Gilberto Morgan-Villela

Alpha 1‐antitrypsin: A novel tumor‐associated antigen identified in patients with early‐stage breast cancer

Several studies have demonstrated that sera from patients with cancer contain antibodies that recognize a unique group of autologous antigens called tumor‐associated antigens (TAA). In the current study, we employed an immunoproteomic approach, combining 2DE, Western blot, and MALDI‐MS to identify TAA in the sera of patients diagnosed with infiltrating ductal or in situ carcinoma breast cancer. Sera obtained from 25 newly diagnosed patients with stage II breast cancer and 20 healthy volunteers was evaluated for the presence of novel TAA. Alpha 1‐antitrypsin (A1AT) antibodies were detected in 24 of 25 patients with breast cancer (96%) and in 2 of 20 controls (10%). Sensitivity of detection of autoantibodies against A1AT in patients with breast cancer was 96%. Our preliminary results suggest that A1AT and autoantibodies against alpha 1 antitrypsin may be useful serum biomarkers for early‐stage breast cancer screening and diagnosis.

CYP1A1 *2B and *4 polymorphisms are associated with lung cancer susceptibility in Mexican patients

BACKGROUND CYP1A1 is a gene involved in the high aryl hydrocarbon hydroxylase -inducible phenotype, which is a genetically-determined variation among individuals that has been associated with lung cancer risk. More specifically, CYP1A1 *2B and *4 polymorphisms have been associated with high susceptibility to lung cancer among cigarette smokers. MATERIALS AND METHODS DNA was obtained from blood samples and we studied by PCR-RFLP the distribution of CYP1A1 *2B (n=248) and *4 (n=222) polymorphisms in healthy controls and 222 lung cancer patients from a Mexican population. RESULTS Comparisons between groups showed an increased risk for lung cancer patients of *2B/*2B (18%; OR 7.6; 95% CI 3.0-19.2) and *4/ *4 genotypes (15%; OR 11.45; 95% CI 2.19-59.85) compared to the control group (1% for *2B/ *2B and 4.4% for *4/ *4). A significant association between lung cancer and homozygous *2B/ *2B passive smokers and *4/*4 ever (cigarettes) and passive smokers was also observed (p<0.05). Multivariate analysis revealed an increased risk for the *2B/*2B genotype (OR 6.83), as well as for *4/*4 (OR 28.8). CONCLUSION The results of the study indicate a significant association between *2B/*2B and *4/*4 genotypes and the risk of developing lung cancer among Mexicans.

Calidad de Vida en Mujeres Mexicanas con Cáncer de Mama en Diferentes Etapas Clínicas y su Asociación con Características Socio-Demográficas, Estados Co-Mórbidos y Características del Proceso de Atención en el Instituto Mexicano del Seguro Social

INTRODUCTION Quality of life is the most studied PRO (patient reported outcome) in cancer patients. With early diagnosis and better treatments in breast cancer, this entity has been transformed in a chronic disease with longer survival. The joint effects of diseases and treatment on quality of life are each day more important to consider in survival patients. OBJECTIVE To evaluate quality of life, socioeconomic factors, co-morbidities, and the attendance process impact on quality of life in breast cancer women with different clinical stages attending at the Instituto Mexicano del Seguro Social using the EORCT QLQ-C30 RESULTS The scores of EORTC QLQ-C30 (v3) were: Global health status / QoL: 73.47 (± 20.81), physical functioning 76.98 (± 20.85), role functioning 76.60 (± 27.57), emotional functioning 64.53 (± 26.81), cognitive functioning 74.47 (± 26.02), social functioning 84.96 (± 23.20), fatigue 31.94 (± 25.45), nausea and vomiting 19.49 (± 26.93), pain 28.95 (± 27.27), dyspnea 15.29 (± 24.62), insomnia 35.13 (± 32.10), appetite lost 18.04 (± 28.75), 18.04 (± 28.75), constipation 19.20 (± 32.11), diarrhea 12.9 (± 24.25), financial difficulties 40.57 (± 37.26). The scores with EORTC QLQ-BR23 were: body image 74.84 (± 31.69), sexual functioning 13.73 (± 22.55), sexual enjoyment 32.86 (± 36.17), future perspectives 51.69 (± 38.00), systemic therapy side effects 30.82 (± 20.71), breast symptoms 22.85 (± 23.49), arm symptoms 27.53 (± 24.75), upset by hair loss 43.80 (± 44.01). CONCLUSIONS Clinical stage in breast cancer is associated with differences in the scores from fatigue, nausea and vomiting and financial difficulties according to the evolution of the disease and the physical detriment associated. Socio-demographic features were related role functioning, fatigue and pain in single women with higher scores.

Body weight changes after adjuvant chemotherapy of patients with breast cancer: results of a Mexican cohort study

&NA; Weight gain is observed in breast cancer patients receiving chemotherapy and is a well‐known complication. Several factors that contributing to weight gain have been identified. However, there is a lack of information about factors associated with weight changes following adjuvant chemotherapy. A retrospective cohort of 200 pre‐ and post‐menopausal Mexican patients treated for breast cancer was made. Anthropometric variables were measured before/after treatment. Biomarkers, cellular differentiation and chemotherapy were similar between groups. Weight gain occurred in 85.6% of pre‐menopausal and 72.6% of post‐menopausal women (p = .03). At the end of chemotherapy, weight and body mass index (BMI) did not differ significantly between pre‐menopausal (69.3 ± 12.6 kg; 26.6 ± 4.8 kg/m2) and post‐menopausal women (69.5 ± 10.9 kg; 27.3 ± 4.4 kg/m2) (p = .91 and 0.34). Dexamethasone doses were higher in pre‐menopausal (85.7 ± 39.1 g) than post‐menopausal patients (79.2 ± 22.5 g; p = .13). Weight loss was observed in 9.2% of pre‐menopausal and 20.2% of post‐menopausal patients (p = .04). A multivariate analysis revealed that age (OR = 2.7; 95% CI = 1.26‐5.79; p = .01), menopausal status (OR = 2.29; 95% CI = 1.09‐4.80; p = .03), dexamethasone dosage (OR = 2.1; 95% CI = 1.04‐4.23; p = .03) and daily caloric intake (OR = 2.3; 95% CI = 1.12‐5.10; p = .02) were independent variables that inducted weight gain. Pre‐ and post‐menopausal women gained weight, but more pre‐menopausal patients showed gain. An effort should be made to administer lower steroid doses to reduce weight gain.

Prevalence of the Triple-Negative Phenotype in Mexican Patients with Breast Cancer Treated in Private Practice

Background: Identifying the biological profile of breast cancer is fundamental to predict the response to various treatments and for prognosis. The aim of this study was to determine the triple-negative breast cancer prevalence in patients treated in private practice in Mexico. Methods: The study was performed using Mexican patients older than 18 years and had a histopathological diagnosis of breast adenocarcinoma and immunohistochemical studies for estrogen, progesterone, and HER2/Neu receptors, according to validated standards. Results: A total of 1,989 patients with a mean age of 52.9 ± 13.4 (23–93) years and a tumor size of 2.72 ± 1.12 cm were evaluated. The TNBC biological subtype was observed in 17.3%, HER2/Neu overexpression in 22.6%, and the presence of positive hormonal receptors (estrogen and/or progesterone) in 60.1% of the cases. An association was found between the TNBC type and the degree of differentiation (P<0.01), p53 overexpression (P<0.01, OR=1.84, 95% CI 1.35–2.52), proliferation index (P<0.01, OR=1.83, 95% CI 1.44–2.34), and tumor size (P<0.01). TNBC patients were younger (P<0.01) and lymph node involvement was more common in these patients (P<0.01, OR=4.57, 95% CI 3.53–5.90). Conclusions: TNBC is a highly aggressive tumor with a lower prevalence in women treated in private practice than in patients treated through the Seguro Popular, probably as a consequence of faster detection and opportune treatment.

Evaluación de la Calidad de Vida en Pacientes con Linfoma no Hodgkin y Cáncer Colo-Rectal en Diferentes Etapas Clínicas Atendidos en el Instituto Mexicano del Seguro Social

INTRODUCTION In Mexico during 2008, were reported 127,604 new cancer cases, 6,347 of them were colorectal cancer cases and 4,276 non-Hodgkin lymphoma (NHL) cases. OBJECTIVE To evaluate health related quality of life in non-Hodgkin lymphoma and colorectal cancer cases in different clinical stages, attended in a High Specialty Medical facility at the Instituto Mexicano del Seguro Social, during a 13 month period. RESULTS 162 patients were included, 56.8% (n=92) with NHL and 43.2% (n=70) with colorectal cancer. The scores obtained in the NHL group were: Global health status/QoL: 67.75 (± 27.55), physical functioning 69.64 (± 29.98), role functioning 71.38 (± 33.73), emotional functioning 69.7 (± 26.57), cognitive functioning 75.36 (± 28.01), social functioning 79.35 (± 29.38), fatigue 35.27 (± 28.27), nausea and vomiting 13.41 (± 21.85), pain 28.08 (± 30.25), dyspnea 19.20 (± 32.11), insomnia 30.80 (± 38.03), appetite lost 26.45 (± 36.16), constipation 19.20 (± 32.11), diarrhea 12.32 (± 26.48), financial difficulties 26.09 (± 35.57). In colorectal cancer patients the scores were: Global health status/QoL: 68.21 (± 24.46), physical functioning 67.38 (± 30.45), role functioning 65.48 (± 35.70), emotional functioning 66.43 (± 26.84), cognitive functioning 78.57 (± 26.49), social functioning 75.24 (± 31.05), fatigue 37.78 (± 31.62), nausea and vomiting 20.00 (± 28.32), pain 37.38 (± 34.45), dyspnea 11.90 (± 26.64), insomnia 28.09 (± 35.73), appetite lost 23.81 (± 36.40), constipation 19.05 (± 32.88), diarrhea 20.95 (± 31.17), financial difficulties 34.76 (± 38.67). CONCLUSIONS With these basal results is important a follow-up with special attention to the treatment and attendance processes, in patients with this neoplasms and their impact on the quality of life.