Introduction. The current management of advanced non-small cell lung cancer (NSCLC) includes the characterization of Programmed Death Ligand-1 (PD-L1) expression for potential immune checkpoint inhibitor treatment. There is currently no available data regarding the patterns of PD-L1 expression in NSCLC, as well as their association with clinicopathologic profile in Filipino patients.Methodology. Clinicopathologic characteristics of 187 consecutive NSCLC clinical samples with PD-L1 testing using the clone 22C3 pharmaDx kit were collected. The presence of stromal tumor-infiltrating lymphocytes (TILs) were assessed in hematoxylin and eosin-stained slides. PD-L1 expression on tumor cells (TC) and stromal TILs were evaluated.Results. Of the 187 cases, there were 112 males and 75 females. The mean age at diagnosis was 66.4 years old (32-92 years old). It is composed of 131 cases of adenocarcinoma, 15 squamous cell carcinoma, 4 adenosquamous carcinoma, 32 non-small cell carcinoma, not otherwise specified, 3 poorly differentiated malignancy, 1 large cell carcinoma, and 1 mucinous carcinoma. Specimen types included 17 pleural fluid cell blocks, 60 tumor cell block samples, and 110 tissue biopsies. Tumor cell PD-L1 expression was identified in 59.1% of the 110 tissue biopsies. PD-L1 TPS for histologic specimens are as follows: TPS ≥50%, TPS 1-49%, and TPS <1% were observed in 23.6%, 35.5%, and 40.9% in our lung cancer cohort, respectively. Of the 77 cytology specimens, 50.6% presented with TC PD-L1 expression. TPS for this subgroup include: 49.4% with no PD-L1 expression, 35.1% with low PD-L1 expression, and 15.6% showing high PD-L1 expression. PD-L1 expression on TC did not correlate with age, sex, or histology for both specimen type subgroups. Stromal tumor-infiltrating lymphocytes were noted in 74.5% of tissue biopsies. Tumor cell block samples did not demonstrate stromal TILs. For tissue biopsies, female gender and TPS 1-49% were more likely to have <50% PD-L1 expression on TILs. Conclusion.Overall TC PD-L1 expression was observed in more than half (55.6%) of NSCLC patients in our cohort. The prognostic value of PD-L1 and clinical response to immune checkpoint inhibitors in the Filipino population needs to be further investigated.
Background The prevalence of myocardial perfusion alterations in autoimmune diseases has been estimated by previous studies at 40%. There is no consensus on the scrutiny of cardiovascular alterations in patients with Antiphospholipid Syndrome. Objectives To evaluate the existence and seriousness of ischemic cardiomyopathy or asymptomatic ventricular dysfunction in a group of patients with primary or secondary Antiphospholipid Syndrome using 99Tc MIBI Gated-SPECT and equilibrium radioisotope ventriculography. Methods This is a transversal study performed in collaboration with the Rheumatology Departments of the following hospitals: General Naval de Alta Especialidad (SEMAR), Centro Médico Nacional 20 de Noviembre (ISSSTE), and the Department of Nuclear Medicine of the Instituto Nacional de Cardiología “Ignacio Chávez”. The study started on January 1, 2010 and ended on November 15, 2010. Twelve patients participated in the study and all of them underwent a myocardial perfusion study with 99Tc MIBI Gated-SPECT and a planar equilibrium radioisotope ventriculography and SPECT. Results A total of 12 patients participated. There was no evidence of ischemic cardiomyopathy in any of the patients. The systolic and diastolic functions of the left ventricle were normal on all cases. Right ventricle alterations were observed: a third had dilation; one had systolic dysfunction (8%); and 4 had diastolic dysfunction (33%). The association of right ventricle dysfunction and the presence of seropositivity of anticardiolipin andtibodies isotype IgG and lupus anticoagulant (p=0.041) stands out. Conclusions Even though the Antiphospholipid Syndrome is associated with accelerated atherosclerosis, this group of patients didn’t present any evidence of coronary disease or left ventricle dysfunction. However, right ventricle anomalies were found. These anomalies might be related to alterations of pulmonary circulation. Further studies are needed to establish the origin of these alterations. References Ian N. Bruce, Dafna D. Gladman. Single Photon Emission Computed Tomography Dual Isotope Myocardial Perfusion Imaging in women with Systemic Lupus Erythematosus. II. Predictive Factors For Perfusion Abnormalities. J Rheumatol 2003; 30: 288-91. Alexanderson E, Cruz P. Endothelial dysfunction in patients with antiphospholipid syndrome assessed with positron emission tomography. J Nucl Cardiol (2007);14:566-72. Nilda Espinola Zavaleta, Erick Alexánderson. Análisis de la utilidad de ecocardiografia de contratte y medicina nuclear en afecciόn cardiovascular de origen autoinmune. Archivos de Cardiología de México Vol. 75 2005:42-48. E. Alexánderson, A. Gόmez-Leόn. Myocardial ischemia in patients with primary antiphospholipid syndrome: a 13N-ammonia PET assessment. Rheumatology 2008;47:894-896. Disclosure of Interest None Declared
Results 87 patients (82 females) had mean age 29.23 ±13.13SD (6 -62) at TB infection, mean SLE disease duration 3.40±4.44SD (<1-23) years. There were 59 (67%) PTB, 5 (6%) EPTB, 23 (27%) DTB. Extra-pulmonary sites included 8 meningitis or brain abscess, 7 soft tissue abscess, 7 pleural effusion, 3 genitourinary, 3 arthritis, 1 hepatobiliary, 1 ileocecal, 1 cutaneous. Average SLEDAI score was 4. , nephritis in 31 (35.63%). Average cumulative prednisone was 15.29±19.38SD (0.5-86.4) grams; mean daily prednisone was 13.87+10.5SD mg (0 -50) with 22 patients (25.29%) taking immunosuppressives 3 months preceding TB. Significant risks for DTB were nephritis (p=0.017) and prednisone >11 mg/d (p<0.05). Sixty three (72.41%) successfully completed anti-TB treatment. Among 24 deaths, 9 were attributed to TB (6 disseminated, 3 PTB respiratory failure), 15 due to active lupus. Conclusions In this cohort, nephritis and recent prednisone dose >11 mg/day were significant risk factors for disseminated TB which is associated with poor prognosis. Background and aims Patients with systemic lupus erythematosus (SLE) and antiphospholipidsyndrome (APS) are at increased risk of atherosclerosis, and occurs much earlier compared to the general population even after accounting for traditional risk factors. Aim of the work: To examine the association between serum TWEAK, leptin and subclinical atherosclerosis in SLE and APS. Patients and methods Serum tumour necrosis factor (TNF)-like weak inducer of apoptosis(TWEAK) and leptin were measured in 30 SLE patients, 26 SLE patients with secondary APS(SLE-APS), 14 with primary APS (pAPS) and 20 age and sex matched control. The SLE diseaseactivity index (SLEDAI) was assessed in SLE patients. The intima media thickness (IMT) was measuredby carotid ultrasound. Results Serum TWEAK was significantly higher in patients with pAPS (945.1±16.2 pg/ml) than in SLE-APS (755.3 ±59.9 pg/ml), SLE patients (499.2±47.1 pg/ml) and control (129.6±18.6 pg/ml) (p<0.001). Also, serum leptin was significantly higher in pAPSpatients (14.0±2.8 ng/ml) compared to that in SLE-APS (6.5±0.9 ng/ml), SLE patients (3.8±1.2 ng/ ml) and control (1.6±0.6 ng/ml) (p<0.001). The IMT was significantly increasedin the pAPS patients compared to SLE-APS group (p<0.001), SLE patients (p=0.006) and to the control (p<0.001). A significant correlation was found between TWEAK with the body massindex and high density lipoprotein in SLE-APS and inversely with the random blood sugar and thediastolic blood pressure in SLE patients. Serum leptin only significantly correlated with the totalleucocytic count in SLE patients. Background and aims Systemic lupus erythematosus is a common autoimmune disease occurring predominantly in women. Anaemia is common in SLE patients, the most commom cause of anaemia is anaemia of chronic disease. The key mediator of anaemia of chronic disease is Hepcidin.The aim of this study was to determine the role of hepcidin in anaemia of chronic disease in SLE and its role in differentiation between ACD and IDA. Methods The ...
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