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Biomedical subjects

A I Spriggs

Publications and source records attributed to A I Spriggs.

At least 19 recordsLinked to original sources

Use of immunocytochemical staining to identify cells in peritoneal fluid and washings at laparoscopy and laparotomy.

Specimens of peritoneal fluid or peritoneal washings from a series of 106 patients who had had laparotomy or laparoscopy for gynaecological complaints were studied "blind" by conventional cytology and immunocytochemical staining. The antibodies used were Ca 1 or Ca 2, anti-CEA, and HMFG-2 or E29. All these are directed against epithelial antigens and are expressed on most malignant epithelial cells and weakly or not at all on mesothelial cells. It was hoped that these reactions would confirm diagnoses made by conventional cytology and possibly show malignant cells which had not already been identified. Of 28 patients with malignant disease (chosen to exclude any with frank ascites), eight gave positive immunochemical reactions, only four having been reported positive from conventional examination. Of 77 patients without malignant disease, HMFG-2 or E29 gave positive reactions in seven, Ca 1 or Ca 2 in two, and anti-CEA in two (reactions with plasma cells being disregarded). Some misleading reactions were probably due to endometrial cells. It was concluded that the antibodies used in this study are not sufficiently specific or sensitive to allow immunocytochemical staining to replace conventional cytological diagnosis but are a useful supplementary aid.

Adult

Ca2 and Ca3. New monoclonal antibodies evaluated as tumor markers in serous effusions.

Ca2 and Ca3 are new monoclonal antibodies of IgG1 class, directed against the Ca antigen, a mucus-type glycoprotein expressed on the surface of a wide range of malignant human cells and certain specialized normal epithelia. These antibodies were produced by immunization with purified preparations of the Ca antigen. They were tested to assess their value in the diagnosis of malignant effusions. Immuno-alkaline-phosphatase staining was used. Smears of pleural and peritoneal effusions were chosen to show: undoubted malignant cells of various types; and mesothelial cells in effusions from cases in which cancer was not in question. The Ca2 antibody, at 1 in 20 dilution of the culture supernatant, was the most specific, giving no reactions with benign mesothelial cells from any of the 35 cases tested. Malignant cells were clearly stained in 35 of 40 cases of carcinoma or mesothelioma. The staining was negative in two cases of oat cell bronchial carcinoma, and in three of four cases of carcinoma of the colon. Ca3 gave similar, but somewhat stronger, reactions with carcinoma cells, but was less specific, reacting weakly with mesothelial cells in 8 of 35 benign effusions. Because the false-negative reactions given by the Ca series of antibodies are to some extent complementary to those given by monoclonal antibodies directed against the carcinoembryonic antigen (CEA), a combination of Ca2 and anti-CEA is recommended as a most useful addition to the normal cytologic examination of effusions.

Antibodies, Monoclonal

Women with positive cervical smears but without surgical intervention. A follow-up study.

By a collaborative effort among British cytopathologists, 101 women were identified who had had unsuspected "positive" cervical smears but who, after at least 2 years, had still escaped biopsy through refusal, default, or failure to trace. Of these, 31 still could not be traced; 10 were traced but could not be further examined (8 because they refused); 7 had clinically diagnosed carcinoma of the cervix; and the remaining 53 had further smears and/or biopsies after a mean interval of 5.2 years. In 19 of the 53 the smear had become negative or biopsy showed no lesion. Regression was confined to women aged under 40 at the time of the initial positive smear. In 20 cases biopsy showed dysplasia or carcinoma-in-situ, in 3 microinvasive carcinoma, and in 3 occult invasive carcinoma. Of the 7 women who presented clinically with carcinoma of the cervix, this caused death in 5.

Adult

Joint fluid cytology in Reiter's disease.

The diagnostic value of the finding of cytophagocytic macrophages (CPM) in the joint fluid of patients with Reiter's disease has been re-examined. CPM were found in 46% of Reiter's disease fluids and in 45% of other inflammatory knee joint fluids. Higher CPM scores, on a 4-point grading, were commoner in Reiter's disease but the difference was not statistically significant. Further, although the graded polymorphonuclear leucocyte phagocytosis shown by CPM was greater in Reiter's disease this also was not significant. It is concluded that the presence of CPM in joint fluid is of little discriminating value.

Arthritis, Reactive

Cervical smears.

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Adolescent

Adenocarcinoma of the uterine cervix: cytological evidence of a long preclinical evolution.

Adenocarcinoma of the cervix occurred in 13 women who had previously had "negative" cervical smears. These smears were reviewed, and abnormalities were found in six cases, the intervals ranging from two to eight years. It is concluded that adenocarcinoma, like squamous carcinoma of the cervix, can have a prolonged evolution during which it is cytologically detectable.

Adenocarcinoma

Duplication of part of the long arm of chromosome 1 in marrow cells of a treated case of myelomatosis.

In a case of classical myelomatosis treated with melphalan, a clone of cells with a chromosomal abnormality was found in the bone marrow during remission. There was good reason to think that the hemopoietic cells, rather than plasmacytoma cells, were implicated. Although the clone persisted, no evidence of leukemia developed over a period of observation of 2 yr. The anomaly was interpreted as a duplication of part of the long arm of chromosome 1, which appeared to involve the segment q21 to q31.

Aged

Intracellular mucous inclusions. A feature of malignant cells in effusions in the serous cavities, particularly due to carcinoma of the breast.

Three cases of carcinoma of the breast are described, in which similar tumour cells were found in pleural or peritoneal fluid. The cells were characterized by the frequent presence of 'bull's-eye' vacuoles, in which a central spot was deeply stained by Giemsa, eosin or periodic acid-Schiff (PAS). In one of these it was shown by electron microscopy that the vacuoles are lined by microvilli, and that their mucinous content is condensed in the central area, presumably as a result of failure to discharge the secretion.

Aged

Letter: Microvilli.

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Adenocarcinoma