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Tumor progression and metastasis is mediated not only by tumor cells but by the surrounding stroma as well, including the vascular endothelium. Knowledge of the molecular and cellular interactions that promote metastasis is required to determine prognostic markers and therapeutic targets for metastatic breast cancer. A clinically relevant syngeneic model of breast cancer metastasis has been used to determine gene expression alterations that occur in both tumor epithelial cells and the associated vascular endothelium throughout metastatic progression. A number of candidates have been identified as over-expressed or suppressed in tumor endothelium and in the tumor cells themselves during metastatic progression. Some of these have been verified and are being analysed further for their functional role in metastasis, and for their role in human breast cancer. Of particular interest are 3 groups of genes- the increased expression and activity of cathepsin proteases and their inhibitor Stefin A, suppression of interleukin receptors IL13r 1 and IL4r and the interferon regulatory factor IRF7 (genes involved in immune defence) and also suppression of a novel gene that may have promise as a metastasis suppressor, Lrch2. In the human disease, our studies have shown that a lack of Stefin A primary tumor expression decreased risk of recurrence and improved patient outcome in a small cohort study.

Book Source: Digital Library of India Item 2015.550349 dc.contributor.author: Geschickter, Charles F. dc.date.accessioned: 2015-10-14T21:40:47Z dc.date.available: 2015-10-14T21:40:47Z dc.date.copyright: 1949 dc.date.digitalpublicationdate: 2011/03 dc.date.citation: 1949 dc.identifier.barcode: 04990010031163 dc.identifier.origpath: /data8/upload/0228/445 dc.identifier.copyno: 1 dc.identifier.uri: http://www.new.dli.ernet.in/handle/2015/550349 dc.description.scannerno: Banasthali University dc.description.scanningcentre: C-DAK, Kolkata dc.description.main: 1 dc.description.tagged: 0 dc.description.totalpages: 884 dc.format.mimetype: application/pdf dc.language.iso: Sanskrit dc.publisher.digitalrepublisher: Digital Library of India dc.publisher: London, J. B. Lippincott Company dc.rights: Copyright permitted dc.source.library: Dr. Robert Heiling Library, S.m.s.medical College, Jaipur dc.subject.classification: Medical dc.title: Tumors Of Bone(third Edition) dc.type: Print - Paper dc.type: Book

A deep learning-based system for accurate diagnosis of pelvic bone tumors

This article is from Cancer Research and Treatment : Official Journal of Korean Cancer Association , volume 43 . Abstract Purpose: Response to neo-adjuvant chemotherapy is an important prognostic factor for osteosarcoma (OS) and the Ewing sarcoma family of tumors (ESFT). [F-18]-fluorodeoxy-D-glucose (FDG)-positron emission tomography (PET) is a non-invasive imaging modality that predicts histologic response to chemotherapy of various malignancies; however, limited data exist about the usefulness of FDG-PET in predicting the histologic response of pediatric bone tumors to chemotherapy. We analyzed the FDG-PET imaging characteristics of pediatric bone tumors and determined the association with response to chemotherapy. Materials and Methods: Pediatric patients with OS (n=19) or ESFT (n=17) were evaluated for FDG-PET standard uptake values before (SUV1) and after (SUV2) chemotherapy. The relationship to the chemotherapy response was assessed by histopathology in surgically-excised tumors. A complete data set (SUV1, SUV2, and histologic response) was available in 23 patients. Results: While the mean SUV1s were not different between patients with OSs and ESFTs (9.44 vs. 6.07, p=0.24), the SUV2s were greater in the patients with OSs than ESFTs (4.55 vs. 1.66, p=0.01). The ratios of SUV2-to-SUV1 (SUV2 : SUV1) were 0.65 and 0.35 for OS and ESFT, respectively (p=0.08). All of the patients with ESFTs and 47% of the patients with OS had a favorable histologic response to chemotherapy. The SUV2 : 1 [(SUV1-SUV2)/SUV1]≥0.5 and SUV2≤2.5 were related to favorable histologic responses to chemotherapy; the sensitivity and specificity of SUV2 : 1 at 0.5 and SUV2 at 2.5 were 93% and 88%, and 88% and 78%, respectively. Conclusion: FDG-PET can be used as a non-invasive surrogate to predict response to chemotherapy in children with bone tumors.

This article is from Cancer Research and Treatment : Official Journal of Korean Cancer Association , volume 43 . Abstract Purpose: Response to neo-adjuvant chemotherapy is an important prognostic factor for osteosarcoma (OS) and the Ewing sarcoma family of tumors (ESFT). [F-18]-fluorodeoxy-D-glucose (FDG)-positron emission tomography (PET) is a non-invasive imaging modality that predicts histologic response to chemotherapy of various malignancies; however, limited data exist about the usefulness of FDG-PET in predicting the histologic response of pediatric bone tumors to chemotherapy. We analyzed the FDG-PET imaging characteristics of pediatric bone tumors and determined the association with response to chemotherapy. Materials and Methods: Pediatric patients with OS (n=19) or ESFT (n=17) were evaluated for FDG-PET standard uptake values before (SUV1) and after (SUV2) chemotherapy. The relationship to the chemotherapy response was assessed by histopathology in surgically-excised tumors. A complete data set (SUV1, SUV2, and histologic response) was available in 23 patients. Results: While the mean SUV1s were not different between patients with OSs and ESFTs (9.44 vs. 6.07, p=0.24), the SUV2s were greater in the patients with OSs than ESFTs (4.55 vs. 1.66, p=0.01). The ratios of SUV2-to-SUV1 (SUV2 : SUV1) were 0.65 and 0.35 for OS and ESFT, respectively (p=0.08). All of the patients with ESFTs and 47% of the patients with OS had a favorable histologic response to chemotherapy. The SUV2 : 1 [(SUV1-SUV2)/SUV1]≥0.5 and SUV2≤2.5 were related to favorable histologic responses to chemotherapy; the sensitivity and specificity of SUV2 : 1 at 0.5 and SUV2 at 2.5 were 93% and 88%, and 88% and 78%, respectively. Conclusion: FDG-PET can be used as a non-invasive surrogate to predict response to chemotherapy in children with bone tumors.

This article is from Cancer Research and Treatment : Official Journal of Korean Cancer Association , volume 43 . Abstract Purpose: Response to neo-adjuvant chemotherapy is an important prognostic factor for osteosarcoma (OS) and the Ewing sarcoma family of tumors (ESFT). [F-18]-fluorodeoxy-D-glucose (FDG)-positron emission tomography (PET) is a non-invasive imaging modality that predicts histologic response to chemotherapy of various malignancies; however, limited data exist about the usefulness of FDG-PET in predicting the histologic response of pediatric bone tumors to chemotherapy. We analyzed the FDG-PET imaging characteristics of pediatric bone tumors and determined the association with response to chemotherapy. Materials and Methods: Pediatric patients with OS (n=19) or ESFT (n=17) were evaluated for FDG-PET standard uptake values before (SUV1) and after (SUV2) chemotherapy. The relationship to the chemotherapy response was assessed by histopathology in surgically-excised tumors. A complete data set (SUV1, SUV2, and histologic response) was available in 23 patients. Results: While the mean SUV1s were not different between patients with OSs and ESFTs (9.44 vs. 6.07, p=0.24), the SUV2s were greater in the patients with OSs than ESFTs (4.55 vs. 1.66, p=0.01). The ratios of SUV2-to-SUV1 (SUV2 : SUV1) were 0.65 and 0.35 for OS and ESFT, respectively (p=0.08). All of the patients with ESFTs and 47% of the patients with OS had a favorable histologic response to chemotherapy. The SUV2 : 1 [(SUV1-SUV2)/SUV1]≥0.5 and SUV2≤2.5 were related to favorable histologic responses to chemotherapy; the sensitivity and specificity of SUV2 : 1 at 0.5 and SUV2 at 2.5 were 93% and 88%, and 88% and 78%, respectively. Conclusion: FDG-PET can be used as a non-invasive surrogate to predict response to chemotherapy in children with bone tumors.

Aim: Although bone tumors are rare they are complex in terms of diagnosis, patient monitoring, and treatment plans. We aimed to determine the properties, frequency, and distribution of bone tumors in a group of adults. Material and Method: The histopathology reports of all bone samples of the adults that were recorded in a private pathology laboratory in Istanbul between 2009 and 2015 were reviewed. Results: There was a total of 78 patients, 44 male (56%) and 34 (44%) female. The average age was 42.46 years. 47 lesions (60.25%) were benign, 31 (39.75%) malignant. The lesions were most common in the lower extremities (44 cases, 56.4%) and secondly in the upper extremities (17 cases, 22%). Osteochondroma (16 cases, 34%), simple bone cysts (7 cases, 16%), and enchondroma (6 cases, 13%) were the most frequent benign lesions. 20 of 31 malignant lesions were metastasis, followed by chondrosarcoma (5 cases, 6.25%) and chondroblastic osteosarcoma (2 cases, 2.5%). 35% of the metastases were from lung cancer and 19% were from renal cell cancer. 67% of the metastatic lesions were in males. Discussion: Knowledge of the properties and diseases related to adult bone tumors is extremely important. Because they are so rare, the diagnosis may be delayed, causing significant morbidity and mortality.

Aim: Although bone tumors are rare they are complex in terms of diagnosis, patient monitoring, and treatment plans. We aimed to determine the properties, frequency, and distribution of bone tumors in a group of adults. Material and Method: The histopathology reports of all bone samples of the adults that were recorded in a private pathology laboratory in Istanbul between 2009 and 2015 were reviewed. Results: There was a total of 78 patients, 44 male (56%) and 34 (44%) female. The average age was 42.46 years. 47 lesions (60.25%) were benign, 31 (39.75%) malignant. The lesions were most common in the lower extremities (44 cases, 56.4%) and secondly in the upper extremities (17 cases, 22%). Osteochondroma (16 cases, 34%), simple bone cysts (7 cases, 16%), and enchondroma (6 cases, 13%) were the most frequent benign lesions. 20 of 31 malignant lesions were metastasis, followed by chondrosarcoma (5 cases, 6.25%) and chondroblastic osteosarcoma (2 cases, 2.5%). 35% of the metastases were from lung cancer and 19% were from renal cell cancer. 67% of the metastatic lesions were in males. Discussion: Knowledge of the properties and diseases related to adult bone tumors is extremely important. Because they are so rare, the diagnosis may be delayed, causing significant morbidity and mortality.

Aim: Although bone tumors are rare they are complex in terms of diagnosis, patient monitoring, and treatment plans. We aimed to determine the properties, frequency, and distribution of bone tumors in a group of adults. Material and Method: The histopathology reports of all bone samples of the adults that were recorded in a private pathology laboratory in Istanbul between 2009 and 2015 were reviewed. Results: There was a total of 78 patients, 44 male (56%) and 34 (44%) female. The average age was 42.46 years. 47 lesions (60.25%) were benign, 31 (39.75%) malignant. The lesions were most common in the lower extremities (44 cases, 56.4%) and secondly in the upper extremities (17 cases, 22%). Osteochondroma (16 cases, 34%), simple bone cysts (7 cases, 16%), and enchondroma (6 cases, 13%) were the most frequent benign lesions. 20 of 31 malignant lesions were metastasis, followed by chondrosarcoma (5 cases, 6.25%) and chondroblastic osteosarcoma (2 cases, 2.5%). 35% of the metastases were from lung cancer and 19% were from renal cell cancer. 67% of the metastatic lesions were in males. Discussion: Knowledge of the properties and diseases related to adult bone tumors is extremely important. Because they are so rare, the diagnosis may be delayed, causing significant morbidity and mortality.

The absorption of RNase by ascites tumor cells and bone marrow cells was followed by measuring enzymic activity and the radioactivity of cell suspensions incubated in the presence of enzyme labeled with 1311. Experiments indicated that the enzyme penetrated into the interior of the cells and that the rate of penetration depended on the concentration of RNase in the medium. The penetration of the enzyme into ascites tumor cells was not affected by temperature as long as the concentration of RNase in the external medium did not exceed a certain threshold value. These facts suggested that several mechanisms- diffusion, membrane activity, pinocytosis-all differentially influenced by temperature, facilitate the penetration of RNase into the cell. In the light of these new results, the effects of RNase on the metabolism of normal cancerous cells are discussed.

This article is from BMC Musculoskeletal Disorders , volume 15 . Abstract Background: The purpose of this study was to compare the outcome, complications and survival of the commonly used surgical reconstructions of the proximal humerus after intrarticular tumour resection in our hospital. Methods: Between 1998 and 2010, 41 consecutive proximal humeral reconstructions using prosthesis (group P, n = 25) or recycled pasteurized autograft combined with non-vascularised fibula autograft (group B, n = 16) were performed. Results: The mean follow-up was 57.7 months. Fourteen patients (8 patients in group P and 6 in group B) died during the follow-up period, the disease-specific survival of patients in group P was 74.5% at 5 years and in group B was 67.0%. Local recurrences were occurred in 3 cases (12.0%) in group P and 2 (12.5%) in group B. Pulmonary metastases were observed in 4 patients (16.0%) in group P and 4 (25.0%) in group B. There was no significant difference in the incidence of local recurrence, pulmonary metastasis or death of disease. Revisions were indicated in 9 patients (36.0%) in group P and 5 (31.25%) in group B. Thought the incidence of revisions was higher in group P, there was no significant difference in these two groups. The Kaplan-Meier 5-year implant survival estimates, with revision for any reason as the end point, were 80.6% and 68.8% for group P and group B, respectively. The mean MSTS Score was 63.6% in group P and 63.0% in group B. These differences were not statistically significant. Conclusions: The study could show that prosthetic reconstruction and reconstruction with recycled pasteurized autograft are similar in terms of their local recurrence and metastasis, while the incidence of revisions was higher for patients with prosthetic reconstruction.

This article is from BMC Musculoskeletal Disorders , volume 15 . Abstract Background: The purpose of this study was to compare the outcome, complications and survival of the commonly used surgical reconstructions of the proximal humerus after intrarticular tumour resection in our hospital. Methods: Between 1998 and 2010, 41 consecutive proximal humeral reconstructions using prosthesis (group P, n = 25) or recycled pasteurized autograft combined with non-vascularised fibula autograft (group B, n = 16) were performed. Results: The mean follow-up was 57.7 months. Fourteen patients (8 patients in group P and 6 in group B) died during the follow-up period, the disease-specific survival of patients in group P was 74.5% at 5 years and in group B was 67.0%. Local recurrences were occurred in 3 cases (12.0%) in group P and 2 (12.5%) in group B. Pulmonary metastases were observed in 4 patients (16.0%) in group P and 4 (25.0%) in group B. There was no significant difference in the incidence of local recurrence, pulmonary metastasis or death of disease. Revisions were indicated in 9 patients (36.0%) in group P and 5 (31.25%) in group B. Thought the incidence of revisions was higher in group P, there was no significant difference in these two groups. The Kaplan-Meier 5-year implant survival estimates, with revision for any reason as the end point, were 80.6% and 68.8% for group P and group B, respectively. The mean MSTS Score was 63.6% in group P and 63.0% in group B. These differences were not statistically significant. Conclusions: The study could show that prosthetic reconstruction and reconstruction with recycled pasteurized autograft are similar in terms of their local recurrence and metastasis, while the incidence of revisions was higher for patients with prosthetic reconstruction.

This article is from BMC Musculoskeletal Disorders , volume 15 . Abstract Background: The purpose of this study was to compare the outcome, complications and survival of the commonly used surgical reconstructions of the proximal humerus after intrarticular tumour resection in our hospital. Methods: Between 1998 and 2010, 41 consecutive proximal humeral reconstructions using prosthesis (group P, n = 25) or recycled pasteurized autograft combined with non-vascularised fibula autograft (group B, n = 16) were performed. Results: The mean follow-up was 57.7 months. Fourteen patients (8 patients in group P and 6 in group B) died during the follow-up period, the disease-specific survival of patients in group P was 74.5% at 5 years and in group B was 67.0%. Local recurrences were occurred in 3 cases (12.0%) in group P and 2 (12.5%) in group B. Pulmonary metastases were observed in 4 patients (16.0%) in group P and 4 (25.0%) in group B. There was no significant difference in the incidence of local recurrence, pulmonary metastasis or death of disease. Revisions were indicated in 9 patients (36.0%) in group P and 5 (31.25%) in group B. Thought the incidence of revisions was higher in group P, there was no significant difference in these two groups. The Kaplan-Meier 5-year implant survival estimates, with revision for any reason as the end point, were 80.6% and 68.8% for group P and group B, respectively. The mean MSTS Score was 63.6% in group P and 63.0% in group B. These differences were not statistically significant. Conclusions: The study could show that prosthetic reconstruction and reconstruction with recycled pasteurized autograft are similar in terms of their local recurrence and metastasis, while the incidence of revisions was higher for patients with prosthetic reconstruction.

In this study, we have utilized glioma patients along with two unique murine glioma models: RCAS glioma model and Gl261 model to study various lineages of BMDCs during different stages of glial tumors. Importantly, we identified the unique the population VEGFR2+MDSCs in both patients and mice, which might be used as a surrogate marker for glioma diagnosis and prognosis in future. We have validated the changes of myeloid lineage and endothelial lineages during the progression of gliomas, and We observed bone marrow derived mesenchymal stem cells have only minimal effort on tumor progression. We have created inducible VEGFR2 knockout system in RCAS-tva model. We demonstrated that bone marrow derived VEGFR2 signaling plays an important role in myeloid differentiation, and infiltration into tumor tissues. Deficiency of VEGFR2 in BMDCs led to impairment of tumor associated myeloid cells and delayed progression of low-grade glioma. Primary tumor up-regulates VEGFR2 in BMDCs through ID2/E2A pathway. All of these findings may have implications to suppress the switch of low-grade to high-grade transformation, and predict the long-term survival.

In this study, we have utilized glioma patients along with two unique murine glioma models: RCAS glioma model and Gl261 model to study various lineages of BMDCs during different stages of glial tumors. Importantly, we identified the unique the population VEGFR2+MDSCs in both patients and mice, which might be used as a surrogate marker for glioma diagnosis and prognosis in future. We have validated the changes of myeloid lineage and endothelial lineages during the progression of gliomas, and We observed bone marrow derived mesenchymal stem cells have only minimal effort on tumor progression. We have created inducible VEGFR2 knockout system in RCAS-tva model. We demonstrated that bone marrow derived VEGFR2 signaling plays an important role in myeloid differentiation, and infiltration into tumor tissues. Deficiency of VEGFR2 in BMDCs led to impairment of tumor associated myeloid cells and delayed progression of low-grade glioma. Primary tumor up-regulates VEGFR2 in BMDCs through ID2/E2A pathway. All of these findings may have implications to suppress the switch of low-grade to high-grade transformation, and predict the long-term survival.

In this study, we have utilized glioma patients along with two unique murine glioma models: RCAS glioma model and Gl261 model to study various lineages of BMDCs during different stages of glial tumors. Importantly, we identified the unique the population VEGFR2+MDSCs in both patients and mice, which might be used as a surrogate marker for glioma diagnosis and prognosis in future. We have validated the changes of myeloid lineage and endothelial lineages during the progression of gliomas, and We observed bone marrow derived mesenchymal stem cells have only minimal effort on tumor progression. We have created inducible VEGFR2 knockout system in RCAS-tva model. We demonstrated that bone marrow derived VEGFR2 signaling plays an important role in myeloid differentiation, and infiltration into tumor tissues. Deficiency of VEGFR2 in BMDCs led to impairment of tumor associated myeloid cells and delayed progression of low-grade glioma. Primary tumor up-regulates VEGFR2 in BMDCs through ID2/E2A pathway. All of these findings may have implications to suppress the switch of low-grade to high-grade transformation, and predict the long-term survival.

The advancements in surgical techniques and the integration of adjuvant chemotherapy have significantly prolonged the survival rates of patients with bone and soft tissue tumors. However, the symptoms associated with the disease and its treatment continue to impose substantial challenges on patients, their families, and healthcare providers. The Symptom Management Model (SMM) has become a prevalent framework in the management of cancer-related symptoms. This model encompasses symptom experience, symptom management strategies, and outcomes, offering a structured approach to guide symptom assessment, intervention, and evaluation. At present, studies related to the symptom management of bone and soft tissue tumors are increasing, but there is a large heterogeneity between the studies. A scoping review is a rigorous method to understand the landscape of current research to understand the range of evidence available. To provide a basis for clinical symptom management, this review aims to explore the symptom experience, symptom management strategies, and outcomes of patients with bone and soft tissue tumors within the context of the SMM. The scoping review reporting framework of Arksey and O`Malley guided this review and we will determine the inclusion and exclusion criteria by Population, Concept, and Context (PCC) principles. We will search the PubMed, Embase, Cochrane Library, CINAHL, CNKI, WANFANG DATA, and SinoMed databases.

The advancements in surgical techniques and the integration of adjuvant chemotherapy have significantly prolonged the survival rates of patients with bone and soft tissue tumors. However, the symptoms associated with the disease and its treatment continue to impose substantial challenges on patients, their families, and healthcare providers. The Symptom Management Model (SMM) has become a prevalent framework in the management of cancer-related symptoms. This model encompasses symptom experience, symptom management strategies, and outcomes, offering a structured approach to guide symptom assessment, intervention, and evaluation. At present, studies related to the symptom management of bone and soft tissue tumors are increasing, but there is a large heterogeneity between the studies. A scoping review is a rigorous method to understand the landscape of current research to understand the range of evidence available. To provide a basis for clinical symptom management, this review aims to explore the symptom experience, symptom management strategies, and outcomes of patients with bone and soft tissue tumors within the context of the SMM. The scoping review reporting framework of Arksey and O`Malley guided this review and we will determine the inclusion and exclusion criteria by Population, Concept, and Context (PCC) principles. We will search the PubMed, Embase, Cochrane Library, CINAHL, CNKI, WANFANG DATA, and SinoMed databases.

This article is from World Journal of Surgical Oncology , volume 11 . Abstract Background: The clinical symptoms and radiographic appearance of osteomyelitis can mimic those of bone tumors. Methods: We reviewed 10 patients with osteomyelitis of the femur who were initially diagnosed as having bone tumors and were subsequently transferred to our institution. Results: Nocturnal pain of moderate intensity occurred in seven patients, and all 10 patients had elevated C-reactive protein levels. The radiographic findings included the following: a permeative, moth-eaten osteolytic lesion in six patients, an osteolytic lesion with sclerotic borders in three patients, and cortical destruction with pathological fracture in one patient. Magnetic resonance imaging was performed for eight patients, and only one had a positive penumbra sign. All patients underwent a surgical biopsy to confirm the final diagnosis for histological analysis and cultures. Klebsiella pneumoniae was detected in six patients and Staphylococcus aureus, the most common organism in osteomyelitis, was detected in three. Recurrence of infection occurred in five patients following debridement surgery; of these three had a Klebsiella pneumoniae infection. All patients received antibiotic treatment for an average of 20.4 weeks (range, 4 to 44) and surgical treatment an average of 1.8 times (range, 1 to 4). At the final follow-up, all patients were fully recovered with no signs of infection. Conclusions: When used in combination, clinical examinations, laboratory data, and radiographic findings can reliably distinguishing osteomyelitis from bone tumors.

This article is from World Journal of Surgical Oncology , volume 11 . Abstract Background: The clinical symptoms and radiographic appearance of osteomyelitis can mimic those of bone tumors. Methods: We reviewed 10 patients with osteomyelitis of the femur who were initially diagnosed as having bone tumors and were subsequently transferred to our institution. Results: Nocturnal pain of moderate intensity occurred in seven patients, and all 10 patients had elevated C-reactive protein levels. The radiographic findings included the following: a permeative, moth-eaten osteolytic lesion in six patients, an osteolytic lesion with sclerotic borders in three patients, and cortical destruction with pathological fracture in one patient. Magnetic resonance imaging was performed for eight patients, and only one had a positive penumbra sign. All patients underwent a surgical biopsy to confirm the final diagnosis for histological analysis and cultures. Klebsiella pneumoniae was detected in six patients and Staphylococcus aureus, the most common organism in osteomyelitis, was detected in three. Recurrence of infection occurred in five patients following debridement surgery; of these three had a Klebsiella pneumoniae infection. All patients received antibiotic treatment for an average of 20.4 weeks (range, 4 to 44) and surgical treatment an average of 1.8 times (range, 1 to 4). At the final follow-up, all patients were fully recovered with no signs of infection. Conclusions: When used in combination, clinical examinations, laboratory data, and radiographic findings can reliably distinguishing osteomyelitis from bone tumors.

This article is from World Journal of Surgical Oncology , volume 11 . Abstract Background: The clinical symptoms and radiographic appearance of osteomyelitis can mimic those of bone tumors. Methods: We reviewed 10 patients with osteomyelitis of the femur who were initially diagnosed as having bone tumors and were subsequently transferred to our institution. Results: Nocturnal pain of moderate intensity occurred in seven patients, and all 10 patients had elevated C-reactive protein levels. The radiographic findings included the following: a permeative, moth-eaten osteolytic lesion in six patients, an osteolytic lesion with sclerotic borders in three patients, and cortical destruction with pathological fracture in one patient. Magnetic resonance imaging was performed for eight patients, and only one had a positive penumbra sign. All patients underwent a surgical biopsy to confirm the final diagnosis for histological analysis and cultures. Klebsiella pneumoniae was detected in six patients and Staphylococcus aureus, the most common organism in osteomyelitis, was detected in three. Recurrence of infection occurred in five patients following debridement surgery; of these three had a Klebsiella pneumoniae infection. All patients received antibiotic treatment for an average of 20.4 weeks (range, 4 to 44) and surgical treatment an average of 1.8 times (range, 1 to 4). At the final follow-up, all patients were fully recovered with no signs of infection. Conclusions: When used in combination, clinical examinations, laboratory data, and radiographic findings can reliably distinguishing osteomyelitis from bone tumors.

This article is from World Journal of Surgical Oncology , volume 11 . Abstract Background: The clinical symptoms and radiographic appearance of osteomyelitis can mimic those of bone tumors. Methods: We reviewed 10 patients with osteomyelitis of the femur who were initially diagnosed as having bone tumors and were subsequently transferred to our institution. Results: Nocturnal pain of moderate intensity occurred in seven patients, and all 10 patients had elevated C-reactive protein levels. The radiographic findings included the following: a permeative, moth-eaten osteolytic lesion in six patients, an osteolytic lesion with sclerotic borders in three patients, and cortical destruction with pathological fracture in one patient. Magnetic resonance imaging was performed for eight patients, and only one had a positive penumbra sign. All patients underwent a surgical biopsy to confirm the final diagnosis for histological analysis and cultures. Klebsiella pneumoniae was detected in six patients and Staphylococcus aureus, the most common organism in osteomyelitis, was detected in three. Recurrence of infection occurred in five patients following debridement surgery; of these three had a Klebsiella pneumoniae infection. All patients received antibiotic treatment for an average of 20.4 weeks (range, 4 to 44) and surgical treatment an average of 1.8 times (range, 1 to 4). At the final follow-up, all patients were fully recovered with no signs of infection. Conclusions: When used in combination, clinical examinations, laboratory data, and radiographic findings can reliably distinguishing osteomyelitis from bone tumors.

This article is from Indian Journal of Orthopaedics , volume 46 . Abstract Background:: The extent of tumor may necessitate resection of the complete femur rarely to achieve adequate oncologic clearance in bone sarcomas. We present our experience with reconstruction in such cases using an indigenously manufactured, low-cost, total femoral prosthesis (TFP). We assessed the complications of the procedure, the oncologic and functional outcomes, and implant survival. Materials and Methods:: Eight patients (four males and four females) with a mean age of 32 years, operated between December 2003 and June 2009, had a TFP implanted. The diagnosis included osteogenic sarcoma (5), Ewing's sarcoma (1), and chondrosarcoma (2). Mean followup was 33 months (9–72 months) for all and 40 months (24–72 months) in survivors. They were evaluated by Musculoskeletal Tumor Society score, implant survival as well as patient survival. Results:: There was one local recurrence and five of seven patients are currently alive at the time of last followup. The Musculoskeletal Tumor Society score for patients ranged from 21 to 25 with a mean of 24 (80%). The implant survival was 88% at 5 years with only one TFP needing removal because of infection. Conclusions:: A TFP in appropriately indicated patients with malignant bone tumors is oncologically safe. A locally manufactured, cost-effective implant provided consistent and predictable results after excision of the total femur with good functional outcomes.

This article is from Indian Journal of Orthopaedics , volume 46 . Abstract Background:: The extent of tumor may necessitate resection of the complete femur rarely to achieve adequate oncologic clearance in bone sarcomas. We present our experience with reconstruction in such cases using an indigenously manufactured, low-cost, total femoral prosthesis (TFP). We assessed the complications of the procedure, the oncologic and functional outcomes, and implant survival. Materials and Methods:: Eight patients (four males and four females) with a mean age of 32 years, operated between December 2003 and June 2009, had a TFP implanted. The diagnosis included osteogenic sarcoma (5), Ewing's sarcoma (1), and chondrosarcoma (2). Mean followup was 33 months (9–72 months) for all and 40 months (24–72 months) in survivors. They were evaluated by Musculoskeletal Tumor Society score, implant survival as well as patient survival. Results:: There was one local recurrence and five of seven patients are currently alive at the time of last followup. The Musculoskeletal Tumor Society score for patients ranged from 21 to 25 with a mean of 24 (80%). The implant survival was 88% at 5 years with only one TFP needing removal because of infection. Conclusions:: A TFP in appropriately indicated patients with malignant bone tumors is oncologically safe. A locally manufactured, cost-effective implant provided consistent and predictable results after excision of the total femur with good functional outcomes.

This article is from Indian Journal of Orthopaedics , volume 46 . Abstract Background:: The extent of tumor may necessitate resection of the complete femur rarely to achieve adequate oncologic clearance in bone sarcomas. We present our experience with reconstruction in such cases using an indigenously manufactured, low-cost, total femoral prosthesis (TFP). We assessed the complications of the procedure, the oncologic and functional outcomes, and implant survival. Materials and Methods:: Eight patients (four males and four females) with a mean age of 32 years, operated between December 2003 and June 2009, had a TFP implanted. The diagnosis included osteogenic sarcoma (5), Ewing's sarcoma (1), and chondrosarcoma (2). Mean followup was 33 months (9–72 months) for all and 40 months (24–72 months) in survivors. They were evaluated by Musculoskeletal Tumor Society score, implant survival as well as patient survival. Results:: There was one local recurrence and five of seven patients are currently alive at the time of last followup. The Musculoskeletal Tumor Society score for patients ranged from 21 to 25 with a mean of 24 (80%). The implant survival was 88% at 5 years with only one TFP needing removal because of infection. Conclusions:: A TFP in appropriately indicated patients with malignant bone tumors is oncologically safe. A locally manufactured, cost-effective implant provided consistent and predictable results after excision of the total femur with good functional outcomes.

This article is from Indian Journal of Orthopaedics , volume 46 . Abstract Background:: The extent of tumor may necessitate resection of the complete femur rarely to achieve adequate oncologic clearance in bone sarcomas. We present our experience with reconstruction in such cases using an indigenously manufactured, low-cost, total femoral prosthesis (TFP). We assessed the complications of the procedure, the oncologic and functional outcomes, and implant survival. Materials and Methods:: Eight patients (four males and four females) with a mean age of 32 years, operated between December 2003 and June 2009, had a TFP implanted. The diagnosis included osteogenic sarcoma (5), Ewing's sarcoma (1), and chondrosarcoma (2). Mean followup was 33 months (9–72 months) for all and 40 months (24–72 months) in survivors. They were evaluated by Musculoskeletal Tumor Society score, implant survival as well as patient survival. Results:: There was one local recurrence and five of seven patients are currently alive at the time of last followup. The Musculoskeletal Tumor Society score for patients ranged from 21 to 25 with a mean of 24 (80%). The implant survival was 88% at 5 years with only one TFP needing removal because of infection. Conclusions:: A TFP in appropriately indicated patients with malignant bone tumors is oncologically safe. A locally manufactured, cost-effective implant provided consistent and predictable results after excision of the total femur with good functional outcomes.

A clinically relevant syngeneic model of breast cancer metastasis has been used to determine gene expression alterations that occur both between primary breast cancers with varying metastatic potential and between matched primary and bone metastases. We have immunopurified epithelial and endothelial cell populations and profiled them separately to identify differentially expressed genes, some of which have not previously been associated with breast cancer metastasis. Expression profiles of vascular endothelium derived from primary tumors of varying metastatic potential identified aberrant expression of genes involved in angiogenesis, cell cycle progression, cytoskeletal structure and tumor suppression. Those altered in the primary tumor epithelium included developmental genes, metastasis suppressors and genes involved in cytoskeletal organization, cell cycle progression, apoptosis and transformation. The microarray data was confirmed by quantitative RT-QPCR. Further analysis of epithelium from matched spine metastases revealed some genes that were upregulated further at the metastatic site. These included stefin Al (inhibitor of cathepsin S) that was upregulated in highly metastatic primary epithelium and increased a further 9-fold in matched bone metastases. The expression in spine metastases was verified by in situ hybridization whilst the expression of stefin Al in subsets of tumor cells in invasive human breast cancer was confirmed by immunohistochemistry.

This article is from Indian Journal of Medical and Paediatric Oncology : Official Journal of Indian Society of Medical & Paediatric Oncology , volume 32 . Abstract Background:: Bone tumors remain a daunting challenge to orthopedic surgeons. The challenge is heightened in developing countries due to limited diagnostic and therapeutic facilities as well as due to ignorance. The published literature on this subject is sparse in our environment. Objective:: To determine the pattern of bone tumors including their relative frequencies, age and sex distributions, anatomical sites of occurrence and clinico-pathological characteristics as seen in a tertiary care hospital of south India. Materials and Methods:: This is a retrospective review of all the histologically confirmed bone tumors seen at JSS Medical College and Hospital, Mysore over an 8 year period: 2002 to 2009. Results:: A total of 117 patients (aged 5 to 82 years) with a mean of age of 26.87 years were studied. Seventy-six patients (64.96%) were males and 41 (35.04%) were females. The peak age incidence for primary bone tumors was in the age group of 11-20 years and that for metastatic bone tumors was more than 60 years. Sixty-seven (57.26%) of the tumors were benign. Among these, osteochondroma was the most common, accounting for 26 cases (22.22%) followed by Giant cell tumor (24 cases, 20.51%). Osteosarcoma accounted for 35.14% (13 cases) of all the primary malignant tumors in the study. Lower end of femur was the most common site for primary bone tumors and accounted for 30 cases (25.64%) followed by upper end of tibia and fibula (24 cases, 20.51%). The most common site for metastatic bone tumors was upper end of femur including hip joint followed by spine. Conclusion:: This study showed that primary bone tumors are mainly benign, occurred predominantly in the second decade of life with a male preponderance. Osteochondroma and osteosarcoma are the most common benign and primary malignant bone tumors, respectively. The most common primary foci for metastatic bone tumor are from the respiratory tract.

This article is from Indian Journal of Nuclear Medicine : IJNM : The Official Journal of the Society of Nuclear Medicine, India , volume 29 . Abstract Aim:: The aim of this study is to evaluate the role of 68Ga-DOTATATE positron emission tomography/computed tomography (PET/CT) scan for the detection of bone metastases in pediatric neuroendocrine tumors (NETs) and to compare it with CT scan. Materials and Methods:: A total of 30 patients (18 were males and 12 were females; age range: 1-18 years; mean age 7.6 years) with histologically confirmed NETs referred to our department were retrospectively analyzed. All patients underwent 68Ga-DOTATATE PET/CT scan at the time of diagnosis for primary staging. Contrast enhanced CT (CECT) performed at the time of PET scan acquisition was used for comparison with PET data. Imaging results were analyzed on a per-patient and on a per-lesion basis. Clinical follow-up of all patients and repeat PET/CT imaging (n = 10) was taken as the reference standard. Results:: Out of the 30 patients, 17 had no evidence of bone metastases on any imaging modality or on clinical follow-up while the rest of 13 patients showed evidence of bone metastases (nine showing positivity both on 68Ga-DOTATATE PET and CT scan while four showing positivity only on 68Ga-DOTATATE PET). Compared with CT scan, 68Ga-DOTATATE PET detected bone metastases at a significantly higher rate (P = 0.0039). On a per lesion analysis, out of a total of 225 lesions detected by 68Ga-DOTATATE PET, only 84 lesions could be detected by CT scan. Conclusion:: 68Ga-DOTATATE PET/CT scan is more useful than CECT scan for the early detection of bone metastases in pediatric NETs.

This article is from Indian Journal of Nuclear Medicine : IJNM : The Official Journal of the Society of Nuclear Medicine, India , volume 29 . Abstract Aim:: The aim of this study is to evaluate the role of 68Ga-DOTATATE positron emission tomography/computed tomography (PET/CT) scan for the detection of bone metastases in pediatric neuroendocrine tumors (NETs) and to compare it with CT scan. Materials and Methods:: A total of 30 patients (18 were males and 12 were females; age range: 1-18 years; mean age 7.6 years) with histologically confirmed NETs referred to our department were retrospectively analyzed. All patients underwent 68Ga-DOTATATE PET/CT scan at the time of diagnosis for primary staging. Contrast enhanced CT (CECT) performed at the time of PET scan acquisition was used for comparison with PET data. Imaging results were analyzed on a per-patient and on a per-lesion basis. Clinical follow-up of all patients and repeat PET/CT imaging (n = 10) was taken as the reference standard. Results:: Out of the 30 patients, 17 had no evidence of bone metastases on any imaging modality or on clinical follow-up while the rest of 13 patients showed evidence of bone metastases (nine showing positivity both on 68Ga-DOTATATE PET and CT scan while four showing positivity only on 68Ga-DOTATATE PET). Compared with CT scan, 68Ga-DOTATATE PET detected bone metastases at a significantly higher rate (P = 0.0039). On a per lesion analysis, out of a total of 225 lesions detected by 68Ga-DOTATATE PET, only 84 lesions could be detected by CT scan. Conclusion:: 68Ga-DOTATATE PET/CT scan is more useful than CECT scan for the early detection of bone metastases in pediatric NETs.

Includes bibliographies and index

Includes bibliographical references and index

Includes bibliographical references and index

.

In this study, we have utilized glioma patients along with two unique murine glioma models: RCAS glioma model and Gl261 model to study various lineages of BMDCs during different stages of glial tumors. Importantly, we identified the unique the population VEGFR2+MDSCs in both patients and mice, which might be used as a surrogate marker for glioma diagnosis and prognosis in future. We have validated the changes of myeloid lineage and endothelial lineages during the progression of gliomas, and We observed the increased population of myeloid derived suppressor cells and endothelial progenitor cells in murine glioma models. We have created inducible VEGFR2 knockout system in glioma bearing mice. Taking advantage of this transgenetic model, we demonstrated that bone marrow derived VEGFR2 signaling plays an important role in myeloid differentiation, and infiltration into tumor tissues. Deficiency of VEGFR2 in BMDCs led to impairment of tumor associated myeloid cells and delayed progression of low-grade glioma. All of these findings may have implications to suppress the switch of low-grade to high-grade transformation, and predict the long-term survival.

In this study, we have utilized glioma patients along with two unique murine glioma models: RCAS glioma model and Gl261 model to study various lineages of BMDCs during different stages of glial tumors. Importantly, we identified the unique the population VEGFR2+MDSCs in both patients and mice, which might be used as a surrogate marker for glioma diagnosis and prognosis in future. We have validated the changes of myeloid lineage and endothelial lineages during the progression of gliomas, and We observed the increased population of myeloid derived suppressor cells and endothelial progenitor cells in murine glioma models. We have created inducible VEGFR2 knockout system in glioma bearing mice. Taking advantage of this transgenetic model, we demonstrated that bone marrow derived VEGFR2 signaling plays an important role in myeloid differentiation, and infiltration into tumor tissues. Deficiency of VEGFR2 in BMDCs led to impairment of tumor associated myeloid cells and delayed progression of low-grade glioma. All of these findings may have implications to suppress the switch of low-grade to high-grade transformation, and predict the long-term survival.

Tumor progression and metastasis is mediated not only by tumor cells but by the surrounding stroma as well, including the vascular endothelium. Knowledge of the molecular and cellular interactions that promote metastasis is required to determine prognostic markers and therapeutic targets for metastatic breast cancer. A clinically relevant syngeneic model of breast cancer metastasis has been used to determine gene expression alterations that occur in both tumor epithelial cells and the associated vascular endothelium throughout metastatic progression. Expression profiles of immunopurified cell populations derived from primary tumors of varying metastatic potential have identified aberrant gene expression in endothelial (Cathepsin D, SNAIL and FoxPI) and tumor/epithelial (Stefin A1 and Breast Cancer Metastasis Suppressor gene 1, BRMS1) cells. Analysis of matched primary tumors and spine metastases revealed the additional up-regulation of the cathepsin inhibitor Stefin Al at sites of distant metastasis, including lung and bone. Further, we have preliminary evidence of prognostic significance of Stefin A expression in primary human breast tumors, with a significant increase in Stefin A positivity in tumors derived from patients that developed soft tissue and bone metastases (N=24). In a small study, human breast cancer bone metastases were positive for Stefin A, indicating the clinical validity of the murine model and the potential significance of Stefin A in bone metastasis. In co-cultures, Stefin Al expression is induced in vitro in highly metastatic cells when co-cultured with stroma. The role of cathepsins and the inhibitor Stefin A1 in breast cancer metastasis are under investigation by examining the effect of stefin A over-expression on metastasis and the associated role of the cathepsins.

Book Source: Digital Library of India Item 2015.552884 dc.contributor.author: Dahlin, David C. dc.date.accessioned: 2015-10-14T22:24:24Z dc.date.available: 2015-10-14T22:24:24Z dc.date.copyright: 1957 dc.date.digitalpublicationdate: 2011/03 dc.date.citation: 1957 dc.identifier.barcode: 99999990042015 dc.identifier.origpath: /data8/upload/0239/298 dc.identifier.copyno: 1 dc.identifier.uri: http://www.new.dli.ernet.in/handle/2015/552884 dc.description.scannerno: Banasthali University dc.description.scanningcentre: Banasthali University dc.description.main: 1 dc.description.tagged: 0 dc.description.totalpages: 218 dc.format.mimetype: application/pdf dc.language.iso: Sanskrit dc.publisher.digitalrepublisher: Digital Library of India dc.publisher: U. S. A., Charles C Thomas dc.rights: Copyright permitted dc.source.library: Dr. Robert Heiling Library, S.m.s.medical College, Jaipur dc.subject.classification: Medical dc.title: Bone Tumors dc.type: Print - Paper dc.type: Book

The Royal College of Surgeons of England

The Royal College of Surgeons of England

The Royal College of Surgeons of England

Aim: The aim of this study is to analyze the results of surgical treatment of patients with giant cell tumor in the distal radius according to the Campanacci grade. Material and Method: The data of 20 patients with giant cell tumor localized in the distal radius were analyzed retrospectively. 5 patients were Campanacci grade I, 13 patients were grade II and 2 patients were grade III. Patients with Grade I and II lesions underwent intralesional curettage + adjuvant treatments. Patients with Grade III underwent en bloc resection + reconstruction. Results: The mean age of 6 male and 14 female patients was 28.6 years. Recurrence developed in a total of 7 (35%) patients after the surgery in approximately 9 months. Post-operative complications developed in 2 patients (10%). There was no significant difference between the surgical approaches performed according to the tumor grade. Discussion: Intralesional curettage treatment is recommended for Campanacci grade I tumors and en bloc resection is recommended for grade II and III tumors.

Aim: The aim of this study is to analyze the results of surgical treatment of patients with giant cell tumor in the distal radius according to the Campanacci grade. Material and Method: The data of 20 patients with giant cell tumor localized in the distal radius were analyzed retrospectively. 5 patients were Campanacci grade I, 13 patients were grade II and 2 patients were grade III. Patients with Grade I and II lesions underwent intralesional curettage + adjuvant treatments. Patients with Grade III underwent en bloc resection + reconstruction. Results: The mean age of 6 male and 14 female patients was 28.6 years. Recurrence developed in a total of 7 (35%) patients after the surgery in approximately 9 months. Post-operative complications developed in 2 patients (10%). There was no significant difference between the surgical approaches performed according to the tumor grade. Discussion: Intralesional curettage treatment is recommended for Campanacci grade I tumors and en bloc resection is recommended for grade II and III tumors.

Purpose: The gold standard treatment for primary bone sarcoma is limb saving (salvage) procedure in the indicated case. Today, limb saving surgery is considered safe and routine for approximately 90 % of patients with malignant bone tumours involving extremity. In our retrospective study of 40 patients having malignant bone tumour treated by limb salvage and mega prosthesis replacement of different regions like proximal humerus, proximal femur, distal femur, proximal tibia, we have studied mid and long term follow-ups in terms of life expectancy (survival), recurrence, implant-related complications, and functional outcome.

Purpose: The gold standard treatment for primary bone sarcoma is limb saving (salvage) procedure in the indicated case. Today, limb saving surgery is considered safe and routine for approximately 90 % of patients with malignant bone tumours involving extremity. In our retrospective study of 40 patients having malignant bone tumour treated by limb salvage and mega prosthesis replacement of different regions like proximal humerus, proximal femur, distal femur, proximal tibia, we have studied mid and long term follow-ups in terms of life expectancy (survival), recurrence, implant-related complications, and functional outcome.

Purpose: The gold standard treatment for primary bone sarcoma is limb saving (salvage) procedure in the indicated case. Today, limb saving surgery is considered safe and routine for approximately 90 % of patients with malignant bone tumours involving extremity. In our retrospective study of 40 patients having malignant bone tumour treated by limb salvage and mega prosthesis replacement of different regions like proximal humerus, proximal femur, distal femur, proximal tibia, we have studied mid and long term follow-ups in terms of life expectancy (survival), recurrence, implant-related complications, and functional outcome.

In this study, we have utilized glioma patients along with two unique murine glioma models: RCAS glioma model and Gl261 model to study various lineages of BMDCs during different stages of glial tumors. Importantly, we identified the unique the population VEGFR2+MDSCs in both patients and mice, which might be used as a surrogate marker for glioma diagnosis and prognosis in future. We have validated the changes of myeloid lineage and endothelial lineages during the progression of gliomas, and We observed bone marrow derived mesenchymal stem cells have only minimal effort on tumor progression. We have created inducible VEGFR2knockout system in RCAS-tva model. We demonstrated that bone marrow derived VEGFR2 signaling plays an important role in myeloid differentiation, and infiltration into tumor tissues. Deficiency of VEGFR2 in BMDCs led to impairment of tumor associated myeloid cells and delayed progression of low-grade glioma. Primary tumor up-regulates VEGFR2 in myeoloid cells throughID2/E2A pathway. This work has shown the importance of myeloid derived ID2/VEGFR2 signaling in low-grade to high-grade glioma transformation.

In this study, we have utilized glioma patients along with two unique murine glioma models: RCAS glioma model and Gl261 model to study various lineages of BMDCs during different stages of glial tumors. Importantly, we identified the unique the population VEGFR2+MDSCs in both patients and mice, which might be used as a surrogate marker for glioma diagnosis and prognosis in future. We have validated the changes of myeloid lineage and endothelial lineages during the progression of gliomas, and We observed bone marrow derived mesenchymal stem cells have only minimal effort on tumor progression. We have created inducible VEGFR2knockout system in RCAS-tva model. We demonstrated that bone marrow derived VEGFR2 signaling plays an important role in myeloid differentiation, and infiltration into tumor tissues. Deficiency of VEGFR2 in BMDCs led to impairment of tumor associated myeloid cells and delayed progression of low-grade glioma. Primary tumor up-regulates VEGFR2 in myeoloid cells throughID2/E2A pathway. This work has shown the importance of myeloid derived ID2/VEGFR2 signaling in low-grade to high-grade glioma transformation.

This article is from BMC Cancer , volume 13 . Abstract Background: Neural-cadherin (N-cadherin) is one of the most important molecules involved in tissue morphogenesis, wound healing, and the maintenance of tissue integrity. Recently, the cleavage of N-cadherin has become a focus of attention in the field of cancer biology. Cadherin and their ectodomain proteolytic shedding play important roles during cancer progression. The aims of this study are to investigate the serum soluble N-cadherin (sN-CAD) levels in patients with malignant bone and soft tissue tumors, and to evaluate the prognostic significance of the sN-CAD levels. Methods: We examined the level of serum sN-CAD using an ELISA in 80 malignant bone and soft tissue tumors (bone sarcoma, n = 23; soft tissue sarcoma, n = 50; metastatic cancer, n = 7) and 87 normal controls. The mean age of the patients was 51 years (range, 10–85 years) and the mean follow-up period was 43 months (range, 1–115 months). Results: The median serum sN-CAD level was 1,267 ng/ml (range, 135–2,860 ng/ml) in all patients. The mean serum sN-CAD level was 1,269 ng/ml (range, 360–2,860 ng/ml) in sarcoma patients, otherwise 1,246 ng/ml (range, 135–2,140 ng/ml) in cancer patients. The sN-CAD levels in patient were higher than those found in the controls, who had a median serum level of 108 ng/ml (range, 0–540 ng/ml). The patients with tumors larger than 5 cm had higher serum sN-CAD levels than the patients with tumors smaller than 5 cm. The histological grade in the patients with higher serum sN-CAD levels was higher than that in the patients with lower serum sN-CAD levels. A univariate analysis demonstrated that the patients with higher serum sN-CAD levels showed a worse disease-free survival rate, local recurrence-free survival rate, metastasis-free survival rate, and overall survival rate compared to those with lower serum sN-CAD levels. In the multivariate analysis, sN-CAD was an independent factor predicting disease-free survival. Conclusions: sN-CAD is a biomarker for malignant bone and soft tissue tumors, and a potentially valuable pre-therapeutic prognostic factor in patients with bone and soft tissue sarcoma.

This article is from BMC Cancer , volume 13 . Abstract Background: Neural-cadherin (N-cadherin) is one of the most important molecules involved in tissue morphogenesis, wound healing, and the maintenance of tissue integrity. Recently, the cleavage of N-cadherin has become a focus of attention in the field of cancer biology. Cadherin and their ectodomain proteolytic shedding play important roles during cancer progression. The aims of this study are to investigate the serum soluble N-cadherin (sN-CAD) levels in patients with malignant bone and soft tissue tumors, and to evaluate the prognostic significance of the sN-CAD levels. Methods: We examined the level of serum sN-CAD using an ELISA in 80 malignant bone and soft tissue tumors (bone sarcoma, n = 23; soft tissue sarcoma, n = 50; metastatic cancer, n = 7) and 87 normal controls. The mean age of the patients was 51 years (range, 10–85 years) and the mean follow-up period was 43 months (range, 1–115 months). Results: The median serum sN-CAD level was 1,267 ng/ml (range, 135–2,860 ng/ml) in all patients. The mean serum sN-CAD level was 1,269 ng/ml (range, 360–2,860 ng/ml) in sarcoma patients, otherwise 1,246 ng/ml (range, 135–2,140 ng/ml) in cancer patients. The sN-CAD levels in patient were higher than those found in the controls, who had a median serum level of 108 ng/ml (range, 0–540 ng/ml). The patients with tumors larger than 5 cm had higher serum sN-CAD levels than the patients with tumors smaller than 5 cm. The histological grade in the patients with higher serum sN-CAD levels was higher than that in the patients with lower serum sN-CAD levels. A univariate analysis demonstrated that the patients with higher serum sN-CAD levels showed a worse disease-free survival rate, local recurrence-free survival rate, metastasis-free survival rate, and overall survival rate compared to those with lower serum sN-CAD levels. In the multivariate analysis, sN-CAD was an independent factor predicting disease-free survival. Conclusions: sN-CAD is a biomarker for malignant bone and soft tissue tumors, and a potentially valuable pre-therapeutic prognostic factor in patients with bone and soft tissue sarcoma.