Cancer

The implication of new evidence from Sweden is that greater benefit will result from screening women ages 40-49 years annually compared with every 18 months.

See also pages 2091-9.

In spite of evidence to the contrary, some low grade central nervous system tumors and even nonneoplastic lesions can be misconstrued as aggressive neoplasms and treated accordingly. However, when these lesions are reviewed in their full clinical, radiologic, and pathologic context, features often are present suggesting that a low grade neoplasm or nonneoplastic lesion is present. This article reviews these alerting features.

Four hundred and thirty-nine asymptomatic adults were examined by both balloon and sponge cytologic samplers, followed by endoscopy. The balloon and sponge samplers had sensitivities of 47% and 24%, respectively, and specificities of 81% and 92%, respectively, for detecting histologic squamous dysplasia or carcinoma.

In this study, coinfection with the hepatitis B and C viruses was found to be much less prevalent than generally is claimed. Even in a few hepatocellular carcinoma (HCC) patients with this coinfection, the mutually exclusive viral replication was noted, suggesting that coinfection plays little if any role in the development of HCC.

To the authors' knowledge, this study represents the first time functional thrombin receptors have been identified in human epidermoid carcinoma HEp-2g cells and the involvement of protein kinase C in thrombin receptor-mediated effects on proliferation of HEp-2g cells demonstrated.

This study found stereotactic radiosurgery to be a safe and effective treatment for patients with lung carcinoma with brain metastases. However, further comparison with results after whole brain irradiation or tumor resection is warranted.

Repeat isolated limb perfusion with tumor necrosis factor and melphalan after failure of initial isolated limb perfusion using chemotherapeutics alone for patients with in-transit melanoma is associated with a response rate similar to the best response rates achieved with initial isolated limb perfusion with any available regimens.

A randomized trial of mammographic screening for breast carcinoma was conducted in Gothenburg, Sweden among women ages 39-49 years, with an 18-month interscreening interval. A statistically significant 45% reduction in breast carcinoma mortality was observed in association with invitation to screening.

See also pages 2035-9.

The bcl-2 gene is in germ line configuration and its CpG island is demethylated independently of its level of expression in sporadic breast carcinoma. Moreover, the expression of bcl-2 is correlated inversely with the immunohistochemical expression of p53 but not with the presence of p53 gene mutation.

The level of tumor chromogranin A immunohistochemical staining was found to be a strong predictor of disease specific survival and was superior to standard pathologic prognostic factors in 71 patients with localized prostate carcinoma treated with radical prostatectomy.

Testicular tumors of the adrenogenital system are bilateral benign testicular masses that may develop in the early adult life of males with congenital adrenal hyperplasia and resemble Leydig's cell tumors. A case report of associated seminoma and myelolipoma in the undescended testis of a patient with congenital adrenal hyperplasia is presented. The possibility of an associated neoplasm that could be potentially fatal should be considered whenever a testicular tumor in a patient with the adrenogenital syndrome continues to grow despite adequate hormonal treatment.

A response rate of 31% (95% confidence interval, 18-46%) is reported for the combination of 5-fluorouracil, interferon-α, and interleukin-2 in the treatment of patients with metastatic renal cell carcinoma. The toxicity of this combination was significant and did not appear to justify its use in general practice.

Progesterone receptor (PR) in astrocytic tumors correlates with histologic grade. PR positive tumors represent those astrocytomas with a higher Ki-67 labeling index.

Although pleomorphic xanthoastrocytomas are relatively benign, slow growing astrocytic tumors, occasional rapid progression to a malignant glioma occurs. A review of histologic features and DNA flow cytometry in tumors from 12 patients did not reveal any factors that predicted recurrence in two patients. Surprisingly, DNA flow cytometry parameters were significantly higher than those found in low grade fibrillary astrocytomas and were most similar to malignant astrocytic tumors.