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Primary systemic therapy (PST) is a standard treatment for patients with locally advanced breast cancer. We report one of our patients to demonstrate the optimal use of FDG-PET-CT in the routine clinical workup during PST, especially when clinicians face contradictory clinical and pathological findings, and to show the advantages of this imaging modality in the decision-making process about the initial treatment choice. By reviewing the literature we would also like to confirm that FDG-PET-CT is highly sensitive in the measurement of the early therapeutic response and the prediction of the complete pathological remission, as early as after the first cycle of chemotherapy is administered.
EN
Apoptosis is a physiological process that occurs in the human body throughout the entire life span. This process can be seen in the tissues of the stomatognathic system. A disorder in such programmed cell death processes leads to the development of pathological lesions. Among these are inflammation, osteolytic lesions and neoplastic hyperplasia. We put forward that future studies should concentrate on how to use the knowledge of apoptotic processes and their inhibitors in therapeutic processes involving the stomatognathic system.
EN
The prognostic relevance of disseminated nodal tumor cells has been demonstrated by several groups. However, their biological behaviour still remains unclear.The aim of the study. Analyse the phenotypic characteristics of disseminated tumor cells in lymph nodes.Material and methods. We established an immuno-enzymatic immuno-gold double-staining technique to simultaneously identify an epithelial antigen as well as the co-expression of plakoglobin, HLA class-I, ICAM-I and Ki-67 on isolated tumor cells. Epithelial cells were marked by the monoclonal antibody Ber-EP4. These results were compared with the corresponding primary tumors.Results. Loss of HLA class-I expression on Ber-EP4+ cells was observed in 33.3% of the patients. ICAM-I neo-expression was detected in 46%, whereas 54% of the cases were ICAM-1 negative. Plakoglobin was expressed in 16% while Ki-67 was detectable only in 5% of the patients. Comparison with the corresponding primary tumors revealed phenotypic alterations of the disseminated cells. In 20% of the cases HLA class-I down-regulation was found, while in 38% plakoglobin was not detectable. In contrast to the primary tumors with a proliferation index of 39%, the nodal Ber-EP4+ cells appeared to be Ki-67 negative in 95% of the patients.Conclusions. Our phenotypic analysis demonstrates that Ber-EP4+ cells in lymph nodes not only display characteristics typical of malignant cells but also phenotypic alterations, in comparison with primary tumors. This is indicative of a selective process which might result in adapted metastatic phenotypes.
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