No description available.

BACKGROUND:The aim of this study was to evaluate clinico-pathologic specific predictors of recurrence for stage II/III disease. Improving recurrence prediction for resected stage II/III colon cancer patients could alter surveillance strategies, providing opportunities for more informed use of chemotherapy for high risk individuals.METHODS:871 stage II and 265 stage III patients with colon cancers were included. Features studied included surgery date, age, gender, chemotherapy, tumor location, number of positive lymph nodes, tumor differentiation, and lymphovascular and perineural invasion. Time to recurrence was evaluated, using Cox's proportional hazards models. The predictive ability of the multivariable models was evaluated using the concordance (c) index.RESULTS:For stage II cancer patients, estimated recurrence-free survival rates at one, three, five, and seven years following surgery were 98%, 92%, 90%, and 89%. Only T stage was significantly associated with recurrence. Estimated recurrence-free survival rates for stage III patients at one, three, five, and seven years following surgery were 94%, 78%, 70%, and 66%. Higher recurrence rates were seen in patients who didn't receive chemotherapy (p=0.023), with a higher number of positive nodes (p<0.001). The c-index for the stage II model was 0.55 and 0.68 for stage III.CONCLUSIONS:Current clinic-pathologic information is inadequate for prediction of colon cancer recurrence after resection for stage II and IIII patients. Identification and clinical use of molecular markers to identify the earlier stage II and III colon cancer patients at elevated risk of recurrence are needed to improve prognostication of early stage colon cancers.

<p>Diss. (sammanfattning) Umeå : Umeå universitet, 1980 härtill 4 uppsatser</p> / digitalisering@umu

O interesse pela doença de Crohn tem aumentado progressivamente em nosso país.Muitas publicações têm surgido na área nos últimos anos. O tratamento inicial é clínico, mas a maioria dos doentes precisa de tratamento cirúrgico ao longo da evolução. Mais de 70% dos pacientes com doença de Crohn serão operados durante o curso da doença. A recorrência sintomática ou não da doença de Crohn na anastomose íleo-cólica tem levado diversos autores a tentar novas técnicas cirúrgicas com o objetivo de retardá-la ou previni-la. Taxas de reoperação de 40% em cinco anos e 55% em dez anos já foram publicadas. O tipo de técnica cirúrgica utilizada e a sua relação com a recorrência na anastomose após ressecção ileal ou ileocolônica é, portanto, um tópico de grande importância quando se trata a doença de Crohn. Considerando-se a importância da recidiva na qualidade de vida dos pacientes com Doença de Crohn, julgamos oportuno avaliar e comparar a taxa de recorrência da doença de Crohn e a morbidade das anastomoses látero-laterais em relação às termino-terminais em pacientes com acometimento da doença em íleo terminal. Foram revisados prontuários cujos dados foram coletados prospectivamente no ambulatório de doenças inflamatórias no período de setembro de 1984 a março de 2004. Apenas os pacientes com diagnóstico de doença de Crohn em intestino delgado exclusivamente ou associada a manifestação em intestino grosso que foram submetidos a enterectomia ou a ressecção de intestino delgado e cólon direito em algum momento do tratamento foram incluídos na pesquisa (total de 141 pacientes e 185 procedimentos analisados-média de 1,65 por paciente). A indicação cirúrgica mais frequente foi por intratabilidade clínica, seguida por fístula intestinal, das quais a mais frequente foi a enterocutânea.Em 185 procedimentos realizados,101 foram seguidos de anastomose látero-lateral mecânica e 84 seguidos de término-terminal manual. Das cirurgias realizadas, a mais frequente foi a enterectomia associada a ressecção de colon direito.As complicações foram divididas em precoces e tardias.A complicação precoce mais frequente foi deiscência de anastomose.A taxa global de complicações foi de 15,1%.Dos 84 procedimentos com anastomose término-terminal realizados, 40 recidivaram(47,6%), com um intervalo médio de cinco anos entre o procedimento inicial que deu origem à recidiva e o procedimento de correção. Entre os 101 procedimentos realizados com anastomose látero-lateral, apenas seis pacientes foram reoperados, num intervalo médio de três anos, e nenhum deles foi por complicação junto à anastomose látero-lateral. Concluímos portanto, que a enterectomia seguida de anastomose láterolateral mecânica deve se constituir na técnica cirúrgica de eleição, por determinar número de reoperação por Doença de Crohn sintomática significativamente menor que as anastomoses término-terminais. / Around 70% of patients with ileal Crohn´s disease will be submeted to a surgical procedure during their lives. This study compares the recurrence rates and morbidity between surgeries followed by a wide-lumen stapled anastomosis and conventional endto-end anastomosis. We studied 185 surgical procedures in a retrospective analyses. There were 84 procedures followed by an end-to-end anastomosis and the recurrence rate was 47,6%.Among the 101 wide-lumen stapled anastomosis procedures, only 6 patients had to be submeted to a new surgery. We conclude that the enterectomy followed by a wide-lumen stapled anastomosis is the gold standard surgery for patients with ileal Crohn´s disease.

Os carcinomas de cabeça e pescoço representam um problema na saúde pública, sendo a oitava causa no mundo de morte por câncer. A taxa de crescimento do tumor, o seu local de expansão, bem como a metástase das células cancerígenas depende muito da vascularização do tumor, sendo que esta é a responsável pelo fornecimento constante de nutrientes e de oxigênio para o crescimento tumoral. Sendo assim a angiogênese é considerada um processo essencial dentro do processo neoplásico. A avaliação dos vasos sanguíneos tumorais neoformados em carcinomas espinocelulares de boca, usando o anticorpo CD105, mostra um crescimento significativo da densidade microvascular. Baseado nestes, o objetivo do trabalho é avaliar através da imunoistoquímica a possível correlação de aumento no número de vasos sanguíneos correlacionando com diferentes grupos de processo inflamatório divididos em: pouco, moderado e intenso infiltrado inflamatório no front tumoral. Na literatura os autores de um modo geral correlacionam infiltrados inflamatórios e angiogênese, neste trabalho tentamos correlacionar se um maior ou menor infiltrado inflamatório tem influência nessa angiogênese. As lâminas foram avaliadas microscopicamente por dois profissionais de forma que eles não sabiam da classificação dada pelo outro e só quando ambos estavam em comum acordo essas lâminas foram classificadas. Para a análise estatística foi realizado a comparação múltipla entre os 03 grupos através da Análise de variância (comparação das três médias) e também o teste de Tukey, onde se observou diferença entre os grupos I e III e nos grupos II e III, porém entre os grupos I e II não houve diferença significativa. Com isso os resultados nos mostram uma correlação positiva entre a presença de maior quantidade de vasos sanguíneos, onde se encontra maior quantidade de infiltrado inflamatório, quando comparado com áreas de menor infiltrado inflamatório. / Carcinomas of the head and neck represent a public health problem, being the eighth leading cause of worldwide cancer deaths. The growth rate of the tumor, its location expansion and metastasis of cancer cells depends greatly on tumor vascularity, and this is responsible for the constant supply of oxygen and nutrients for tumor growth. Thus angiogenesis is considered an essential process within the neoplastic process. The evaluation of newly formed tumor blood vessels in oral squamous cell carcinoma using the CD105 antibody, shows a significant increase in microvascular density. Based on these, the goal is to evaluate by immunohistochemistry the possible correlation of an increased number of blood vessels correlate with different groups of inflammatory process divided into: minor, moderate and intense inflammatory infiltrate in the tumor front. In the literature, authors generally correlated angiogenesis and inflammatory infiltrates, in this work we try to correlate to a greater or lesser inflammatory infiltrate that affects angiogenesis. The slides were evaluated microscopically by two professionals so that they did not know the rating given by others and only when both were in agreement these slides were classified. For statistical analysis, the multiple comparisons between the three groups was performed by analysis of variance (comparison of three average) and also the Tukey test, where a difference was observed between groups I and III and groups II and III, but between groups I and II significativa.Com that there was no difference in the results show a positive correlation between the presence of a larger amount of blood vessels, where it is most inflammatory infiltrate when compared to areas of lesser amounts of inflammation.

Nasopharyngeal cancer (NPC) is endemic in Southern China and Hong Kong. It has traditionally been treated by local radiotherapy with great success especially for early stage disease. However the treatment outcome in advanced stage disease is unsatisfactory. / Results from this series of combined clinical, translational and laboratory studies have redefined the role of hypoxia, angiogenesis and metastasis as new therapeutic targets in NPC. Novel biomarkers and new therapeutic approaches were developed based on these targets. / To develop new therapies in NPC, we demonstrated in a randomized controlled phase 2 clinical trial that sequential therapy of neoadjuvant chemotherapy followed by chemoradiotherapy was well tolerated with a manageable toxicity profile that allowed subsequent delivery of full dose chemoradiotherapy. This strategy reduced distant metastasis which translated into improved patient survival. In preclinical studies, the antiangiogenesis agent sunitinib demonstrated potent in vitro and in vivo growth inhibition in NPC. In a phase 2 clinical trial, sunitinib demonstrated modest clinical activity in heavily pretreated NPC patients. However, the unexpected high incidence of severe hemorrhage from upper aero-digestive tract in NPC patients who received prior high dose RT to the region is of concern. We propose to exclude NPC patients with disease recurrence within previous radiation field and/or with vascular invasion from future antiangiogenesis therapy. / To investigate potential new therapeutic targets and biomarkers in NPC, we first confirmed from the Hong Kong NPC study group of 2915 patients' database that distant metastasis was the leading cause of NPC failure after primary radiotherapy. We further showed that hypoxia induced broad changes of both up- and down-regulated gene expressions involved in diverse biological processes in NPC cells. Over-expression of biomarkers of hypoxia and angiogenesis (including HIF-1alpha, CA IX and VEGF) is common in NPC and is associated with poor prognosis. Elevated plasma osteopontin is a biomarker of distant metastasis, and pre-treatment plasma osteopontin level may be a useful biomarker of response to radiotherapy in NPC. / Hui, Pun. / "September 2010." / Adviser: Anthony Chan. / Source: Dissertation Abstracts International, Volume: 73-04, Section: B, page: . / Thesis (M.D.)--Chinese University of Hong Kong, 2011. / Includes bibliographical references (leaves 269-293). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [201-] System requirements: Adobe Acrobat Reader. Available via World Wide Web.

Acute myocardial infarction (AMI) rat model was adopted to test the effect of AngioT in vivo. AngioT was directly injected into the ischaemic region of the left ventricle immediately after the ligation of left anterior descending artery. The densities of vessels in AngioT treated hearts were on average 3-4 folds higher compared with non-treated hearts after two and seven days post infarction. Using TUNEL method, approximately 3-fold lower numbers of apoptotic cardiomyocytes were detected in AngioT treated AMI hearts compared with controls. The infarcted volume estimated by Masson's Trichrome staining was significantly decreased in AngioT treated hearts (27.44%+/-7.34% vs. 39.53%+/-5.97%, p&lt;0.05) compared with control hearts 14 days post infarction. Echocardiography demonstrated that left ventricular ejection fraction and fraction shortening in AngioT treated hearts were significantly improved by 10.4% and 22.3% compared to those in the control hearts 2-day post infarction (p&lt;0.05). These improvements were maintained for 2-week post infarction. / Based on the analysis of rat angiogenesis specific superarray, VEGFb, VEGFc and FGF7, were found to be highly expressed in AngioT treated AMI hearts compared to the controls. The expression levels of survival related genes Bcl2 and Akt1 were increased to 3.3 and 2.8 folds respectively in AngioT treated AMI hearts compared with the controls (both p&lt;0.05). Based on the signal transduction pathway finder superarray, Jak-Stat pathway activators, Interleukin 4 receptor and Interferon regulatory factor 1 (IL4R and IRF1), were found to be highly expressed in the AngioT treated AMI heart. / In conclusion, bioactive angiogenic factors (AngioT) were isolated from Geum. japonicum Thunb. Var. Chinense F. Bolle (GJ). Intra-cardiomuscular injection of AngioT had beneficial effects on the acute myocardial infarction. The underlying mechanisms might be related to the activation of Jak-Stat Pathway and over expressions of angiogenic factors and survival associated genes. The therapeutic properties of AngioT appear entirely novel and may provide a new dimension for therapeutic angiogenesis for the treatment of acute ischaemic heart disease. / In the present study, an angiogenic tannins fraction (AngioT) was isolated from Geum. japonicum Thunb. Var. Chinense F. Bolle using bio-assay guided strategy. AngioT increased the proliferation of human umbilical vein endothelial cell (HUVEC) in culture within 24-hour, 48-hour and 72-hour treatment in a dose-dependent pattern. The EC50 of AngioT on HUVEC was less than 25mug/ml. Conditional media from AngioT treated HUVEC stimulated the proliferation of HUVEC significantly greater than conditional media from non-treated HUVEC. Using 2-dimensional electrophoresis and MALDI-TOF, VEGFa was identified in the AngioT treated conditional medium. / Ischaemic heart disease remains the leading cause of morbidity and mortality in most countries. Severe ischaemia of myocardium induces myocardial infarction and results in an irreversible loss of myocardium. Restoration of coronary blood flow by rapid angiogenesis may offer a direct and effective therapeutic way to intractable ischaemic heart diseases. / Key words. ischaemic heart disease; myocardial infarction; therapeutic angiogenesis; Geum japonicum; apoptosis; tannins; VEGF; Jak-Stat pathway / Gu, Xuemei. / "Sep 2007." / Adviser: Peter Tong Chun Yip. / Source: Dissertation Abstracts International, Volume: 69-08, Section: B, page: 4615. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2007. / Includes bibliographical references (p. 159-177). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstract in English and Chinese. / School code: 1307.

Os carcinomas de cabeça e pescoço representam um problema na saúde pública, sendo a oitava causa no mundo de morte por câncer. A taxa de crescimento do tumor, o seu local de expansão, bem como a metástase das células cancerígenas depende muito da vascularização do tumor, sendo que esta é a responsável pelo fornecimento constante de nutrientes e de oxigênio para o crescimento tumoral. Sendo assim a angiogênese é considerada um processo essencial dentro do processo neoplásico. A avaliação dos vasos sanguíneos tumorais neoformados em carcinomas espinocelulares de boca, usando o anticorpo CD105, mostra um crescimento significativo da densidade microvascular. Baseado nestes, o objetivo do trabalho é avaliar através da imunoistoquímica a possível correlação de aumento no número de vasos sanguíneos correlacionando com diferentes grupos de processo inflamatório divididos em: pouco, moderado e intenso infiltrado inflamatório no front tumoral. Na literatura os autores de um modo geral correlacionam infiltrados inflamatórios e angiogênese, neste trabalho tentamos correlacionar se um maior ou menor infiltrado inflamatório tem influência nessa angiogênese. As lâminas foram avaliadas microscopicamente por dois profissionais de forma que eles não sabiam da classificação dada pelo outro e só quando ambos estavam em comum acordo essas lâminas foram classificadas. Para a análise estatística foi realizado a comparação múltipla entre os 03 grupos através da Análise de variância (comparação das três médias) e também o teste de Tukey, onde se observou diferença entre os grupos I e III e nos grupos II e III, porém entre os grupos I e II não houve diferença significativa. Com isso os resultados nos mostram uma correlação positiva entre a presença de maior quantidade de vasos sanguíneos, onde se encontra maior quantidade de infiltrado inflamatório, quando comparado com áreas de menor infiltrado inflamatório. / Carcinomas of the head and neck represent a public health problem, being the eighth leading cause of worldwide cancer deaths. The growth rate of the tumor, its location expansion and metastasis of cancer cells depends greatly on tumor vascularity, and this is responsible for the constant supply of oxygen and nutrients for tumor growth. Thus angiogenesis is considered an essential process within the neoplastic process. The evaluation of newly formed tumor blood vessels in oral squamous cell carcinoma using the CD105 antibody, shows a significant increase in microvascular density. Based on these, the goal is to evaluate by immunohistochemistry the possible correlation of an increased number of blood vessels correlate with different groups of inflammatory process divided into: minor, moderate and intense inflammatory infiltrate in the tumor front. In the literature, authors generally correlated angiogenesis and inflammatory infiltrates, in this work we try to correlate to a greater or lesser inflammatory infiltrate that affects angiogenesis. The slides were evaluated microscopically by two professionals so that they did not know the rating given by others and only when both were in agreement these slides were classified. For statistical analysis, the multiple comparisons between the three groups was performed by analysis of variance (comparison of three average) and also the Tukey test, where a difference was observed between groups I and III and groups II and III, but between groups I and II significativa.Com that there was no difference in the results show a positive correlation between the presence of a larger amount of blood vessels, where it is most inflammatory infiltrate when compared to areas of lesser amounts of inflammation.

<p>Angiogenesis is necessary for the growth and spread of solid tumors. In these studies angiogenesis was measured in childhood malignancies in general and in Wilms’ tumor in particular, and cutting needle biopsy (CNB) specimens were evaluated for diagnosis in childhood renal tumors. </p><p>In 33 patients with Wilms’ tumor, tumor capillaries were quantified, expression of angiogenic growth factors in tumor tissue investigated, and concentrations of angiogenic growth factors in serum measured. Reference values for angiogenic growth factors were obtained in 80 healthy adults (fibroblast growth factor 2 [FGF-2], vascular endothelial growth factor A [VEGF-A]) and 94 healthy children (angiogenin [ANG], epidermal growth factor [EGF], FGF-2, hepatocyte growth factor [HGF], tumor necrosis factor alpha [TNFA] and VEGF-A) aged 0.5-18 years. These reference values were compared with values in sera taken at diagnosis in 268 children with tumors and leukemias. CNB specimens were evaluated in 25 children with renal tumors.</p><p>A large number of capillaries was an independent prognostic factor for a poor outcome in Wilms’ tumor. Angiogenic growth factors were expressed in Wilms’ tumor tissue, and elevated concentrations of HGF and VEGF-A were found in both benign and malignant tumors. HGF was increased in leukemia, and TNFA was increased in leukemia, lymphoma and neuroblastoma. CNB, which proved to be a safe procedure, had a sensitivity of 76%. </p><p>These studies have demonstrated that quantification of capillaries is a prognostic factor in Wilms’ tumor and that HGF, TNFA and VEGF-A are frequently elevated in sera from children with cancer. Quantification of capillaries in tumor tissue and of circulating angiogenic growth factors would therefore seem to be of clinical relevance in managing children with cancer.</p>

Angiogenesis is necessary for the growth and spread of solid tumors. In these studies angiogenesis was measured in childhood malignancies in general and in Wilms’ tumor in particular, and cutting needle biopsy (CNB) specimens were evaluated for diagnosis in childhood renal tumors. In 33 patients with Wilms’ tumor, tumor capillaries were quantified, expression of angiogenic growth factors in tumor tissue investigated, and concentrations of angiogenic growth factors in serum measured. Reference values for angiogenic growth factors were obtained in 80 healthy adults (fibroblast growth factor 2 [FGF-2], vascular endothelial growth factor A [VEGF-A]) and 94 healthy children (angiogenin [ANG], epidermal growth factor [EGF], FGF-2, hepatocyte growth factor [HGF], tumor necrosis factor alpha [TNFA] and VEGF-A) aged 0.5-18 years. These reference values were compared with values in sera taken at diagnosis in 268 children with tumors and leukemias. CNB specimens were evaluated in 25 children with renal tumors. A large number of capillaries was an independent prognostic factor for a poor outcome in Wilms’ tumor. Angiogenic growth factors were expressed in Wilms’ tumor tissue, and elevated concentrations of HGF and VEGF-A were found in both benign and malignant tumors. HGF was increased in leukemia, and TNFA was increased in leukemia, lymphoma and neuroblastoma. CNB, which proved to be a safe procedure, had a sensitivity of 76%. These studies have demonstrated that quantification of capillaries is a prognostic factor in Wilms’ tumor and that HGF, TNFA and VEGF-A are frequently elevated in sera from children with cancer. Quantification of capillaries in tumor tissue and of circulating angiogenic growth factors would therefore seem to be of clinical relevance in managing children with cancer.