Evaluation of E-cadherin, Ki-67 and lymphatic vessel invasion in abdominal metastases of human breast cancer.

BACKGROUND: Abdominal metastasis is a rare finding in human breast cancer and is associated with a poor prognosis. Previous data suggest that mainly invasive lobular carcinomas tend to metastasize to the abdomen. The aim of the present study was to offer deeper insight into the biology of this rare kind of tumor spread. MATERIALS AND METHODS: The expression of the cell adhesion protein E-cadherin, the cell proliferation marker Ki-67, as well as lymphatic vessel invasion (LVI), determined by staining with D2-40, were analyzed by immunohistochemistry in samples of primary breast cancer (n=12) and their associated abdominal metastases. RESULTS: In nine cases the tumors and their abdominal metastases were E-cadherin-positive and biologically belonged to the invasive ductal subtype. In three E-cadherin-positive cases, abdominal metastasis was an earlier event compared to E-cadherin-negative cases (90 months versus 37 months). None of the primary tumors showed LVI after immunostaining with D2-40. Higher Ki-67 levels were found in the E-cadherin-positive primaries and metastases. CONCLUSION: Most of the investigated tumors biologically belonged to the invasive ductal subtype. The findings of this analysis provided evidence that metastatic spread to the abdomen does not predominantly appear in lobular invasive carcinomas.

Mortality from neurodegenerative disease and exposure to extremely low-frequency magnetic fields: 31 years of observations on Swiss railway employees.

AIMS: The objective of the present study was to investigate the relationship between extremely low-frequency magnetic field (ELF-MF) exposure and mortality from several neurodegenerative conditions in Swiss railway employees. METHODS: We studied a cohort of 20,141 Swiss railway employees with 464,129 person-years of follow-up between 1972 and 2002. For each individual, cumulative exposure was calculated from on-site measurements and modelling of past exposure. We compared cause-specific mortality in highly exposed train drivers (mean exposure: 21 microT) with less exposed occupational groups (for example station masters: 1 microT). RESULTS: The hazard ratio for train drivers compared to station masters was 1.96 [95% confidence interval (CI) = 0.98-3.92] for senile dementia and 3.15 (95% CI = 0.90-11.04) for Alzheimer's disease. For every 10 microT years of cumulative exposure senile dementia mortality increased by 5.7% (95% CI = 1.3-10.4), Alzheimer's disease by 9.4% (95% CI = 2.7-16.4) and amyotrophic lateral sclerosis by 2.1% (95% CI = -6.8 to 11.7). There was no evidence for an increase in mortality from Parkinson's disease and multiple sclerosis. CONCLUSIONS: This study suggests a link between exposure to ELF-MF and Alzheimer's disease and indicates that ELF-MF might act in later stages of the disease process.

Leukaemia, brain tumours and exposure to extremely low frequency magnetic fields: cohort study of Swiss railway employees.

AIMS: To investigate the relationship between extremely low frequency magnetic field (ELF-MF) exposure and mortality from leukaemia and brain tumour in a cohort of Swiss railway workers. METHODS: 20,141 Swiss railway employees with 464,129 person-years of follow-up between 1972 and 2002 were studied. Mortality rates for leukaemia and brain tumour of highly exposed train drivers (21 muT average annual exposure) were compared with medium and low exposed occupational groups (i.e. station masters with an average exposure of 1 muT). In addition, individual cumulative exposure was calculated from on-site measurements and modelling of past exposures. RESULTS: The hazard ratio (HR) for leukaemia mortality of train drivers was 1.43 (95% CI 0.74 to 2.77) compared with station masters. For myeloid leukaemia the HR of train drivers was 4.74 (95% CI 1.04 to 21.60) and for Hodgkin's disease 3.29 (95% CI 0.69 to 15.63). Lymphoid leukaemia, non-Hodgkin's disease and brain tumour mortality were not associated with magnetic field exposure. Concordant results were obtained from analyses based on individual cumulative exposure. CONCLUSIONS: Some evidence of an exposure-response association was found for myeloid leukaemia and Hodgkin's disease, but not for other haematopoietic and lymphatic malignancies and brain tumours.