bluuebunny/crossref_metadata_2025 huggingface dataset:
Characterization of Laboratory Working Standard for Quality Control of Immunometric and Radiometric Estrogen Receptor Assays. Clinical Evaluation on Breast Cancer Biopsies
Authors: Piffanelli Adriano , Pelizzola Dario , Giovannini Gloria , Catozzi Laura , Faggioli Laura , Giganti Melchiorre
Published: April 2018

The objective of the study was to characterize a low-cost and reliable working standard material for quality control of estrogen receptor (ER) determination with dextran-coated charcoal (DCC) and enzyme immunoassay (EIA) methods. Human fibromatous uterine lyophilized cytosol demonstrated good characteristics of stability and applicability for this purpose. Eleven laboratories participated in the intralaboratory and interlaboratory quality control study, and they achieved slightly higher coefficients of variation for ER-EIA (interlaboratory, 37.7 %; intralaboratory, 22.9 %) than for ER-DCC (Interlaboratory, 24.2 %; intralaboratory, 15.7 %). There was an excellent correlation between ER results with ER-EIA and ER-DCC for 268 breast cancer biopsies. Quality assurance for ER assays using DCC techniques and immunometric methods with monoclonal antibodies (ER-EIA) can be set up with this available material of human origin to satisfy the characteristics of both techniques and the species specificity of monoclonal antibodies.
Immunohistochemical Investigation of Axillary Lymph Nodes for Micrometastases in Patients with Breast Cancer Using E29
Authors: Cavaliere Antonio , Falini Brunangelo , Antonini Giacomo
Published: April 2018

The axillary lymph nodes from 31 mammary carcinoma patients who had undergone radical mastectomy and were negative for metastases at routine histologic examination of hilar sections, were investigated with E29, an anti-epithelial monoclonal antibody, to detect the presence of neoplastic epithelial cells. In 4 of 433 lymph nodes examined (0.9 %) this antibody revealed the presence of epithelial metastatic foci which had not been observed at routine histological examination or interpreted as histiocytes. The 4 lymph nodes belonged to 4 different patients.
Neuroendocrine Effects of Subcutaneous Interleukin-2 Injection in Cancer Patients
Authors: Lissoni Paolo , Barni Sandro , Rovelli Franco , Crispino Sergio , Fumagalli Gabriele , Pescia Simonetta , Vaghi Massimo , Camesasca Giovanna , Tancini Gabriele
Published: April 2018

Intravenous interleukin-2 (IL-2) administration has been shown to influence several hormonal secretions. The present study was carried out to investigate the endocrine effects of subcutaneous therapy with IL-2. Six patients with advanced renal cancer were studied. They were treated subcutaneously with IL-2 according to the schedule proposed by Atzpodien et al. Venous blood samples were collected at O-time and 1, 8 and 12 hours after the first IL-2 pulse of 9 × 106 IU/m2 at 8.00 a.m.; on a separate occasion, samples were collected during a saline infusion only. In each blood sample, serum levels of Cortisol, β-endorphin, GH, PRL, FSH, LH, TSH and the pineal hormone melatonin were measured by RIA. Both Cortisol and β-endorphin significantly increased after IL-2 injection. GH rose but not to a significant extent. PRL, FSH, LH and TSH did not change after IL-2. Finally, melatonin levels markedly decreased after IL-2 injection in the only 2 patients with elevated concentrations of this hormone before the start of immunotherapy. These results suggest that the endocrine effects of subcutaneous IL-2 therapy are similar to those previously described with intravenous administration.
Influence of Mitoxantrone on the Syntheses of Dna and Proteins of Mouse Tissues
Authors: Dusonchet Luisa , Candiloro Vincenza , Crosta Lucia , Sanguedolce Rosario , Armata Maria Gabriella , Rausa Luciano
Published: April 2018

In view of the structural similarity of mitoxantrone to anthracyclines and its ability to intercalate into DNA, we studied its influence on the synthetic processes of DNA and proteins in CD-1 mice tissues. By studying at the DNA level the impairment of 2H-thymidine incorporation and its return to normal, it was found that bone marrow and spleen showed similar behavior, i.e., a rapid return to normal, which occurred before bone marrow cell number and spleen weight returned to basal values. At the cardiac level, the incorporation values of precursors into DNA, reduced by treatment with mitoxantrone, came back very slowly to the control ones. Hepatic DNA showed a lower sensitivity to mitoxantrone. Analysis of 3H-leucine incorporation into three protein fractions of the heart showed that the contractile proteins were the most responsive fractions to mitoxantrone treatment. Experiments on CD-1 mice treated repeatedly with mitoxantrone revealed that the antitumor drug, at the cumulative dose of 8 mg/kg i.v., induced alterations in myocardiac morphology similar qualitatively to those induced by doxorubicin, although smaller quantitatively.
Muir-Torre Syndrome: A Case Report
Authors: Bisceglia Michele , Zenarola Patrizia
Published: April 2018

The authors present a case of Muir-Torre syndrome, the « sporadic » form, with a review of the literature. The importance of the close scrutiny of these patients and their relatives is stressed.
Fibrosarcoma of the Thymic Region. A Case Report
Authors: Pescarmona Edoardo , Remotti Daniele , Marzullo Antonella , Faraggiana Tullio , Muda Andrea Onetti , Baroni Carlo D.
Published: April 2018

Fibrosarcoma of the mediastinum is an unusual tumor and only few cases have been reported. We describe the clinical and pathologic findings of a case of mediastinal mass in a 34 year old woman. The histologic, histochemical, immunocytochemical and ultrastructural features of the tumor were consistent with a diagnosis of fibrosarcoma. Furthermore, the tumor displayed evidence of close relations with the thymus capsule; the possibility that it may arise from the thymic stroma is considered. The differential diagnosis of spindle cell tumors of the mediastinum is also discussed.
Heterogeneity and Phenotypic Instability of Chemotherapeutic and Immunologic Sensitivity in Murine and Human Melanoma Cell Clones
Authors: Supino Rosanna , Rodolfo Monica , Mariani Mariangela , Mapelli Elena
Published: April 2018

The aim of the present study was to examine the phenotypic heterogeneity of murine and human melanoma cell lines with particular reference to anticancer drug sensitivity, growth pattern and susceptibility to lysis by lymphokine (rIL2) activated killer (LAK cells). Clones selected for a different drug sensitivity were tested to evaluate the stability of such properties after different in vitro passages. A possible relationship between drug sensitivity and LAK susceptibility was also analyzed. The results indicated a high heterogeneity in murine and in human melanoma clones for all the parameters. However, drug sensitivity, which was stable although for only a few passages in an untreated human melanoma, was highly unstable in murine naturally or drug-induced resistant cells. Finally, whereas human drug-resistant clones were sensitive to lysis by LAK cells and an inverse correlation was found with the level of drug resistance, murine clones appeared to be LAK sensitive, and no correlation was found between the level of drug resistance and LAK sensitivity. Our data indicate a different stability in drug response of human and murine cells and a different behaviour of human and murine drug-resistant cells in response to LAK lysis.
High Dose Alpha-2B Interferon+Folinic Acid in the Modulation of 5-Fluorouracil. A Phase II Study in Advanced Colorectal Cancer with Evidence of An Unfavorable Cost/Benefit Ratio
Authors: Labianca Roberto , Pancera Gianfranco , Tedeschi Lucilla , Dallavalle Giuseppe , Luporini Alberto , Luporini Gino
Published: April 2018

The combination of folinic acid (FA) and 5-fluorouracil (5FU) is the most active systemic chemotherapy against advanced colorectal cancer. Experimental and clinical studies have suggested that the activity of 5FU can be improved by the addition of alpha-interferon (IFN). To evaluate the possibility of a double modulation of 5FU, a pilot study was conducted in the period July 1989-December 1989 with the following regimen: FA (200 mg/m2 i.v. bolus × 5 days) + 5FU (400 mg/m2 i.v. in 15 min × 5 days) + alpha-2b IFN (10 × 104 IU subcutaneously on alternate days). FA and 5FU administrations were repeated every 28 days; IFN was administered every week. In the 16 treated patients, 4 partial responses, 4 no changes, and 8 with progression of disease were observed, with an objective response rate of 25% (95% CI, 7.8%–55.1%). Median duration of response was 9.5 months, as was overall survival. Toxicity (fever, fatigue, neurotoxicity, stomatitis and diarrhea) was considerable and led to a reduction in IFN doses in 10/16 patients. Due to the unfavorable cost/benefit ratio, the study was closed and a new trial, with different doses and schedule of IFN, was started within the GISCAD (Italian Group for the Study of Digestive Tract Cancer).
Effect of Medroxyprogesterone Acetate on Immunohistochemical Expression of Estradiol in Endometrial Carcinoma
Authors: Yokoyama Yasuhiro , Sumi Hirohisa , Tamaya Teruhiko
Published: April 2018

The effect of medroxyprogesterone acetate (MPA) on the immunohistochemical expression of estradiol (E2) was investigated in 25 cases of endometrial carcinoma. Twenty-three cases of the endometrial carcinomas showed positive Immunoreactivity for E2. The immunohistochemical expression of E2 was more intensive in carcinoma cells than in stromal cells. Although the morphologic alterations induced by MPA treatment were observed only in 2 cases who were administered more than 30,000 mg of MPA, the staining intensity in most cases appeared to decrease after the treatment. The decrease in E2 immunoreactivities of cancer cells as well as of stromal cells in Grade 1 or Grade 2 was significant. These results suggest that MPA might decrease the E2 content in endometrial carcinoma cells as well as in stromal cells.
Small Cell Carcinoma of the Gallbladder: Clinical Course and Response to Chemotherapy
Authors: Ron Ilan-Gil , Wigler Nelly , Ilie Bianca , Chaitchik Samario
Published: April 2018

Small cell carcinoma of the gall bladder is a rare tumor. The neoplasm is highly lethal, metastasizes early, and may cause death shortly after diagnosis. An oat cell carcinoma of the gallbladder metastatic to the liver and adjacent lymph nodes is described in a 60-year-old male. Partial cholecystectomy was performed followed by aggressive chemotherapy with etoposide and cisplatinum. An 80 % reduction in the size of the unexcised tumor was noted over a period of 6 months. The partial response and the relatively long survival of the patient suggest the use of the above protocol for these rare cases.
Primary Hodgkin's Disease of the Stomach. A Case Report
Authors: Colucci Giuseppe , Giotta Francesco , Maiello Evaristo , Fucci Livia , Caruso Maria Lucia
Published: April 2018

Primary gastric Hodgkin's disease is rare and has been reported in only 2 % of patients with primary gastric lymphomas. Its existence is quite controversial, and new immunohistochemical techniques and flow cytometry have reduced the frequency of diagnosis of this pathology. The authors describe a case of primary gastric Hodgkin's disease in a 61-year-old woman.
Testing Cervicography and Cervicoscopy as Screening Tests for Cervical Cancer
Authors: Cecchini Silvia , Bonardi Rita , Mazzotta Antonia , Grazzini Grazia , Iossa Anna , Ciatto Stefano
Published: April 2018

Aims and Background

Suboptimal sensitivity is currently reported for Pap test in screening for cervical cancer. Colposcopy is known to be more sensitive than cytology but its use as a screening test is not possible due to costs and complexity. Screening by cervicography has been suggested as a compromise being less costly and feasible. The present study evaluates the feasibility of screening by cervicography and cervicoscopy (naked eye examination of the cervix after acetic acid lavage) on a consecutive screening series.

Methods

Cervicography and cervicoscopy were performed by the smear taker in subjects consecutively attending a screening clinic. Women with abnormal cytology (atypia or more severe lesion) and/or abnormal cervicography or cervicoscopy (acetowhite lesion) underwent colposcopic assessment. The three screening methods were compared according to positivity rate, CIN 2-3 detection rate and positive predictive value.

Results

2105 consecutive subjects were screened. Positivity rate was 3.8 %, 15.3 % or 25.4 % for cytology, cervicography or cervicoscopy, respectively, 486 of 555 women attended the assessment phase, 281 directed biopsies were performed and 8 CIN 2-3 lesions were detected. Cytology, cervicography and cervicoscopy, detected 5.5, or 7 of 8 CIN 2-3 lesions, respectively. The positive predictive value was 0% for cytologic atypia, 25 % for cytologic SIL, 1.75 % for cervicography and 2.05% for cervicoscopy. Detecting one CIN 2-3 lesion at cytology cost $ 5,543. The cost per each additional cytologically negative CIN 2-3 lesion detected at cervicography or cervicoscopy was $ 12,947 or $ 3,916, respectively.

Conclusions

The study confirms the limited sensitivity of cytology for CIN 2-3. The association of cervicography was not cost effective. Cervicoscopy was poorly specific but increased the detection rate of CIN 2-3 at relatively low costs. Cervicoscopy is worth further evaluation as a screening test.
A Weekly Schedule of Epirubicin in Pretreated Advanced Breast Cancer
Authors: Barni Sandro , Archili Caterina , Lissoni Paolo , Paolorossi Franco , Crispino Sergio , Tancini Gabriele
Published: April 2018

Aims

Epirubicin is an analogue of doxorubicin with a similar activity but less toxicity. The aim of this study was to evaluate the efficacy and the tolerability of a weekly schedule of epirubicin.

Methods

Fifty-three patients with metastatic breast cancer, pretreated and/or with a low performance status, were treated with 25 mg/m2/week of the drug.

Results

Of the 49 evaluable patients, 3 achieved a complete response (6.1 %) and 21 a partial response (42.8 %) with a median duration of 6.3 months. Median survival was significantly higher in responders than in nonresponders: 15.2 vs 6.0 months (P < 0.005). Furthermore, a marked improvement in performance status was observed (ECOG scale). No cardiologic toxicity was observed, and gastrointestinal toxicity was low.

Conclusions

Epirubicin administered weekly represent a valid alternative to conventional treatments.
Production and Characterization of a Tumor-Specific Monoclonal Antibody Act19 Recognizing an Epitope Distinctive from Sialosyl-Tn on the TAG72 Antigen
Authors: Xiang Jim , Moyana Terence , Chen Zhinan , Han Wenzhou , Ping Tiejing , Li Eiqen
Published: April 2018

Aims

A murine monoclonal antibody ACT19 directed at the TAG72 tumor-associated antigen, which was originally defined by the B72.3 antibody, was established.

Methods

This was done by immunizing mice with the bovine mucin followed by the selection of hybridomas secreting antibodies with the desired specificity. In order to better characterize this antibody, its immunoreactivity was compared to that of the B72.3 antibody.

Results

The data showed that the ACT19 antibody bound specifically to the TAG72 antigen as the B72.3 antibody did. However, there were some differences between ACT19 and B72.3. Firstly, the immunoreactivity of ACT19 for the bovine mucin was lower than that of B72.3. Secondly, the immunoreactivity of ACT19 for the TAG72 antigen was not inhibited by N-acetylgalactosamine, nor was that of B72.3. Thirdly, ACT19 did not compete the binding reactivity of B72.3 for the TAG72 antigen. This suggests that the epitope defined by ACT19 is different from the sialosyl-Tn epitope recognized by B72.3. Immunoperoxidase staining of various tumors, normal and embryonic tissues for ACT19 was carried out. For the various tumors, only adenocarcinomas from the colon and stomach showed remarkable positivity. All the normal tissues were negative, except for weak positivity involving the zona reticularis of the adrenal cortex, and intestinal goblet cells. Embryonic tissues showed a wide spectrum of positivity with staining of the small and large intestine, stomach and renal tubules.

Conclusions

The ACT19 antibody appears to be a useful marker for colon and stomach cancers, and this additional anti-TAG72 antibody may be useful in conjunction with the B72.3 antibody in pathology and clinical application.
Conventional Radiographic follow-up in the Irradiated Lung
Authors: Guzzon Adalgiso , Milani Franco , Spagnoli Ivo , Danesini Gian Maria , Laffranchi Alberto , Potepan Paolo , Giovannardi Giulia , Gattoni Filippo
Published: April 2018

Aims

To highlight the different changes induced in lung tissues by various forms of radiotherapy (RT) according to tumor site and type.

Methods

A retrospective analysis of the roentgenographic evaluation of and long-term follow-up data on 2375 patients who received RT for various intrathoracic and extrathoracic tumors at the National Cancer Institute of Milan.

Results

The iconographic patterns of post-RT changes, grouped by site and type of tumor and RT procedure and described in detail, afford deeper insight into a little-known area of lung pathology.

Conclusions

These descriptions of common and uncommon patterns of the irradiated lung as they appear on conventional chest roentgenograms enable the radiologist and radiotherapist to assess exactly the response of tumor and lung tissues and to plan the most appropriate clinical follow-up.
Renal Cancer after Busulphan Treatment for Chronic Myeloid Leukemia. A Case Report
Authors: Iurlo Alessandra , Foa Paolo , Sala Marco , Maiolo Anna Teresa
Published: April 2018

The incidence of secondary malignancies following chemotherapy is progressively increasing, mostly due to prolonged survival of patients treated for primary cancer. So far, only 3 cases of solid cancer following busulphan administration have been reported. We describe the case of a patient who developed a renal cancer after 4 years of busulphan treatment for chronic myeloid leukemia. Immunosuppression rather than mutagenesis seems to be responsible for the emergence of second solid cancers in patients receiving busulphan.
Small Bowel Metastasis from Squamous Cell Carcinoma of the Larynx. A Case Report
Authors: Airoldi Mario , Gabriele Pietro , Succo Giovanni , Valente Guido , Brando Vincenzo
Published: April 2018

Small bowel metastases from squamous cell carcinoma of the head and neck are relatively rare and in some cases asymptomatic. In the case herein reported, small bowel metastasis from a laryngeal carcinoma caused a life-threatening complication. The surgical approach was effective in saving the patient's life. Death occurred for neck tumor progression without abdominal signs of secondary lesions. A review of the previously reported cases is provided.
The Role of Medical Counseling in Secondary Prevention of Cancer in the Elderly
Authors: Giunta Sergio , Piantartelli Lucio , Basso Andrea , Morresi Angelo , Lanza Riccardo , Groppa Giuseppe , Caruso Umberto , Fiori Leo
Published: April 2018

In western countries the elderly are those who experience the major impact of cancer, as epidemiologic data clearly show. Thus, secondary prevention of cancer (SPC) in older persons deserves more attention than it has received until now. Target subjects, however, are often reluctant to enter SPC plans. The reasons range from the lack of knowledge about the importance of SPC to the underevaluation of the risk of cancer, or, even more often, to the anxiety and fear that may stem from such a clinical investigation. In this context, the intervention known as couseling finds its natural and essential role. In the paper some general considerations on the significance of medical counseling is given, with particular emphasis on its role in SPC in the elderly. The analysis herein reported points out the specific skills and methods that physicians can adopt to cope with the eventually adverse influences that may affect the participation of the elderly in SPC initiatives. However, such action should avoid any paternalistic approach and respect the patient's will and autonomy.
Stage I Seminoma of the Testis: Long Term Results and Toxicity with Adjuvant Radiotherapy
Authors: Amichetti Maurizio , Fellin Giovanni , Bolner Andrea , Busana Lucia , Pani Giuseppe , Romano Mario , Scillieri Marco , Maluta Sergio
Published: April 2018

Aims and background

Pure testicular seminoma has historically been treated with post-orchidectomy radiation therapy with excellent results. Recently, several aspects of the treatment of stage I seminoma have been questioned. We assessed long-term results and toxicity of patients with pure testicular seminoma treated at the Department of Radiation Oncology of S. Chiara Hospital, Trento.

Methods

From 1953 to 1987, 102 patients with stage I pure testicular seminoma were given megavoltage irradiation with curative intent. All patients had a minimum follow-up of 3 years (maximum 37 years, median 13 years). They received a mean para-aortic/pelvic dose of 33.07 Gy (range 23.70-45.20 Gy) with different doses and fields reflecting the change in techniques over a long period of time.

Results

The cause-specific actuarial survival at 30 years was 99% and crude survival 67%. One patient had an out-field relapse (inguinal) after a few months and was cured with radiotherapy and chemotherapy. Another patient relapsed with widespared metastases and died after 1 year of progressive disease. Early toxycity was mild and the treatment was well tolerated. Late side effects were reported in 8/102 patients.

Conclusion

In our series adjuvant radiation therapy resulted in cure rates corresponding to those reported in the literature. The 30-year actuarial survival of 99% was extremely good and the toxicity of the treatment was mild. Post-orchidectomy radiation to the para-aortic and ipsilateral pelvic nodes is a safe and effective method of preventing recurrences and is currently to be considered the treatment of choice in stage I testicular seminoma.
Cytogenetic Findings in Primary Non-Small Cell Lung Cancer
Authors: D'Alessandro Elvira , Lo Re Maria Luisa , Crisci Roberto , Ligas Claudio , Coloni Giorgio Furio
Published: April 2018

Non-small cell lung cancer (NSCLC) shows a complex cytogenetic heterogeneity and up to now no particular chromosomal aberration seems to characterize its malignant evolution. We therefore performed cytogenetic analyses of 20 primary NSCLC, 8 adenocarcinomas and 12 squamous cell carcinomas on direct preparations or short-term cultures. Only 1 case was analyzed after long-term culture. Results were obtained from 11 samples and clonal rearrangements were found in 3 cases, a diploid and a near-triploid clone with several aberrations such as i (9q), rob (14; 15) and rob (21; 21) in 1 case, a near-triploid clone in 1 case, and Y chromosome loss in 1 case. Other aberrations found were sporadic, but + 7 aneuploidy and translocations involving 1p were detected in 2 and 3 samples respectively. Although to date it has been very difficult to recognize primary changes in NSCLC, nevertheless a literature review and our results indicate that i(9q) and robertsonian translocations are relevant findings.
R75251 in Prostate Cancer Patients in Progression after First-Line Hormonal Treatment
Authors: Boccardo Francesco , Cannata Daniela , Guarneri Domenico , Oneto Francesco , Cortesi Enrico , Bono Aldo
Published: April 2018

Introduction

The therapeutic potential of R75251, a ketoconazole derivative which has shown marked antitumor activity in animals and in men, was investigated in 16 patients with advanced prostatic cancer progressing after one or more lines of hormone therapy.

Patients and methods

Patients were given the drug at 150 mg/b.i.d. for one month. After the first month of treatment, the dose was increased to 300 mg/b.i.d. In all patients, treatment was continued until disease progression or the development of severe toxicity. Clinical and biochemical assessments were performed on days 0, 14 and 28 and then repeated on a monthly basis.

Results

Of the 13 evaluable patients, 12 showed stable disease by strictly employing US-NPCP criteria. However, in 3 patients a clear effect was observed on the volume of their measurable lesions. In addition, 2 of them showed a more than 50% decrease of prostate-specific antigens (PSA). Overall, 50% of patients showed some decrease in PSA baseline levels. Overall tolerance to treatment was good.

Conclusions

Our results, although achieved in a small number of patients, suggest that R75251 has a moderate but definite activity in patients with hormone-refractory prostate cancer and that the value of this drug as second-line treatment in these patients should be further investigated.
Possible Correlation between Some Biologic Effects and the Clinical Course in Patiens Treated with Continuous Infusion of Interleukin-2 plus Alpha-2 Interferon for Metastatic Renal Cell Carcinoma
Authors: Baiocchi Claudia , Landonio Giuseppe , Balzarmi Gabriella , Cacioppo Carlo , Calgaro Mario , Ferrari Massimo , Gottardi Ornella , Majno Margherita , Scanzi Francesco , Ghislandi Enrico , Brando Bruno
Published: April 2018

Background

Interleukin-2 therapy is known to cause many biologic effects, which are enhanced by the administration of interferon prior to or immediately after interleukin-2 infusion. Some of these effects could be related to the clinical response.

Methods

Sixteen patients with metastatic renal cell carcinoma were treated with continuous infusion of interleukin-2 plus alpha-2 interferon. Differential leukocyte count and lymphocyte subset evaluation were performed every 3 days during interleukin-2 treatment. At each cycle, the presence of the following antibodies was tested: antithyroid, antinuclear, antiplatelet and antierythrocyte.

Results

Fifteen patients were evaluable for response. No complete response was observed. Five patients obtained partial response (33%) and 3 stable disease (20%): 2 of them underwent surgical resection of metastases and obtained complete response. Some of our patients showed a significant increase in eosinophils, CD25+ lymphocytes and antithyroid antibodies. The association of these parameters, calculated with a “score” system, was also related to a better clinical response.

Conclusions

Eosinophils, CD25+ lymphocytes and antithyroid antibodies could have a predictive value for the efficacy of interleukin-2 and alpha-2 interferon therapy in metastatic renal cell carcinoma.
Prostate Cancer: Population-Based Survival Rates in Central Italy
Authors: Crocetti Emanuele , Buiatti Eva , Amorosi Andrea
Published: April 2018

Aims

To evaluate survival in prostate cancer patients in the Province of Florence where the Tuscany Cancer Registry is active.

Methods

The survival of 777 patients with prostate cancer diagnosed in the period 1985-87 was evaluated. The observed and relative survival rates 1, 3 and 5 years after diagnosis were computed. Also the prognostic effect of age, disease extension, tumor grade, histological verification, place of residence and year of diagnosis were evaluated using univariate and multivariate analysis.

Results

The observed survival was 73.4% 1 year, 42.5% 3 years and 29.2% 5 years after diagnosis. The relative survival was respectively 78.7%, 53.0% and 43.0%. Significant independent risks were evident when the disease was extended out of the prostate, for patients older than 80 years, for high grade tumors and for patients without histological verification.

Conclusion

The 5-year relative survival rate in the province of Florence is similar to those from other European Registries and the Latina Registry, but much lower than the one reported by the SEER program in the US. Data on histological verification percentage, availability of information on disease extension, and tumor grade are discussed as indicators of the quality of the diagnostic approach in comparison with other registries.
A Multicenter Study of Colorectal Adenomas Rationale, Objectives, Methods and Characteristics of the Study Cohort
Authors: Bruzzi Paolo ,   * The SMAC Workgroup is reported in the Appendix.
Published: April 2018

Background and Aims

The Multicenter Study of Colorectal Adenomas (SMAC) is a retrospective-prospective cohort study involving four Gastrointestinal Endoscopy Units in Italy. The main aim of the study is to evaluate the relationship between clinical and pathologic information at index colonoscopy and subsequent incidence of adenoma and colorectal carcinoma. We report the rationale, objectives and methods of the study, including patient characteristics at initial presentation.

Methods

All patients were consecutively identified from the endoscopy registries of the four Centres from January 1, 1985 to December 31, 1992. Inclusion criteria were: age 18-69 years, endoscopy performed with adequate toilette at least up to the rectosigmoid junction, and removal of all detectable polyps. Exclusion criteria were: familial adenomatous polyposis, inflammatory bowel diseases, adenocarcinoma in adenoma with infiltrated margins, previous invasive cancer at any site, colon resection and geographic inaccessibility.

Results

Out of 20,071 patients who underwent endoscopy at the four Centres, 11,959 fulfilled the eligibility criteria (5,892 males and 6,067 females, mean age = 51.1 ± 11.6 years). The main reasons for exclusion were age (n = 4,020) and previous or present colorectal cancer (n = 2,389). Symptoms were the most common reason for referral (72.3%), while post-polypectomy follow-up and positive fecal occult blood accounted for most of the remaining cases. A pancolonoscopy was performed in 3,088 patients (25.8%), while a left-sided endoscopy was performed in 7,887 (66%). A total number of 4,810 polyps were removed from 2,699 patients (2,994 adenomas, 1,580 hyperplastic polyps and 236 polyps lost after resection). A significant association (p < 0.001) between age and the endoscopic findings was observed. The subjects without polyps (n = 9,198) had the lowest age (mean = 49.9; 95%CL = 49.6 - 50.1) followed by the patients with hyperplastic polyps (n = 661; mean age = 52.3; 95%CL = 51.5-53.1), and the patients with adenomas (n = 1,732; mean age = 56.2; 95%CL = 55.8 - 56.6), and the patients with hyperplastic polyps and adenomas (n = 306; mean age = 57.2; 95%CL = 56.3 - 58.2). Polyps were diagnosed more frequently in males than in females (28.6% versus 17.0%; p < 0.0001).

Conclusion

This study provides some insights in the natural history of colorectal cancer and stresses the need to develop adequate strategies in the follow-up of subjects after either positive or negative colonoscopy.
Hairy Cell Leukemia: An Ultrastructural Study of Hairy Cells before and after Interferon Therapy
Authors: Morroni Manrico , Cinti Saverio
Published: April 2018

Aims and background

To test the diagnostic relevance of the presence of ribosome-lamellae complexes (RLC) in 18 hairy cell leukemia (HCL) cases, and to correlate clinical response to interferon (IFN) therapy with hairy cell ultrastructural modifications in 5 of these cases.

Methods

Peripheral blood samples of 18 HCL patients were studied by transmission electron microscopy. Five of these patients received IFN treatment and subsequently were evaluated at different intervals for ultrastructural modifications of the peripheral blood.

Results

RLC were observed in 66.66% of our 18 HCL patients, but in less than 1% of all the cases contained in the files (consisting of over 8,000 cases) of our Electron Microscopy Unit. The microvilli disappeared after IFN therapy in the patients who did not display RLC before therapy (2 cases), whereas they were fewer, shortened and blunted, but still evident, in the cases where RLC had been observed before therapy (3 cases). Moreover, in the HCL cases with pre-therapy RLC, neoplastic cells still synthesized RLC after IFN treatment, but their morphologic aspect was immature.

Conclusions

Our study suggests that: 1) the presence of RLC, when associated to the hairy aspect of the cells, has considerable diagnostic value even though RLC are observed in other rare neoplastic and non-neoplastic conditions; 2) HCL cases with pre-therapy RLC exhibited a morphologic response to IFN therapy different from that of cases without pre-therapy RLC; 3) the quantitative and qualitative modifications of RLC following IFN treatment, as yet unexplained, are probably related to IFN action, in line with a previous report.
Clinical Efficacy of Cancer Subcutaneous Immunotherapy with Interleukin-2 in Relation to the Pretreatment Levels of Tumor Growth Factor Insulin-Like Growth Factor-1
Authors: Lissoni Paolo , Barni Sandro , Ardizzoia Antonio , Frigerio Franco , Paolorossi Franco , Cazzaniga Marina , Tancini Gabriele , Rocco Francesco , Aapro Matti
Published: April 2018

Aims and background

IGF-1 has been proven to be one of the most important growth factors for normal and neoplastic cells. Abnormally high levels of IGF-1 have been observed in cancer patients. Since it has been demonstrated that some growth factors may counteract the action of antitumor cytokines, the presence of increased IGF-1 concentrations could reduce the efficacy of cancer biotherapies with cytokines, such as IL-2. The present study was performed to evaluate the efficacy of IL-2 immunotherapy in relation to the pretreatment levels of IGF-1 in advanced cancer patients.

Methods

The study included 20 consecutive patients with metastatic renal cell cancer who were treated subcutaneously with IL-2 at 6 million IU/day for 5 days/week for 6 weeks. IGF-1 serum levels were measured by RIA on venous blood samples collected before the immunotherapy, after 3 weeks, and at the end of IL-2 injection.

Results

Objective tumor regressions were obtained in 5/20 patients, consisting of 1 complete response (CR) and 4 partial responses (PR). Nine patients had stable disease and the last 6 patients progressed. Abnormally high pretreatment levels of IGF-1 were seen in 13/20 patients. The percent of clinical responses (CR + PR) was significantly higher in patients with normal pretreatment concentrations of IGF-1 than in those with elevated levels (4/7 vs 1/13, P < 0.01). No significant changes in mean IGF-1 levels occurred during IL-2 therapy. However, mean IGF-1 levels increased in progressing patients and decreased in those with a response or stable disease, even though none of the differences was statistically significant.

Conclusions

The study showed that high pretreatment levels of IGF-1 are associated with a reduced efficacy of IL-2 immunotherapy of renal cancer. Further studies are required to establish whether IGF-1 levels simply reflect the extension of disease, or whether they may influence per se the action of IL-2.
Tobacco, Alcohol, Diet and Risk of prostate Cancer
Authors: De Stefani Eduardo , Fierro Luis , Barrios Enrique , Ronco Alvaro
Published: April 2018

A hospital-based case-control study of the association between tobacco smoking, alcohol drinking and several relevant dietary items and prostate cancer was carried out in the National Cancer Institute of Uruguay between January 1988 and December 1994. The sample included 156 patients with histologically proven prostatic cancer and 302 controls with a variety of neoplastic and non-neoplastic diseases. The results showed increased risks of prostate cancer associated with beer drinking, meat, milk and fruit consumption, after adjusting for major confounders. The possible role of N-nitroso compounds from beer in prostatic carcinogenesis is discussed.
Variability and Discontinuity of the Pathognomonic Systemic Effects Caused by Walker 256 Tumor Progression in Rats
Authors: Rettori Ovidio , Vieira-Matos Ana Neuza , Tahin Quivo S.
Published: April 2018

Cancer pathognomonic systemic effects (PSE) have high individual variability. For this reason present data were collected daily and synchronized considering four main points: inoculation day, onset of PSE, aggravation and death. The subclinical period free of PSE ranged between 15.7±2.2 days, the clinical period was less variable, 8.9±0.5 days, divided in a moderate and a grave phase of nearly the same length. PSE involved disturbances of fundamental homeostatic regulations: appetite, sodium, water, immune, etc. PSE triggering correlated highly with survival (r2=0.95, P<0.01), but poorly with primary tumor growth, and it was anticipated by metastases from 20.5±2.6 to 10.6±1.1 days (P<0.01). After multifocal simultaneous inoculations, PSE triggering was anticipated to 4.2±0.2 days (marked reduction of individual variability), in the presence of small total-tumor masses, absence of macroscopic metastases, and without changes in the following clinical period features. PSE triggering seems to be a major prognostic indicator probably related to multifocal tumor growth.
Suspected Extragonadal Germ-Cell Cancer Syndrome Presenting with an Orbital Mass and Elevation of Serum Cea, CA19-9 and CA50 Levels
Authors: Cruz Juan J , Dueñas Alfonso , Sanchez Consuelo , Fonseca Emilio , Gomez Amalia , Martin German , Sanchez Pedro , Navalon Marta , Garcia-Palomo Andres
Published: April 2018

Patients with extragonadal germ-cell cancer syndrome (EGCCS) represent a subgroup of patients with poorly differentiated carcinoma or adenocarcinoma of an unknown primary site for whom potentially curative therapy is available. We report the case of a young man presenting an orbital tumor and high serum levels of CEA, CA19-9 and CA50 for whom an initial diagnosis of metastatic poorly differentiated carcinoma was made. Suspecting EGCCS, he was treated as for a germ-cell tumor. While in treatment, he underwent residual orbital mass resection, and the histologic diagnosis was embryonal carcinoma based on alphafetoprotein immunoperoxidase staining. We discuss the rare location at diagnosis, the impressive increase in the commonly considered gastrointestinal markers that he showed, and the potential utility of these markers for such patients.
A Case of Breast Angiosarcoma: Diagnostic Imaging and Review of the Literature
Authors: Zincone Gian Emilio , Perego Paolo , Rossi Gian Marco , Bovo Giorgio
Published: April 2018

Primary angiosarcoma of the breast is a rare tumor, with approximately 170 cases reported in the literature (1-3, 10, 11, 15). Reports on the imaging characteristics of these tumors have been occasional until a recent review by Liberman et al. (11). Diagnostic imaging of the masses include mammographic and ultrasound examinations (5): the imaging characteristics of the tumor can be nonspecific and sometimes heterogeneous (11). Only recently was one case evaluated with magnetic resonance imaging (11).

We present the mammographic and sonographic features of a case of primary angiosarcoma of the breast with an inflammatory appearance.
Bone Marrow Biopsy for the Staging of Non-Hodgkin's Lymphoma: Bilateral or Unilateral Trephine Biopsy?
Authors: Luoni Marco , Declich Paolo , De Paoli Alberto , Fava Sergio , Marinoni Patrizia , Montalbetti Luigi , Sangalli Gabriele , Sciuccati Patrizia , Tocci Antonio , Tosi Anna , Assi Agnese , Cassi Edmondo
Published: April 2018

Aim

The occurrence of unilateral involvement in bilateral bone marrow trephine biopsies in non-Hodgkin's lymphomas (NHL) at disease onset (10-20% of cases) has been reported since the early 70s. Therefore, although these studies were based on small series, the use of bilateral bone marrow biopsies has become the rule. However, the clinical value of this procedure has never been clearly established. The aim of the present study was to ascertain the true value of bilateral bone marrow biopsy in the staging of NHL.

Study Design

We examined 368 cases of NHL (A-H according to the Working Formulation) (WF), without leukemic involvement of the peripheral blood, in order to evaluate: 1) the incidence of unilateral bone marrow involvement; 2) the percentage of patients who, as a result of unilateral bone marrow involvement, changed from stages I-II to stage IV; 3) assessment of response to therapy for patients with both bilateral or unilateral bone marrow involvement.

Results

In the A-C NHL groups of WF there was a unilateral bone marrow involvement of 8.8%. Overall, bone marrow involvement induced a change from clinical stages I-II to stage IV in 5.6% of cases, a figure which would correspond to a false negative rate of 2.8%, if unilateral bone marrow biopsy was performed. In the D-F and G, H groups of WF, unilateral involvement was 10.1% and 8.5% respectively; the change in stage from I-II to IV by unilateral bone marrow involvement respectively amounted to 1.4% and 2.8%, which correspond to respective false negative rates of 0.7% and 1.4%.

Conclusions

On the basis of these results and of the present therapeutic strategies, we propose: bilateral bone marrow biopsy for clinical stages I-II of all NHL; no bone marrow biopsy at disease onset for clinical stages III and IV of A to H histologic subtypes of the WF; unilateral bone marrow biopsy (A-C subtypes of the WF) or bilateral (D-H of the WF), after the regression of extramedullary localizations.
Solitary Thyroid Metastasis from a Renal Cell Carcinoma Diagnosed and Treated 12 Years before: A Case Report
Authors: Innocente Roberto , Bortolus Roberto , De Paoli Antonino , Boz Giovanni , Gobitti Carlo , Cicuta Gianni , Sulfaro Sandro , Trovò Mauro G.
Published: April 2018

The authors report a case of a solitary thyroid metastasis in a 62-year-old woman. The clinical history of the patient and the histologic findings are consistent with a renal origin of the tumor.

Gli Autori riportano un caso di metastasi unica tiroidea in una donna di 62 anni. I dati anamnestici ed i reperti anatomo-patologici suggeriscono una origine renale della neoplasia.
Mucinous Carcinoma of Sweat Glands
Authors: Urso Carmelo , Salvadori Adriana , Bondi Roberto
Published: April 2018

Three cases of primary cutaneous mucinous carcinoma of sweat gland origin are presented. Patients were a 47-year-old man and 2 females aged 70 and 71 years. The clinical and pathologic features of the described tumors were similar to those reported in the literature, except for 2 of the involved sites (abdominal skin and vulva), not previously described.
Phase II Trial of Oral Tegafur and Folinic Acid with Mitoxantrone as First-Line Regimen in Patients with Metastatic Breast Cancer
Authors: Alonso Vicente , Santander Carmen , Florián Jesús , Alonso Martina , Isla Ma Dolores , Escudero Pilar , Sáenz Alberto , Tres Alejandro
Published: April 2018

Background

Tegafur acts as a deport form of 5-fluorouracil when administered orally for longs periods of time, since it is an active drug in metastatic breast cancer, with response rates of 29-44%. Biochemical modulation with folinic acid and the addition of mitoxantrone could increase the efficacy of tegafur in patients with metastatic breast cancer.

Methods

A prospective phase II trial in patients with previously untreated metastatic breast cancer was carried out. The scheme consisted of mitoxantrone, 12 mg/m2 intravenous day 1, oral tegafur, 750 mg/m2/day divided in three equal doses, and leucovorin 15 mg/8 h orally for days 1-21, given in a 4-week schedule. None patient had received chemotherapy for metastatic breast cancer, although 16 patients had received previous adjuvant chemotherapy.

Results

Thirty-four patients were included. Objective responses were achieved in 20 of 32 patients assessable for response, with 1 complete response and 19 partial responses. The objective response rate was 62.5% (95% confidence intervals, 48-76%). The median duration of response was 10 months. Grade III-IV toxicity according to WHO criteria was digestive (nausea/vomiting) in 12.5%, diarrhea in 25% and stomatitis in 25% of patients. Other toxicities were low. Eight patients required dose-reduction.

Conclusions

We achieved a significant response rate with the scheme, which was administered on an outpatient basis. It seems to be safe and effective as first-line treatment in metastatic breast cancer, with a short median response duration. The size of the trial does not permit definitive conclusions, and the role of biochemical modulation of tegafur in combination with mitoxantrone remains to be defined.
Oncostress: Evaluation of Burnout in Lombardy
Authors: Barni Sandro , Mondin Roberto , Nazzani Renato , Archili Caterina
Published: April 2018

Aims

This study was carried out to evaluate how working with oncologic patients (from various points of view) can cause personal discomfort for the operator.

Methods

Questionnaires (n=406) consisting of many requisites concerning personal and professional factors, organizational and work aspects were evaluated. They were given to oncologic doctors, radiotherapists, various specialists, nurses and radiotherapy technicians in Lombardy.

Results

The study revealed a state of anxiety in 52.7% of subjects and depression in 16%, mainly in the professional nursing categories and in particular in women and the young. The most singular aspects observed were not related to work organization.

Conclusions

Working in an oncologic environment is, in different ways, the cause of “oncostress” and distinctly induces burnout. However, it appears to be less significant in Italy than indicated in the literature.
Pulmonary Lymphangioleiomyomatosis: A Case Report in Postmenopausal Woman Treated with Pleurodesis and Progesterone (Medroxyprogesterone Acetate)
Authors: Zanella Alida , Toppan Paola , Nitti Donato , Lise Mario
Published: April 2018

The main problem in the treatment of pulmonary lymphangioleiomyomatosis, which frequently occurs in the reproductive age, is the control of chylothorax and disease progression. We herein report a case of a 62-year-old woman who underwent surgery for recurrent chylothorax. Histologic examination of lung and lymph node biopsies demonstrated lymphangioleiomyomatosis. Thirty-six months after tetracycline pleurodesis and high-dose medroxyprogesterone acetate therapy, the disease was stable and chylothorax effectively controlled. It would therefore appear that hormonal treatment with medroxyprogesterone acetate may be beneficial in postmenopausal women.
Pathologic Features of Hereditary Non-Polyposis Colorectal Cancer
Authors: Messerini Luca , Mori Sabrina , Zampi Giancarlo
Published: April 2018

In hereditary non-polyposis colorectal cancer (HNPCC) patients, the cancer frequently arises in the proximal colon and is often multiple (synchronous or metachronous). Pathologic differences seem to exist between hereditary and sporadic large bowel cancer, but the data are not uniform. Many authors reported that the following histologic features are often present in HNPCC: 1) mucinous histotype, 2) poorly differentiated tumors, 3) presence of peritumoral lymphocytic infiltrate, with Crohn's-like lymphoid reaction. Such features have also been found in apparently sporadic colorectal cancer with, but not in sporadic colorectal cancer without DNA replication errors. Many studies have suggested that adenoma plays a main role in HNPCC carcinogenesis, and that the “adenoma-carcinoma sequence” may be the pathway to cancer in HNPCC as in sporadic colorectal cancer. Moreover, HNPCC adenomas show an early onset, villous component, high-grade dysplasia, and positivity for DNA replication errors more frequently than sporadic adenomas. Such data suggest that the adenoma-carcinoma sequence is accelerated in HNPCC and that surveillance in these patients should therefore be strict to avoid cancer development.