bluuebunny/crossref_metadata_2025 huggingface dataset:
Discordant serum thyroglobulin results generated by two classes of assay in patients with thyroid carcinoma
Authors: Weightman David R. , Mallick Ujjal K. , Fenwick John D. , Perros Petros
Published: June 2003

BACKGROUND

Serum thyroglobulin measurement is an integral part of monitoring patients with thyroid carcinoma, but analytic problems pose serious difficulties in the utility of this test.

METHODS

Between 1997 and 1998, serum samples from 83 patients with differentiated thyroid carcinoma were collected. Serum thyroglobulin was assayed by both radioimmunoassay and by an immunoradiometric assay. The disease status of patients with discordant serum thyroglobulin results was assessed in June 2001. Therefore, the predictive value of a single thyroglobulin measurement was assessed by evaluating the clinical status of patients 3 years later.

RESULTS

Discordant serum thyroglobulin results were noted in 17 (20.4%) patients. Of the 17 patients with discordant results, 16 had adequate clinical follow‐up data. Of these 16 patients, 11 patients had detectable levels of serum thyroglobulin by immunoradiometric assay (range, 1.4–350 μg/L) whereas levels were undetectable by radioimmunoassay (< 1 μg/L). All 11 patients had evidence of metastases 3 years later. Two patients had undetectable serum thyroglobulin levels using the immunoradiometric assay (< 1 μg/L), whereas they had detectable levels using radioimmunoassay (serum thyroglobulin 7.2–30 μg/L). The serum samples from both patients had normal recoveries and positive antithyroglobulin antibodies. Both patients developed metastases 3 years later.

CONCLUSIONS

False‐negative serum thyroglobulin results were significantly higher with the radioimmunoassay method compared with the immunoradiometric assay. The immunoradiometric assay is more reliable than the radioimmunoassay, particularly in patients who have no thyroglobulin antibodies. This finding is novel in that traditional immunoradiometric assay systems compared with radioimmunoassays usually have a higher incidence of false‐negative results when assessed against clinical status. The immunoradiometric assay is subject to false‐negative results in some patients with thyroglobulin antibodies, even when recovery experiments indicate the absence of interference. Thyroglobulin antibodies should be measured in all patients with differentiated thyroid carcinoma and if positive, results should be interpreted with extreme caution. Cancer 2003;98:41–7. © 2003 American Cancer Society.

DOI 10.1002/cncr.11472
A Phase II study of irinotecan in patients with advanced renal cell carcinoma
Authors: Fizazi Karim , Rolland Frédéric , Chevreau Christine , Droz Jean‐Pierre , Mery‐Mignard Dominique , Culine Stéphane , Escudier Bernard
Published: June 2003

BACKGROUND

Patients with disseminated renal cell carcinoma (RCC) have a poor outcome, and the disease is considered highly resistant to chemotherapy. Irinotecan is an active drug in the treatment of a number of neoplastic diseases and is not concerned with the multidrug‐resistance phenotype of tumor cells, a common mechanism of drug inactivation and resistance in patients with RCC. Therefore, the authors tested the antitumor activity of irinotecan in patients with RCC.

METHODS

Patients with disseminated RCC received irinotecan (350 mg/m2) every 3 weeks. The primary objective of the study was to determine the overall response rate. Two groups of patients were defined: previously treated patients (Group A) and nonpretreated patients (Group B).

RESULTS

Forty‐two eligible patients were recruited: Twenty‐six patients (Group A) had received previous chemotherapy or immunotherapy, and 16 patients had received no previous systemic therapy (Group B). The median number of cycles received per patient was 3 cycles (range, 1–6 cycles). A dose reduction was required in only 8% of cycles. Two patients, one in each group, had minor responses. Eleven patients (42%) in Group A and 1 patient (12%) in Group B had disease stabilization. Overall, therapy was tolerated well. Grade 4 neutropenic fever occurred in 17% of patients. The 1‐year overall survival rate was 61% (95% confidence interval, 42–80%) in Group A and 19% (95% confidence interval, 0–49%) in Group B.

CONCLUSIONS

Irinotecan was tolerated well and had limited activity in patients with disseminated RCC at the dose and schedule used in the current study. A high percentage of disease stabilization was observed in cytokine‐pretreated patients. Cancer 2003;98:61–5. © 2003 American Cancer Society.

DOI 10.1002/cncr.11474
Infections in patients with aplastic anemia
Authors: Torres Harrys A. , Bodey Gerald P. , Rolston Kenneth V. I. , Kantarjian Hagop M. , Raad Issam I. , Kontoyiannis Dimitrios P.
Published: June 2003

BACKGROUND

Infection is a significant cause of death in patients with aplastic anemia (AA). However, few recent studies have examined infectious complications in patients with AA.

METHODS

The authors retrospectively evaluated the type of infections, associated pathogens, and outcome of infectious episodes (IEs) in patients with AA who were treated at The University of Texas M. D. Anderson Cancer Center between July 1994 and June 2000.

RESULTS

Fifty‐two patients with a median age of 37 years (range, 3–83 years) were identified. Overall, 104 IEs were documented in 42 patients (81%). The most common microbiologically documented infections were bacteremias (38%) followed by pneumonias (16%). Most patients (55%) had bacterial infections, mainly caused by gram‐positive cocci. Multidrug‐resistant, gram‐negative bacilli also were not uncommon in this patient population. Five of 12 patients who died during the study period died of infection. All of these patients had invasive fungal infections, mostly due to molds. All five patients had prolonged and severe neutropenia.

CONCLUSIONS

Infections remain a major cause of death in patients with AA. Bacterial infections, especially those caused by gram‐positive cocci, constitute the main cause of IE. Invasive mold infections, however, are the major cause of death in this patient population. Cancer 2003;98:86–93. © 2003 American Cancer Society.

DOI 10.1002/cncr.11478
Elevated expression levels of NCOA3, TOP1, and TFAP2C in breast tumors as predictors of poor prognosis
Authors: Zhao Chen , Yasui Kohichiroh , Lee Chol Joo , Kurioka Hideaki , Hosokawa Youhei , Oka Takahiro , Inazawa Johji
Published: June 2003

BACKGROUND

Amplification of DNA in certain chromosomal regions plays a crucial role in the development and progression of human malignancies, specifically when protooncogenic target genes within those amplicons are overexpressed. Comparative genomic hybridization studies have revealed frequent amplification at 20q in primary breast tumors. The aim of the current study was to identify specific genes in the 20q amplicon that were likely to have clinical significance.

METHODS

The authors examined 38 primary breast tumors by using a quantitative real‐time reverse transcription–polymerase chain reaction assay to determine expression levels of 18 potential targets for amplification events involving 20q. Potential correlations between elevated expression of the genes in question and clinicopathologic parameters or clinical outcomes were analyzed.

RESULTS

Elevated expression of NABC1 was significantly associated with positive estrogen (P < 0.001) and progesterone (P = 0.027) receptors in breast tumors, and high expression of PTK6 was significantly correlated with positive estrogen receptor status (P = 0.022) and postmenopausal status (P = 0.008). Patients whose tumors showed elevated expression of NCOA3 (AIB1) had significantly shorter disease‐free (P = 0.017) and overall (P = 0.0021) survival times after surgery than did other patients with breast tumors. Reduced disease‐free survival, but not reduced overall survival, was associated with high expression of TOP1 (P = 0.035) and TFAP2C (P = 0.035).

CONCLUSIONS

TOP1, TFAP2C, and (particularly) NCOA3 may be prognostic indicators for patients with breast tumors. Cancer 2003;98:18–23. © 2003 American Cancer Society.

DOI 10.1002/cncr.11482
The correlation between patient characteristics and expectations of benefit from Phase I clinical trials
Authors: Weinfurt Kevin P. , Castel Liana D. , Li Yun , Sulmasy Daniel P. , Balshem Andrew M. , Benson Al B. , Burnett Caroline B. , Gaskin Darrell J. , Marshall John L. , Slater Elyse F. , Schulman Kevin A. , Meropol Neal J.
Published: June 2003

BACKGROUND

Patients in Phase I clinical trials sometimes report high expectations regarding the benefit of treatment. The authors examined a range of patient characteristics to determine which factors were associated with greater expectations of benefit from Phase I trials.

METHODS

Participants were adult patients with cancer who had been offered participation in Phase I studies and had decided to participate. Patients completed interviewer‐administered surveys before initiation of treatment. Physicians assessed Eastern Cooperative Oncology Group performance status for each patient. Statistical analyses (Pearson product moment correlation and t tests) used multiple imputation to account for missing data.

RESULTS

Overall, 593 patients who were offered participation in Phase I trials were contacted, and 328 patients agreed to participate in a study of decision making by cancer patients. Of these, 260 patients (79%) enrolled in a Phase I trial. Patients' expectations regarding the chance that their disease would be controlled with experimental therapy were unrelated to age, gender, living situation, education level, or functional status. Expectations were correlated positively with beliefs about the benefit of standard therapy and the maximum benefit patients may experience from experimental therapy. Greater expectations of benefit were associated with better health‐related quality of life, stronger religious faith, optimism, relative health stock, monetary risk seeking, and poorer numeracy.

CONCLUSIONS

Expectations expressed as beliefs in personal outcomes may be related more to quality of life and personality variables than to patients' knowledge or functional status. Whether such expectations are accurate reflections of knowledge has important implications for evaluating the informed consent process. Cancer 2003;98:166–75. © 2003 American Cancer Society.

DOI 10.1002/cncr.11483
Analysis of racial differences in incidence, survival, and mortality for malignant tumors of the uterine corpus
Authors: Sherman Mark E. , Devesa Susan S.
Published: June 2003

BACKGROUND

In the United States, incidence rates for malignant tumors of the uterine corpus are lower among blacks than among whites, whereas mortality rates are higher among blacks. Reasons for the higher level of mortality among blacks have been debated.

METHODS

Using data from the Surveillance, Epidemiology, and End Results program, the authors compared incidence rates by histopathologic type for malignant tumors of the uterine corpus (including uterus, not otherwise specified) during the period 1992–1998 among white Hispanic, black, and white non‐Hispanic patients. The authors also compared cumulative relative survival rates for blacks and whites by histopathologic type and by other factors, and they calculated estimated type‐specific mortality rates.

RESULTS

Overall incidence (per 100,000 woman‐years) of corpus malignancy was significantly lower among white Hispanics (14.04; 95% confidence interval [CI], 13.39–14.72) and blacks (15.31; 95% CI, 14.61–16.04) compared with white non‐Hispanics (23.43; 95% CI, 23.06–23.81). Compared with white non‐Hispanics, blacks had significantly higher incidence rates of serous/clear cell carcinoma (rate ratio, 1.85; 95% CI, 1.61–2.12), carcinosarcoma (rate ratio, 2.33; 95% CI, 1.99–2.72), and sarcoma (rate ratio, 1.56; 95% CI, 1.31–1.86). Survival was worse for blacks than for whites in every histopathologic category and in ‘usual’ types of endometrial adenocarcinoma, stratified by stage, grade, and age. Rare aggressive tumor types accounted for 53% of mortality among blacks, compared with 36% among whites.

CONCLUSIONS

Less favorable outcomes for usual types of endometrial adenocarcinoma and for rare aggressive tumors contribute equally to the relatively high mortality due to corpus cancer among black women. Cancer 2003;98:176–86. Published 2003 by the American Cancer Society.*

DOI 10.1002/cncr.11484
Treatment outcome after radiotherapy alone for patients with Stage I–II nasopharyngeal carcinoma
Authors: Chua Daniel T. T. , Sham Jonathan S. T. , Kwong Dora L. W. , Au Gordon K. H.
Published: June 2003

BACKGROUND

The objective of this study was to review the long‐term treatment outcome of patients with American Joint Committee on Cancer (AJCC) 1997 Stage I–II nasopharyngeal carcinoma (NPC) who were treated with radiotherapy alone.

METHODS

One hundred forty‐one patients with NPC had AJCC 1997 Stage I–II disease (Stage I NPC, 50 patients; Stage II NPC, 91 patients) after restaging and were treated with radiotherapy alone between September 1989 and August 1991. Fifty‐seven patients had lymph node disease, and the median greatest lymph node dimension was 3 cm. The median dose to the nasopharynx was 65 grays. The median follow‐up was 82 months (range, 4–141 months).

RESULTS

Patients who had Stage I disease had an excellent outcome after radiotherapy. The 10‐year disease specific survival, recurrence free survival (RFS), local RFS, lymph node RFS, and distant metastasis free survival rates were 98%, 94%, 96%, 98%, and 98%, respectively. Patients who had Stage II disease had a worse outcome compared with patients who had Stage I disease: The corresponding 10‐year survival rates were 60%, 51%, 78%, 93%, and 64%. The differences all were significant except for lymph node control. Among patients who had Stage II disease, those with T1–T2N1 NPC appeared to have a worse outcome compared with patients who had T2N0 NPC. No significant differences in survival rates were found with respect to lymph node size or status for patients with T1–T2N1 disease.

CONCLUSIONS

When patients with NPC had their disease staged according to the AJCC 1997 classification system, patients with Stage I disease had an excellent outcome after they were treated with radiotherapy alone. Patients with Stage II disease, especially those with T1–T2N1 disease, had a relatively worse outcome, and more aggressive therapy, such as combined‐modality treatment, may be indicated for those patients. Cancer 2003;98:74–80. © 2003 American Cancer Society.

DOI 10.1002/cncr.11485
Phase II study of α2 interferon in the treatment of the chronic myeloproliferative disorders (E5487)
Authors: Radin Arthur I. , Kim Haesook T. , Grant Barbara W. , Bennett John M. , Kirkwood John M. , Stewart James A. , Hahn Richard G. , Dutcher Janice P. , Wiernik Peter H. , Oken Martin M.
Published: June 2003

BACKGROUND

In vitro and clinical data suggest a therapeutic role for α2 interferon (IFN) in the treatment of the chronic myeloproliferative disorders. Accordingly, a multiinstitutional, Phase II trial of IFN in patients with agnogenic myeloid metaplasia (AMM), essential thrombocythemia (ET), and polycythemia rubra vera (PRV) in thespentphase was initiated. The objectives of this study were 1) to investigate the response rates that may be achieved with IFN in the treatment of patients with these disorders, 2) to estimate the durability of the responses, and 3) to assess the toxicities of IFN in these populations.

METHODS

Enrollment was limited to patients with AMM, ET, or PRV who already had developed 1) anemia or transfusion dependency, 2) thrombocytosis uncontrolled by standard therapy, 3) hemostatic complications, or 4) symptomatic splenomegaly. Initially, patients were started on IFN at a dose of 5 MU/m2per day as a subcutaneous injection. After the first 16 patients had been treated, the starting dose of IFN was reduced to 2 MU/m2per day because of unexpected toxicities.

RESULTS

IFN demonstrated different levels of efficacy and toxicity in each of the three diseases studied. The overall response rates achieved among the evaluable patients in each category were as follows: ET, 88.2% (n= 17 patients; 1 complete response and 14 partial responses); PRV, 41.7% (n= 12 patients; 1 complete response and 4 partial responses); and AMM, 3.2% (n= 31 patients; 0 complete responses and 1 partial response). Thrombocytosis and leukocytosis were controlled in nearly all patients, with reversal of splenomegaly and resorption of myelofibrosis achieved in fewer patients. The toxicities attributed to IFN differed notably among the three disease groups: patients who had AMM suffered systemic and neurologic toxicities more frequently than patients who had PRV or ET; whereas patients who had ET experienced a greater than expected incidence of hepatic abnormalities, most typically transient elevations of serum amino acid transaminase levels.

CONCLUSIONS

The current study demonstrated the safety and efficacy of IFN in patients with ET, PRV, and AMM. Objective responses and/or disease stabilization were obtained in patients with all three disease entities, including the reversal of splenomegaly and resorption of myelofibrosis in some patients. Cancer 2003;98:100–9. © 2003 American Cancer Society.

DOI 10.1002/cncr.11486
A survey of intensity‐modulated radiation therapy use in the United States
Authors: Mell Loren K. , Roeske John C. , Mundt Arno J.
Published: June 2003

BACKGROUND

The objective of this study was to assess the current level of intensity‐modulated radiation therapy (IMRT) use in the United States.

METHODS

Three‐hundred thirty‐three randomly selected radiation oncologists were sent a 13‐question survey regarding IMRT use. IMRT users were asked about the number of patients and sites treated, their reasons for adopting IMRT, and future plans for its use. Physicians who did not use IMRT were asked about their reasons for not using IMRT; whether they intended to adopt it in the future; and, if so, their reasons.

RESULTS

One‐hundred sixty‐eight responses (50.5%) were received. Fifty‐four respondents (32.1%) stated that they currently used IMRT. Most IMRT users (79.6%) had adopted IMRT since 2000. Academic physicians were more likely to use IMRT (P = 0.003) compared with private practitioners. The percent of physicians using IMRT in practices comprised of 1 physician, 2–4 physicians, or > 4 physicians were 15.4%, 28.4%, and 44.2%, respectively (P = 0.02). The most common sites treated were head and neck malignancies and genitourinary tumors. Of the 114 IMRT nonusers, 96.5% planned to use IMRT in the future, with 91.8% planning to use IMRT within 3 years. Among IMRT nonusers, the most common reason cited for not using IMRT was lack of necessary equipment. The most common reasons for adopting IMRT (users) or wanting to adopt IMRT (nonusers) were to improve delivery of conventional doses and to escalate dose.

CONCLUSIONS

Approximately one‐third of radiation oncologists in the United States use IMRT. However, this number appears to be growing rapidly. Efforts to ensure the safe and appropriate application of this new technology are warranted. Cancer 2003;98:204–11. © 2003 American Cancer Society.

DOI 10.1002/cncr.11489
From the Boltzmann equation to the Stokes‐Fourier system in a bounded domain
Authors: Masmoudi Nader , Saint‐Raymond Laure
Published: June 2003

We prove that the renormalized solutions of the Boltzmann equation considered in a bounded domain with different types of (kinetic) boundary conditions converge to the Stokes‐Fourier system with different types of (fluid) boundary conditions when the main free path goes to zero. This extends the work of F. Golse and D. Levermore [9] to the case of a bounded domain. © 2003 Wiley Periodicals, Inc.
Quantifying curvelike structures of measures by using L2 Jones quantities
Authors: Lerman Gilad
Published: June 2003

We study the curvelike structure of special measures on ℝn in a multiscale fashion. More precisely, we consider the existence and construction of a sufficiently short curve with a sufficiently large measure. Our main tool is an L2 variant of Jones' β numbers, which measure the scaled deviations of the given measure from a best approximating line at different scales and locations. The Jones function is formed by adding the squares of the L2 Jones numbers at different scales and the same location. Using a special L2 Jones function, we construct a sufficiently short curve with a sufficiently large measure. The length and measure estimates of the underlying curve are expressed in terms of the size of this Jones function. © 2003 Wiley Periodicals, Inc.
An inverse problem for the dynamical Lamé system with two sets of boundary data
Authors: Imanuvilov Oleg , Isakov Victor , Yamamoto Masahiro
Published: June 2003

We prove uniqueness and a Hölder‐type stability of reconstruction of all three time‐independent elastic parameters in the dynamical isotropic system of elasticity from two special sets of boundary measurements. In proofs we use Carleman‐type estimates in Sobolev spaces of negative order. © 2003 Wiley Periodicals, Inc.
Crossover study of three methods for low‐level white blood cell counting on two types of flow cytometer
Authors: Dijkstra‐Tiekstra M. J. , Schrijver J. G. , van der Meer P. F. , Laport R. F. , Gratama J. W. , Levering W. H. B. M. , van Delden C. J. , de Wildt‐Eggen J.
Published: June 2003

Background

Flow cytometric methods were previously shown to be preferable to microscopic and volumetric methods for counting residual white blood cells (WBCs). In this study, three flow cytometric, low‐level WBC counting methods were cross compared using two flow cytometers.

Methods

Double‐filtered red cell and platelet concentrates were spiked with different amounts of WBC to obtain panels of unspiked and 0.3, 1.0, 3.3, and 10.0 WBC/μl. The methods of BD Biosciences (BDB), Beckman‐Coulter (BC), and an in‐house method were performed on flow cytometers from BDB and BC. Samples were measured in ninefold. We required that (a) r2be at least 0.98 (linearity), (b) at least 80% of observations fell within 20% of expected values (accuracy), and (c) the coefficients of variation be at least 20% (precision) for samples containing at least 3.3 WBC/μl.

Results

For the red cell panel, our requirements were met by the BDB method on both flow cytometers and by the BC and in‐house methods on the BDB flow cytometer only. For the platelet panel, our requirements were met on all combinations of methods and flow cytometers, except for the in‐house method on the BDB flow cytometer. Intra‐assay variation was lowest for the BDB method, irrespective of the type of flow cytometer used.

Conclusion

Based on accuracy and precision, the BDB method on the BDB flow cytometer produced the best results for counting low‐level WBCs. Cytometry Part B (Clin. Cytometry) 54B:39–45, 2003. © 2003 Wiley‐Liss, Inc.
Multiple method comparison: Statistical model using percentage similarity
Authors: Scott Lesley E. , Galpin Jacky S. , Glencross Deborah K.
Published: June 2003

BACKGROUND

Method comparison typically determines how well two methods agree. This is usually performed using the difference plot model, which measures absolute differences between two methods. This is often not applicable to data with wide ranges of absolute values. An alternative model is introduced that simplifies comparisons specifically for multiple methods compared to a gold standard.

METHODS

The average between a new method and the gold standard is represented as a percentage of the gold standard. This is interpreted as a percentage similarity value and accommodates wide ranges of data. The representation of the percentage similarity values in a histogram format highlights the accuracy and precision of several compared methods to a gold standard. The calculation of a coefficient of variation further defines agreement between methods.

RESULTS

Percentage similarity histograms of several new methods can be compared to a gold standard simultaneously, and the comparison easily visualized through use of a single 100% similarity reference line drawn common to all plots.

CONCLUSION

This simple method of comparison would be particularly useful for multiple method comparison and is especially applicable for centers collating for external quality assessment or assurance programs to demonstrate differences in results between laboratories. Cytometry Part B (Clin. Cytometry) 54B:46–53, 2003. © 2003 Wiley‐Liss, Inc.
Phenotypic and molecular characterization of CD103+ CD4+ T cells in bronchoalveolar lavage from patients with interstitial lung diseases
Authors: Braun Ruedi K. , Foerster Martin , Grahmann P. Reinhard , Haefner Daniela , Workalemahu Grefachew , Kroegel Claus
Published: June 2003

Background

The integrin CD103 is preferentially expressed on intraepithelial T lymphocytes, and cells expressing this integrin may play a regulatory role in the microenvironment of the epithelial cell layer.

Methods

The relative number of CD103+/CD4+ T cells in the bronchoalveolar lavage was significantly elevated in all patients diagnosed with interstitial lung diseases compared with patients with other non‐fibrotic disorders of the lung.

Results

Analysis by flow cytometry showed that the CD103+ and the CD103− subpopulations were memory T cells based on the high expression of CD45RO+. However, the CD103+/CD4+ T cells were CD25low, CD27−, CD28low, and CD62L−, whereas the CD103−/CD4+ T cells expressed CD25 and CD62L and were CD27high and CD28high. In addition, the CD103+/CD4+ T cells expressed significantly higher quantities of VLA‐1 and CD101 than did CD103−/CD4+ T cells. Reverse transcriptase polymerase chain reaction analysis of purified CD103+ and CD103− CD4+ T cells showed production of tumor necrosis factor (TNF) α‐R‐1 (p55), TNF‐α‐R‐2 (p75), interferon γ, interleukin‐10, and TNF‐α mRNA in both subpopulations. No interleukin‐4 mRNA was detected in either subpopulation.

Conclusions

CD103+/CD4+ T cells represent a T‐helper 1–like subpopulation in human lungs with a distinct effector phenotype. Despite the lack of CD27 and the low CD25 and CD28 expression, these cells show a high degree of activation. These results suggest that CD103 expressing CD4 T cells in the lung are continuously activated, long‐living cells. Cytometry Part B (Clin. Cytometry) 54B:19–27, 2003. © 2003 Wiley‐Liss, Inc.
Flow cytometric HLA‐B27 screening: Cross‐reactivity patterns of commercially available anti–HLA‐B27 monoclonal antibodies with other HLA‐B antigens
Authors: Levering Wilfried H. B. M. , Wind Henk , Sintnicolaas Kees , Hooijkaas Herbert , Gratama Jan W.
Published: June 2003

Background

Some 50 clinical laboratories in the Benelux perform flow cytometric HLA‐B27 screening and participate in the Benelux external quality assessment scheme operational since 1995. Results from this scheme indicate that cross‐reactivity of HLA‐B27 monoclonal antibodies (mAbs) is a major problem.

Methods

We analyzed cross‐reactivity patterns of commercially available mAbs for HLA‐B27 screening. Three clones of HLA‐B27 mAb (ABC‐m3, n = 3; FD705; and GS145.2) from five manufacturers were evaluated. Test cells were selected as to express HLA‐B antigens with known serologic cross‐reactions (HLA‐B7, B12, B13, B16, B17, B22, B37, B40, B41, B42, B47, and B48). Cells without B27 cross‐reactive antigens (B5, B8, B14, B15, B21, and B35) and cells positive for B27 were included as controls. All tests were performed and interpreted as recommended by the manufacturers. Cross‐reactivity was defined as increased fluorescence intensity in comparison with the baseline reactivity observed with the corresponding immunoglobulin G isotype control mAb.

Results and Conclusions

All mAbs tested showed cross‐reactivity, ranging from weak (±) to strong (+), with different antigens and different degrees of intensity—ABC‐m3: (±) B12, B16, B17, B41, B47, and B48 and (+) B7, B13, B22, B37, B40, and B42; GS145.2: (±) B13, B17, B22, B40, and B47 and (+) B7, B16, B37, B42, and B48; FD705: (±) B12, B13, B16, and B48 and (+) B17, B37, and B47. If one mAb had been used for HLA‐B27 screening, ABC‐m3 would have yielded nine false‐positive B27 assignments, FD705 would have yielded seven, and GS145.2 would have yielded two. This problem largely canbe avoided by the combined use of two different mAb clones. The combination of FD705 and GS145.2 yielded the best results, with one false‐positive HLA‐B27 assignment among the 99 HLA‐B27− samples of this highly selected panel. Cytometry Part B (Clin. Cytometry) 54B:28–38, 2003. © 2003 Wiley‐Liss, Inc.
Flow cytometry in the bone marrow staging of mature B‐cell neoplasms
Authors: Stacchini A. , Demurtas A. , Godio L. , Martini G. , Antinoro V. , Palestro G.
Published: June 2003

Background

Even though flow cytometric (FC) analysis of bone marrow aspirates is often performed in hematolymphoid disorders at diagnosis and during disease monitoring, its role has not been defined during the staging of B‐non–Hodgkin's lymphoma (B‐NHL) and B‐cell lymphoproliferative diseases. The goal of this study was to provide an objective evaluation of how FC might help in the detection of bone marrow involvement by the different types of B‐cell malignant neoplasms.

Methods

Fifty‐four staging and 156 restaging bone marrow biopsies and bone marrow aspirates, obtained from 185 consecutive patients, were analyzed retrospectively. The results of the morphologic examination and FC were reviewed independently, and their ability to detect bone marrow involvement was compared.

Results

FC and morphology agreed in 176 cases (83.8%), i.e., both showed 77 positive cases and 99 negative ones. Discrepant results were obtained in 30 cases (14.2%) in which morphologic examination showed 25 (11.9%) positive cases, whereas FC showed no evidence of disease. FC detected involvement in five cases (2.4%) in the presence of a histologically negative bone marrow biopsy. All morphologically undetermined bone marrow cases (four) were negative by FC.

Conclusions

Neither morphologic examination nor FC alone is adequate for the detection of all cases of B‐lymphoid neoplasm bone marrow involvement. FC failed to detect bone marrow involvement in those B‐NHL cases having focal paratrabecular infiltration, but proved to be more sensitive than histology in detecting small clonal B‐cells in B‐NHL, which demonstrated fewer than 5% neoplastic infiltrates. The clinical relevance of minimal disease detected by FC alone needs further evaluation because staging of lymphomas currently is based only on morphologic data. Cytometry Part B (Clin. Cytometry) 54B:10–18, 2003. © 2003 Wiley‐Liss, Inc.
Intravascular papillary endothelial hyperplasia of the neck masquerading as malignancy on fine‐needle aspiration cytology
Authors: Suh Kwang‐Sun , Shin Kyeong‐Suk , Park In‐Ae
Published: June 2003

Papillary endothelial hyperplasia (PEH) is an exuberant, usually intravascular endothelial proliferation that, in many respects, mimics angiosarcoma. A case of PEH originally suggestive of embryonal carcinoma by fine‐needle aspiration is presented. A 12‐year‐old boy presented with a palpable mass on the right side of the neck. The mass was subsequently aspirated. Cytopathologic features showed cohesive sheets of polygonal pleomorphic cells with vesicular nuclei and prominent multiple nucleoli in a hemorrhagic background. Cytologic findings were strongly suggestive of metastatic embryonal carcinoma. There was no evidence of a primary lesion. After the mass was surgically excised, the pathologic findings showed PEH. A retrospective immunocytochemical stain for factor VIII‐related antigen on a destained ethanol‐fixed smear confirmed the endothelial nature of the polygonal cells. A vascular lesion should be considered, especially when atypical polygonal cells in a hemorrhagic background are present, as they were in this case. Diagn. Cytopathol. 2003;29:14–17. © 2003 Wiley‐Liss, Inc.
Cervical cancer screening program of Paraná: Cost‐effective model in a developing country
Authors: Bleggi Torres Luiz F. , Werner Bettina , Totsugui Joel , Collaço Luiz M. , Araújo Samuel Régis , Huçulak Márcia , Boza Edwin Javier , Fischer Rose Mari , de Laat Lucinelli , Sobbania Luiz Carlos , Raggio Armando
Published: June 2003

The purpose of this study is to report the organization of a cost‐effective screening program for cervical cancer in a developing country such as Brazil. The Cervical Cancer Screening Program of Paraná (CCSPP) was launched in October 1997 and was the result of a joint collaboration between the government of Paraná (Secretary of Health of the State of Paraná), scientific societies (pathologists, gynecologists, and nurses), and a nongovernmental organization called the Women's Popular Forum of Paraná. The main goal of the program was to enhance the Papanicolaou (Pap) smear screening to coverage up to 85% of female adult population with a 3‐yr interval between examinations, as well as to reduce the incidence and mortality from cervical cancer in the state of Paraná, a Southern state of Brazil. The cytological findings in all Pap smears recorded in a central computer‐based register during 5 yr of the program (October 1997–October 2002) are discussed. During that period, 2,244,158 Pap smears were performed in women included in the program from the 398 cities of the state of Paraná. The cytological smears were analyzed according to the Bethesda System. The previous year, before the program was launched, a Pap smear was taken from 43% of women of Paraná. At the end of 5 yr, coverage was increased to around 86%. The great majority of examinations had a negative result (98%). Only 2% of examinations had cytological abnormalities (n = 44,621). Low‐grade lesions predominated in women aged 15–30 yr, and the high‐grade lesions were more common in women aged 25–45 yr. Patients older than 40 yr had the greatest incidence of invasive cancer. Although the program is only 5 yr old, a decrease in the mortality from cervical cancer in women from Paraná is clearly apparent: in 1998, 297 women died of cervical cancer, as compared with 188 as of September 2002. Diagn. Cytopathol. 2003;29:49–54. © 2003 Wiley‐Liss, Inc.
Parachordoma or chordoma periphericum? Case report of a tumor of the thoracic wall
Authors: Tong Guoxia , Perle Mary Ann , Desai Panna , Kumar Asok , Waisman Jerry
Published: June 2003

We report the findings from an aspiration biopsy and resection of a chordoma‐like tumorous mass in the wall of the thorax of a 36‐yr‐old man with immunohistochemical, ultrastructural, and cytogenetic studies. The 4‐cm oval tumor was an incidental finding on physical examination, and no other lesions were identified after comprehensive radiologic studies. The aspirate was composed of sheets and nests of cells with distinct borders in a myxoid and fibrillary extracellular matrix. The neoplastic cells were uniform and round or polygonal with abundant pale blue vacuolated cytoplasm and small round, central or eccentric nuclei. On electron microscopy, mitochondrial rough endoplasmic reticulum complexes were seen in neoplastic cells. These features were similar to those of a conventional chordoma. However, the cytogenetic pattern, 43,XY,‐1,‐2,der (5)t(1p;5q),‐6,add(8p),add(10q), was not typical. In addition, the neoplastic cells were positive for vimentin, S‐100, AE1/AE3, CAM 5.2, and CK 19; were focally positive for EMA and smooth muscle actin; and were negative for cytokeratin 1 and 10 (34βE12), CK 7, CK 8 (35H 11B), CK 17, and CK 20. The cytogenetic and immunohistochemical patterns were different from conventional chordoma and its peripheral counterpart, chordoma periphericum, suggesting the diagnosis of parachordoma. To the best of our knowledge, this is the first report of fine‐needle aspiration of this newly defined and rare entity. Diagn. Cytopathol. 2003;29:18–23. © 2003 Wiley‐Liss, Inc.
Cytologic features of small‐cell carcinoma on ThinPrep®
Authors: Bavikatty Neil R. , Michael Claire W.
Published: June 2003

The use of ThinPrep® (TP) technology for fine‐needle aspiration (FNA) cytology has become widely accepted. However, some literature suggests that small‐cell carcinoma may present a diagnostic pitfall due to morphologic alterations. In this study, we retrospectively compared 14 FNA of small‐cell carcinoma prepared using TP with corresponding conventional smears (CS). We also examined the TP appearance of 23 other small round‐cell lesions in order to determine if differential diagnostic features were preserved. TP and CS were evaluated semiquantitatively for background, architecture, chromatin quality, nuclear molding, nuclear smearing, nucleolar prominence, amount of cytoplasm, nuclear size, and single‐cell necrosis. The data were analyzed using the McNemar χ2 test.

TP slides of small‐cell carcinoma showed a cleaner background than CS (P < 0.005). Although some degree of nuclear molding was preserved, it was decreased in amount (P < 0.025) and subtler in quality. Similarly, nuclear smearing was present but decreased in amount (P < 0.05), and less prominent qualitatively. The amount of discernible cytoplasm was greater on TP (P < 0.005). No significant differences were found for any of the other parameters studied. The presence of nuclear molding was the single most useful feature in differentiating small‐cell carcinoma from other small round‐cell tumors on TP.

Small‐cell carcinoma may be diagnosed with confidence by FNA using TP. However, pathologists should be aware of certain morphologic alterations in order to avoid diagnostic pitfalls. Diagn. Cytopathol. 2003;29:8–12. © 2003 Wiley‐Liss, Inc.
Pelvic washing cytology of ovarian Sertoli‐Leydig‐cell tumor with retiform pattern: A case report
Authors: Guo Meihua , Lim Jennifer C. , Wojcik Eva M.
Published: June 2003

A Sertoli‐Leydig‐cell tumor is an exceptionally rare neoplasm. We present the pelvic washing cytomorphology of an ovarian Sertoli‐Leydig‐cell tumor with a retiform pattern in a 24‐yr‐old female. The cytologic features in this case were tight tissue fragments composed of small, relatively uniform cells with scanty cytoplasm and small rounded or blunt papillary fragments with hyalinized cores lined with small, mildly atypical cuboidal cells. Differential diagnoses included borderline and well‐differentiated papillary serous tumors, clear‐cell carcinoma, and collagen balls. Correlation of cytologic findings with histomorphology is crucial for correct interpretation of pelvic washings in cases of Sertoli‐Leydig‐cell tumors. Diagn. Cytopathol. 2003;29:28–30. © 2003 Wiley‐Liss, Inc.
Fine‐needle aspiration cytology of intraabdominal extralobar pulmonary sequestration: A case report
Authors: Rajendiran Swaminathan , Kapoor Vibhu , Schoedel Karen
Published: June 2003

A 55‐yr‐old female presented with a mass near the left adrenal gland detected on a CT scan performed for breast cancer staging. A CT‐guided fine‐needle aspiration (FNA) was performed and showed scattered ciliated cells, compatible with benign respiratory‐type epithelial cells. CT‐guided needle biopsy also showed fibrocollagenous and fibroadipose connective tissue with focal respiratory type epithelium with subepithelial mucus glands. A final diagnosis of extralobar pulmonary sequestration (ELS) was rendered after surgical resection. This uncommon benign congenital malformation should be considered in the differential diagnosis of FNA of an intraabdominal mass in an adult. Diagn. Cytopathol. 2003;29:24–27. © 2003 Wiley‐Liss, Inc.
Reporting of atypical squamous cells, cannot exclude a high‐grade squamous intraepithelial lesion (ASC‐H) on cervical samples: Is it significant?
Authors: Selvaggi Suzanne M.
Published: June 2003

“Atypical squamous cells, cannot exclude a high‐grade squamous intraepithelial lesion (ASC‐H)” is a new diagnostic category in the 2001 Bethesda nomenclature system for cervical cytology. The purpose of this 7‐mo retrospective study (March 1, 2002–September 30, 2002) was to evaluate the significance of ASC‐H on cervical Thin Prep® Pap Tests™. During this period, 25 (0.27%) of 9,214 Pap Tests were diagnosed as ASC‐H, 22 of which resulted in either follow‐up cervical biopsies and/or cervical cones, and which formed the basis of this study. Tissue specimens (22 cases) were negative in 5 cases (23%) and positive in 17 cases (77%). Of the positive specimens, there were 2 (12%) low‐grade squamous intraepithelial lesions (LSIL) and 15 (88%) high‐grade squamous intraepithelial lesions (HSIL). Of the 22 cases, ASC‐H diagnoses included immature/atypical squamous metaplasia vs. a squamous intraepithelial lesion (SIL) in 19 (86%) cases, and tight clusters of small cells with a high nuclear to cytoplasmic ratio in 3 (14%) cases. The results of this study indicate that the reporting of ASC‐H on cervical samples does lead to the detection of HSILs in a significant number of cases (68% in this study). Therefore, further evaluation of the patient is warranted. Diagn. Cytopathol. 2003;29:38–41. © 2003 Wiley‐Liss, Inc.
Incidental detection of microfilariae in aspirates from Ewing's sarcoma of bone
Authors: Ahluwalia Charanjeet , Choudhury Monisha , Bajaj P.
Published: June 2003

Microfilariae have been reported as coincidental findings with various neoplasms. We present a case in which microfilariae were encountered in fine‐needle aspiration (FNA) smears from a 10‐yr‐old boy who presented with a lytic lesion in the diaphysis of the right tibial bone. Stained aspirates from the swelling were composed of a dispersed population of small round cells with scanty to vacuolated cytoplasm. Two sheathed microfilariae with several nuclei and cephalic and caudal clearing were identified. A diagnosis of Ewing's sarcoma with presence of microfilariae of Wuchereria bancrofti was made. The diagnosis of Ewing's sarcoma was confirmed on histopathology. Diagn. Cytopathol. 2003;29:31–32. © 2003 Wiley‐Liss, Inc.
The place of fine‐needle aspiration in the preoperative diagnosis of the congenital sublingual teratoid cyst
Authors: Babuccu Orhan , Işiksaçan Özen Özlem , Hoşnuter Mübin , Kargi Eksal , Babuccu Berfu
Published: June 2003

The term “teratoid cyst” was first used by Meyer in his classification of dysontogenetic cysts of the cervicofacial region, which was based on the type of germinative layers included in the cyst wall. Sublingual location of a dermoid cyst is not common, with an incidence of 1.6%. The teratoid cyst is the least common, accounting for 1.8% of sublingual dermoid cysts, and such lesions are extremely rare in infancy. In our case, a 7‐mo‐old male infant was referred with a sublingual mass. Ultrasonography yielded a cystic mass with internal echoes but no specific diagnosis. The smears obtained from fine‐needle aspiration (FNA) displayed sheets of large, benign‐appearing, anucleated and nucleated squamous cells. There were a number of neutrophils, which had no significant importance. No atypical cells were observed. According to the clinical picture and FNA findings, it appeared to be a cystic structure of keratogenous origin and could have been any type of dermoid cyst. The cyst was excised completely by the oral approach. On histopathological examination, the presence of skin appendages along with mature cartilage and respiratory epithelium confirmed the final diagnosis of a teratoid cyst. In conclusion, although FNA is not comparable with computed tomography (CT) and magnetic resonance imaging (MRI), it might be valuable for the diagnosis of lesions occurring in this anatomical location. It is safe, cost‐effective, and reliable. FNA is not only able to help selecting the most appropriate surgical method, but also be used as a therapeutic modality in some emergencies or during surgery. Diagn. Cytopathol. 2003;29:33–37. © 2003 Wiley‐Liss, Inc.
Clinical impact (cost‐effectiveness) of qualifying atypical squamous cells of undeterminate significance (ASCUS) in cases favoring a reactive or dysplastic process
Authors: Carozzi F.M. , Cariaggi M.P. , Bonardi L. , Bulgaresi P. , Cecchini S. , Ciatto S. , Cipparrone I. , Galanti L. , Maddau C. , Matucci M. , Rubeca T. , Troni G.M. , Turco P. , Zappa M. , Confortini M.
Published: June 2003

The cost‐effectiveness of qualifying ASCUS cases into two different subcategories, favoring a reactive (ASCUS‐R) or dysplastic process (ASCUS‐S), was evaluated at the Centro per lo Studio e la Prevenzione Oncologica of Florence in a prospective study. The study determined the positive predictive value (PPV) for histologically confirmed cervical intraepithelial neoplasia grade 2 (CIN2) or more (CIN>) severe lesion of the two ASCUS subgroups. ASCUS‐S had a PPV (10.78%) comparable to low‐grade squamous intraepithelial lesions (LSIL) (11.40%). For ASCUS‐R cases, the recommendation of 6‐mo repeat cytology prompting colposcopy in cases of persistent ASCUS or more severe cytology was also effective, as it selected a subgroup with a relatively high PPV (10.34%). The cost‐effectiveness of a protocol based on ASCUS qualification was compared with two other possible options for nonqualified ASCUS cases: immediate colposcopy and colposcopy in persistent ASCUS at 6‐mo repeat cytology.. The detection rate of CIN2> was substantially higher using ASCUS qualification (35.9 vs 14.8 or 17.1). The cost per ASCUS subject was €24.99, 27.11, or 25.14 and that per CIN2> detected was €697, 1,831 or 1,470 for the three options, respectively. The evidence that ASCUS detection option implies a higher detection rate of CIN2> and subsequently a lower cost per CIN2> detection must be considered with caution and deserves confirmation by other comparative studies. Diagn. Cytopathol. 2003;29:4–7. © 2003 Wiley‐Liss, Inc.
Selective phosphorylation of dihydroquercetin with trivalent phosphorus reagents
Authors: Nifant'ev E. E. , Kukhareva T. S. , Dzgoeva Z. M. , Vasyanina L. K. , Koroteev M. P. , Kaziev G. Z.
Published: June 2003

Characteristic features of phosphorylation of dihydroquercetin with trivalent phosphorus reagents were studied. Preparative methods for regioselective phosphorylation were found. The most important chemical properties of dihydroquercetin phosphites and cyclophosphites were studied. © 2003 Wiley Periodicals, Inc. Heteroatom Chem 14:399–403, 2003; Published online in Wiley InterScience (www.interscience.wiley.com). DOI 10.1002/hc.10115
Cyclo[bis(1,7‐naphthylenedialkylamidophosphites)]
Authors: Nifantyev Eduard E. , Rasadkina Elena N. , Evdokimova Yuliya B. , Stash Adam I. , Belsky Vitaly K. , Vasyanina Larisa K.
Published: June 2003

The possibility of regioselective cyclobisphosphorylation of nonsymmetrical bisphenols was shown for the 1,7‐dihydroxynaphthalene–phosphorous acid triamide system. The structure and essential chemical properties of the first nonsymmetrical phosphacyclophane were studied. New data demonstrating peculiar features of bisphenol diamidophosphites were obtained. © 2003 Wiley Periodicals, Inc. Heteroatom Chem 14:404–412, 2003; Published online in Wiley InterScience (www.interscience.wiley.com). DOI 10.1002/hc.10143
The reaction OF N‐dichlorophosphoryl‐ P‐trichlorophosphazene with alkyl grignard reagents
Authors: Aslan F. , Ozturk A. I. , Arslan M.
Published: June 2003

The reactions of N‐dichlorophosphoryl‐P‐trichlorophosphazene Cl3PNP(O)Cl2 (1) with benzylmagnesium bromide, 2‐phenylethylmagnesium bromide, trimethylsilylmethylmagnesium chloride, n‐butylmagnesium bromide, cyclohexylmagnesium bromide, cyclopentylmagnesium bromide, tert‐butylmagnesium bromide, iso‐propylmagnesium bromide, and ethylmagnesium bromide were studied. Tri‐ and pentaalkyl phosphazenes were obtained in very poor yield from trimethylsilylmethylmagnesium chloride and cyclohexylmagnesium bromide, respectively. Trialkylphosphoryl compounds formed from benzyl‐, 2‐phenylethyl‐, and n‐butylmagnesium bromide. No phosphorus compound could be isolated from the reaction of 1 with t‐butyl‐, cyclopentyl‐, iso‐propyl‐, and ethylmagnesium bromide. © 2003 Wiley Periodicals, Inc. Heteroatom Chem 14:413–416, 2003; Published online in Wiley InterScience (www.interscience.wiley.com). DOI 10.1002/hc.10153