotion may not be relevant to the development of breast cancer. Its role in the progression of existing disease requires clarification.

Adult↗
PubMed1982

Patterns of axillary nodal involvement in breast cancer. Predictability of level one dissection.

Two hundred consecutive mastectomies with total axillary dissection were analyzed for patterns of involvement at levels one, two and three. The purpose was to determine the accuracy of level one axillary dissection in predicting the status of the entire lymph node chain in carcinoma of the breast. Level one was defined as latissimus dorsi to lateral pectoralis minor; level two behind the pectoralis minor and level three medial pectoralis minor to thoracic inlet. The average number of nodes analyzed per patient was 22. The average number of nodes recovered per level was 14 at level one, 11.5 at level two and eight at level three. One hundred twenty patients (60%) had no nodal involvement, while 80 patients had metastases to axillary lymph nodes. There were seven patients (3.5% of the entire 200) who had positive nodes at levels two and/or three without metastasis to level one. This represents the incidence of "skip" metastases. The group exhibiting "skip" metastases comprise 5.5% of patients (seven of 127) with negative axillary nodes at level one and 8.7% of patients (seven of 80) with axillary metastases secondary to carcinoma of the breast. In the authors' experience, level one lymph node dissection is an accurate predictor of the status of the entire lymph node chain. Negative nodes at level one would indicate lack of involvement at levels two and three with nearly 95% accuracy.

Adult↗
PubMed2004

Contribution of three components to individual cancer risk predicting breast cancer risk in Italy.

We used data from a multicentre case-control study conducted in Italy between 1991 and 1994 on over 2500 cases of breast cancer and a comparable number of controls, and estimates of breast cancer incidence in Italy to compute individual breast cancer risk for Italian women. The estimated probabilities between age 50 and 80 ranged from approximately 5% (for a woman with no family history and low modifiable risk profile) to about 30% (for a woman with young family history and high modifiable risk) on the basis of various women's baseline characteristics. Expected numbers of breast cancer cases using the present model were compared with those based on the USA Gail model, and with the observed ones in the comparison group of the Italian Tamoxifen Trial. These show a closer agreement between the observed and the expected total numbers of breast cancers than the USA Gail model. Thus, the Gail model can be improved for use in other populations by using estimates of incidence and risk which are more appropriate to the target population.

Adult↗
PubMed2004

Molecular markers in dysplasia of the larynx: expression of cyclin-dependent kinase inhibitors p21, p27 and p53 tumour suppressor gene in predicting cancer risk.

Premalignant conditions affect the larynx. Dysplasia can progress in severity resulting in cancer depending on many clinical, pathological and molecular factors. The purpose of this study was to examine the expression of the p21 and p27 cyclin-dependent kinase inhibitors and p53 tumour suppressor gene in dysplasia of the larynx. A total of 114 cases of untreated dysplasia were selected from the archives of the University of Newcastle. p21, p27 and p53 immunohistochemistry was performed and the cases followed up. Twenty-eight dysplasias (24%) subsequently developed into cancers. Expression of the molecular factors studied was not associated with cancer progression. p53 expression was associated with smoking (P = 0.005). In contrast, grade of dysplasia was significantly associated with cancer risk (odds ratio 6.7; P = 0.0001). The majority (75%) of cancers were detected within 12 months of dysplasia being diagnosed.

Adult↗
PubMed1995

Breast cancer: prediction with artificial neural network based on BI-RADS standardized lexicon.

PURPOSE: To determine if an artificial neural network (ANN) to categorize benign and malignant breast lesions can be standardized for use by all radiologists. MATERIALS AND METHODS: An ANN was constructed based on the standardized lexicon of the Breast Imaging Recording and Data System (BI-RADS) of the American College of Radiology. Eighteen inputs to the network included 10 BI-RADS lesion descriptors and eight input values from the patient's medical history. The network was trained and tested on 206 cases (133 benign, 73 malignant cases). Receiver operating characteristic curves for the network and radiologists were compared. RESULTS: At a specified output threshold, the ANN would have improved the positive predictive value (PPV) of biopsy from 35% to 61% with a relative sensitivity of 100%. At a fixed sensitivity of 95%, the specificity of the ANN (62%) was significantly greater than the specificity of radiologists (30%) (P < .01). CONCLUSION: The BI-RADS lexicon provides a standardized language between mammographers and an ANN that can improve the PPV of breast biopsy.

Adult↗
PubMed2004

Do early premalignant changes in normal breast epithelial cells predict cancer development?

A recent report suggests that, in an in vitro model of premalignant breast cells (vHMECs), silencing of INK4A gene is accompanied by over-expression of cyclo-oxygenase (COX)-2. This suggests that COX-2 over-expression may be an early event in breast cancer aetiology permitting clones within the normal epithelium to evade apoptosis, to increase their numbers and perhaps acquire further changes that promote the formation of hyperplasias, and eventually carcinomas. While COX-2 expression in normal breast epithelium in vivo has not been proven to be linked to an increased risk of breast cancer, its over-expression in the premalignant model in vitro does provide preliminary evidence that COX-2 inhibition may be a useful chemoprevention strategy.

Apoptosis↗