Is there any correlation among adiponectin levels in serum, tumor tissue and normal tissue of the same patients wih breast cancer?

PURPOSE

Adiponectin is secreted from adipose tissue and is characterized by hyperinsulinemia which is related with obesity. Although serum adiponectin levels in patients with breast cancer have been studied previously, adiponectin levels in the serum, tumor and normal tissue of the same patients have not been simultaneously investigated. The aim of this study was thus to evaluate the relationship among serum, tumor and normal tissue adiponectin levels in patients with breast cancer.

METHODS

Fifty-three patients with breast cancer who were operated at the Dr. Lutfi Kirdar Kartal Education and Research Hospital, Department of Surgery, between February 2008 and June 2008, were analyzed. Their serum adiponectin levels, tumor tissue and normal breast tissue adiponectin levels were compared. The correlation between postoperative histopathological parameters, insulin resistance parameters and adiponectin levels was also examined.

RESULTS

The mean adiponectin levels in tumor tissue, normal breast tissue and serum were 56 ± 9.6 ng/ml, 56 ± 10 ng/ml and 43.5 ± 3.1 ng/ml, respectively. The serum adiponectin levels were inversely correlated with tumor tissue adiponectin levels (p=0.001, r=-0.43). When tumor tissue adiponectin levels were increased, serum adiponectin levels were decreased. O n the other hand, there was a positive correlation between normal breast tissue adiponectin levels and tumor tissue adiponectin levels (p=0.0001, r= 0.850). The tumor tissue adiponectin level was inversely correlated with tumor stage (p=0.037 , r= -0.29). Moreover, in early-stage and low grade tumors, both tumor tissue and normal tissue adiponectin levels were high compared with those of advanced stage or high grade tumors (p=0.027, r= -0.32 and p=0.004, r= -0.408, respectively). In the subgroup analyses, no significant relationship was found between insulin resistance parameters and adiponectin levels (p>0.05).

CONCLUSION

Our results indicate that serum adiponectin levels were inversely correlated with tumor tissue adiponectin levels, but no relationship between normal breast tissue and tumor tissue adiponectin levels was demonstrated. Adiponectin levels in breast tumor tissue increase while serum adiponectin levels decrease. Adiponectin might play an important role in the prevention of tumor progression by decreasing tissue neovascularization.

Apical lymph nodes at the root of the inferior mesenteric artery in distal colorectal cancer: an analysis of the risk of tumor involvement and the impact of high ligation on anastomotic integrity

BACKGROUND

What level of arterial ligation is best in left-sided colon cancer and rectal cancer remains controversial. This study aims to assess the necessity and risk of high ligation from an oncological and technical perspective.

METHODS

The lymph nodes at the origin of the inferior mesenteric artery (IMA) were separated as apical nodes in all patients operated for distal colorectal cancer in our department. The number and status of the nodes were prospectively assessed, and demographic and tumor-related variables were evaluated as risk factors for apical tumor invasion. Anastomotic leaks were also evaluated.

RESULTS

A hundred and three patients (52 [50.5%] males, 60.3+/-12.9 years old) were included. The number of non-apical lymph nodes harvested was 14.5+/-7.1 with an additional 4.4+/-3.2 apical nodes at the high ligation site. Tumor invasion of apical nodes was observed in 6 (5.8%) patients. Two of these (1.9%) had no other positive nodes (skip metastases). Although none of the variables evaluated was found significant for predicting apical node positivity, tumor invasion was detected in 8.5 and 22.2% of patients with pT3 and pN2 cancers, respectively. Among patients, who had an anastomosis (n = 84, 81.6%), anastomotic leak was observed in 7(8.3%) and 1 (1.2%) of these patients required emergency relaparotomy. There was no mortality related to high ligation.

CONCLUSIONS

High ligation of IMA may be routinely performed in patients with distal colorectal cancer, since tumor invasion of apical lymph nodes is neither rare (>5%) nor predictable, and skip metastases may also occur. This is especially true in case of an advanced disease for which apical node positivity peaks. The anastomotic leak rate is less than 10%, and mortality is low after high ligation of IMA.

The association of tissue and serum adiponectin levels with the parameters of insulin-resistance in breast cancer patients

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Background: Adiponectin is a novel adipocyte-secreted proteine and associated with insulin-resistant (IR) status, such as type 2 diabetes mellitus and obesity. The inverse correlation between serum adiponectin levels and breast cancer risk was previously documented. Moreover, the association of high tissue adiponectin levels with breast cancer has been recently reported. In the present study, the relationship among tumor, normal breast tissue and serum adiponectin levels, breast cancer, and the other IR parameters were evaluated. Methods: Fifty-three patients with diagnosed and histologically confirmed breast cancer were included in our study. We analyzed the correlation among the levels of normal and tumor breast tissue adiponectin and serum adiponectin levels. In addition, the association of tissue and serum adiponectin levels with the various classical risk and IR factors, such as body mass index, menopausal status and, tumor size, stage, lymph node status, hormonal status were also studied. Results: Tumor tissue adiponectin levels (56 ± 9.6 ng/ml) were similar with normal breast tissue (56 ± 10 ng/ml) (p>0.05). However, the serum adiponectin levels were significantly lower compared with both normal and tumor tissue (p<0.05). In addition, the inversely association of serum adiponectin levels with tumor tissue adiponectin levels was detected (p=0.001). The inverse correlation between T stage and tumor tissue adiponectin was found (p=0.03). The levels of serum adiponectin were significantly more higher in patients with c- erb-B2 overexpressed (p=0,008). Both nuclear and histologic grade were significantly associated with serum adiponectin levels (p=0.04,p=0.04, respectively). On the other hand, the reverse relationship between nuclear grade and, both tumor (p=0.01) and normal tissue (p=0.009) adiponectin levels was also detected. In subgroup analysis, the correlation among demographic, clinicopathologic, IR parameters, tissue and serum adiponectin levels was not found (p>0.05). Conclusions: Our results suggest that the low serum adiponectin and high normal and tumor tissue adiponectin levels detected in breast cancer patients and serum adiponectin levels inversely associated with tumor tissue adiponectin levels.

No significant financial relationships to disclose.

[Ecthyma contagiosum epidemics in Turkey]

In the years 1979 and 1980 after the religious holidays of the "Feast of Sacrifice" in Izmir (Turkey), there was an epidemic-type of outbreak of 31 cases of ecthyma contagiosum. On the occasion of the sacrificial feast day the amateur butchers, their helpers, housewives, and others came into direct contact with virus-infected parts and were infected with the ecthyma contagiosum virus, which includes the paravaccinia group.