Cancer

The malignant Hodgkin and Reed–Sternberg cells (H/RS) of Hodgkin disease express CD40 receptor that can transduce survival signals. In this report, the authors identify benign infiltrating and circulating B cells as a potential source for CD40 ligand, raising the possibility that B cells may contribute to the survival of H/RS cells in vivo.

Eighty-one patients with lymphomatous involvement of the breast were evaluated retrospectively, and clinical data were obtained; 44% of patients had primary lymphoma of the breast, and the other patients had breast involvement of disseminated disease at the time of initial diagnosis (29%) or had a recurrence of preexisting lymphoma to the breast (27%). Screening mammography has not altered substantially the detection of breast lymphoma.

This study showed that high levels of plasma endostatin correlated with poor clinical outcomes in patients with acute myeloid leukemia/myelodysplastic syndrome.

Allogeneic peripheral blood stem cell transplantation with prophylactic growth factor-primed donor lymphocyte infusion may be a potentially curative strategy for the treatment of patients with hematologic malignancies who have a high risk of recurrence.

The authors compared the efficacy and toxicity of the liposome-encapsulated doxorubicin, TLC D-99 and conventional doxorubicin in first-line treatment of metastatic breast carcinoma. They found that single-agent TLC D-99 produces less cardiotoxicity than doxorubicin, while providing comparable antitumor activity.

Understanding why women fail to use breast cancer screening as recommended and finding ways to encourage prompt annual screening from the age of 40 years may lead to considerable reductions in death from breast carcinoma, and such efforts should have a high priority.

In multiple endocrine neoplasia type 2B (MEN 2B) patients, total thyroidectomy together with neck lymph node dissection should be performed as soon as the diagnosis of the MEN 2B syndrome is made, preferably within the first 6 months of life. The authors did not demonstrate a more aggressive phenotype of medullary thyroid carcinoma (MTC) occurring in MEN 2B syndrome, compared with other MTCs.

Combined modality therapy using radioimmunotherapy and chemotherapy with dacarbazine (DTIC) or a two- or four-drug combination including DTIC augments the antitumor efficacy of either modality alone for medullary thyroid carcinoma, without a significant increase in toxicity.

Both in situ and invasive carcinoma in pancreatic intraductal papillary-mucinous neoplasms (IPMNs) may be more common than previously recognized. Colloid (mucinous) carcinomas and tubular carcinomas occur that resemble conventional ductal adenocarcinomas. Although they are less aggressive as a group than ductal adenocarcinomas, IPMNs may pursue a deadly course, even in the absence of identifiable invasive carcinoma. Conversely, patients with invasive tubular carcinomas arising from IPMNs may have a more favorable clinical course than patients with ductal adenocarcinomas without an IPMN component.

A retrospective study of 933 patients who had undergone gastrectomy for early gastric carcinoma revealed that early gastric carcinoma with signet ring cell histology had a lower rate of lymph node metastasis and more favorable prognosis. Early gastric carcinoma with signet ring cell histology could be managed by less invasive surgery.

The familial atypical multiple mole melanoma syndrome shows a strong association with pancreatic carcinoma in context with the CDKN2A germline mutation that may constitute a hereditary cancer syndrome involving these and possibly other forms of cancer.

This Phase II study of gemcitabine and docetaxel in patients with advanced pancreatic carcinoma demonstrated that this combination is tolerable. A median survival of 8.9 months in this patient population warrants further exploration of this combination in multicenter studies.

The authors used analysis of X chromosome inactivation to determine the clonal origin of muscle-invasive urothelial carcinoma of the urinary bladder. Some muscle-invasive urothelial carcinomas may arise from independently transformed progenitor urothelial cells, supporting the “field effect” theory for bladder carcinogenesis.

Collecting or Bellini duct carcinoma (CDC) is a rare variant of kidney carcinoma that is associated with an aggressive course and extremely poor prognosis. CDC accounts for approximately 1–3% of all renal neoplasms and has a tendency to occur in younger, male, and white patients. Immunotherapy does not appear to be effective and to the authors' knowledge there are no standard treatment regimens for CDC. In the current study, the authors report a patient with CDC who achieved a major response to combination chemotherapy with doxorubicin and gemcitabine.

The pelvic control or actuarial complication rates were comparable between high-dose-rate and low-dose-rate treatment in a prospective randomized clinical trial for the treatment of cervical carcinoma.

In patients with vulvar carcinoma, the adhesion molecule CD44v6 confers prognostic information in addition to that provided by the established clinicopathologic parameters of tumor stage and lymph node status.

Quality of life and mood were prospectively investigated for one year among women with early stage and regionally advanced gynecologic cancers. Over and above disease extent and treatment intensity, patients' ability to find positive meaning, acceptance, and social support was prospectively related to better QOL at one year, whereas disengagement was related to poorer QOL and mood.

The activity of serum lysophospholipase D, which produces bioactive lysophosphatidic acids in patients with ovarian tumors, was roughly equivalent in healthy women, patients with benign tumors, and patients with ovarian carcinoma. Therefore, the activity of serum lysophospholipase D would not be a good marker for ovarian carcinoma.

Serum squamous cell carcinoma (SCC) antigen is transcribed by two nearly identical genes (SCCA1 and SCCA2) and is produced mainly by SCCA1. In the current study, the authors found that the serum SCC antigen level was high in patients with sinonasal inverted papilloma (IP), and that IP overexpressed SCCA1. Serum SCC antigen may have potential to be a useful biologic marker for patients with sinonasal IP.

Gene transfer and expression of exogenous p53 by using Ad-p53 demonstrates suppressive effects on human papillomavirus immortalized and carcinogen transformed oral keratinocytes as well as head and neck carcinoma cells. Results suggest that p53 gene transfer may be appropriate for clinical studies in patients at risk for head and neck carcinoma.

It has been suggested that the expression of glial cell line-derived neurotrophic factor (GDNF) in patients with bile duct carcinoma plays a role in perineural invasion, which is a prognostic factor, through chemoattraction to its receptors, GDNF receptor α1 and RET receptor tyrosine kinase, which are expressed in peripheral nerve tissues.

Transforming growth factor-β1 may be a useful serologic marker in detecting hepatocellular carcinomas earlier because it shows higher sensitivity than alpha-fetoprotein with the same specificity in the diagnosis of small hepatocellular carcinomas.

Age should not dictate which septuagenarians should be entered on chemotherapy-based treatment studies among patients with Stage III and IV nonsmall cell lung carcinoma.

p53 mutation analysis is helpful in distinguishing pulmonary metastasis from second primary lung carcinoma.

In a cohort of 600 patients with primary nonthoracic T2 soft tissue sarcomas, routine chest computed tomography (CT) scanning was most cost-effective in patients with extremity and/or high-grade lesions. Chest CT scanning had a lower yield, was less cost-effective, and did not appear to be indicated routinely for patients with low-grade sarcomas.

Immunomagnetic epithelial cell enrichment can find tumor cells in pleural and peritoneal fluids that would not be detected by conventional cytologic analysis.

The genetic model for colorectal tumorigenesis is well known, and colorectal adenomas, which have varying degrees of dysplasia, have been considered attractive neoplastic lesions for the analysis of genetic changes in the early stage of colorectal tumorigenesis. Although it is believed that p53 suppressor gene mutations, compared with the K-ras oncogene, occur at a later stage of colorectal tumorigenesis, the distribution of these genetic alterations at an early stage remains poorly characterized. In this study, it was found that the prevalence and frequency of p53 positive immunostaining were significantly greater compared with those of K-ras mutations in both low-grade and high-grade dysplasia, suggesting that the p53 suppressor gene may be associated more closely with the progression of colorectal adenomas compared with the K-ras oncogene.

Galectin ligands Lamp-1, Lamp-2, and Mac-2-BP that influence tumor progression by altering cell to cell interaction were analyzed in human pancreatic carcinoma. Lamp-1 overexpression was associated with better survival, whereas for Lamp-2 and Mac-2-BP this was not observed.

Telomerase activity in thymoma tissue is higher than in both thymic carcinoma and primary lung adenocarcinoma. Telomerase activity relates to induced immature lymphocytes in thymoma and relates to tumor stage in thymic carcinoma.

Catheter-related venous thrombosis is one of the most frequent complications of central venous catheters. The objective of this prospective study was to assess whether silver-coated central venous catheters pose an additional risk in the development of catheter-related thrombosis. The authors concluded that the novel silver-coated central venous catheter does not cause a higher rate of central venous thrombosis compared with standard central venous catheters.

The combined experience of the Italian and German Cooperative Groups for Pediatric Soft Tissue Sarcoma provides evidence that over time multimodal treatment including surgery and sarcoma-based chemotherapy has improved patient survival.

This study examined neuropilin-1 and –2 upregulation of vascular endothelial growth factor (VEGF) in human neuroblastoma, concluding that neuropilin might be a sensitive angiogenic measure of VEGF systems in neuroblastoma, particularly in its early stages.

The authors investigated the feasibility and efficacy of intensive chemotherapy given prior to irradiation in pediatric patients with malignant glioma. The findings indicated that early, intensive chemotherapy increases survival rates in patients with completely resected malignant glioma.

A multicountry ecologic study was conducted to determine dietary links to breast carcinoma mortality. It was found that the fraction of energy derived from animal products is the highest risk factor, and, conversely, that fraction of energy derived from vegetable products is the highest risk reduction factor, with latitude, an index for solar ultraviolet-B radiation playing an important role for developed Western countries, and alcohol (risk) and fish intake (risk reduction) playing minor roles.

During the metaplasia-dysplasia-carcinoma sequence in Barrett esophagus, cyclin B1 positive cells not only increase significantly in number but also expand within the mucosal crypt to more superficially located zones.