Background: Body mass index (BMI) is an independent prognostic factor for survival in breast cancer patients. Patients with higher BMI were found to have poorer cancer prognosis and lower survival rates. Many factors as ghrelin, adiponectin and leptin, have been implicated in obesity but their correlation with breast carcinogenesis and treatment outcome is still a debate. Objective: To identify the relation of ghrelin, adiponectin and leptin with BMI in breast cancer patients and their possible role in carcinogenesis and treatment outcome. Subjects and Methods: Sera from 80 breast cancer patients were analyzed. Ghrelin, adiponectin and leptin were assayed by commercial RIA kits, and their levels were correlated with BMI, clinicopathological parameters and relapse-free survival. The median duration of patients' follow-up was 32 months. Results: 73.7% of the cohort was overweight/ obese. Compared to breast cancer patients with normal BMI, overweight/obese patients had a significantly higher tumor size and higher histological grade. Overweight/obese patients had higher leptin and lower ghrelin and adiponectin levels. Adiponectin was lower in patients with higher tumor grade and lymph node involvement, while ghrelin decreased with increasing tumor size and histological grade. Only serum ghrelin levels were significantly correlated to better disease-free survival. Conclusion: Ghrelin, adiponectin and leptin are significant factors in controlling BMI in breast cancer patients but only ghrelin is a significant predictor of better outcome and recurrence-free survival.
BackgroundHepatitis C arthropathy is one of the most important extra-hepatic manifestations of HCV. Its clinical presentation is rheumatoid like in about 30% of the cases and the differentiation between both is very important and difficult at the same time as the treatment is completely different. Anti-cyclic citrullinated peptide (Anti- CCP) antibodies can be used as serological markers in differentiation between them but many studies have variable and non-conclusive results concerning its importance.ObjectivesThe aim of this study is to determine whether anti- CCP antibody is helpful alone in discriminating patients with HCV-associated arthropathy from patients with rheumatoid arthritis.MethodsIn this cross sectional comparative study we included 70 subjects, from Tanta University Hospital, Egypt and divided them into four groups: 30 Rheumatoid arthritis patients not infected with HCV,15 HCV patients with typical polyarthritis like RA without erosions or rheumatoid nodules, 15 HCV patients without arthropathy and 10 Normal subjects as a control group. We measured the level of Anti-CCP and RF in all groups.ResultsBy the end of the study we found that anti-CCP was positive in 83.3% of RA group, 66.7% of HCV with arthropathy group, 40% of HCV without arthropathy group and in 30% of normal control group and there was a significant difference between RA group and HCV without arthropathy and control group, but there was no significant difference between RA and HCV arthropathy However during the comparison between the four groups as regard the degree of positivity of anti-CCP level there was a big difference in the degree of positivity in RA group and HCV arthropathy where 19 (63.3%) were strong positive in RA groups while only (20%)were strong positive in HCV related arthropathy.Table 1.Comparison between anti-CCP among the studied groupsGroup IGroup IIGroup IIIGroup IVχ2P valueNegative5 (16.7%)5 (33.3%)9 (60%)7 (70%)Weak positive4 (13.3%)5 (33.3%)5 (33.3%)3 (30%)Moderate positive2 (6.7%)2 (13.3%)0 (0%)0 (0%)29.70.000*Strong positive19 (63.3%)3 (20%)1 (6.7%)0 (0%)ConclusionsAnti CCP can be a used as an early step in differentiating RA from HCV related arthropathy. If its level is strong positive this can highly suggest early rheumatoid arthritis but if the level is moderately positive or weak positive or even negative it is not enough alone as a marker differentiating RA from HCV related arthropathy.ReferencesMichele Bombardieri, Cristiano Alessandri, Giancarlo Labbadia ea. Role of anti-cyclic citrullinated peptide antibodies in discriminating patients with rheumatoid arthritis from patients with chronic hepatitis C infection-associated polyarticular involvement. Arthritis Res Ther 2004;6(2):R137–41.E Or, A C, Ayten Y, N Gr-P, Hulagu S. The positivity of rheumatoid factor and anti-cyclic citrullinated peptide antibody in nonarthritic patients with chronic hepatitis c infection. Rheumatol International 2010;30(4):485–8.M.Elnadry, Abdel-Rashed M, M.A.Abdel-Monem, S.El-Eter, Fathy W. Anti-Cyclic Citrullinated Peptide Fre...
Background: Sporadic breast cancer might be caused by low-penetrance genes, including genes constituting the DNA repair pathways. Defective DNA repair is a common imprint of cancer that promotes the accretion of DNA errors and genomic instability. The clustering of damage in DNA may stimulate breast carcinogenesis. Aims: The goal of the study is to evaluate the role of single nucleotide polymorphisms in DNA repair genes XRCC1 Arg399Gln, XPD Lys751Gln, RAD51 G135C and XRCC3 Thr241Met as genetic indicators of susceptibility to breast cancer and to evaluate their role in treatment outcome. Methodology: The study included 248 females diagnosed with primary breast cancer and 232 normal healthy females. Patients were clinically followed up for 5 years after completing chemotherapy. Genomic DNA was isolated and the four polymorphisms under investigation were assessed by PCR-RFLP technique. Findings: XRCC1 399Gln, XPD 751Gln and XRCC3 241Met alleles were significantly associated with breast cancer risk (OR = 2.63, 2.17 and 3.21; respectively), with carriers having lower disease free survival (DSF). When grouping patients based on the number of affected genotypes they carry, DFS decreased as the number of affected genotypes increased (P accum <0.001), patients carrying three (HR=4.74, p<0.001) or two (HR=3.35, p=0.005) affected genotypes had significantly worse DFS compared with those carrying zero (reference) or one (HR=1.37, p=0.093) affected genotype. RAD51 5'UTR G135C polymorphism was not associated with breast cancer risk (p=0.932) or with DFS. Conclusion: XRCC1 Arg399Gln, XPD Lys751Gln and XRCC3 Thr241Met polymorphisms may take a significant part in sporadic breast cancer as risk factors and in prognosis, where patients carrying XRCC1 Arg/Arg, XPD Lys/Lys and XRCC3 Thr/Thr genotypes had significantly diminished risk for breast cancer and higher DFS. DFS decreased as the number of affected genotypes increased. But RAD51 5'UTR G135C polymorphism did not associate with either risk or prognosis of breast cancer.
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