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Biomedical subjects

C R Gillis

Publications and source records attributed to C R Gillis.

At least 73 records · Page 4Linked to original sources

Modifying risk of developing lung cancer by changing habits of cigarette smoking.

Data from a hospital based case-control study of lung cancer in Western Europe were used to examine changes in the risk of developing lung cancer after changes in habits of cigarette smoking. Only data for subjects who had smoked regularly at some time in their lives were included. The large size of the study population (7181 patients and 11 006 controls) permitted precise estimates of the effect of giving up smoking. Risks of developing lung cancer for people who had given up smoking 10 or more years before interview were less than half of those for people who continued to smoke. The reduction in risk was seen in men and women and in former smokers of both filter and non-filter cigarettes but varied by duration of smoking habit before giving up. The protective effect of giving up became progressively greater with shorter duration of smoking habit. The risks after not smoking for 10 years for both men and women who had previously smoked for less than 20 years were roughly the same as those for lifelong non-smokers. Reducing the number of cigarettes smoked a day or switching from non-filter to filter cigarettes also lowered the risk of developing lung cancer but not to the extent associated with giving up smoking.

Europe↗

Patterns of lung cancer risk according to type of cigarette smoked.

A case-control study of lung cancer involving interviews with 7,804 cases and 15,207 hospital-based controls was carried out in seven locations in Western Europe. The large study size permitted the calculation of precise estimates of the relative risk of lung cancer associated with smoking different types of cigarettes. Lifelong nonfilter smokers were at nearly twice the risk of lung cancer compared to lifelong filter smokers after controlling for duration of cigarette use and number smoked per day (RR = 1.7 for males and 2.0 for females). Lung cancer risks for filter, nonfilter and mixed smokers increased in proportion to intensity and duration of smoking and decreased with years since stopping smoking. The findings indicate that prevention activities should continue to emphasize smoking cessation, although switching to low-tar cigarettes may also yield some reductions in lung cancer risk.

Adult↗

Pre-operative carcino-embryonic antigen and survival in patients with colorectal cancer.

The relationship between pre-operative levels of carcino-embryonic antigen (CEA), resectability of the primary tumour, the extent of tumour spread and subsequent survival was studied in 333 patients with colorectal cancer. Twenty-five per cent of patients undergoing 'curative' resection had elevated CEA levels compared with fifty-six per cent of patients receiving palliative treatment. Twenty-five per cent of patients with Dukes B or C tumours had elevated pre-operative CEA levels compared with seventy per cent of patients with stage D disease. In patients undergoing 'curative' resection there was no correlation between pre-operative CEA levels and subsequent survival. In patients undergoing palliative resection, elevated pre-operative CEA levels were associated with poor survival. Although pre-operative levels of CEA reflect the extent of the underlying disease process, estimations of pre-operative CEA levels are of limited value in predicting patients with a poor prognosis following curative resection for colorectal carcinoma.

Carcinoembryonic Antigen↗

Autologous x-irradiated tumour cells and percutaneous BCG in operable lung cancer.

To determine the value of specific immunotherapy with adjuvant BCG in operable lung cancer, the immunological and clinical results of serial postoperative injections of autologous irradiated tumour cells and BCG were compared with those of a single preoperative injection of BCG in two randomly selected groups of patients undergoing resection of their tumours. There was a significant rise in tuberculin skin reactivity from seven weeks to 11 months after operation in the treated group. Actuarial curves for survival and freedom from tumour recurrence and median survival times showed an advantage for the treated patients who had stage I tumours, but these differences were significant only at the levels p = 0.07 - 0.09. Survival and duration of freedom from tumour recurrence was greater in autograft-treated patients whose skin responded to a weak test dose of dinitrochlorobenzene (DNCB) after sensitisation with 2% DNCB than in control DNCB-positive patients (p = 0.02). There were no significant differences in the actual proportion of patients from each group surviving at two years. The results show that this form of specific immunotherapy with adjuvant may have a beneficial effect in patients with stage I tumours and those who become sensitised to 2% DNCB after the first exposure.

Aged↗

Local tumour invasion as a prognostic factor in colorectal cancer.

A prospective study was carried out of 404 patients with colorectal cancer who were followed up for a mean period of 42 months. Macroscopic extramural tumour invasion was found at laparotomy in 46 patients undergoing apparently curative surgery and the survival rate was significantly reduced in these patients. The site of primary tumour in the colon or rectum did not influence the incidence of local tumour spread, but local invasion was related to the incidence of lymph node metastases and histological grading of the tumour. A staging classification has been proposed based not on lymphatic metastases, but on the extent of local tumour penetration. This modified staging system combines the operative findings with pathological grading of the tumour and emphasizes the prognostic significance of local tumour invasion.

Adenocarcinoma↗

Cell-mediated immunity in operable bronchial carcinoma: the effect of injecting irradiated autologous tumour cells and BCG.

In 52 patients undergoing tests of cell-mediated immunity before surgical resection of bronchial carcinoma a positive tuberculin test result was found in 71% compared with 68% of age- and sex-matched controls. Sensitisation to DNCB occurred in 52% of 37 patients but in 78% of controls. There was depression of lymphocyte transformation by PPD in 19 patients compared with controls (P=0.001), but there was no difference in lymphocyte transformation by PHA or pokeweed mitogen between 34 patients and controls. In a pilot study patients were randomly allocated to autograft (eight) or non-autograft (seven) groups. The autograft group were given an intradermal injection of a suspension of irradiated autologous tumour-cells mixed with intradermal BCG on the day of operation. Tests of cell-mediated immunity were repeated two weeks after operation. Five patients in each group received a course of radiotherapy to the mediastinum three weeks after operation. There was a rise in cutaneous tuberculin reactivity (P=0.08) and total leucocyte count (P=0.09) in the autograft group postoperatively with a fall in total lymphocyte and T lymphocyte counts in the non-autograft group (P less 0.05). These differences, however, were not followed by any difference in the frequency of tumour recurrence or the survival rate two years after operation. The results show that the immunological surveillance mechanism is impaired even in patients with early bronchial carcinoma and that it is possible to overcome postoperative immunological depression with specific immunotherapy combined with BCG. This treatment did not produce any clinical advantage in this small number of patients and the skin lesions caused the patients considerable discomfort.

Aged↗