Search

Objectives: To investigate the importance of FDG PET/CT in predicting pathologic complete response (pCR) in primary breast lesions and axillary lymph nodes of patients with local, advanced breast cancer who were given neoadjuvant chemotherapy (NAC). Methods: One hundred twenty-one patients who had FDG PET/CT and underwent surgery due to local, advanced breast cancer before and after NAC were involved in the study. SUVmax and SULpeak values before and after NAC were evaluated using FDG PET/CT and post-surgical responses were re-evaluated. Results: Our study included 121 patients in total and 34 patients (28.1%) had a complete response in the breast, and 53 patients (43.8%) had a complete response in axillary lymph nodes. PostSUVmax and PostSULpeak values ≤1.15 and the activity presenting the pCR were controlled and the sensitivity and specificity were found as 61.8% and 61.8%, and 73.3% and 77.0%, respectively, for the breast (p<0.001 and p<0.001). The reduction rate (RR) of SUVmax >88% and the SULpeak (RR) >81% values and the activity presenting the pCR were controlled and the sensitivity and specificity were found as 80.0% and 81.8%, and 80.0% and 60.7%, respectively, for the breast (p<0.001 and p<0.001). Conclusion: The decrease of SUVmax and SULpeak values detected between PET/CT studies before and after NAC were well correlated with the pathologic response. FDG-PET/CT has high sensitivity and specificity in the evaluation of treatment response rates in breast lesions of patients with breast cancer receiving NAC. [ABSTRACT FROM AUTHOR]

Pannus formation is an infrequent but serious complication of prosthetic heart valve surgery. The cause of pannus is recognized as a bioreaction to the prostheses; histological investigations have shown that pannus comprises collagen and elastic tissues containing endothelial cells, chronic inflammatory cells, and myofibroblasts. However, the detailed mechanism of its formation has not been fully demonstrated. We aimed to evaluate the potential role of vascular endothelial growth factor (VEGF) and matrix metalloproteinase-2 (MMP-2) in the pathogenesis of pannus formation in three patients with mechanical prosthetic heart valves. Pannus specimens removed from the prostheses were fixed in 10% neutral-buffered formalin for 24 hours after surgical removal and paraffin-embedded using standard procedures. Serial sections were cut at 4 μm for immunohistochemistry analysis. Hematoxylin and eosin (HE) was used in the histological analysis. VEGF and MMP- 2 were studied in the immunohistochemistry analysis. Three patients with mechanical prosthetic obstruction due to pannus overgrowth underwent redo valve surgery. In the first and second patients, the mitral prosthesis was explanted along with the pannus overgrowth. The third patient had both aortic and mitral prostheses; the aortic prosthesis was explanted with obstructive pannus formation, whereas the mitral valve was spared with excision of the nonobstructive pannus. The immunohistochemical study demonstrated the expressions of MMP-2 and VEGF in all of the pannus specimens acquired from these cases. VEGF and MMP-2 may play a role in the mechanism of pannus formation as the elements of the chronic active inflammatory process.