RESUMEN
Aim. To assess dual time point 2-deoxy-2-[18F]fluoro-d-glucose 18FFDG PET-CT accuracy in nodal staging and in detection of extra-axillary involvement.M aterial and methods. Dual time point [18F] FDG PET/CT scan was performed in 75 patients. Visual and semiquantitative assessment of lymph nodes was performed. Semiquantitative measurement of SUV and ROC-analysis were carried out to calculate SUVmax cut-off value with the best diagnostic performance. Axillary and extra-axillary lymph node chains were evaluated.Results. Sensitivity and specificity of visual assessment was 87.3% and 75%, respectively. SUVmax values with the best sensitivity were 0.90 and 0.95 for early and delayed PET, respectively. SUVmax values with the best specificity were 1.95 and 2.75, respectively. Extra-axillary lymph node involvement was detected in 26.7%.Conclusion. FDG PET/CT detected extra-axillary lymph node involvement in one-fourth of the patients. Semiquantitative lymph node analysis did not show any advantage over the visual evaluation (AU)
Objetivo. Valorar la precision diagnóstica de la PET-CT con 2-deoxi-2-[18F]fluor-d-glucosa [18F] FDG en doble fase en la estadificación ganglionar y en la detección de afectación extra-axilar. Material y métodos. Se realizó una [18F] FDG PET-TC en doble fase a 75 pacientes. Se valoraron los ganglios linfáticos de forma visual y semicuantitativa. Se realizaron medidas del SUV y análisis ROC para calcular el valor de SUV max con la mejor precisión diagnóstica. Se evaluaron los niveles axilares y extra-axilares.Resultados. La sensibilidad y especificidad del análisis visual fue del 87.3% y 75% respectivamente. Los valores de SUVmax con la mejor sensibilidad fueron de 0.90 y 0.95 para el PET en fase precoz y tardía respectivamente. Los valores de SUV max con la mejor especificidad fueron de 1.95 y 2.75 respectivamente. Se detectó afectación ganglionar extra-axilar en el 26.7%.Conclusión. La PET-TC con FDG detectó afectación ganglionar extra-axilar en una cuarta parte de las pacientes. El análisis semicuantitativo no pareció aportar ninguna ventaja sobre la valoración visual (AU)
Asunto(s)
Humanos , Femenino , Tomografía de Emisión de Positrones/instrumentación , Tomografía de Emisión de Positrones/métodos , Tomografía de Emisión de Positrones , Tomografía Computarizada por Tomografía de Emisión de Positrones/instrumentación , Tomografía Computarizada por Tomografía de Emisión de Positrones/métodos , Tomografía Computarizada por Tomografía de Emisión de Positrones , Fluorodesoxiglucosa F18 , Neoplasias de la Mama/diagnóstico , Estadificación de Neoplasias/instrumentación , Estadificación de Neoplasias/métodos , Estadificación de Neoplasias , Enfermedad de Castleman/diagnóstico , Sensibilidad y Especificidad , Medicina Nuclear/métodos , Medicina Nuclear/organización & administraciónRESUMEN
AIM: To assess dual time point 2-deoxy-2-[(18)F]fluoro-D-glucose (18)(F)FDG PET-CT accuracy in nodal staging and in detection of extra-axillary involvement. MATERIAL AND METHODS: Dual time point [(18)F] FDG PET/CT scan was performed in 75 patients. Visual and semiquantitative assessment of lymph nodes was performed. Semiquantitative measurement of SUV and ROC-analysis were carried out to calculate SUV(max) cut-off value with the best diagnostic performance. Axillary and extra-axillary lymph node chains were evaluated. RESULTS: Sensitivity and specificity of visual assessment was 87.3% and 75%, respectively. SUV(max) values with the best sensitivity were 0.90 and 0.95 for early and delayed PET, respectively. SUV(max) values with the best specificity were 1.95 and 2.75, respectively. Extra-axillary lymph node involvement was detected in 26.7%. CONCLUSION: FDG PET/CT detected extra-axillary lymph node involvement in one-fourth of the patients. Semiquantitative lymph node analysis did not show any advantage over the visual evaluation.
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Neoplasias de la Mama/diagnóstico por imagen , Carcinoma Ductal de Mama/secundario , Radioisótopos de Flúor , Fluorodesoxiglucosa F18 , Metástasis Linfática/diagnóstico por imagen , Imagen Multimodal/métodos , Estadificación de Neoplasias/métodos , Tomografía de Emisión de Positrones/métodos , Radiofármacos , Tomografía Computarizada por Rayos X/métodos , Adulto , Anciano , Axila , Biopsia con Aguja Fina , Neoplasias de la Mama/patología , Carcinoma Ductal de Mama/diagnóstico por imagen , Carcinoma Ductal de Mama/patología , Femenino , Humanos , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Estudios Prospectivos , Curva ROC , Sensibilidad y Especificidad , Biopsia del Ganglio Linfático Centinela , TóraxRESUMEN
This phase II trial evaluated the efficacy and toxicity of weekly docetaxel as treatment of advanced metastatic breast cancer patients resistant to prior anthracycline chemotherapy. After the first 18 patients, the initial dose (40 mg/m2, 30-min i.v. infusion for 6 consecutive weeks, followed by 2-week rest) was reduced to 36 mg/m2 in the remaining 17 patients due to the incidence of toxicity (28% grade 3-4 asthenia). Overall response rate was 34% (95% CI, 19-50): two complete (6%) and ten partial responses (28%) were found. The median duration of response was 6.8 months, the median time to disease progression was 8.4 months, and the median overall survival was 13.6 months (median follow-up of 11.4 months). Neutropenia was the only severe hematologic toxicity (17% of patients), whereas asthenia, nail, ocular and skin disorders were the most common nonhematologic toxicities. Only one death during further follow-up was related to toxicity (caused by pulmonary fibrosis). In conclusion, we found weekly docetaxel to be an active and safe chemotherapy regimen for patients with metastatic breast resistant to previous anthracyclines. This weekly regimen caused minimal myelosupression, while retaining significant activity against advanced breast cancer. Both factors provide attractive possibilities for the development of combination therapies incorporating weekly docetaxel. Nevertheless, the number of patients receiving either dose (40 and 36 mg/m2) which we studied is low and our results require confirmation on larger groups of patients.
Asunto(s)
Antineoplásicos Fitogénicos/farmacología , Neoplasias de la Mama/tratamiento farmacológico , Neoplasias de la Mama/patología , Paclitaxel/análogos & derivados , Paclitaxel/farmacología , Taxoides , Adulto , Anciano , Antineoplásicos Fitogénicos/administración & dosificación , Antineoplásicos Fitogénicos/efectos adversos , Progresión de la Enfermedad , Docetaxel , Esquema de Medicación , Resistencia a Antineoplásicos , Femenino , Humanos , Persona de Mediana Edad , Metástasis de la Neoplasia , Neutropenia/inducido químicamente , Paclitaxel/administración & dosificación , Paclitaxel/efectos adversos , Fibrosis Pulmonar/inducido químicamente , Análisis de Supervivencia , Resultado del TratamientoRESUMEN
PURPOSE: DNA study by cytometric methods is one of the prognosis factors considered in malignant tumours. Flow cytometry (FCM) was the most frequently used techniques in cell suspensions. Image cytometry (ICM) was also applied in cellular smears and it is possible to measure the results with an Image Analyzer, which supposes a substancial advantage over DNA studies. To confirm the results and correlation of the two techniques a controversial subtype of lymphoid tumour was selected: Anaplastic large cell lymphoma (ALCL). MATERIAL AND METHODS: Fifty four cases of ALCL (23 classical type and 31 ACL-Hodgkin related) were studied. Cytometry was performed in paraffin-embedded tissues previously dewaxed, rehydrated and minced. FCM was done in suspensions incubated with ribonuclease A and stained with propidium iodide in an EPICS-C flow cytometer. ICM study was performed in Feulgen-stained smears and measured by an Image Analyzer CAS-200. RESULTS: All cases were aneuploid. ALCL were 30.5% hypodiploid (HpD) and 69.5% hyperdiploid (HrD) by FCM; 43.5% HpD and 56.5% HrD by ICM. ALCL-HR were 58% HpD and 42% HrD by FCM; 68% HpD and 32% HrD by ICM. There was a lack of correlation of 22% between both methods but it was not statistically significant. CONCLUSIONS: We can conclude the obtained results by FCM and ICM are almost similar.
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ADN de Neoplasias/análisis , Citometría de Flujo , Procesamiento de Imagen Asistido por Computador , Linfoma/patología , Aneuploidia , Estudios de Evaluación como Asunto , Enfermedad de Hodgkin/genética , Enfermedad de Hodgkin/patología , Humanos , Linfoma/clasificación , Linfoma/genética , Linfoma de Células B Grandes Difuso/genética , Linfoma de Células B Grandes Difuso/patología , Adhesión en Parafina , Manejo de Especímenes/métodosRESUMEN
Genetic instability has been recently related to point mutations on genes involved in DNA repair pathway of errors produced during replication. These molecular alterations have been described in hereditary and sporadic colon carcinomas and related tumors. To examine genetic instability on lympho- and myeloproliferative processes, we analyzed the behaviour of 10 microsatellite markers and one VNTR on different chromosomes in 10 patients with non-Hodgkin lymphomas (NHL), one patient with acute lymphoblastic leukemia (ALL) and 10 patients with acute myeloid leukemia (AML). Mobility shifts were found in three of those cases. One of them showed genetic instability for several markers--microsatellites and VNTR- and the other two showed differences for only one marker. As a correlation between point mutations in MSH2 gene and the presence of genetic instability in hereditary non-polyposis colon cancer (HNPCC) and related tumors has been found, we analyzed the sequence of a conversed region of this gene in the cases showing this phenomenon. We only found a polymorphism, previously described, in 669 codon from cDNA.