scholarly journals GASTROINTESTINAL CHANGES DURING NUTRITIONAL FOLLOW-UP OF CANCER PATIENTS UNDERGOING OUTPATIENT CHEMOTHERAPY

2020 ◽  
Vol 57 (4) ◽  
pp. 354-360
Author(s):  
Laiz SARAGIOTTO ◽  
Vânia Aparecida LEANDRO-MERHI ◽  
José Luis Braga de AQUINO ◽  
José Alexandre MENDONÇA
Keyword(s):  
Nutritional Status ◽  
Cancer Patients ◽  
Colorectal Neoplasia ◽  
Signs And Symptoms ◽  
Estimating Equation ◽  
Significance Level ◽  
Outpatient Chemotherapy ◽  
Significant Difference ◽  
And Gender

ABSTRACT BACKGROUND: Cancer patients may have gastrointestinal changes that influence nutritional status. OBJECTIVE: To investigate the occurrence of gastrointestinal changes resulting from outpatient chemotherapy treatment in cancer patients. METHODS: In a retrospective longitudinal study, the nutritional status and chemotherapy gastrointestinal changes (nausea, vomit, diarrhea, constipation, mucositis, dysphagia, xerostomia, inappetence, dysgeusia and heartburn) in cancer patients (n=187) were investigated in an outpatient follow-up. For the study of the parameters over time, the generalized estimating equation (GEE) method was used. Kruskal-Wallis, Mann-Whitney tests and Spearman coefficient, at a significance level of 5% were also used. RESULTS: The majority of the patients were female (63.64%) and the mean age was 57.5±12.1 years. The most frequent symptoms were nausea (18.54%); inappetence (18.31%); intestinal constipation (11.58%); diarrhea (7.98%); xerostomia (7.59%) and vomiting (7.43%). The nutritional status did not exhibit any relevant changes (P=0.7594). However, a higher prevalence of eutrophy was observed, followed by overweight; vomiting exhibited a significant difference (P=0.0211). The nausea symptom exhibited a significant difference with a higher prevalence of colorectal neoplasia when compared to breast neoplasia (P=0.0062); as well as vomiting in lung and colorectal neoplasias (P=0.0022), and dysphagia, in head and neck neoplasia, when compared to other neoplasms (P<0.001). There was a statistically significant difference between the number of medical appointments and gender (P=0.0102) and between dysphagia and gender (P<0.0001). CONCLUSION: The study findings enhance the need for signs and symptoms follow up, as well as nutritional status follow up of patients undergoing outpatient chemotherapy.

scholarly journals Acompanhamento longitudinal do manejo de sintomas em serviço especializado de cuidados paliativos oncológicos

2021 ◽  
Vol 11 (4) ◽  
Author(s):  
Karine Marques Costa dos Reis ◽  
Cristine Alves Costa de Jesus
Keyword(s):  
Palliative Care ◽  
Cancer Patients ◽  
Signs And Symptoms ◽  
Longitudinal Assessment ◽  
Significance Level ◽  
Parametric Test ◽  
Symptom Scores ◽  
Diagnosis Of Cancer ◽  
Specialized Unit

Objetivo: Analisar a funcionalidade e os sintomas de pacientes oncológicos em fim de vida durante internação em unidade especializada em cuidados paliativos. Método: Trata-se de avaliação longitudinal da admissão até o óbito, com monitorização semanal da funcionalidade e score de sintomas, de 59 participantes. Utilizou-se o teste paramétrico Wilcoxon pareado, para avaliação da mediana dos scores de sintomas e funcionalidade com nível de significância de 5%. Resultados: A amostra do estudo consistiu em indivíduos do sexo feminino, com idade média de 60 anos e funcionalidade limitada. Predominou o diagnóstico de câncer do trato digestório. Quanto a avaliação dos sintomas e funcionalidade, considerando a segunda e terceira semana de internação observou-se melhora do score dor, cansaço e tristeza, como também da função. Conclusão: Apesar de internação tardia e com grande extensão da doença, o participante apresentou melhora de alguns sintomas sugerindo o benefício dos cuidados paliativos. Em unidade especializada, houve melhora dos sintomas dor, cansaço e tristeza, com também da funcionalidade dos participantes em duas semanas de internação. Assim, esses achados corroboram quanto a importância do cuidado baseado no conforto e auxiliará na elaboração de políticas públicas e no planejamento do cuidado do enfermeiro.Descritores:  Cuidados Paliativos; Sinais e Sintomas; Neoplasias; Enfermagem. Longitudinal follow-up of the management of symptoms in specialized palliative oncological care serviceObjective: To analyze the functionality and symptoms of end-of-life cancer patients during hospitalization in a specialized unit in palliative care. Method: This is a longitudinal assessment from admission to death, with weekly monitoring of functionality and symptom score, of 59 participants. The paired Wilcoxon parametric test was used to assess the median of symptom scores and functionality with a significance level of 5%. Results: The study sample consisted of female individuals, with an average age of 60 years and limited functionality. The diagnosis of cancer of the digestive tract predominated. Regarding the assessment of symptoms and functionality, considering the second and third week of hospitalization, an improvement was noted in the pain, tiredness and sadness score, as well as in function. Conclusion: Despite late hospitalization and with a large extent of the disease, the participant showed improvement in some symptoms suggesting the benefit of palliative care. In a specialized unit, the symptoms of pain, tiredness and sadness, as well as the functionality of the participants in the weeks of hospitalization. Therefore, these results corroborate the importance of care based on convenience and assistance in the development of public policies and guide the planning of care for the sick.Descriptor: Palliative Care; Signs and Symptoms; Neoplasms; Nursing.Seguimiento longitudinal del manejo de sintomas en servicio especializado de atención oncológica paliativaObjetivo: Analizar la funcionalidad y los síntomas de los pacientes con cáncer al final de la vida durante la hospitalización en una unidad especializada de atención paliativa. Método: Esta es una evaluación longitudinal desde el ingreso hasta la muerte, con monitoreo semanal de la funcionalidad y la puntuación de los síntomas, de 59 participantes. La prueba de Wilcoxon paramétrica pareada se utilizó para evaluar la mediana de las puntuaciones de los síntomas y la funcionalidad con un nivel de significación del 5%. Resultados: La muestra del estudio consistió en individuos femeninos, con una edad promedio de 60 años y funcionalidad limitada. Predominó el diagnóstico de cáncer del tracto digestivo. En cuanto a la evaluación de los síntomas y la funcionalidad, considerando la segunda y tercera semana de hospitalización, se observó una mejora en el puntaje de dolor, cansancio y tristeza, así como en la función. Conclusión: A pesar de la hospitalización tardía y con una gran extensión de la enfermedad, el participante mostró una mejoría en algunos síntomas que sugieren el beneficio de los cuidados paliativos. En una unidad especializada, los síntomas de dolor, cansancio y tristeza, así como la funcionalidad de los participantes en las semanas de hospitalización. Por lo tanto, estos resultados corroboran la importancia de la atención basada en la conveniencia y la asistencia en el desarrollo de políticas públicas y guían la planificación de la atención a los enfermos.Descriptor: Cuidados Paliativos; Signos Y Síntomas; Neoplasias; Enfermería.

scholarly journals 18F-FDG PET/CT Parameters for Predicting Prognosis in Esophageal Cancer Patients Treated With Concurrent Chemoradiotherapy

2021 ◽  
Vol 20 ◽  
pp. 153303382110246
Author(s):  
Seokmo Lee ◽  
Yunseon Choi ◽  
Geumju Park ◽  
Sunmi Jo ◽  
Sun Seong Lee ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Cancer Patients ◽  
Fdg Pet ◽  
Concurrent Chemoradiotherapy ◽  
Curative Intent ◽  
Squamous Cell Esophageal Cancer ◽  
Pet Ct ◽  
Significant Difference ◽  
Fdg Pet Ct

Background and Aims: This study evaluated the prognostic value of 18F-fluorodeoxyglucose positron emission tomography with integrated computed tomography (18F-FDG PET/CT) performed before and after concurrent chemoradiotherapy (CCRT) in esophageal cancer. Methods: We analyzed the prognosis of 50 non-metastatic squamous cell esophageal cancer (T1-4N0-2) patients who underwent CCRT with curative intent at Inje University Busan Paik Hospital and Haeundae Paik Hospital from 2009 to 2019. Median total radiation dose was 54 Gy (range 34-66 Gy). Our aim was to investigate the relationship between PET/CT values and prognosis. The primary end point was progression-free survival (PFS). Results: The median follow-up period was 9.9 months (range 1.7-85.7). Median baseline maximum standard uptake value (SUVmax) was 14.2 (range 3.2-27.7). After treatment, 29 patients (58%) showed disease progression. The 3-year PFS and overall survival (OS) were 24.2% and 54.5%, respectively. PFS was significantly lower ( P = 0.015) when SUVmax of initial PET/CT exceeded 10 (n = 22). However, OS did not reach a significant difference based on maximum SUV ( P = 0.282). Small metabolic tumor volume (≤14.1) was related with good PFS ( P = 0.002) and OS ( P = 0.001). Small total lesion of glycolysis (≤107.3) also had a significant good prognostic effect on PFS ( P = 0.009) and OS ( P = 0.025). In a subgroup analysis of 18 patients with follow-up PET/CT, the patients with SUV max ≤3.5 in follow-up PET/CT showed longer PFS ( P = 0.028) than those with a maximum SUV >3.5. Conclusion: Maximum SUV of PET/CT is useful in predicting prognosis of esophageal cancer patients treated with CCRT. Efforts to find more effective treatments for patients at high risk of progression are still warranted.

scholarly journals An Analysis of the Relationship Between Job Satisfaction and Employee Engagement

2017 ◽  
Vol 55 (2) ◽  
pp. 243-262 ◽  
Author(s):  
Anton Vorina ◽  
Miro Simonič ◽  
Maria Vlasova
Keyword(s):  
Job Satisfaction ◽  
Employee Engagement ◽  
Business Performance ◽  
Modern World ◽  
P Value ◽  
Significance Level ◽  
The Public ◽  
Significant Difference ◽  
And Gender ◽  
The Relationship

AbstractThis paper examines the relationship between employee engagement and job satisfaction. People spend most of their time at work, and their motivation is considered to be an important factor for job performance. Enthusiastic employees, who focus their efforts on achieving their companies′ goals are a key competitive advantage in the modern world. The effect of employee engagement on business performance has been studied by various experts. They found out the similar conclusion: “the more enthusiastic the workers are, the better operating results they achieve for the company”. An occasional sample of 594 respondents who are employed in the public and non-public sector in Slovenia was used for the purpose of this study. The main goal of the research is to determine whether (and how) the employee engagement influences job satisfaction. A written survey was conducted from 4 January 2016 to 14 March 2016. IBM SPSS 20 was used for the statistical analysis. The results confirm that the relationship between employee engagement and job satisfaction is positive and statistically significant (5 % significance level), based on the linear regression F (1, 583) =296.14, p-value = 0.000, R-square = 0.337. The results also show that there is no statistically significant difference between employee engagement and gender and there is no statistically significant difference between job satisfaction and gender.

scholarly journals Teething Problems and Parental Beliefs in Nigeria

2009 ◽  
Vol 10 (4) ◽  
pp. 75-82 ◽  
Author(s):  
Foluso J. Owotade ◽  
Morenike O. Folayan ◽  
Temitope A. Esan ◽  
Elizabeth O. Oziegbe ◽  
Comfort A. Adekoya-Sofowora
Keyword(s):  
Signs And Symptoms ◽  
Cross Sectional Study ◽  
Parental Beliefs ◽  
Cross Sectional ◽  
Socioeconomic Class ◽  
Low Socioeconomic ◽  
Significant Difference ◽  
And Gender ◽  
Symptoms And Signs ◽  
Rule Out

Abstract Aim To determine signs and symptoms associated with teething, parental beliefs about teething, and the effects of socioeconomic status on teething in Nigerian children. Methods and Materials A cross-sectional study consisting of 1,013 mothers of children between the ages four to 36 months who visited the immunization clinics at the Community Health Centres in Ife Central and Ife East Local Government Areas. Data was analyzed using STATA (Intercooled release 9) for Windows. Results A total of 765 mothers (75.5%) reported systemic signs and symptoms in their children. Fever (51.8%), diarrhea (12.5%), and vomiting (2.9%) were the most prevalent symptoms and signs reported. Teething problems were reported by 60% of mothers from a high socioeconomic class, as well as 76.7% and 77.9% from middle and low socioeconomic classes, respectively. Interestingly, 65.5% of mothers believed teething should be accompanied with systemic signs and symptoms such as fever (42.1%), diarrhea (13.9%), and vomiting (0.6%). No significant difference was noted between breastfeeding status, gender of the child, and reported systemic signs and symptoms noticed by the mothers. Conclusion Most mothers in the study reported signs and symptoms adduced to teething in their children irrespective of their beliefs. Fever ranked highest of the signs and symptoms reported. Mothers of children from the high socioeconomic class reported fewer teething symptoms. Breastfeeding status and gender of the child had no effect on teething problems in the children studied. Clinical Significance Most signs and symptoms adduced to teething by parents may actually be due to underlying infections. Thus, there is a need to rule out occult infection during the tooth eruption period. Citation Oziegbe EO, Folayan MO, Adekoya-Sofowora CA, Esan TA, Owotade FJ. Teething Problems and Parental Beliefs in Nigeria. J Contemp Dent Pract 2009 July; (10)4:075-082.

scholarly journals Evaluation of crestal bone resorption around cylindrical and conical implants following 6 months of loading: A randomized clinical trial

2017 ◽  
Vol 11 (03) ◽  
pp. 317-322 ◽  
Author(s):  
Naser Sargolzaie ◽  
Hamid Reza Arab ◽  
Marzieh Mohammadi Moghaddam
Keyword(s):  
Bone Loss ◽  
Chi Square ◽  
Pocket Depth ◽  
Significance Level ◽  
Crestal Bone Loss ◽  
Significant Difference ◽  
Chi Square Test ◽  
Male Patients ◽  
Maxilla And Mandible

ABSTRACT Objective: The purpose of this clinical study was to evaluate the effect of implant body form (cylindrical and conical implants) on crestal bone levels during 6 months' follow-up after loading. Materials and Methods: A total of 32 SPI implants (19 conical implants/13 cylindrical implants) were randomly placed in 12 male patients using a submerged approach. None of the patients had compromising medical conditions or parafunctional habits. Periapical radiographs using the parallel technique were taken after clinical loading and 6 months later. Clinical indices including pocket depth and bleeding on probing (BOP) were recorded on 6-month follow-up. Data were analyzed by independent samples t-test and Chi-square test with a significance level of 0.05. Results: Six months after loading, crestal bone loss was 0.84 (±0.29) mm around the cylindrical implants and 0.73 (±0.62) mm around the conical types, which was not significantly different (P = 0.54). Pocket depth around the cylindrical and conical implants was 2.61 (±0.45) mm and 2.36 (±0.44) mm, respectively (P = 0.13). BOP was observed among 53.8% and 47.4% of the cylindrical implants and conical (P = 0.13). Bone loss and pocket depth in the maxilla and mandible had no significant difference (P = 0.46 and P = 0.09, respectively). Conclusion: In this study, although bone loss and clinical parameters were slightly higher in the cylindrical implants, there was no significant difference between the conical- and cylindrical-shaped implants.

scholarly journals Altered Preoperative Nutritional Status in Colorectal Cancer: A Not So Infrequent Issue

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Javier Páramo-Zunzunegui ◽  
Araceli Ramos-Carrasco ◽  
Marcos Alonso-García ◽  
Rosa Cuberes-Montserrat ◽  
Gil Rodríguez-Caravaca ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Weight Loss ◽  
Observational Study ◽  
Nutritional Status ◽  
Cancer Patients ◽  
Prospective Observational Study ◽  
Colorectal Neoplasia ◽  
Nutritional Risk ◽  
A Value ◽  
Asymptomatic Patients

Introduction. Malnutrition and weight loss in cancer patients is a common problem that affects the prognosis of the disease. In the case of CRC, malnutrition rates range between 30 and 60%. Objectives. Description of the preoperative nutritional status of patients diagnosed with colorectal neoplasia who will undergo surgery. Materials and Methods. A prospective observational study is performed. Results. Of 234 patients studied, we observed that 139 (59%) had some degree of nutritional risk. Of all of them, 44.9% (N = 47) had 1-2 points according to MUST and 25% (N = 27) had more than 2 points. No differences were found when studying nutritional risk according to the location of the neoplasm. It was observed that 2.15% of the patients were underweight, 51% overweight, and 23% obese. 19.4% of patients lost less than 5 kg in the 3–6 months prior to diagnosis, 20.7% lost between 5 and 10 kg, and 2.1% lost more than 10 kg. In asymptomatic patients, the weight loss was lower than in symptomatic patients, loss <5 kg, 8.2% vs. 22.8%, and loss 5–10 kg, 16.2% vs. 29.3%, with a value of p = 0.016 . 5% (N = 7) of the patients had hypoalbuminemia record. 16.5% (N = 23) had some degree of prealbumin deficiency and 20.9% (N = 29) of hypoproteinemia. Symptomatic patients had more frequent analytical alterations, 1-2 altered parameters in 48.8% (N = 20) of asymptomatic vs. 61.2% (N = 22) in the symptomatic, p = 0.049 .

scholarly journals Assessment of the Value of Preoperative Serum Levels of CA 242 and CEA in the Staging and Postoperative Survival of Colorectal Adenocarcinoma Patients

2003 ◽  
Vol 18 (3) ◽  
pp. 182-187 ◽  
Author(s):  
S.B. Kim ◽  
L.C. Fernandes ◽  
S.S. Saad ◽  
D. Matos
Keyword(s):  
Colorectal Adenocarcinoma ◽  
Radical Surgery ◽  
Roc Curves ◽  
Serum Levels ◽  
Control Group ◽  
Significance Level ◽  
Ca 242 ◽  
Preoperative Serum ◽  
Significant Difference

Introduction CEA is the most frequently used tumor marker in colorectal cancer. There may be an improvement in its efficacy when used in association with CA 242. Aim The purpose of this study was to evaluate the efficacy of preoperative serum levels of the tumor markers CA 242 and CEA in the staging and postoperative follow-up of colorectal adenocarcinoma patients. Patients and Methods Of a series of 134 patients with colorectal adenocarcinomas 90 underwent radical surgery and 44 palliative surgery. The control group consisted of 22 organ donors. The cutoff serum levels utilized were 5 ng/mL for CEA and 20 U/mL for CA 242. The mortality during follow-up was recorded in order to determine the duration of survival. The data were submitted to statistical analysis using diagnostic tests, the chi-square test, survival analysis (Kaplan and Meier) and ROC curves. A significance level of p ≤ 0.05 was applied. Results The sensitivity of CEA in Dukes’ stages A, B, C and D was 27.8%, 32.4%, 32.1% and 66.7%, respectively. The sensitivity of CA 242 was 11.1%, 16.2%, 30.8% and 50%. When both markers were combined, the sensitivity was 33.3%, 48.6%, 40.7% and 72.5%. In the group of patients who underwent radical surgery the mean survival was 60.47 months for those with high preoperative CEA levels, 52.22 months for those with high preoperative CA 242 levels, and 44.80 months for those with elevated levels of both markers. There was a statistically significant difference in survival between patients undergoing radical surgery with elevated CA 242 levels, especially when CEA was also elevated, and patients without elevated CA 242. Conclusion Preoperative serum levels of CA 242 showed less efficacy than CEA levels for the staging of colorectal adenocarcinoma patients. Elevated preoperative serum levels of CA 242 alone were related to poor survival, especially in association with high levels of CEA.

Randomized cooperative study of perioperative chemotherapy in breast cancer.

1995 ◽  
Vol 13 (11) ◽  
pp. 2712-2721 ◽  
Author(s):  
M R Sertoli ◽  
P Bruzzi ◽  
P Pronzato ◽  
P Queirolo ◽  
D Amoroso ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Preliminary Evidence ◽  
Breast Cancer Patients ◽  
Free Survival ◽  
Node Negative ◽  
Significant Survival ◽  
Significant Difference ◽  
Estrogen Receptor Negative

PURPOSE The aim of this multicentric randomized trial was to determine whether reducing the interval between surgery and chemotherapy improves the outcome of breast cancer patients. PATIENTS AND METHODS Between June 1985 and July 1992, 600 breast cancer patients, clinical stages T1-3A,N0-2,M0 were randomly assigned to a perioperative cycle (PC) of cyclophosphamide 600 mg/m2, epidoxorubicin 60 mg/m2, and fluorouracil 600 mg/m2 (CEF). Node-negative (N-) patients did not receive any further treatment. Node positive (N+) patients received 11 cycles if previously given PC, or 12 cycles of CEF alternated with cyclophosphamide 600 mg/m2, methotrexate 40 mg/m2, and fluorouracil 600 mg/m2 (CMF). In addition, N+ patients received concomitant or sequential 5-year tamoxifen therapy. RESULTS At a median follow-up duration of 5.7 years, no significant difference in survival (88% v 84%, P = .3) between the two treatment arms was seen. However, a difference of borderline significance in relapse-free survival (RFS; 76% v 70%, P = .053) was evident. A significant survival advantage for the PC arm was detected only in the estrogen receptor-negative (ER-) patients (P = .003). RFS was significantly improved in N- patients, postmenopausal patients, and ER- patients. Multivariate analyses show that pathologic tumor size, nodal status, receptor status, and treatment (only in ER- patients) are significantly correlated with survival and RFS. PC toxicity did not influence wound healing. CONCLUSION This study provides preliminary evidence that PC positively affects relapse rate and survival in some subgroups, namely, ER- patients.

The sensitivity and specifity of DR-70 as a tumor marker for gastrointestinal cancers.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e22061-e22061
Author(s):  
Burcak Erkol ◽  
Basak Bala Oven ◽  
Vedat Bayoglu ◽  
Nurcan Paker ◽  
Koray Kochan ◽  
...  
Keyword(s):  
Tumor Marker ◽  
Cancer Patients ◽  
Sensitivity And Specificity ◽  
Gastrointestinal Cancer ◽  
Degradation Products ◽  
Early Stage ◽  
Gastrointestinal Cancers ◽  
Predictive Values ◽  
Significant Difference

e22061 Background: There is a great need to detect gastrointestinal cancers at an early stage, reduce morbidity and mortality. CEA and CA 19-9 are widely used serological markers for gastrointestinal cancers during follow-up. Their utility are limited because of their low sensitivity. In this study, a novel tumor marker DR-70 is evaluated for the sensitivity and specificity, relationship between clinical parameters and compared with CEA and CA 19-9. Methods: Blood sera of 101 histologically proven gastrointestinal cancer patients (38 female, 63 male; 42 colon, 25 rectum, 18 stomach, 9 pancreas, 4 esophagus and 3 cholangiocellular carcinomas) and 105 healthy blood donors were included. The TNM stage of the disease and histologic grade was shown. All patients and controls were also tested for CEA and CA 19-9 levels. In DR-70 immunoassay, the fibrin degradation products were quantitatively measured using ELISA DR-70 kits. Results: The median DR-70, CEA and CA19-9 levels were 1.6 µg/mL, 3.05 ng/mL and 22.2 IU/L in cancer patients, they were lower in healthy control 0.5 µg/mL, 0.9 ng/mL, 1.9 IU/L; p < 0.001. While the stage and grade increased, the levels of DR-70, CEA and CA-19-9 (p < 0.05) were increased significantly. DR-70 and CA19-9 values were highest in patients with pancreas, and lowest in rectum cancer, there was no statistically significant difference between tumor localization and CEA levels.The sensitivity, specificity and the cut-off value of DR-70, in patients with malignancy by using ROC analysis were found as 97%, 95% and < 0.75 µg/mL, respectively. The positive and negative predictive values were 95%, and 97% and the efficacy was 96%. Sensitivities of CEA (cut off value 3ng/mL) and CA 19-9 (cut off value 37 U/ml) were 52% and 39% respectively, the specificities were 94% and 99% for CEA and CA 19-9, respectively; sensitivity increased by combined use of both of them. Conclusions: Due to its high sensitivity and specificity, high positive and negative predictive values DR-70 can be used more frequently as a tumor marker for detection of gastrointestinal cancer. It can also be used in tumor progression and treatment follow-up because of positive correlation between DR-70 levels and the tumor stage.

scholarly journals Prognostic significance of plasma osteopontin level in breast cancer patients

2015 ◽  
Vol 6 (1) ◽  
pp. 27-32
Author(s):  
Hanan R. Nassar ◽  
Alfred E. Namour ◽  
Hanan E. Shafik ◽  
Amr S. El Sayed ◽  
Samar M. Kamel ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Bone Metastasis ◽  
Cancer Patients ◽  
Biochemical Marker ◽  
Menopausal Status ◽  
P Value ◽  
Breast Cancer Patients ◽  
Pathological Type ◽  
Significant Difference

Abstract Many studies have demonstrated that osteopontin (OPN) contributes functionally to aggressive behaviour in many tumours including breast cancer. This study aims to investigate its role as a simple biochemical marker easily measured in plasma of breast cancer patients to give an early signal for metastases and to detect its relationship to clinicopathological findings and survival. We measured plasma OPN, CA15.3 and serum alkaline phosphatase (ALP) activity in 55 patients, 28 with early stage breast cancer and 27 with bone metastasis out of whom 20 had metastasis in other sites. The median age at diagnosis for non-metastatic cases was 60 years (range 35-85) and for metastatic cases was 45.5 years (range 32-59). In the non-metastatic group, 78.57% of the patients were histologically graded as grades I and II and 21.43% as grade III tumours. In the metastatic group, 81.48% of the patients had grades I and II and 18.52% had grade III tumours; 54% of patients in the non-metastatic group were at stage II and 46% were at stage III at presentation. All patients of group II had bone metastasis, 33% had liver metastases, 25.9% had lung metastasis and 14.8% had lymph node metastasis. Patients with non-metastatic disease had a median OPN level of 55 ng/ml (range 54-150 ng/l), while those in the metastatic group had a median of 148.0 ng/l (range 56.0-156.0 ng/l), a difference which was statistically significant (P = 0.001). There was no statistically significant difference in the median levels of CA15.3 and ALP between both groups. The median OPN level was significantly higher with serum ALP level above 90, progesterone receptor (PR) status, bone and visceral metastasis. Median OPN was not affected significantly by menopausal status (P-value 0.3), tumour grade (P-value 0.3), estrogen receptor (ER) status (P-value 0.7), pathological type (P-value 0.42) or serum CA15.3 level (P-value 0.6). At the end of 12-year follow-up, 83% of the patients survived (92.3% in the non-metastatic versus 74.1% in the metastatic group). The estimated median survival for the whole study population at 12 years was 13 years (95% CI 8.144-17.856). The estimated median survival was 13 years (95% CI 0) and 12 years (95% CI 4.893-19.11) in patients with median OPN levels of <142 and ≥142, respectively, a difference which was not statistically significant (P = 0.343). No statistically significant difference in overall survival OS was noticed in relation to menopausal status (P = 0.7), pathological type (P = 0.4) and hormone receptor status (P = 0.3). At 6-year follow-up, it was found that OS was affected by the presence of visceral metastasis, tumour grade, serum plasma level of ALP and the serum level of CA15.3 (P = 0.0006, 0.007, 0.001 and 0.03, respectively). However, the presence of bone metastasis did not affect OS (P = 0.6). Osteopontin level can be a simple biochemical marker easily measured in plasma of breast cancer patients to give early signals for metastases, but not a prognostic factor for survival.

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