Pathology findings and validation of gastric and esophageal cancer cases in a European cohort (EPIC/EUR-GAST).

OBJECTIVE: Cardia, non-cardia and intestinal and diffuse subtypes of gastric cancer may have different trends and etiological factors. However, the available information is not always collected in population cancer registries, and heterogeneous criteria have been applied for the histopathological classification of tumors. We describe the pathological features of incident gastric and esophageal cancers identified within the European Prospective Investigation into Cancer and Nutrition (EPIC). MATERIAL AND METHODS: In an investigation on gastric and esophageal cancer (EUR-GAST) in the EPIC project, a validation study of diagnoses reported by EPIC centers was conducted by a European panel of pathologists. Original pathology reports, stained slides of tumors and the respective paraffin blocks were requested from the centers. RESULTS: The whole series encompassed 467 cancer cases (gastric and esophageal cancers). Material was available for histopathological validation in 263 cases (56%); in the remaining cases, information was retrieved from the original reports (n=110; 24%) or codes provided by the EPIC centers (n=94; 20%). Among cases submitted to histopathological validation reported originally as unknown histotype or unknown site, a specific diagnosis was made in 95% and 74% of the cases, respectively. In cases for which only the original reports were available, the respective percentages were 46% and 67%. Gastric adenocarcinomas were classified according to site (cardia (29.4%), non-cardia (48.2%) and unknown (22.4%)) and histological type (intestinal (33.4%), diffuse (33.7%) and mixed, unclassified or unknown (32.9%)). Frequency of cardia was higher in Northern countries (35%) than in Mediterranean countries (18%). CONCLUSIONS: In addition to providing epidemiological data within the EPIC cohort on gastric and esophageal adenocarcinomas, the results reported here confirm the relevance of a validation study, notably for multicenter studies.

Plasma and dietary vitamin C levels and risk of gastric cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC-EURGAST).

Vitamin C is an antioxidant and inhibitor of carcinogenic N-nitroso compound production in the stomach. Higher dietary vitamin C consumption is associated with decreased risk of gastric cancer (GC) in numerous case-control studies, but data from prospective studies are limited, particularly so for blood measures of vitamin C. The objective of this study was to determine the association of plasma and dietary vitamin C levels with the risk of GC in a case-control study nested within the European Prospective Investigation into Cancer and Nutrition (EPIC), a large cohort involving 10 European countries. Using a fluorometric method, vitamin C was measured in pre-diagnostic plasma from 215 GC cases (matched controls = 416). Conditional logistic regression models adjusted by body mass index, total energy intake, smoking status/duration/intensity and Helicobacter pylori infection status were used to estimate relative cancer risks. No association with GC risk was observed for dietary vitamin C, whereas an inverse GC risk was observed in the highest versus lowest quartile of plasma vitamin C [odds ratio (OR) = 0.55, 95% confidence interval (CI) = 0.31-0.97, P(trend) = 0.043], which was maintained after exclusion of cases with

[Prognostic significance of prostatic carcinoma grading according to Helpap]. / Zur prognostischen Bedeutung des Grading von Prostatakarzinomen nach Helpap.

The prognostic significance of the subgrading system introduced by Helpap was retrospectively examined in 342 prostatic carcinomas, revealing a distinct decrease on survival rate with increasing grade of malignancy: during the first three years following diagnosis 21 per cent of the patients with carcinomas graded as Ib died, while all patients with grade Ia carcinomas were still alive. Thus, according to our results, a clinical observation, but no further surgical treatment is recommended in grade Ia cases. At the time of diagnosis, 54.3 per cent of our cases were at the stages T3 or T4. 15.4 per cent of the carcinomas were incidental. The majority (52 per cent) of these cases had to be graded as Ia or Ib, but only 14.8 per cent of the non-incidental tumors did belong to these prognostically most favourable groups. In summary, the prostate carcinoma grading system introduced by Helpap is characterized by prognostic significance and good reproducibility, and thus should be part of the routine diagnosis of prostate carcinoma.

[Primary malignant melanoma of the central nervous system]. / Primäres malignes Melanom des Zentralnervensystems.

Obduction of a woman aged 52 years, showed a diffuse primary leptomeningeal melanoblastosis with development of a malignant melanoma in adjacent region of brain parenchyma. Clinically it was misdiagnosed as a haematoma.