Symptoms and General Pathology

All Conditions

Heart and Blood Diseases

Inflammation

Atherosclerosis

Necrosis

Arteriosclerosis

Arterial Occlusive Diseases

Vascular Diseases

All Drugs and Chemicals

Bone Density Conservation Agents

Calcium

Calcium, Dietary

Andriana Bertolami, MD, PhD

Andrei C Sposito, MD, PhD

Subclinical atherosclerosis is the atherosclerotic process identified before clinical symptoms and thus it can be a useful marker of future cardiovascular events. It can be evaluated by many methods. This study included the diagnosis of subclincal atherosclerosis by four different methods: coronary calcium score, carotid doppler ultrasound to quantify intima media thickness and carotid plaques, exercise stress test and ankle brachial index. Clinical data, anthropometric measures (body mass index, abdominal circumference), markers of inflammation (high sensitive - C reactive protein, TNF alfa and Lipoprotein Associated Phospholipase A2), fat tissue function (leptin, resistin and adiponectin), glucose metabolism (fasting plasma glucose, glycated hemoglobin and insulin) and genetics markers of atherosclerotic process were evaluated as biomarkers of subclinical atherosclerosis in a uneventful population.

This study cross-sectionally evaluated consecutive patients at the outpatient clinic of Dyslipidemia and of Hypertension and Nephrology Medical Sections of Dante Pazzanese Institute of Cardiology, a cardiologic tertiary hospital in São Paulo - Brazil. After they fulfilled inclusion criteria and signed an informed consent, a brief medical history and anthropometric data (abdominal circumference, height and weight for body mass index calculation) were collected. Within of a month after inclusion, all patients underwent blood sample collection for dosing fast plasma glucose and insulin and 2 hours after 75g of dextrose test glucose and insulin, fast serum triglycerides, total cholesterol, HDL cholesterol, creatinine, high sensitive c-reactive protein (hs-CRP), HbA1c, thyroid stimulating hormone (TSH), free thyroxin (fT4), creatine kinase, adiponectin, resistin, leptin, tumor necrosis factor alpha (TNF-α), lipoprotein associated phospholipase A2 (Lp-PLA2). Blood sample was also stored for DNA (rs2383206, rs10757274, rs10757278, rs1051931, rs16874954 and rs1799724) and RNA PLA2G7 (2-ΔCT), TNF-α (2-ΔCT), LEP (2-ΔCT), LEPR (2-ΔCT) extraction and analyses.

Subclinical atherosclerosis was evaluated by four methods: carotid doppler ultrasound, cardiac computed tomography, exercise stress test and ankle-brachial index (ABI). All above tests were performed at the same day.

Carotid Doppler ultrasound was performed by using high-resolution Vivid 7 ultrasound (GE, USA) and high-frequency linear transducer type 9 MHz with automated measurement. Carotid Intima media thickness (cIMT) was evaluated 1 cm distal of the posterior wall of the left and right common carotid arteries and the presence of atherosclerotic plaques in common, internal and external carotid arteries was assessed. Carotid plaque was defined by the presence of focal wall thickening at least 50% greater than that of the surrounding vessel wall, or as a focal region with IMT greater than 1.5 mm, which protrude into the lumen and that is distinct from the adjacent boundary.

Cardiac Computed Tomography was performed to determine coronary calcium score (CAC) and calcium distribution. Hepatic density was performed to evaluate the presence of hepatic steatosis with Aquilion apparatus (Toshiba Medical, Tochigi, Japan) with 64 rows of detectors. The acquisition of tomographic data was represented by images of average thickness (3 mm) and low intensity (50 milliamps, 120 kV) and coupled to the electrocardiogram. Calcium score was considered present when its density in the coronary artery was above 130 Housfield units (HU) for at least 3 continuous pixels (\> 1 mm2) of the same coronary artery. Calcium score comprised the sum of individual scores of the left and right coronary arteries.

Exercise stress test was performed following under one of following protocols: Bruce, modified Bruce or Ellestad treadmill. The test was interrupted if maximum heart rate was reached or if clinical symptoms installed, including exhaustion. The exam was considered positive when there were: negative horizontal/descending deflection of ST segment measured at the J point ≥1 mm, pain suggestive of coronary artery disease, complex and sustained ventricular arrhythmias, plateau or drop in systolic blood pressure in effort and/or functional capacity lower than 5 METS.

ABI tests were performed with the patient in the supine position after resting for five minutes. Palpation of bilateral arterial pulses of pedial, posterior tibial, popliteal and brachial were performed. Measures of systolic pressures were made by a 5 MHz ultrasonography. The relationship between systolic and diastolic pressures of upper and lower limbs was used for calculating the ABI. The test was considered positive when at least one of the relationships was less than 0.9.

Personal and clinical characteristics of the patients will be described according to group using absolute and relative frequencies for qualitative characteristics and summary measures (mean, standard deviation, median, minimum and maximum) for quantitative characteristics. Distribution of the variables will be tested using Kolmogorov-Smirnov test. Comparative analyses for non-normal data will be performed using Kruskal-Wallis test and expressed as median (interquartile range). Normal data will be evaluated using analyses of variance (ANOVA) and expressed as mean ± standard deviation. To evaluate associations between categorical variables chi-square test and Fisher's Exact test will be used. Analysis of covariance (ANCOVA) adjusted for age and sex will be used to compare clinical and biochemical measures between groups (glucose, insulin, Homa-R, hs-PCR, HDL-c, triglycerides, LDL-c, HbA1c, TNF-α, leptin, 2 hours glucose and regular use of medication). Ordinal logistic regression will be used to evaluate subclinical atherosclerosis. A two-tailed P value \< 0.05 will be considered statistically significant.

Genetical, Anthropometrical and Biochemical Factors Influencing High Risk Subclinical Atherosclerosis

Subclinical Atherosclerosis: Biomarkers of Early Disease

Subclinical atherosclerosis evaluation by quantifying intima media thickness by Doppler

Subclinical atherosclerosis evaluation by Coronary Artery Calcium by CT

Subclinical atherosclerosis evaluation by brachial ankle index (BAI) by blood pressure measurement

Myocardial ischemia investigation by treadmill exercise test

Blood samples for Adiponectin, resistin, leptin, tumor necrosis factor alpha (TNF-α), lipoprotein associated phospholipase A2 (Lp-PLA2) dosing

University of Campinas, Brazil

Instituto Dante Pazzanese de Cardiologia

Adriana Bertolami

Nutritional and Metabolic Diseases

Neoplasms

Urinary Tract, Sexual Organs, and Pregnancy Conditions

Obesity

Endometrial Neoplasms

Overweight

Overnutrition

Nutrition Disorders

Body Weight

Uterine Neoplasms

Genital Neoplasms, Female

Urogenital Neoplasms

Uterine Diseases

Genital Diseases, Female

Genital Diseases

Urogenital Diseases

Female Urogenital Diseases

Pregnancy Complications

Female Urogenital Diseases and Pregnancy Complications

Potential participants will be identified in the Royal Surrey NHS Foundation trust - either seen here or referred here and receiving her treatment here for diagnosed endometrial cancer.

Patients diagnosed with endometrial cancer will be identified through the Gynaecological Oncology Multi-Disciplinary Team meeting or by the Gynaecological Oncology or Medical Oncology teams.

Blood sample will be collected on the day of the surgery when they are in the theatres and then repeated on day 1 post-operative in gynaecology ward and at 3/6 months post-surgery follow-up in clinic.

For the women undergoing chemotherapy, blood sample will be procured prior to commencing chemotherapy and after 3rd (with the blood test before the fourth cycle of chemotherapy) and 6th cycles of chemotherapy.

Blood and tissue sample collection from patients undergoing surgery for endometrial cancer and blood sample collection only from patients undergoing chemotherapy for endometrial cancer

Blood and tissue sample collection from patients with endometrial cancer

The number of women diagnosed with uterine cancer continues to rise each year. Since the early 1990s, there has been almost 55% rise in the United Kingdom (UK). 34% of endometrial cancer can be attributed to obesity. In the obese state, the function of adipose tissue deteriorates resulting in a state of chronic inflammation. Adipocytokine-related signalling pathways promote cancer development by causing inflammation, cell proliferation, DNA damage and by inhibiting apoptosis. The investigators postulate that adipocytokines levels are significantly different in uterine cancer patients of different weight categories and different grade/stage/ type of tumour.

Any woman attending the hospital with endometrial cancer and receiving treatment here will be invited to participate in the study. Consent will be sought to obtain 30mls (2 1/2 tablespoons) of venous blood at the time of surgery, on day 1 post-surgery and 3/6 months post-surgery during routine follow-up to check biomarker (adiponectin, leptin, tumour necrosis factor alpha, interleukin-6, Insulin-like growth factors 1 and 2) levels to see if the markers can be used to assess response to treatment. The investigators will also get consent to collect tissue - adipose tissue (after surgery) and uterine cancer tissue and lymph nodes (after histo-pathological evaluation) to assess for biomarkers. The investigators will also obtain blood samples from patients undergoing chemotherapy for advanced stage endometrial. All tissues procured will be anonymised and analysed at the oncology laboratory, Leggett building, University of Surrey and later correlated with patients' medical data as well as with tumour grade, stage and type. The investigators will also use archival tissue blocks stored at the same laboratory for analysis (previously consented for use in research). These are anonymised tissue and there is no link to patients' data.

The aim would be to ultimately find immuno-stimulatory/ suppressive biomarkers in order to develop novel diagnostic/ prognostic tools.

1. BACKGROUND

   Endometrial cancer is the most common malignancy of the female genital tract. It is the fourth most common cancer in the UK with around 9,500 new cases in 2017, current lifetime risk being 1 in 36 women. The number of women diagnosed with endometrial cancer continues to rise each year. Since the early 1990s, uterine cancer incidence rates have increased by almost three-fifths (55%) in the UK (2015-2017). The association between endometrial cancer and obesity is well documented. 7.5% of all cancers in women in UK are attributable to being overweight / obese (BMI ≥25 kg/m2). For endometrial cancer, this risk rises to 34%. A review of meta-analyses showed endometrial cancer risk is 16% higher per 5 kg- gained during adulthood, 29% higher per 10cm increase in hip circumference and 27% higher per 10cm increase in waist circumference. This higher endometrial cancer risk with raised BMI is present in both pre- and post-menopausal women. Moreover, patients who are obese tend to have a poorer outcome with more co-morbidities than their non-obese counterparts.

   In the overweight and obese state, the function of the adipose tissue deteriorates resulting in a state of chronic inflammation. In this inflammatory state, adipocytes and macrophages secrete several molecules, adipokines and inflammatory cytokines, which may promote tumour development and angiogenesis and stimulate adhesions and migration of cells.

   Most implicated adipocytokines in the tumorigenesis pathway are adiponectin, leptin, tumour necrosis factor-α (TNF-α), Interleukin-6 (IL-6) and Insulin-like growth factor 1 and 2 (IGF 1 and 2).

   Adipocytokine related signalling pathways are important in the development of an inflammatory microenvironment for tumours. This process is thought to increase the risk of endometrial cancer by inducing cell proliferation and preventing cell apoptosis. Adiponectin, the most abundant adipokine, has been suggested to have anti-angiogenic, anti-inflammatory, and anti-apoptotic properties. Raised leptin levels in obese state promotes inflammation by stimulating the production of IL-6, TNFα as well as IL-1 and IL-126. Leptin and adiponectin secretion are counter-regulated in vivo. A study by Luhn et. al. has shown adiponectin to have inverse relationship with the risk of endometrial cancer and leptin to have a direct correlation.

   Also, in an inflammatory environment, macrophages secrete potent proinflammatory cytokines such as TNF-α and IL-6, which are known to activate numerous transcription factors that regulate the expression of genes involved in immune responses, anti-apoptosis, angiogenesis, and metastasis. The mechanisms of tumorigenesis are thought to be involved are free-radical production that cause DNA damage and impaired DNA repair.

   Research have further suggested that systemic levels of insulin-like growth factor (IGF) is dysregulated in obesity either due to increased IGF production or by down-regulation of IGF binding protein (IGFBP) production. IGF 1 is a growth and proliferation promotor and has inhibitory effects on cell death and is a major contributor in many neoplastic transformations.

   The above biomarkers are physiologically interrelated and are likely to reflect a more restricted number of underlying biological pathways. Possibly, they work in a synergistic capacity to modulate the risk of developing endometrial cancer. If specific patterns of cytokine expression were found to be predictive of adverse outcome, then the specific receptors may be targeted as a therapeutic option for endometrial cancer11. No study so far has looked at all these markers together in the serum and tissue samples of the same endometrial cancer patients to give a more wholesome idea about their effect on tumour genesis, progression and outcome. Therefore, this study is designed to assess the prognostic significance of these six biomarkers in the blood and tissue of endometrial cancer patients and co-relating the levels with their BMI and tumour type, after adjusting for age, parity, smoking status, menopausal status, use of hormone replacement therapy (HRT)/ hormonal contraception, and prevalence of diabetes and hypertension.
2. RATIONALE

   Development of novel biomarkers for a variety of uses including diagnosis, treatment monitoring and prognostication is on the Cancer Reform Strategy agenda and actively encouraged by the National Cancer Research Institute and Medical Research Council.

   Understanding how adipocytokines influence endometrial cancer risk may help to elucidate biological mechanisms important for the observed obesity-endometrial cancer association.
3. THEORITICAL FRAMEWORK

   As the incidence of endometrial cancer continues to rise there is a health need for a better diagnostic and prognostic approach.

   Studying the different biomarker levels in blood and cancer tissue will enable us to look for new targets that may be useful in the treatment and prognostication of this cancer.

   Also, if the levels of these markers change significantly post-treatment, the investigators can investigate if it will be possible to use these markers to assess response to treatment as follow-up for risk of recurrence forms an important part of the treatment protocol.
4. RESEARCH QUESTIONS / OBJECTIVES:

   To assess the relationship between the endometrial cancer and blood and tissue biomarkers in patients referred for endometrial cancer management to Royal Surrey NHS Foundation trust and to correlate with obesity and tumour characteristics.
5. STUDY DESIGN and METHODS of DATA COLLECTION AND DATA ANALYSIS

   5.1. Study design

   All patients being referred to the Royal Surrey NHS Foundation trust with diagnosed uterine cancer will be given the research information leaflet.

   Initially, an invitation letter will be sent alongside the patients' clinic appointment letter to inform them of the study and give them time for preliminary consideration of the study.

   Patients will then be approached in the outpatients' clinics after the initial consultation by the clinician. They will be given a participant information leaflet detailing the study rationale, methodology and analysis. Patients who agree to participate in the study will be asked to sign a consent form after explanation.

   Demographic data will be collected at the same time to correlate various risk factors associated with the development of uterine cancer. This data will be collected by:
   * A short patient interview (10 minutes)
   * Patients' medical notes Data from the interview will be directly entered into an existing departmental database for Gynaecological oncology which is password protected and stored on NHS computers. A copy of the data proformas from the interview will be filed in a secure room within the University department to allow for source data verification.

   Participants will then have 30mls (2 ½ tablespoons) of venous blood taken on the day of the surgery.

   Tissue samples from the participants undergoing hysterectomy will be collected as follows: the PI will collect any fresh tissue (adipose tissue) directly from theatre before fixing as it is not needed for establishing diagnosis and the uterine cancer tissue and lymph node will be collected by the PI after histo-pathological examination from the histo-pathology department after the diagnosis is established. All tissue processing will adhere to Human Tissue Authority (HTA) guidelines and will be performed at the Oncology laboratory at Leggett building at University of Surrey.

   The participants will have a repeat blood test (30mls) on day 1 post-surgery and at their 3 or 6 months routine post-surgery follow up appointment.

   For those participants who are recommended chemotherapy, the investigators will also ask consent to collect demographic data at the time of consultation and baseline blood sample (30mls venous blood) before commencing chemotherapy and after 3rd and 6th chemotherapy cycles to assess any changes in the biomarkers that may correlate with progression or regression of disease.

   The investigators will also obtain archival tissue blocks (of uterine cancer patients consented from a previous study for use during an appropriate ethics committee approved research) to help increase the number of recruitments for this study. Their demographic data with identification log will be made available to the PI only to assess for correlation between their data and the tissue diagnosis during analysis.

   5.2. Sample analysis

   ELISA will be used to assay bio-marker levels in blood samples.

   For tissue analysis the investigators will set up a tissue microarray (TMA). This will allow more uniform staining of the sample for immunohistochemistry with no inter-specimen variation of the staining method. Each case will be reviewed, and the area of interest (tumour) will be marked on the slide and cores from the areas of interest will be used to create the microarray block. Sections can then be cut from the microarray block and slides prepared for immune staining. The advantage of using this method is that the samples are subjected to the same conditions while being stained and the same part of a tumour can be reliably stained for several markers. Tissue sections from the TMA will be used for immune-staining and the expression of the markers of interest will be scored. Clinical data which is available on the cases will then be correlated with the histological and immunohistochemical scores and statistical analysis will be carried out.

   5.3. Data analysis

   Standard statistical analytical tools will be used to analyse the data. Relation between different variables will be sought with odds ratio, confidence interval and significance with P value (\<0.05 significant). The Mann-Whitney U test will be used to assess differential expression of immune markers between tissue types -blood and tumour tissue. Correlation with clinical characteristics will be determined using univariate log-rank and multivariable Cox proportional hazards adjusting for age, stage, grade and histology.
6. SAMPLE AND RECRUITMENT

Potential participants will be identified in the Royal Surrey NHS Foundation trust - either seen here or referred here and receiving her treatment here for diagnosed endometrial cancer.

6.1. Sample size

The investigators will aim to recruit 30-60 patients with diagnosed endometrial cancer in the study. This sample size will also include archived tissue sample (formerly consented and stored in Leggett building, University of Surrey, for use in future ethical research).

6.2. Recruitment

All patients seen or referred with endometrial cancer at the Royal Surrey Oncology Department will be invited to participate in the study.

Patients will not receive any payments for participation in the study. The investigators aim to obtain all information and samples at the time of routine visits.

6.2.1. Sample identification

Patients diagnosed with endometrial cancer will be identified through the Gynaecological Oncology Multi-Disciplinary Team meeting or by the Gynaecological Oncology or Medical Oncology teams.

6.2.2. Consent

Written consent will be obtained after the patient has received the participant information leaflet and had the opportunity to discuss and ask questions about the study. Enough time will be given for the purpose. Patients must all have capacity to consent. Consent will be undertaken by clinicians on the Gynaecological Oncology team. If necessary, a translator or language line can be used.

Consent will also be taken for use of samples (anonymised and stored in Leggett building, University of Surrey following all regulations by HTA) for use in future research.

Adipocytokines in Endometrial Cancer

Adipocytokines and Their Relationship to Obesity and Endometrial Cancer

All personal information will be anonymised so that researchers except the Principal Investigator (PI) will be blinded to this information. At all times, the NHS Code of Confidentiality will be followed. Only the PI will have access to the 'key' to the patient identifiers connecting the samples to the clinical data of the patients which will be stored in a secured encrypted database on a NHS computer.

Levels of adiponectin and leptin in serum will be measured by ELISA in ng/mL and in the tissues by immunohistochemistry

Levels of adiponectin and leptin in serum will be measured by ELISA in ng/mL

Levels of cytokines- tumour necrosis factor alpha (TNFα) and interleukin 6 (IL-6) will be measured in serum by ELISA in pg/mL and in the tissues by immunohistochemistry

Levels of cytokines - tumour necrosis factor alpha (TNFα) and interleukin 6 (IL-6) will be measured in serum by ELISA in pg/mL

Levels of Insulin like growth factors 1 and 2 (IGF 1 and 2) will be measured in serum by ELISA in ng/mL and in the tissues by immunohistochemistry

Levels of Insulin like growth factors 1 and 2 (IGF 1 and 2) will be measured in serum by ELISA in ng/mL

Levels of biomarkers in serum and tissue will be correlated with obesity (WHO classification of BMI) after adjusting for confounding factors like age, parity, menopause, use of HRT/ hormonal contraception, smoking, diabetes and hypertension, using statistical tools like univariate log-rank and multivariable Cox proportional hazards analysis.

Levels of biomarkers in serum and tissue will be correlated with tumour grade/ stage and type after adjusting for BMI, age, parity, menopause, use of HRT/ hormonal contraception, smoking, diabetes and hypertension, using statistical tools like univariate log-rank and multivariable Cox proportional hazards analysis.

Levels of adiponectin and leptin in serum will be measured by ELISA in ng/mL to measure change from baseline levels

Levels of cytokines - tumour necrosis factor alpha (TNFα) and interleukin 6 (IL-6) will be measured in serum by ELISA in pg/mL to measure change from baseline

Levels of tumour necrosis factor alpha (TNFα) and interleukin 6 (IL-6) will be measured in serum by ELISA in pg/mL to measure change from baseline levels

Levels of Insulin like growth factors 1 and 2 (IGF 1 and 2) will be measured in serum by ELISA in ng/mL to measure change from baseline

Levels of Insulin like growth factors 1 and 2 (IGF 1 and 2) will be measured in serum by ELISA in ng/mL to measure change from baseline levels

Royal Surrey County Hospital NHS Foundation Trust

GRACE Group

University of Surrey

Gland and Hormone Related Diseases

Blood and Lymph Conditions

Immune System Diseases

Rare Diseases

Diabetes Mellitus

Syndrome

Leukemia

Precursor Cell Lymphoblastic Leukemia-Lymphoma

Leukemia, Lymphoid

Microvascular Angina

Metabolic Syndrome

Neoplasms by Histologic Type

Hematologic Diseases

Insulin Resistance

Hyperinsulinism

Metabolic Diseases

Glucose Metabolism Disorders

Acute Lymphoblastic Leukemia

Lymphoblastic Lymphoma

Acute Graft Versus Host Disease

Childhood Acute Lymphoblastic Leukemia

Abdominal Obesity Metabolic Syndrome

ALL survivors 5 years after completion of treatment, during routine medical follow up

family history, anthropometric measurements and blood sampling

sample without DNA

Bella Bielorai, MD

Yael Weintraub, MD

Background: Acute Lymphoblastic Leukemia (ALL) is the most common malignancy in children. It accounts for 25% of all childhood cancers. Peak incidence occurs between 2 to 5 years of age. Modern treatment regimens have improved cure rates from virtually zero (in the 1950's) to current overall survival rates of approximately 80%.The high survival rates have introduced us to novel medical problems as a consequences of the different treatment regimens. No single treatment modality exists today but rather several treatment protocols are accepted worldwide. As such, the population of the childhood ALL survivors differ in their toxic exposure: cranial \& spinal radiotherapy, intrathecal and/or systemic chemotherapy and bone marrow transplantation .As the survival rates grow, there are more young adult ALL survivors worldwide susceptible to these late effects of treatment.

Numerous reports have pointed out that this particular group is at increased risk to develop cardiovascular disease (CVD) and diabetes (MS). The metabolic syndrome, i.e hypertension, dyslipidemia, impaired glucose metabolism and obesity, occurs at a younger age than the general population.

Adipocytokines, mediators secreted by adipose tissue, play an important role in the regulation of carbohydrates and lipid metabolism.Changes in serum adipokine levels precede the clinical symptoms.

We aim to identify and assess prevalence of the MS in ALL survivors. We aim to characterize the population at risk to develop DM and CVD prior to overt clinical disease. Characterization will be done by measuring serum adipocytokines and inflammatory cytokine profiles .Biochemical characterization of the group at risk will enable us to intervene in the preventive stage in the future.

Serum leptin, resistin ,adiponectin ,CRP, PAI ,TNF-α, IL-6 will be taken as part of initial blood test screening in patients following an overnight fast. Adiponectin and leptin levels will be determined by RIA (Linco, St. Charles, MO), Insulin, will be determined by chemiluminescent immunometric method (Immulite 2000, Diagnostic Products Corporation, Los Angeles, CA).

Adipokines as Predictors of the Metabolic Syndrome in ALL Survivors

Adipocytokines as Predictors of the Metabolic Syndrome in Survivors of Childhood Acute Lymphoblastic Leukemia

Sheba Medical Center

Dr. Yael Weintraub

Skin and Connective Tissue Diseases

Carcinoma

Breast Neoplasms

Breast Diseases

Skin Diseases

Jonnathan Guadalupe Santillán Benítez, MSc

Leobardo Manuel Gómez Oliván, PhD

Hugo Mendieta Zeron, PhD

Objective:

Evaluate body mass index (BMI), leptin, Leptin/adiponectin (L/A) ratio and cancer antigen (CA) 15-3 together as reliable biomarkers for breast cancer.

Patients:

Consecutive patients aged between 40 - 60 years, with breast disease and informed consent.

Interventions:

Patients' Anthropometric and laboratorial characteristics classified by BMI in the group of cancer and patients with benign breast disease as well as biochemical tests of leptin, adiponectin,CA 15-3, hemoglobin, glucose low-density lipoprotein cholesterol (LDLC), high-density lipoprotein cholesterol (HDLC) levels were obtained as well as a blood sample to analyze CA 15-3 levels with a electrochemiluminescence immunoassay.

Hypothesis:

Using together leptin, L/A ratio, CA 15-3 and BMI could offer a reliable approach to detect high risk women to develop breast cancer.

Serum levels of leptin, adiponectin and CA 15-3, as well as anthropometric and biochemical parameters were analyzed in 88 female patients attending mammography study. Predictive values of BMI, leptin, L/A ratio and CA 15-3 were determined with 95% confidence interval (CI).

The Tetrad BMI, Leptin, Leptin/Adiponectin (L/A) Ratio and CA-15-3 is a Reliable Biomarker of Breast Cancer

Phase 1. Collect Samples of Breast Biopsy Patients Treated at the Hospital Radiology Service Maternal Perinatal Monica Pretelini

Universidad Autonoma del Estado de Mexico

Materno-Perinatal Hospital of the State of Mexico

Behaviors and Mental Disorders

Depressive Disorder

Depression

Pain

Behavioral Symptoms

Mood Disorders

Mental Disorders

Psychotic Disorders

Central Nervous System Depressants

Psychotropic Drugs

Anesthetics

Esketamine

Antidepressive Agents

The experimental group will be given 0.25mg/kg esketamine slowly intravenously after anesthesia induction During administration, blood pressure and heart rate were observed.

The control group will receive the same amount of normal saline after anesthesia induction

The experimental group will be given 0.25mg/kg esketamine slowly intravenously after anesthesia induction

The experimental group will be given 0.5ml/kg normal saline intravenously after anesthesia induction

normal saline

LIU M YU

esketamine is an optical isomer of ketamine. Compared with ketamine, esketamine has the characteristics of higher effective value, stronger receptor affinity, less adverse reactions of nervous system, and pharmacokinetics is controllable.

Domestic and foreign studies have focused on the therapeutic effect of esketamine on major depression, but less attention has been paid to perioperative depression.This study intends to explore the effect of small doses of esketamine on patients with breast cancer.Postoperative depression and pain are observed.

This study intends to explore the effect of small doses of esketamine on patients with breast cancer.WE pay attention to :

1. Safety of low-dose single intravenous injection of esketamine (1)The influence of intraoperative vital signs of patients after medication, such as blood pressure and heart rate fluctuation; (2)the duration of recovery after anesthesia; (3)postoperative adverse reactions, such as nausea and vomiting, dizziness and diplopia, respiratory depression, laryngeal spasm, delirium agitation, etc
2. Effect of single intravenous injection of low-dose ketamine on postoperative depression in patients undergoing radical mastectomy (1) 1 day before surgery, 2 days, 5 days, 30 days, 90 days after surgery Hamilton Depression Scale scores; (2) The serum leptin level 1 day before surgery, 2 days after surgery and 5 days after surgery; (3) Correlation between depression scale score and leptin level
3. Effects of low dose esketamine on acute and chronic pain in patients undergoing radical mastectomy

   * visual analogue scale scores at 6, 12 and 24 hours after surgery;

     * visual analogue scale scores at 3, 5, 30 and 90 days after surgery;

       * the number of analgesic remedies

180 patients will be divided into two groups according to the random number table method: control group (normal saline group),treatment group (esketamine group), 120 cases in each group.

esketamine 10ml (5mg/ml) and normal saline 10ml were respectively set as drug A or drug B.

Without the knowledge of the experimenter, the predetermined dose of drug A or B will be given to the experimenter before induction of anesthesia, with 0.05 mL /kg for each patient.

After all samples are collected, the third party will announce the grouping and medication.

Effect of Low-dose Esketamine on Postoperative Depression in Patients With Breast Cancer

The total rough score is the sum of all the scores in the 20 items, and then the rough score is multiplied by 1.25 to take the round part to get the standard score.

An SDS score of 53 to 62 is classified as mild depression, 63 to 72 as moderate depression, and 73 or more as major depression.

visual analogue scale 0 points painless;

1 to 3 points for mild pain; 4 to 6 points moderate pain; Severe pain on a 7-9 scale; 10 points severe pain.

The serum leptin level 1 day before surgery, 2 days ,5 days 30 days and 90 days after surgery

Yangzhou University

Department of Anesthesiology, Yangzhou University Affiliated Hospital

Digestive System Diseases

Rectal Neoplasms

Colorectal Neoplasms

Intestinal Neoplasms

Gastrointestinal Neoplasms

Digestive System Neoplasms

Gastrointestinal Diseases

Intestinal Diseases

Rectal Diseases

Level of serum adipokines will be measured with flow cytometry

serum adipokines

Cihad Tatar, MD

Cihad Tatar

Husnu Sevik, MD

It has been shown that adipokines (resistin, leptin, adiponectin) secreted from adipose tissue and proinflammatory cytokines such as IL-6, TNF-a are associated with the risk of developing colorectal cancer. However, the role of these factors in predicting clinical response to neoadjuvant therapy in rectal cancers is unknown. In this study, the role of serum adipokine levels before neoadjuvant therapy in predicting clinical response in patients with rectal cancer is investigated. For this purpose, blood will be drawn from patients with rectal cancer who will receive neoadjuvant therapy, serum adipokines will be studied and clinical response to neoadjuvant therapy will be compared.

The Role of Serum Adipokines in Predicting Response to Neoadjuvant Therapy in Patients With Rectal Cancer

The Adiponectin, Adipsin, Leptin, Resistin levels will be measured with flow cytometric analysis.

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization
Genetical, Anthropometrical and Biochemical Factors Influencing High Risk Subclinical Atherosclerosis	NCT02487615	Primary Prevent...		25 Years - 70 Years	Instituto Dante Pazzanese de Cardiologia
Adipocytokines in Endometrial Cancer	NCT04697264	Endometrial Can... Obesity	Blood and tissu...	-	University of Surrey
Adipokines as Predictors of the Metabolic Syndrome in ALL Survivors	NCT00566566	Leukemia Metabolic Syndr...	sample without ...	6 Years - 45 Years	Sheba Medical Center
Genetical, Anthropometrical and Biochemical Factors Influencing High Risk Subclinical Atherosclerosis	NCT02487615	Primary Prevent...		25 Years - 70 Years	Instituto Dante Pazzanese de Cardiologia
The Tetrad BMI, Leptin, Leptin/Adiponectin (L/A) Ratio and CA-15-3 is a Reliable Biomarker of Breast Cancer	NCT01643148	Female Breast C...		40 Years - 60 Years	Materno-Perinatal Hospital of the State of Mexico
Effect of Low-dose Esketamine on Postoperative Depression in Patients With Breast Cancer	NCT04850937	Depression	Esketamine normal saline	18 Years - 65 Years	Yangzhou University
The Role of Serum Adipokines in Predicting Response to Neoadjuvant Therapy in Patients With Rectal Cancer	NCT04598984	Rectal Cancer S...	serum adipokine...	18 Years -	Istanbul Training and Research Hospital

Spots Global Cancer Trial Database for leptin

Every month we try and update this database with for leptin cancer trials from around the world to help patients and their families find trials that might be right for them.
We offer this 100% free of charge and do not endorse any of the trials listed here, we hope it helps you or a loved one.

Spots Global Cancer Trial Database for leptin

Every month we try and update this database with for leptin cancer trials from around the world to help patients and their families find trials that might be right for them. We offer this 100% free of charge and do not endorse any of the trials listed here, we hope it helps you or a loved one.

Every month we try and update this database with for leptin cancer trials from around the world to help patients and their families find trials that might be right for them.
We offer this 100% free of charge and do not endorse any of the trials listed here, we hope it helps you or a loved one.