The role of gut microbiota in the development of sporadic colorectal cancer (CRC) is supported by a number of studies, however, the conclusiveness of published metagenomic studies is questioned by technical pitfalls and limited by small cohort sizes. In this review, we evaluate the current knowledge critically and outline practical solutions. We also list candidate CRC risk markers that are - in our opinion - well supported by available data and thus deserve clinical validation. Last but not least, we summarise available knowledge useful for improving care for patients immediately.
Purpose: We tested the hypothesis that the presence of CTC is a negative prognostic factor in patients with pancreatic cancer. Pancreatic cancer is one of the most aggressive malignancies with the poor prognosis. Assessment of the circulating tumor cells (CTC) in patients with this highly malignant disease could prevent burdensome surgery in patients with systemic dissemination.
Patients and methods: This was a prospective study to test for the presence of CTC in systemic blood, portal blood, bone marrow and peritoneal lavage in 90 pancreatic cancer patients at the time of surgery using real-time RT-PCR for carcinoembryonic antigen (CEA), epidermal growth factor receptor 1 (EGFR1) and human telomerase (hTERT). Absolute gene expressions of tested markers were correlated with clinical/pathological characteristics and survival parameters.
Results: Overall, 51 of 90 (56.6%) pancreatic cancer patients died, the overall survival median was 8.8 months. We found a statistically significant association between EGFR and hTERT expression levels in the portal blood and clinical stage. We also showed high expression of EGFR and CEA in the peritoneal lavage of patients with metastatic disease, in contrast to patients without the presence of the metastases.
CTC positive patients measured as hTERT in tumor draining blood and CEA in bone marrow showed significantly poorer overall survival (OS) (p=0.005/ p=0.001). We also found statistically significant shorter OS in patients with EGFR positive peritoneal lavage (p=0.01).
Conclusion: The results of this study demonstrate a high sensitivity and specificity of the real-time RT-PCR method for CTC detection in pancreatic cancer. Detection of CTC seems to be negative prognostic factor for overall survival in pancreatic cancer and can influence the radical surgery decision.
Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 4152. doi:10.1158/1538-7445.AM2011-4152
Introduction: Diffuse peritonitis is a serious disease. It is often addressed within urgent management of an unstable patient in shock. The therapy consists of treatment of the source of peritonitis, decontamination of the abdominal cavity, stabilization of the patient and comprehensive resuscitation care in an intensive care unit. A number of scoring systems to determine patient prognosis are available, but most of them require complex input data, making their practical application a substantial problem. Objective: Our aim was to assess simple scoring systems within a cohort, evaluate the level of mortality, morbidity, and duration of hospital stay, followed by a comparison of the acquired data with the literature and determination of an easily implementable scoring system for use in clinical practice. Material and Methods: We evaluated a group of patients with diffuse peritonitis who underwent surgery in the 2015–2019 period. Medical history, surgical findings, and paraclinical examinations were used as the input for four scoring systems commonly used in practice—MPI, qSOFA, ECOG, and ASA. We compared the results between the systems and with the literature. Results: Our cohort included 274 patients diagnosed with diffuse peritonitis. Mortality was 22.6%, morbidity 73.4%, with a 25.2 day average duration of hospital stay. Mortality and morbidity increased with rising MPI and qSOFA, well-established scoring systems, but also with rising ASA and ECOG, similarly to MPI and qSOFA. Conclusions: The utilized scoring systems correlated well with the severity of the condition and with predicted mortality and morbidity as reported in the literature. Simple scoring systems primarily used in other indications (i.e., ASA and ECOG) have a similar predictive value in our cohort as commonly used systems (MPI, qSOFA). We recommend them in routine clinical practice due to their simplicity.
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