ABSTRACT
Between 1976 and 1986 42 restaging laparotomies (RL) were performed in patients with Hodgkin's disease (HD). Eleven patients had received only radiotherapy, 25 chemotherapy and 6 patients had received radiotherapy plus chemotherapy. Thirty-seven patients underwent RL because of the uncertain answer to therapy. In 17 cases the persistence of abdominal disease was suspected; in 20 patients, on the contrary, the RL was performed to confirm the clinical evaluation of complete remission (CR). In the first group 6 RL (35%) were positive, in the latter group in one case only (5%) evidence of disease was found. In the last 5 patients RL was performed for abdominal recurrence after a Relapse free Survival (RFS) of 60 months (range 25-110 months). RFS of pathologically evaluated patients is significantly higher than that of those clinically evaluated. The great number of false positive (65%) suggests a role of RL in avoiding any further therapy in patients having no clear signs of disease after treatment completion; thus permitting a lower incidence of complications such as: induced leukaemia, neoplasia and infertility.
Subject(s)
Hodgkin Disease/diagnosis , Laparotomy , Neoplasm Recurrence, Local/diagnosis , Adolescent , Adult , Child , Evaluation Studies as Topic , Female , Hodgkin Disease/mortality , Hodgkin Disease/therapy , Humans , Male , Middle Aged , Neoplasm Staging , Time FactorsABSTRACT
In patients undergoing liver scintigraphy, surgical biopsies were obtained at laparotomy. The scintiscans were considered positive on the basis of two different levels of severity of the clinical picture, corresponding to an optimistic or to a pessimistic evaluation of scans. The sensitivity, specificity, predictive value and discriminating factor of the two types of scintiscan evaluation were also assessed.
Subject(s)
Hodgkin Disease/diagnostic imaging , Liver Diseases/diagnostic imaging , Biopsy , Hodgkin Disease/pathology , Humans , Laparotomy , Liver Diseases/pathology , Radionuclide ImagingABSTRACT
In the present study the number of E-RFC and the in vitro response to PHA and ConA were determined for lymphocytes obtained from spleens and lymph nodes of untreated HD patients. The results were correlated with tissue involvement and with the histological pattern of the disease. Our investigation has revealed: (1) involved spleens and lymph nodes contained a higher percentage of T-lymphocytes than uninvolved tissues. The differences was statistically significant for lymph nodes. (2) A statistically significant correlation was not found between T-lymphocyte numbers and histology. (3) Lymphocytes from uninvolved spleens were significantly more reactive to both mitogens than cells from involved spleens and control non-neoplastic spleens as well. (4) Similar results were obtained with lymph node lymphocytes; however, a significant difference was observed only when cells were stimulated with ConA. (5) The difference in proliferative response between uninvolved and involved tissues was maximally expressed in MC and progressively decreased in NS and LP. (6) T-cell enrichment does not alter the difference between uninvolved and involved spleens. (7) Cells from uninvolved and involved spleens, cultured for 24 hours, maintained unchanged their proliferative capacity. In this study evidence is provided that in HD T-lymphocytes from uninvolved tissues are characterized by an increased reactivity in mitogens, whereas cells from involved tissues are normally responsive.
Subject(s)
Hodgkin Disease/immunology , Lymph Nodes/immunology , Spleen/immunology , T-Lymphocytes/immunology , Adolescent , Adult , Cell Division/drug effects , Cells, Cultured , Child , Child, Preschool , Concanavalin A/pharmacology , Female , Hodgkin Disease/pathology , Humans , Lymph Nodes/pathology , Lymphocyte Activation , Male , Middle Aged , Phytohemagglutinins/pharmacology , Spleen/pathology , T-Lymphocytes/drug effectsABSTRACT
Natural killer (NK) activity against K-562 myeloid cell line was evaluated in 21 spleens and 14 lymph nodes from patients with Hodgkin's disease (HD). NK activity of eight HD-involved (HD+) spleens [556 lytic units (LU)] was found 5-fold higher than that of 13 HD-uninvolved (HD-) spleens (112 LU) (p less than 0.01). Moreover, NK activity of HD+ spleens was significantly different (p less than 0.05) from that of three spleens involved by non-HD lymphoma (100 LU). NK activity of four spleens from nonneoplastic patients (250 LU) was intermediate between those of HD+ and HD- spleens. Lymph node cells were about 10-fold less cytotoxic. NK activity of seven HD+ lymph nodes (43 LU) was 3-fold higher than that of three lymph nodes involved by non-HD lymphoma (8 LU). However, these differences were not statistically significant. Our data are compatible with increased NK activity in HD+ tissues as well as with depressed NK activity in HD- tissues. The observation that NK activity of peripheral blood leukocytes from nine HD patients (116 LU) (p less than 0.05 only at 100:1 effector:target cell ratio) may support the latter interpretation. Partial characterization of effector cells in HD+ and in HD- spleens indicated that, in both instances NK cells were nonadherent and almost equally distributed between the erythrocyte-negative and -positive cell fractions. Finally, NK activity of both HD+ and HD- spleen cells could be further potentiated in vitro by interferon.
