Advanced gastric cancer and prognosis.

The morphological features of 158 gastric carcinomas were analyzed in an attempt to identify patterns best correlated with prognosis. To this end, the depth of infiltration, vascular invasion, intra- and perineoplastic lymphocytic infiltrate, lymph node metastases and number of metastatic lymph nodes were evaluated according to the several classifications for advanced gastric cancer. A good correlation between prognosis and histological features of malignancy were observed, as well as different five-year survival rates for Mulligan, Lauren and Ming histotypes. However, when the influence of each single morphological criteria of malignancy was examined, these differences disappeared for Mulligan and Lauren histotypes. On the other hand, the better prognosis for Ming expanding type carcinomas appeared unrelated to any individual feature of malignancy.

Hormone receptors and breast cancer: correlations with clinical and histologic features.

The possible relationships between hormone receptor status and several clinical (age, gynecologic history, clinical stage) and morphologic aspects (histologic grade, vascular invasion, lymphocytic infiltration, necrosis, fibrosis, elastosis and lymph node metastasis) were evaluated. A highly significant correlation between estrogen receptor levels, patient age, menses regularity and postmenopausal status was found. The histologic features most significantly related to tumor receptor status were histologic grade, lymphocytic infiltrate, necrosis and elastosis. Since these same histologic aspects appear to influence prognosis in breast cancer, the prognostic significance attributed to tumor receptor levels is substantiated. Therefore the importance of this assay is confirmed, not only for its diagnostic and therapeutic purposes, but also for its prognostic value.

Is mild gastric epithelial dysplasia an indication for follow-up?

We evaluated the changes over 1-55 months in mild gastric epithelial dysplasia (a relatively frequent, but not widely studied histological lesion) in 20 patients (11 with benign gastric ulcer, eight with chronic gastritis, and one after Billroth 2 operation), in order to ascertain whether to follow-up such patients in the future. Regression of the lesion was documented in 13 (65%), and no change in six (30%). Progression from mild to moderate dysplasia occurred in only one patient (5%). As mild dysplasia regresses or remains unchanged in most patients, at least over the short-term, specific follow-up is probably unnecessary. Nevertheless, a rational program of monitoring the associated precancerous conditions is in order.

Gastric epithelial dysplasia and sulphomucin-type intestinal metaplasia.

The HID-AB histologic staining technique, which distinguishes sulphomucin from sialomucin types of intestinal metaplasia, was employed in endoscopic gastric mucosal biopsies to evaluate their frequency of association with epithelial dysplasia. Sulphomucin-type intestinal metaplasia was found in 33% of the cases under observation; moderate or severe dysplasia was only associated with this type of intestinal metaplasia. Its precancerous significance can be ascertained only by means of prospective studies.

Precancerous significance of colonic type intestinal metaplasia.

Numerous epidemiologic, morphologic and experimental studies have demonstrated the precancerous significance of intestinal metaplasia. We report here the results of a histochemical study of intestinal metaplasia in which 2 types were observed: one with sialomucin-secreting cells typical of the small intestine, and the other with sulphomucin-secreting cells typical of colonic mucosa. The correlation between colonic type intestinal metaplasia and gastric cancer is explored, since a significant precancerous value for this type of intestinal metaplasia is suggested.

Is the solitary papilloma of the bronchus always a benign tumor?

99 pulmonary resections for benign tumors were performed during the period 1967-1978. 4 patients showed bronchial papilloma. Solitary papilloma of the bronchus is one of the rarest benign tumors; the differences of multiple papillomatosis and inflammatory polyp are stressed. Malignant change was observed in 3 of the 4 cases. The 4 patients presented a 2- to 5-year history of hemoptysis episodes and radiographic aspects characterized by intermittent atelectasis. Radical surgery is the only satisfactory therapy; endoscopic removal of the neoplasm is often incomplete and unsatisfactory.

Malignancy grading in squamous carcinoma of uterine cervix treated by surgery.

Some morphological patterns (histological type, vascular invasion, depth of invasion, lymphocytic infiltrate, mode of spread, necrosis) in 125 cases of squamous cervical carcinoma treated by surgery were analysed and graded in order to identify a histoprognostic score. Clinical data on F.I.G.O. stage, modality of surgical treatment, age, hormonal state (pre- or post-menopause) and 5-year survival were known for each patient. Two groups (low and high malignancy) were disclosed, and the difference of survival rate between the 2 was highly significant (P less than 0.001).

[Histochemistry of mucosubstances. Technical considerations]. / Histochimie des mucosubstances. Considérations techniques.

A report concerning the histochemical methods used to differentiate mucosubstances and certain technical modifications made with the aim of obtaining better results : 1) rapid passage in a solution at pH1 after alcian blue reaction in order to ensure staining of sulfate mucosubstances only ; 20 plunging of sections first in FeCl for 10 minutes by the H.I.D. method ; 3) in the methylation reaction the optimum time is 12 hours.

Estrogen receptors and post-receptor markers in human breast cancer: a reappraisal.

Several major defects in the estrogen receptor pathway have been evidenced in most human breast cancers by an immunofluorescence tracing of estradiol receptor complexes at the single cell level. Endogenous peroxidase seems a reliable postreceptor marker for estrogen-sensitive breast cancer cells. Since almost all human breast cancers appear to include both hormone-sensitive and autonomous cell populations, a combined use of endocrine and cytotoxic regimens is urged. The hormonal regulation of tumor growth parameters could be exploited in order to achieve a maximum recruitment of synchronized tumor cells at risk to chemotherapy.