Herencia de la susceptibilidad a los tumores y a las metástasis en roedores / Inheritance of susceptibility to tumors and metastases in rodents

Se investigaron los factores genéticos que regulan la susceptibilidad al Sarcoma E100 (SE100) y al linfoma TACB (L-TACB) de ratas y la capoacidad metastásica de este tumor. A partir de una línea e endocriada de ratas se obtuvo una sublínea resistente eR y otra susceptible eS al S-E 100. Las frecuencias fenotípicas de resistencia y susceptibilidad en e, eR,, eS, F1 y F2 permitieron elaborar un modelo teórico de dos pares de genes independientes que regularían la susceptibilidad al S-E 100. El comportamiento del L-TACB y las diferentes respuestas inmunes a antígenos del S-E 100 y del L-TACB y a antígenos no relacionados (glóbulos rojos de camero) en eR y eS avalaron la hipótesis de que los genes seleccionados regularían la respuesta inmune antitumoral. L participación del sistema inmunológico no descartó la presencia de factores de crecimeiento tumoral en la respuesta diferencial de eR y eS sugerida por la respuesta a injertos de S-E 100 irradiados debajo de la cápsula renal. Los patrones de herencia de dos linfomas, el L-TACB y el DGE en la rata y en el ratón evidenciaron que la susceptibilidad a estos linfomas está regida por genes dominantes. La capacidad metastática del L-TACB estaría condicionada por genes distintos de los que facilitarían el crescimiento del tumor primario

Herencia de la susceptibilidad a los tumores y a las metástasis en roedores / Inheritance of susceptibility to tumors and metastases in rodents

Se investigaron los factores genéticos que regulan la susceptibilidad al Sarcoma E100 (SE100) y al linfoma TACB (L-TACB) de ratas y la capoacidad metastásica de este tumor. A partir de una línea e endocriada de ratas se obtuvo una sublínea resistente eR y otra susceptible eS al S-E 100. Las frecuencias fenotípicas de resistencia y susceptibilidad en e, eR,, eS, F1 y F2 permitieron elaborar un modelo teórico de dos pares de genes independientes que regularían la susceptibilidad al S-E 100. El comportamiento del L-TACB y las diferentes respuestas inmunes a antígenos del S-E 100 y del L-TACB y a antígenos no relacionados (glóbulos rojos de camero) en eR y eS avalaron la hipótesis de que los genes seleccionados regularían la respuesta inmune antitumoral. L participación del sistema inmunológico no descartó la presencia de factores de crecimeiento tumoral en la respuesta diferencial de eR y eS sugerida por la respuesta a injertos de S-E 100 irradiados debajo de la cápsula renal. Los patrones de herencia de dos linfomas, el L-TACB y el DGE en la rata y en el ratón evidenciaron que la susceptibilidad a estos linfomas está regida por genes dominantes. La capacidad metastática del L-TACB estaría condicionada por genes distintos de los que facilitarían el crescimiento del tumor primario (AU)

Fine needle aspiration cytodiagnosis of nasopharyngeal carcinoma in cervical lymph nodes. A study of 40 cases.

The cytologic features of fine needle aspiration (FNA) samples of 40 metastatic nasopharyngeal carcinomas in cervical lymph nodes were reviewed. FNA was performed with 21-gauge or 23-gauge needles; the FNA smears were stained with the Papanicolaou stain or with hematoxylin and eosin. Several typical cytologic features were noted. All cases showed the presence of clusters of cohesive tumor cells, most of which were undifferentiated. Medium-sized oval vesicular nuclei were present in 85% of the cases; all cases had prominent nucleoli. The cytoplasm was generally pale, with ill-defined boundaries in 87.5% of the cases. Mitoses were present in 75% of the cases. Mature lymphocytes were intermingled with tumor cells in all cases. The cytologic features correlated with the histologic features in surgical biopsies of the nasopharynx and lymph nodes. The results show that FNA of cervical lymph nodes can aid in the diagnosis of otherwise occult nasopharyngeal carcinoma and in detecting residual or recurrent nodal disease in patients with nasopharyngeal carcinoma who had undergone treatment.

Detection of Epstein-Barr virus-associated antigen in fine needle aspiration smears from cervical lymph nodes in the diagnosis of nasopharyngeal carcinoma.

Epstein-Barr virus (EBV) has consistently been shown to be associated with undifferentiated nasopharyngeal carcinoma, and an EBV-associated nuclear antigen (EBNA) has been detected in the cells of nasopharyngeal carcinoma. A study on the applicability of EBNA detection in fine needle aspiration (FNA) smears from cervical lymph nodes in the diagnosis of metastatic nasopharyngeal carcinoma was performed. All 11 cases (100%) with metastatic nasopharyngeal carcinoma showed EBNA-positive tumor cells, characterized by bright, granulated nuclear fluorescence. Three (50%) of six cases with other metastatic head and neck carcinomas also showed EBNA-positive tumor cells. These findings suggest that the presence of EBNA-positive tumor cells in FNA smears from cervical lymph nodes is not specific for metastatic nasopharyngeal carcinoma. On the other hand, a negative result in the presence of tumor cells may help to exclude it. A larger study is required to verify these preliminary findings.

Immunohistological studies in five patients with unknown primary carcinomas and poorly differentiated neoplasms.

In the evaluation of five patients with unknown primary carcinomas or poorly differentiated neoplasms, the most critical step was to obtain an accurate histological diagnosis upon which to base therapeutic options and prognosis. This required a thorough pathological examination which included histochemical and immunohistological staining of a properly prepared biopsy specimen of ample size. Two cases of lymphoma, two of carcinoma, and one of melanoma are presented in which the correct pathological diagnosis was made with immunohistological techniques permitting the institution of appropriate therapy. The value of a simple antibody panel employed with properly prepared tissue is clearly demonstrated by these cases.

Purification of two glycoproteins expressing beta 1-6 branched Asn-linked oligosaccharides from metastatic tumour cells.

Increased branching at the trimannosyl core of 'complex-type' Asn-linked oligosaccharides has been observed in both human and murine tumour cells, and appears to be associated with enhanced metastatic potential in several murine tumour models [Dennis, Laferte, Waghorne, Breitman & Kerbel (1987), Science 236, 582-585]. The lectin leucoagglutinin (L-PHA) requires the-GlcNAc beta 1-6Man alpha 1-6Man-linked lactosamine antenna in complex-type oligosaccharides for high-affinity binding and can be used to detect these structures in glycoproteins separated on SDS/polyacrylamide-gel electrophoresis. The major L-PHA-binding glycoproteins in the highly metastatic lymphoid tumour cell line called MDAY-D2 were purified and resolved into two major species, termed P2A (110 kDa) and P2B (130 kDa). P2A had L-PHA-reactive Asn-linked oligosaccharides with polylactosamine sequences as well as a large component of sialylated O-linked carbohydrates. The glycoprotein showed structural characteristics similar to those of leukosialin (i.e. CD43), a glycoprotein previously identified on the surface of leukocytes. Based on monosaccharide compositional analysis and glycosidase digestions, P2B was found to be 50-60% Asn-linked oligosaccharide containing polylactosamine sequences and sialic acid. The N-terminal peptide sequence of P2B was determined to be very similar to that of murine lysosomal membrane glycoprotein (LAMP-1), a ubiquitous glycoprotein found largely in the lysosomal membranes but also in the plasma membrane of several murine and human tumour cell lines.

Prognostic factors in the diagnosis and treatment of primary central nervous system lymphoma.

The authors describe the results of multimodality therapy in 27 patients with biopsy-proven primary central nervous system (CNS) lymphoma treated between 1976 and 1986. Treatment included surgical resection (15 patients), radiotherapy (27 patients), and chemotherapy (nine patients). Actuarial survival rates for the 27 patients at 1, 2, and 5 years after diagnosis were 70%, 54%, and 45%, respectively. Nine patients were recurrence-free at 8 to 106 months follow-up. A multivariate risk analysis identified five factors which had a favorable impact on survival: (1) age less than 60 years (P less than 0.02); (2) preoperative Karnofsky performance score greater than or equal to 70 (P less than 0.02); (3) presence of strictly hemispheric tumor (P less than 0.0003); (4) whole-brain radiation dose between 4000 and 5000 cGy (P less than 0.05); and (5) addition of chemotherapy to radiotherapy (P less than 0.002). Patients with complete tumor resolution on computed tomography 6 months after beginning treatment also had longer survival (P less than 0.01). The presence of malignant cells on cerebrospinal fluid cytologic examination correlated with an increased risk of distant metastasis (P less than 0.05). In those patients whose disease eventually recurred, the administration of an additional therapeutic modality significantly increased the length of postrecurrence survival (P less than 0.05). Although surgical resection provided no increase in survival, the addition of chemotherapy to postoperative cranial irradiation significantly enhanced the duration of survival. Our experience suggests that pretreatment clinical and diagnostic factors can help in predicting survival and in planning treatment.

Pleomorphic adenoma with lymph-node metastases report of two cases.

Two cases of pleomorphic adenoma showing morphologically benign metastases to lymph nodes are reported. In the first case, a 26-year old woman, the lymph node metastases appeared nine years after the primary tumor. In the second case, an 8-year old boy, six years elapsed between the primary and metastatic lesion. A review of the literature of similar cases has been performed.

Primary duodenal carcinoma arising in a non-vaterian tubulo-villous adenoma. A case report with immunocytochemical analysis and review of the literature.

Primary duodenal carcinoma and duodenal adenoma are rare tumours. Duodenal carcinoma makes up about 0.3% of all malignant tumours of the gastrointestinal tract (Alwmark et al. 1980; Spira et al. 1977). The present paper describes a duodenal carcinoma arising in a mixed tubulo-villous non-Vaterian adenoma in a 68 year old male. Immunocytochemical analysis revealed evidence of neuroendocrine differentiation in both adenoma and carcinoma. In a review of the literature a correlation between the size of adenoma and the probability of concomitant carcinoma is demonstrated. Duodenal adenoma measuring more than 4 cm in diameter should be considered potentially malignant.

Computed tomography in intracranial, supratentorial metastases in children.

This study compares the CT characteristics in a consecutive sample of supratentorial metastases (n = 31) with primary tumors of the same location (n = 49) in childhood. Postcontrast CT was performed in all but one of the metastases cases. In all but one of these children the location and type of primary tumor was known at time of occurrence of cerebral metastasis. Primary CNS tumors (n = 12) had a higher incidense of supratentorial metastatic spread than tumor originating elsewhere. Three children had diffuse subarachnoid seeding, while 28 had solid tumors (21 solitary, 7 multiple). The predilection location for the solid metastases was the gray-white matter junction (n = 12). The following CT findings were significantly less frequent in metastases than in primary tumors (P less than 0.05): Midline location, calcification and cyst formation. On the other hand bleeding, pronounced contrast enhancement and location in the gray-white matter junction were more frequent in the metastatic group (P less than 0.05).

[Scintigraphic search for metastases in patients with neoplasms of the head and neck]. / Szintigraphische Metastasensuche bei Patienten mit Malignomen des Kopf-Hals-Bereiches.

Pretherapeutic staging is essential for the management of head and neck cancer. The diagnostic value of liver, brain and bone scanning was estimated by a retrospective study of 281 patients. Bone and liver scans are useful for detecting distant metastases from head and neck cancer. Brain scanning should be replaced by computed tomography, if there is clinical suspicion of intracerebral metastases. Nowadays ultrasound examination of the liver is more useful than liver scans. Thus, bone scanning remains the only radioisotope method used in the routine pretherapeutic staging of head and neck cancer. Chest X-ray, abdominal ultrasound examination and bone scans are adequate methods for the detection of metastases. The management of malignant lymphoma needs a special and more detailed diagnostic approach.

Treatment of extraneural metastatic medulloblastoma with a combination of cyclophosphamide, adriamycin, and vincristine.

Seven patients with extraneural metastases from medulloblastoma were treated with a combination of cytoxan, adriamycin, and vincristine (CAV). None of the patients had evidence of active neural axis disease. All patients with bone metastases responded with a reduction in bone pain and improvement on the radionuclide bone scan. One patient presenting with lymph node metastases showed initial reduction in the size of the palpable nodes. In this group, the median time to the development of extraneural metastasis was 18 months from the time of original diagnosis of central nervous system medulloblastoma. The median duration of response to CAV, after extraneural metastasis, was 17 months (4-65 months). Four of seven patients died of disease-related causes, one patient presumed well was lost to follow-up, and two of seven are still without evidence of active disease at 37 and 65 months. The combination of CAV is well tolerated and provides reasonably good palliation for extraneural medulloblastoma.

Brain metastases: results and effects of re-irradiation.

Re-irradiation for recurrent manifestations of brain metastases has been reported to be of benefit by either increasing the duration of survival or improving the quality of life. The records of 455 patients with brain metastases treated by radiation therapy at the University of Colorado Health Sciences Center from 1975 through 1986 were reviewed. Of these, 44 patients (9.7%) were re-irradiated because of suggestive neurological findings and/or imaging studies diagnostic of recurrent disease. The primary site distribution was as follows: lung (non-small cell)--15 (34%), lung (small cell)--9 (20%), melanoma--5 (11%), breast--4 (9%), genitourinary--4 (9%), unknown--4 (9%), lymphoma--2 (4%), and endometrium--1 (2%). Retreated patients received at least two courses of irradiation and one received three. The median interval between the first and second courses was 34 weeks (7.8 months). For the initial course of treatment, all patients were treated to the whole-brain with megavoltage X rays to a dose of 30-36 Gy (median 30 Gy) at 1.5 to 4.0 Gy/fraction (median 3.0 Gy/fraction). Retreatment also consisted of whole-brain irradiation (37/42 patients) to additional doses of 6-36 Gy (median 25 Gy) at 2.0 to 4.0 Gy/fraction (median 3.0 Gy/fraction). The total cumulative doses to the brain, therefore, varied from 38-75 Gy with a median of 60 Gy. Survival data were available for 42 of 44 patients retreated. All patients died with disease. The overall median survival following the initial course of irradiation was 40 weeks (9.2 months) with 10 patients (24%) living beyond 1 year. The median survival following retreatment, however, was only 8 weeks with one patient surviving greater than 1 year. Only 12 patients (27%) showed partial neurological improvement with re-irradiation and over one-half (55%) either failed to respond or deteriorated during or soon following retreatment. Brain necropsies were performed in 8 patients. Three of these had developed brain necrosis and two most likely died as a direct consequence. It is concluded that retreatment of brain metastases is seldom worthwhile. Survival is usually short and most importantly, the quality of survival frequently is not improved.

Fate of tumor cells injected into left ventricle of heart in BALB/c mice: role of natural killer cells.

The arrest, retention, and elimination (i.e., clearance) of radiolabeled YAC-1 lymphoma cells injected either iv or into the left ventricle (LV) of the heart were studied in male BALB/c mice, with special emphasis on the role of natural killer (NK) cells. After iv injection YAC-1 cells were arrested and, to a large extent, destroyed in the lungs, which contain the first capillary bed that iv injected tumor cells meet. After LV injection the initial distribution of the tumor cells, which depends on the distribution of cardiac output at the time of injection, was estimated by use of radiolabeled microspheres. Using this technique, we have shown that LV-injected tumor cells, in contrast to iv injected tumor cells, were not arrested in the first capillary bed that they encountered but passed viably through the microvasculature of the brain, heart, kidneys, intestinal tract, and to some extent, the bone, skin, and muscle. The only organs that could arrest the LV-injected tumor cells were the lungs and the liver. In the lungs clearance of YAC-1 cells began immediately after the cells were arrested. However, the rate of clearance could be almost abrogated by pretreatment of the recipients with anti-asialo GM1 antiserum, which destroys most of the NK cells in vivo and strongly depresses the in vitro NK cell activity. In contrast, YAC-1 cells arrested in the liver were not cleared from this organ during the first 1-2 hours after arrest. After this delay clearance of the cells commenced. Pretreatment of the recipients with anti-asialo GM1 also strongly depressed the clearance of tumor cells from the liver. Although pretreatment with polyinosinic-polycytidylic acid enhanced in vitro NK cell activity, it could augment only slightly the clearance of YAC-1 cells from the lungs and the liver. Thus these results strongly support the hypothesis that the rapid clearance of tumor cells from both the lungs and the liver depends, at least partially, on the NK cell activity within these organs.

ras p21 oncoprotein expression in human colonic neoplasia--an immunohistochemical study with monoclonal antibody RAP-5.

Expression of the ras oncogene product p21 (ras p21) in benign and malignant human colonic tissues was studied using the monoclonal antibody RAP-5 and the avidin-biotin-peroxidase technique. Histologically normal colonic mucosa and hyperplastic mucosa adjacent to carcinomas (transitional mucosa) were found, in most cases, to be negative for reactivity with the antibody or showed weak staining of a few epithelial cells. Similar findings were observed in hyperplastic and juvenile polyps. Of the 145 adenomas studied, 47 (32.4%) showed detectable levels of ras p21 expression. RAP-5 immunohistochemical staining was significantly associated with the degree of epithelial dysplasia (P less than 0.01) and the size of adenoma (P less than 0.05), but not with the histological type. Fifty-four of 70 primary adenocarcinomas (77.1%) were reactive with RAP-5 and usually demonstrated a higher percentage of stained cells and more intense cytoplasmic staining than that observed in adenomas. Although metastases often displayed a similar or even higher levels of ras p21 expression compared with the primary carcinomas, in 10 cases one or more metastatic lesions showed lower levels of ras p21. These results suggest that enhanced ras p21 expression may, at times, occur in the early stages of human colon carcinogenesis but are probably not associated with metastatic tumour progression.

[A case of secondary malignant lymphoma of the urinary bladder].

A case of secondary malignant lymphoma of the urinary bladder is presented. Clinical diagnosis was metastatic small cell carcinoma in urinary bladder. Pathological diagnosis after autopsy, however, revealed vesical involvement of malignant lymphoma. The primary focus was considered to be the lung, the biopsy specimen of which was initially diagnosed as small cell carcinoma, because clinical manifestation first occurred in the lung and the metastasis to subcutaneous tissue, bladder and other abdominal organs was found subsequently. In a study of secondary involvement of genitourinary organs as seen in the present case, we reviewed 303 patients who had died of malignant lymphoma at our institute between 1960 and 1985.