Purpose-Microsatellite instability (MSI) is the hallmark of cancer with DNA mismatch repair (MMR) deficiency and underlies 20-30% of endometrial cancer. Some in vitro studies suggest that radiation effects are modulated by the MMR system, however, little is known about the relationship between MSI and radiation response. The aim of this study was to elucidate whether MSI predicts clinical outcome in radiation treated endometrioid endometrial cancer (EEC).Methods-We have studied a consecutive series of 93 patients with EEC treated with extrafacial hysterectomy and postoperative radiotherapy. The median clinical follow up of patients was of 138 months, with a maximum of 232 months. Five quasimonomorphic mononucleotide markers (BAT-25, BAT-26, NR21, NR24 and NR27) were used for MSI classification.Results-Twenty five patients (22%) were classified as MSI. Either in the whole series and in early stages (I and II), univariate analysis showed a significant association between MSI and a poorer 10-years local disease free (LDFS), disease free (DFS), and cancer-specific survival (CSS). In multivariate analysis, MSI was excluded from de final regression model in the whole series, but in early stages, MSI provided additional significant predictive information independent of traditional prognostic and predictive factors (age, stage, grade and vascular invasion) for DFS (HR, 3.25, 95%
Stanozolol (ST) is a 17alpha-alkyl anabolic-androgenic steroid (17alpha-AAS) often misused by athletes and bodybuilders. The use of anabolic-steroids by sportsmen and teenagers has increased dramatically, thus raising the question about their hepatotoxicity, specially those such as ST which are orally administered. Previously, we have reported diverse in vivo effects exerted by this steroid and published the existence of a highly specific ST-binding site in male rat liver microsomes. The existence of this binding site, the reported hepatic effects exerted in humans, and the very limited information about its potential hepatotoxicity led us to treat adult male rats acutely and chronically with ST and study different parameters that could indicate liver damage: serum levels of transaminases, concentration of monooxygenase enzymes in liver, liver membrane lipid peroxidation products, liver histopathology, and cell cycle/ploidy status of liver cells. In our study, no changes in serum transaminases or lipid peroxidation levels were obtained. However, acute stanozolol treatment significantly decreased the levels of cytochrome P450 (Cyt. P450) and cytochrome b5 (Cyt. b5) during the first 48 h of treatment, while subsequently, at 72 and 96 h, these microsomal enzymes underwent a significant increase in their levels. In sharp contrast with this response to acute treatment, the content of these two enzymes during chronic treatment showed an important decrease. Interestingly, acutely and chronically ST-treated livers showed slight to moderate inflammatory or degenerative lesions in centrilobular hepatocytes. Flow cytometric analysis demonstrated that both acute and chronic ST treatment were capable of increasing the percentage of S-phase fraction (%SPF) of liver cells. These findings taken together clearly show that this steroid is capable of altering the liver capacity for metabolizing xenobiotics and indicate that high doses of ST could exert a proliferative effect on liver cells. Such data should be considered in risk evaluations for this compound.
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