Jan Kornafel

Wroclaw Medical University, Vrotslav, Lower Silesian Voivodeship, Poland

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Publications (88)123.61 Total impact

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    ABSTRACT: Background. Breast cancer (BC) is a major cause of women's mortality. However, early detection can diminish its mortality rate. In 2007, the Polish Government adopted a population-based breast cancer screening. However, many women still have not received screening mammography despite its easy accessability. Objectives. Exploration of the impact of socioeconomic status and cancer awareness on early diagnosis of BC and participation in screening mammography. Material and methods. A survey of 50 BC patients treated in 2010 in the Lower Silesian Cancer Center. Results. Twenty six patients (52%) with smaller tumor (pT1) were included into an early stage subgroup, and twenty four patients with pT2, 3 and 4 formed the 2nd subgroup. The present study revealed significant correlations between level of education and/ /or cancer awareness, and frequency of breast self-examination and participation in screenings. Women of higher education performed breast self-examination and participated in screenings regularly. Participation in screenings correlated with less advanced disease. The interval between the symptoms of the disease and beginning the treatment in patients with early stage BC was shorter. In contrast, women present with more advanced BC delayed their first examination, in spite of presence of symptoms. Conclusions. A relationship between low socioeconomic status and/or limited cancer knowledge and: (1) low BC screening participation and (2) delayed BC detection despite the easily accessable screening. Strategies to improve BC treatment results should include comprehensive cancer education. Women with low socioeconomic status should be the main target of those educational programmes.
    Family Medicine and Primary Care Review 12/2014; 16(4):329-332.
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    ABSTRACT: According to the definition by the International Agency for Research on Cancer (IARC), primary multiple neoplasms are two or more neoplasms of different histopathological build in one organ, or two or more tumors occurring in one patient, regardless of the time of their occurrence (synchronic - up to 6 months, metachronous - after 6 months), coming from an organ or a tissue and not being an infiltration from another neoplasm, a relapse or a metastasis.
    05/2014; 23(3):433-440. DOI:10.17219/acem/37141
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    ABSTRACT: Cancer patient treatment in Poland remains unsatisfactory when compared to that in other countries. In 2005, this alarming situation prompted the Polish government to launch the "National Program for Combating Neoplastic Diseases" (NPCND). One part of this project was to improve the quality of oncology instruction at the undergraduate level over the years 2006 and 2007 (subsequently extended until 2010 thanks to promising results and the relatively small financial outlay). The program's main aims were to improve existing oncology therapy and to ameliorate the quality of undergraduate oncology education. To evaluate the changes in the quality of undergraduate education as a result of the NPCND program, medical universities were asked to fill out a questionnaire. Responses indicate that the program had a major positive impact on the quality of cancer education mainly as a result of the introduction of a uniform program of training and an increase in the number of classes devoted to oncology. The main unresolved problem is that university hospitals seldom have integrated units catering in-house for surgery, radiotherapy, chemotherapy, etc., and most such "hands-on" teaching still has to be done externally.
    Journal of Cancer Education 03/2014; 29(3). DOI:10.1007/s13187-014-0633-y · 1.05 Impact Factor
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    Radoslaw Tarkowski, Jan Kornafel
    Journal of Cancer Education 12/2013; 29(1). DOI:10.1007/s13187-013-0587-5 · 1.05 Impact Factor
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    ABSTRACT: Aim: The study aimed at the evaluation of the effects of radiotherapy on expression of metallothionein (MT) isoforms, both in the form of quantitative alterations in mRNA, and differences in expression of MTI/II proteins in rectal tumours. Material for the study originated from 21 patients with rectal cancer at stage II or III. Material for immunohistochemical studies [MTI/II, Minichromosome Maintenance Protein 3 (MCM3), Ki-67] and real-time polymerase chain reaction (PCR) (mRNA of MT1F, MT1X and MT2A) was sampled twice: during rectoscopic examination before the start of the preoperative radiotherapy (samples A) and from the post operative specimen, following radiotherapy (samples B). The level of mRNA expression for each of the studied MT isoforms was higher in cancer cells subjected to irradiation. The most extensive differences were observed for the MT2A isoforms (p=0.09). No differences were disclosed between samples A and B in expression of MT I/II protein. The material sampled after radiotherapy manifested a tendency for reduced proliferative activity of the tumour cells: the decrease of MCM3 expression was significant (p=0.022), while in the case of Ki-67, the difference approached statistical significance (p=0.096). Application of radiotherapy to rectal adenocarcinoma cells is followed by an increase in MT mRNA expression level, affecting first of all the MT2A isoform. However, we failed to note an increased expression of MTI/II protein coded by the gene. Moreover, application of radiotherapy was followed by a decrease in expression of MCM3 protein. Our results cannot clearly confirm induction of MT after irradiation of human adenocarcinoma cells. The role of MT in radioprotection remains ambiguous.
    Anticancer research 12/2012; 32(12):5291-7. · 1.87 Impact Factor
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    The Breast 11/2012; 21:S27. DOI:10.1016/S0960-9776(12)70091-7 · 2.58 Impact Factor
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    ABSTRACT: In this study, we hypothesized that not only endothelial malignant cells but also lymphocytes infiltrating tumor epithelium, in patients with endometrial cancer, could be an important source of the gelatinases (matrix metalloproteinase [MMP]-2 and MMP-9) extensive production, which in turn, may facilitate tumor cells infiltration and progression due to the extracellular matrix degradation. First, we isolated lymphocytes from the endometrial carcinoma samples taken from 41 patients who were operated on and from healthy endometrial tissue taken of the same patients after histological verification. Then, we detected the level of CD3-positive cells in endometrial tissues by flow cytometry. Simultaneously, we studied the messenger RNA expression of MMP-2 and MMP-9 in the isolated cells from malignant and unchanged endometrial tissues. Using immunohistochemistry, we compared the protein expression of MMP-2, MMP-9, and CD3 in the studied samples. We showed the enhanced abundance of CD3 lymphocytes both by flow cytometry and immunohistochemistry in the samples from malignant tissues. The expression of MMP-9 in the endometrial carcinoma was increased significantly at the protein level but not at the messenger RNA level. We could not observe any differences concerning MMP-2 expression in both methods of detection. CD-3 lymphocytes significantly infiltrate endometrial cancer tissue, but they do not seem to be the source of enhanced metalloproteinases 2 and 9 expression in the tumor environment. Still, owing to the immunohistochemistry staining, we could show the significant increase of MMP-9 protein in the very close vicinity of tumor-infiltrating CD3 lymphocytes. Could it be the result of CD3 lymphocyte action, or is it just the imperfection of the detecting method we used? This remains unclear. Further studies explaining the role of tumor infiltrating lymphocytes in mediating the endometrial cancer milieu are needed.
    International Journal of Gynecological Cancer 09/2012; 22(8):1303-9. DOI:10.1097/IGC.0b013e318269e27b · 1.95 Impact Factor
  • European Journal of Surgical Oncology 09/2012; 38(9):815. DOI:10.1016/j.ejso.2012.06.257 · 2.89 Impact Factor
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    ABSTRACT: Cervical cancer (CC) occurs more frequently in women who are immunosuppressed, suggesting that both local and systemic immune abnormalities may be involved in the evolution of the disease. Costimulatory CD28 and inhibitory CTLA-4 molecules expressed in T cells play a key role in the balanced immune responses. There has been demonstrated a relation between CD28, CTLA-4, and IFN genes in susceptibility to CC, suggesting their importance in CC development. Therefore, we assessed the pattern of CD28 and CTLA-4 expression in T cells from PB of CC patients with advanced CC (stages III and IV according to FIGO) compared to controls. We also examined the ability of PBMCs to secrete IFN-gamma. We found lower frequencies of freshly isolated and ex vivo stimulated CD4 + CD28+ and CD8 + CD28+ T cells in CC patients than in controls. Loss of CD28 expression was more pronounced in the CD8+ T subset. Markedly increased proportions of CTLA-4+ T cells in CC patients before and after culture compared to controls were also observed. In addition, patients' T cells exhibited abnormal kinetics of surface CTLA-4 expression, with the peak at 24 h of stimulation, which was in contrast to corresponding normal T cells, revealing maximum CTLA-4 expression at 72 h of stimulation. Of note, markedly higher IFN-gamma concentrations were shown in supernatants of stimulated PBMCs from CC patients. Conclusions: Our report shows the dysregulated CD28 and CTLA-4 expression in PB T cells of CC patients, which may lead to impaired function of these lymphocytes and systemic immunosuppression related to disease progression.
    Pathology & Oncology Research 11/2011; 18(2):479-89. DOI:10.1007/s12253-011-9471-y · 1.81 Impact Factor
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    ABSTRACT: To assess the incidence and risk of urinary complications after anterior rectal cancer resection with regard to the surgical device used for total mesorectal excision (TME). During the years 2004-2009 we operated 374 rectal cancer patients with TME and the intent of autonomic nerves sparing intent. Seventeen patients underwent mesorectal dissection with ultrasound scalpel (US). They were compared to the control series of 35 cases selected from the patients for whom electrocautery was used. Selection was done in the manner to eliminate any other significant differences between groups. Intraoperative complications, postoperative mortality, anastomotic leakage and infectious complications did not occur. Urinary bladder disturbances developed in US group in 1 patient (6%) while in 12 patients (34%) in EC group (p<0.05). In US group the character of complication was transient stress incontinence with symptoms being significantly reduced during six postoperative months. In EC group two patients had dysuria, two nycturia, one had both. Stress incontinence occurred in six patients, complete incontinence requiring catheterization in one. When compared to EC, TME with US is related to lower risk of urinary complications and facilitates autonomic nerve preservation due to minimized thermal lateral tissue damage.
    Hepato-gastroenterology 11/2011; 59(115):724-6. DOI:10.5754/hge11460 · 0.91 Impact Factor
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    ABSTRACT: The aim of this study was to compare the imaging symptoms and microscopic findings in females with lobular neoplasia (LN) found on biopsy. 1,478 women who underwent primary open biopsy or surgical excision after percutaneous biopsy were reviewed. In 24 of them (1.6%), LN was found. In four patients, excisional biopsy with hook-wire localization was done primarily due to the radial scar. In 20 females, surgical excision of BIRADS 4 lesion was performed because of the presence of LN in specimens from the vacuum-assisted or core-needle percutaneous biopsy. Postoperative pathologic findings were compared to the radiological symptoms. In 13 women, LN did not produce any radiological symptoms and was an additional histologic finding existing near the other lesion: fibroadenoma and radial scar. In none of these lesions was an invasive cancer noticed. In one single patient, ductal carcinoma in situ was observed in the other segment of the breast. Invasive ductal cancer developed in the contralateral breast in one patient. In 11 patients, LN was diagnosed due to radiological symptoms produced by itself. In this group, the invasive lobular cancer was found in seven lesions (64%). Our finding suggests that LN producing suspicious radiological symptoms can be a different biologic type of this lesion when compared asymptomatic LN diagnosed which is usually found on biopsy as additional microscopic pathology. Symptomatic LN is probably associated with a higher potential of malignant transformation.
    Folia Histochemica et Cytobiologica 10/2011; 49(3):417-24. DOI:10.5603/FHC.2011.0059 · 1.00 Impact Factor
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    ABSTRACT: Background Hepatocyte growth factor plays an important role in tumor growth, metastasis and angiogenesis. C-met is HGF's high affinity receptor.AimThe aim of the study was to assess the correlations between c-met expression and clinic-pathological factors in breast cancer tissues. Furthermore, the purpose of the study was to evaluate the prognostic value of the hepatocyte growth factor receptor (HGFR, c-met) expressions in homogenous group of breast cancer patients.Materials and methodsTumor samples were collected from 302 patients with breast carcinoma treated with primary surgery. We have assessed the percentage of tumor cells with c-met expression, the intensity of reaction and the ratio of these two factors—immunoreactivity according to the Remmele score.ResultsWe have observed no correlations between HGFR immunoreactivities and clinical parameters (tumor size, grade, axillary lymph node status, age). In 5-year observation we have found prognostic value of assessing c-met immunoreactivity in primary tumor.Conclusion Our study has revealed prognostic value of c-met. Unlike in other authors’ studies, our patients’ group is very homogenous which might contribute to obtained results.
    Reports of Practical Oncology and Radiotherapy 09/2011; 16(5):173–177. DOI:10.1016/j.rpor.2011.04.001
  • 23rd European Congress of Pathology, Helsinki; 08/2011
  • 23rd European Congress of Pathology, Helsinki, Finland; 08/2011
  • The Breast 03/2011; 20. DOI:10.1016/S0960-9776(11)70129-1 · 2.58 Impact Factor
  • The Breast 03/2011; 20. DOI:10.1016/S0960-9776(11)70128-X · 2.58 Impact Factor
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    ABSTRACT: To evaluate comparatively the pain associated with ultrasound-guided core-needle (CN) and vacuum-assisted (VA) biopsy for non-palpable breast lesions. 723 women undergoing ultrasound-guided breast biopsy for BIRADS IV and V lesions according to the same standardised protocol were prospectively studied. 14-gauge CN biopsy with an automated gun was performed in 321 patients. In 402 women biopsy was made using 11-gauge VA hand-held probe. Immediately after the procedure patients were interviewed about the pain experienced during the biopsy and were asked to indicate at the pain intensity on a eleven-point scale: from 0 (none) to 10 (extreme, worst possible pain). The median rate of pain experienced by women during biopsy was 4 (range 2-7). There were no significant differences between CN and VA groups with regard to age, body mass index, menopausal status, history of parity, hormone replacement therapy, menopausal status, breast parenchymal pattern (according to Wolfe's classification), family history of breast cancer, lesion size and number of samples. CN biopsy with an automated gun was significantly more painful (P < 0.01) than procedure with VA hand-held device as evaluated by patients: median 6 (4-7) vs 3 (2-5), respectively. Despite using the larger needle VA procedure results in less pain experienced by women in comparison to CN biopsy with automated gun. Reduced patient discomfort should be one of the reasons for the preferential use of VA biopsy in the assessment of non-palpable breast masses.
    European journal of surgical oncology: the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology 02/2011; 37(5):398-403. DOI:10.1016/j.ejso.2011.02.002 · 2.89 Impact Factor
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    ABSTRACT: Minimally invasive biopsy should be a standard practice in the non-operative diagnosis of breast lesions that are suspicious for or highly suggestive of malignancy. The aim of this study was to compare the procedure duration time for different methods of minimally invasive image-guided vacuum-assisted breast biopsy (VABB). Six hundred and ninety-one women with nonpalpable breast masses classified as BI-RADS IV or V were studied. All of them underwent minimally invasive percutaneous VABB with an 11-gauge needle. In 402 patients an ultrasound-guided procedure with a hand-held device was performed while in 289 women stereotactic biopsy was carried out using a dedicated prone table unit with digital imaging. In each case the duration of biopsy was measured in terms of the total procedure time, room time and physician time. There were no significant differences between the stereotactic and ultrasound-guided groups with regard to patient age, body mass index, menopausal status, history of parity, hormone replacement therapy, breast parenchymal pattern (according to Wolfe's classification), family history of breast cancer, mass size and number of samples. Ultrasound-guided biopsy was found to take significantly less time than prone stereotactic biopsy in every aspect of procedure duration. Mean total procedure time, room time, and physician time in minutes were 26.7 ± 8.2 vs 47.5 ± 9.4 (P <0.01), 23.1 ± 8.5 vs 36.5 ± 9.2 (P <0.05), and 12.3 ± 5.6 vs 18.6 ± 5.9 (P <0.05), respectively. Ultrasound-guided breast biopsy is less time-consuming than the stereotactic procedure for both the patient and the physician. Because of the shorter procedure time (as well as other well-known advantages: real-time imaging, lower cost), ultrasound-guided biopsy should be considered the method of choice for sampling suspicious nonpalpable breast masses.
    01/2011; 97(4):517-21. DOI:10.1700/950.10407
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    ABSTRACT: The aim of the study was to evaluate the prognostic value of the vascular endothelial growth factor A (VEGF-A) and hepatocyte growth factor receptor (HGFR, c-met) expressions in homogenous group of breast cancer patients. Tumor samples were collected from 98 patients with invasive ductal breast carcinoma stage II treated with primary surgery. We have observed a strong correlation between VEGF-A and c-met. No correlations were found between VEGF-A or HGFR expressions and clinical parameters (tumor size, grade, axillary lymph node status, age), 5- and 10-years DFS or OS. Our study did not reveal any prognostic value of c-met or VEGF. In addition they are not useful to separate a patients' subgroup with poor prognosis. Unlike in other authors' studies, our patients' group is very homogenous which might tribute to obtained results.
    Folia Histochemica et Cytobiologica 06/2010; 48(1):78-83. DOI:10.2478/v10042-010-0016-0 · 1.00 Impact Factor

Publication Stats

394 Citations
123.61 Total Impact Points

Institutions

  • 2003–2014
    • Wroclaw Medical University
      • • Department of Oncology and Gynaecological Oncology Clinic
      • • Department of Pathomorphology
      • • Department of Histology and Embryology
      Vrotslav, Lower Silesian Voivodeship, Poland
  • 2008–2011
    • Dolnośląskie Centrum Onkologii
      Vrotslav, Lower Silesian Voivodeship, Poland
    • 4 Szpital Wojskowy z Polikliniką we Wrocławiu
      Vrotslav, Lower Silesian Voivodeship, Poland