Relationship between HER-2 overexpression and brain metastasis in esophageal cancer patients

AIM:To study if HER-2 overexpression by locally advanced esophageal cancers increase the chance of brain metastasis following esophagectomy.METHODS:We retrospectively reviewed the medical records of esophageal cancer patients who underwent esophagectomy at University of Iowa Hospitals and Clinics between 2000 and 2010.Data analyzed consisted of demographic and clinical variables.The brain metastasis tissue was assayed for HER-2 overexpression utilizing the FDA approved DAKO Hercept Test.RESULTS:One hundred and forty two patients were reviewed.Median age was 64 years(36-86 years).Eighty eight patients(62%) received neoadjuvant chemoradiotherapy.Pathological complete and partial responses were achieved in 17(19%) and 71(81%) patients.Cancer relapsed in 43/142(30%) patients.The brain was the first site of relapse in 9/43 patients(21%,95% CI:10%-36%).HER-2 immunohistochemistry testing of the brain metastasis tissue showed that 5/9(56%) cases overexpressed HER-2(3+ staining).CONCLUSION:HER-2 overexpression might be associated with increased risk of brain metastasis in esophageal cancer patients following esophagectomy.Further studies will be required to validate this observation.

非动脉炎性前部缺血性视神经病变的视野异常初次检查时的模式和发病率

目的：评价非动脉炎性前部缺血性视神经病变（NA-AION）在初次检查时各种类型视野缺损的模式和发病率。 方法：数据来源于满足我们入组和排除标准的连续的312只眼（共265例患者）。对每一只眼进行全面的眼科评估。包括视力。Goldman视野计测定视野（I-2e,I-2e,I-4e和V-4e目标进行常规检查）和眼内压的纪录：前节裂隙灯检查；检眼镜检查；彩色眼底照相；对于急诊病例。还需要进行荧光素眼底血管造影。视野缺损被分为两组：（1）全视野缺损和（2）中心30°内各种类型的盲点。用有视野缺损的总眼数除以能看见特定目标的总眼数来评估在I-2e，I-4e和V-4e等视力线内各种类型视野缺损的发病率。计算发病率精确的95％可信区间。 结果：265例患者中169例（63．7％）为男性，平均年龄为55．0．4±9．1岁。从第一次视野检查到出现NA-AION的平均间隔时间为2周。在312只眼中。75．3％能看见I-2e目标。90．7％能看见I-4e目标，100％能看见V-4e目标。全视野缺损的总发病率为I-2e内83．4％。I-4e内78．8％。V-4e内68．9％；而中心30。内盲点的发病率则分别为55．3％。49．5％和36．2％。I-2e内48．5％发现中心盲点。I-4e内为43．8％。V-4e内为29．2％。本研究给出了各种类型视野缺损的详细发病率。相对下方象限缺损最为常见（I-2e内34．9％。I-4e内22．3％）。但是仅有8．0％能看见绝对下方象限缺损。与之相反的是。绝对下鼻侧区域的视力丧失是NA-AION中检测到的最常见缺损（22．4％）。但它仅存在于I-2e内3．4％。I-4e内11．0％的眼中。总体而言。视野的鼻侧部分的丧失是最常出现的。 结论：我们的研究揭示了NA-AION可能在最开始就显示出与视神经相关的多种视野缺损。我们的研究同时显示NA-AION中绝对下鼻侧区域的视野缺损（22．4％）比绝对下方象限性视野缺损（8．0％）常见得多。可以认为这是NA-AION中最具有特征性的单视野缺损。我们发现相对下方象限性缺损和绝对下鼻侧区域缺损的同时出现是NA-AION最常见的模式。