Evidence for immune defects in breast and lung cancer patients.

Immunosuppression is often identified in cancer patients. The aim of this study was to evaluate several immune parameters for patients with breast and lung cancer. Immunophenotyping analysis showed that the cancer patients investigated had significantly lower absolute numbers of peripheral blood lymphocytes than controls. The immunosuppression was more evident for the breast cancer subgroup. The most severe immune defect noticed was the marked impairment of IFN-gamma secretion. A shift toward the Th2 phenotype as revealed by assessment of intracellular level of IFN-gamma and IL-4 was also noticed. The secretion of proinflammatory cytokines IL-1beta and TNF-alpha in whole blood cultures was not impaired. Although the proportion of activated cells was slightly lower than in the control group, our results showed that both peripheral T lymphocytes and NK cells of cancer patients could be induced to express early activation marker CD69 after ex vivo mitogen stimulation. In conclusion, our study revealed several immune defects in cancer patients. This suggests that an appropriate immunotherapeutical approach might be used to restore compromised immune functions with beneficial effects on both antitumor and general immunity.

Unusually large adrenal adenoma excreting unusually large amounts of androgen metabolites in urine.

A 27-yr female patient was admitted to the hospital because of secondary amenorrhea and a severe and complex virilization syndrome. The urinary 17-Ks, 17 OHCS and testosterone glucuronide values were greatly increased. The plasma testosterone through very high, was within the normal limits in males (3.52 ng/ml). Urography, echography and CT scan revealed a large right adrenal tumor. Removal of the tumor brought about a considerable clinical improvement: reoccurrence of the menstrual cycle, a progressive decrease in the virilization syndrome and normalization of the urinary 17-Ks, 17-OHCS and of the plasma testosterone.

Serum and intracystic levels of thyroxine (T4) and triiodothyronine (T3) in women with breast macrocysts.

In 15 patients with a total of 22 breast macrocysts serum and intracystic T4 and T3 and intracysts TSH were concomitantly radioimmunoassayed (using a technique with polyethylene glycol (PEG) for T3, T4, and a double antibody technique for TSH). While in most cysts (17/22) the T4 values were under those in the serum, in 21 cysts T3 was 2-18 times above the serum values. Intracystic TSH was at the lower limit of the normal serum TSH values whereas prolactin (PRL) and thyroglobulin (TGL) assayed in several cysts were not different from their serum value. It suggests that breast macrocysts are able to concentrate or even produce triiodothyronine.

Morphologic relationships between thyroid carcinoma and associated thyroid lesions in thyroidectomized patients. Comparison between 60 malignancies and 40 non-malignant goiters.

Given the endemic goiter in Romania, the authors sought to evaluate the morphologic prognostic factors with histogenetic implications in the development of thyroid cancer. On this purpose, the morphologic factors that correlate the type of thyroid cancer to the host stromal alterations were studied on 3 groups of 20 patients each and 2 control lots for multinodular goiter and nodular goiter. One group consisted of cases of thyroid carcinoma associated with endemic goiter, the second group included cases of thyroid carcinoma with thyroiditis and nodular goiter and the third group, the cases of thyroid sclerosing occult carcinoma. The study showed in all the cases, that thyroid cancer evoluates as an autonomic lesion, independent of the endemic goiter which is not a risk factor.

Dermatoglyphics in thyroid cancer.

Digito-palmar dermatoglyphics in 93 subjects with thyroid cancer (34 males, 59 females) of which 87.1% had folliculo-papillar adenocarcinoma were studied qualitatively and quantitatively. The findings were compared to the dermatoglyphics of 100 males and 100 females from the clinically healthy autochthonous population. The thyroid cancer subjects had a lower total digital ridge count (TDRC) and a reduced number of papillar ridges between the a-d triradii, than the control subjects. The A line showed a more marked transversality in cancer males and a more marked obliquity in cancer females. Qualitative examination showed more patterns in the second interdigital area and a higher incidence of typical and atypical form of sulcus transversus in the cancer group as against the controls. Qualitative and quantitative variations in dermatoglyphics were found with respect to the relation between the anatomo-pathologic form and the A, B, or O blood group. However, this variation is not conclusive enough to support the hypothesis of an association between dermatoglyphics and the blood groups in the A, B, O system on the one hand, and dermatoglyphics and the anatomo-pathologic form of thyroid cancer, on the other.

Tamoxifen responders selection by computerized contact thermography in benign breast disease.

Initial thermic breast values recorded by contact thermography in 29 premenopausal patients with benign breast disease were compared to those recorded 4 and 24 hours after a single 20 mg tamoxifen oral administration. Programmes worked out by the thermographic Prometheus computerized system processed the thermic values. The data obtained were analyzed and compared to the clinical effects resulting from 2 or 3 tamoxifen therapeutic cycles subsequently administered to these patients. The results obtained so far are indicative of the possibility to differentiate by thermographic means the responders from non-responders to subsequent tamoxifen-therapy for breast benign disease.

Efficacy and safety of mianserin in the treatment of depression of women with cancer.

Depression is a major complication of cancer. The efficacy and safety of mianserin were evaluated in a randomized placebo-controlled trial of 73 depressed women with cancer. According to RDC diagnosis, all patients showed situational major depression. Both groups were well matched for cancer localization, clinical stages, Karnofsky scores, duration of depression, baseline values on the Hamilton Depression Rating Scale (HDRS), Zung Self-Rating Depression Scale (ZSRDS), and Clinical Global Impression of Illness Severity (CGI-S), and for type of depression, whether dominantly depressive or depressive-anxious. Between days 7-21, there were significantly fewer dropouts with mianserin (7) than with placebo (15). When compared with placebo, there were significant improvements for mianserin for HDRS on days 7, 21 and 28, for ZSRDS on days 7 and 28, and for CGI-S on days 7, 14, 21 and 28. According to Clinical Global Impression of Illness Improvement (CGI-I) there were significantly more responders with mianserin (28) than with placebo (18). The efficacy index for mianserin was significantly greater than for placebo on days 21 and 28. At the end of the trial the scores for HDRS sleep disturbance factor and HDRS anxiety-somatization factor were significantly reduced for mianserin than for placebo. There were no significant differences in side-effects between treatment groups. It is concluded that mianserin is superior to placebo in reducing the severity and duration of depression which is present especially in patients with advanced cancer.(ABSTRACT TRUNCATED AT 250 WORDS)

Fine-needle aspiration biopsy of the thyroid correlated with clinical scintigraphic, echographic and pathologic data in nodular and diffuse goiter.

In order to make thyroid aspiration biopsy, a routine diagnostic and therapeutic procedure in the "C. I. Parhon" Institute of Endocrinology, the authors carried out a study on 100 patients with nodular or diffuse goiter. The results were corroborated by clinical, scintigraphic and echographic data. The cytologic diagnosis was compared with the histopathologic one in 50 operated cases and confirmed by the post-therapeutic clinical course in the remaining 50. The study of the cases classified as benign (83%), suspect (6%) and malignant lesions (11%) was made for each individual diagnosis, taking into account the specific clinical, scintigraphic, echographic, and cytologic aspects. The cytology of cold nodules showed that only 30% of the patients required surgery, the rest of them having benign lesions that benefited from puncture and drug therapy. The cytohistologic concordance in malignant tumors was 93.3% (73.3% for certain, 20% with suspicion). The proportion of false negative diagnoses was 6.6% (one case). None of the findings was falsely positive. The advantages of this procedure are discussed.

The serotonin and prolactin content of the blood in women with idiopathic galactorrhoea.

In two groups of women--one group of 12 normal-mammary-gland controls and another group of 10 idiopathic galactorrhoea patients--we determined the blood concentration of serotonin and prolactin. The obtained data show no significant differences between the studied groups either in serotonin or prolactin levels i.e., serotonin is not implied in the pathogeny of idiopathic galactorrhoea. The data are confirming our previous results concerning the functional correlations between the serotonin system and prolactin release, as well as the data obtained by other authors on the normal values of prolactin in idiopathic galactorrhoea.