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Intratumoral heterogeneity of breast cancer remains a major challenge in successful treatment. Failure of cancer therapies can also be accredited to inability to systemically eradicate cancer stem cells (CSCs). Recent evidence points to the role of epithelial-mesenchymal transition (EMT) in expanding the pool of tumor cells with CSCs features. Thus, we assessed expression level as well as heterogeneity of CSCs markers in primary tumors (PT), lymph node metastasis (LNM), and circulating tumor cells (CTCs)–enriched blood fractions in order to correlate them with signs of EMT activation as well as clinicopathological data of breast cancer patients. Level of CSCs markers (ALDH1, CD44, CD133, OCT-4, NANOG) and EMT markers was quantified in PT (N=107), LNM (N=56), and CTCs-enriched blood fractions (N=85). Heterogeneity of CSCs markers expression within each PT and LNM was assessed by calculating Gini Index. Percentage of ALDH1-positive cells was elevated in PT in comparison to LNM (P = .005). However, heterogeneity of the four CSCs markers: ALDH1 (P = .019), CD133 (P = .009), OCT-4 (P = .027), and CD44 (P < .001) was decreased in LNM. Samples classified as mesenchymal (post-EMT) showed elevated expression of CSCs markers (OCT-4 and CD44 in PT; OCT-4 in LNM; ALDH1, OCT-4, NANOG, CD44 in CTCs). Patients with mesenchymal-like CTCs had worse prognosis than patients with epithelial-like or no CTCs (P = .0025). CSCs markers are enriched in PT, LNM, and CTCs with mesenchymal features, but their heterogeneity is decreased in metastatic lymph nodes. Mesenchymal CTCs phenotype correlates with poor prognosis of the patients.

Aim The aim of the study was to assess the watch&wait strategy for management of patients with close surgical margin after conservative parotidectomy due to early low/intermediate grade parotid carcinoma. Patients and methods Out of 78 patients operated on due to primary parotid gland cancer we selected 32 patients with a history of parotidectomy, and preservation of 7th nerve, with negative (≥1 mm), but close (≤5 mm) surgical margin and who did not receive supplementary radiotherapy due to other indications. Margins ranged from 1 to 3 mm (in 27 cases it was 1 mm, in 3 cases – 2 mm and in 2 cases – 3 mm), average 1.2 mm. The patients underwent further clinical-histological analysis. Results 3 of 32 (9.38%) patients experienced a local recurrence 36, 53 and 56 months post-surgery. The 5-year disease-free survival (DFS) was 90.6%. Recurrences were treated surgically, followed by radiotherapy, which resulted in an overall survival of 107, 104 and 104 months. One patient died 72 months after surgery due to non-oncological causes. The 10-year disease-free survival (DFS) was 96.3%. The 3 patients with recurrence of cancer had histological diagnosis of epithelial-myoepithelial carcinoma LG, with a margin of 2, 1 and 3 mm, respectively. There were no other distinctive features. Conclusion The watch&wait strategy with intensive follow-up seems justified in cases of close margin after excision of I/LG T1/T2 parotid tumors. EMC should be considered as a neoplasm associated with higher risk of recurrence.

Background There are no clinically useful biomarkers predictive of brain metastases (BM) in breast cancer. In this study, we investigated the correlation between expression of selected proteins in the primary tumor and the risk of BM in patients with metastatic breast cancer (MBC). Methods The study included 198 MBC patients (96 with and 102 without BM). Using tissue microarrays derived from the primary tumor, we assessed by immunohistochemical expression of ER, PR, HER2, Ki-67, CK5/6, EGFR, HER3, CXCR4, Rad51, E-cadherin, and claudin 3 and 4. Results Ki-67 ≥14% (hazard ratio [HR] 2.76; P P = 0.014) and ER-negativity (HR 1.72; P = 0.029) were associated with increased risk of BM in the multivariate analysis. A three-biomarker profile including ER, Ki-67 and Rad51 vs. other subtypes combined yielded an HR of 4.43 ( P Conclusions ER-negativity, cytoplasmic expression of Rad51 and high Ki-67 are associated with increased risk of BM.

Extranodal marginal zone lymphoma (EMZL, MALT lymphoma) and carcinoid are neoplasms occurring most frequently in the gastrointestinal tract and respiratory system. Although each of them occurs relatively frequently and separately, the simultaneous appearance of these two neoplasms is exceptionally rare, and only a few cases in the gastrointestinal tract have been described so far. We report a case of a 70-year-old female with the simultaneous presence of MALT lymphoma and tumorlet in the middle lobe of the right lung. To the best of our knowledge, this is the first report of such a collision tumor at the same anatomical site.

1. 1. Quails hatched from eggs incubated at physiological temperature (37.5°C—normal quails) and elevated (39.3°C—warm quails) were injected with l -thyroxine (T4) at dose 600 μg per kg of body wt, every 48 hr for 17 days. 2. 2. After last injection of hormone the total protein level in the blood plasmaa as well as activities of the following enzymes in liver homogenates were detemined: phosphoglucomutase (PGM), glucosephosphate isomerase (GPI), phosphofructokinase (PFK), aldolase (ALD) and lactate dehydrogenase (LDH). 3. 3. The total protein level in the blood plasma was lowered in quails injected with l -thyroxine. Simultaneously, significant increase of the activity of PGM, GPI and PFK was observed. 4. 4. The activity of these enzymes increased up to 138.4;181.0 and 290% of the control in warm quails and 142.1;175.3 and 137.5% of the control in normal quails, respectively. 5. 5. The activity of lactate dehydrogenase in T4-treated quails changed slightly, while the activity of aldolase lowered below the control activity in normal quails and increased up to 163.7% of the control in T4-treated warm quails.