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H Wunderlich

Publications and source records attributed to H Wunderlich.

60 records · Page 4Linked to original sources
PubMedDate not supplied

Fetal fibronectin: a new screening-marker for bladder cancer?

Early detection of transitional cell carcinoma (TCC) of the urinary bladder is essential for effective treatment. While several serum markers have been evaluated, none have been widely accepted for practical clinical use. Thus, urinary markers have been introduced and investigated to detect the evidence of bladder cancer. But sensitivity and specificity range around 80% respectively. In a prospective study we evaluated fetal fibronectin in the urine of patients with TCC of the urinary bladder. The positivity of oncofetal fibronectin was measured in morning urine samples by membrane immunoassay. This FFN membrane immunoassay is a qualitative test, a solid-phase immunogold assay. A positive sample will result in a single spot after binding of the oncofetal fibronectin-immunogold complex to the membrane containing a monoclonal antibody specific to oncofetal fibronectin (FDC-6, which specifically recognizes III-CS region). The morning urine samples were collected from patients with TCC before they underwent transurethral resection (n=40, 34 non-invasive and 6 invasive carcinomas) and healthy controls (n=20). Oncofetal fibronectin was investigated in the surgical samples by immunohistochemistry (antibody FDC-6, APAAP technique). We found a positive result for oncofetal fibronectin in 38/40 patients with transitional cell carcinoma of the urinary bladder. Two patients with a small pTaG1-TCC showed negative results. In the urine of healthy controls no positive results were detected. Thus, there is a sensitivity of 95% and a specificity of 100%. The TCC was demonstrated as a source of oncfn. To our knowledge this is the first study showing that patients with an evident TCC have a demonstrable amount of oncofetal fibronectin in the urine. We conclude that a positive result is common in TCC-patients. The sensitivity and specificity of this test seems to be extraordinarily high. Because of the small number of cases further studies are required.

Adult↗
PubMedDate not supplied

The histopathological heterogeneity of small renal cell carcinoma.

BACKGROUND: Renal tumors resembling renal cell carcinoma but less than 3 cm in diameter historically have been regarded as adenomas because of their low frequency of metastases. However, this concept has been challenged, and it seems that all of these lesions should be considered carcinomas. Thus, the extent of radical surgery of these findings have been reconsidered, in view of the uncertainty regarding their malignant or benign nature. MATERIALS AND METHODS: 107 tumors 40 mm or less in diameter were accordingly divided into three groups and clinico- and histopathological criteria were correlated: group 1: 20 mm or less (n = 33), group 2: 21-30 mm (n = 28) and group 3: 31-40 mm (n = 43). RESULTS: Both lymph node metastases and distant metastases were well correlated with tumor size. Grade 1 renal cell carcinomas decreased in their frequency with an increasing tumor diameter. In grade 3 carcinomas an opposite result was found. With an increase of tumor size the frequency of venous involvement increases as well. Significant more multifocal malignant renal cell carcinoma were seen in renal cell carcinoma between 21-40 mm compared to tumors 20 mm or less in diameter. CONCLUSION: Although the metastatic potential and the biology of small renal tumors are not yet known, it seems that nephron-sparing surgery in patients with renal cell carcinoma more than 20 mm in diameter should only be performed when there is an absolute indication, such as bilateral carcinomas, single kidney or renal failure. The problem is that a long-term follow-up study is mandatory to justify partial nephrectomy as a nephron-sparing operation for renal cell carcinoma more than 20 mm in patients with normal function of the contralateral kidney.

Adrenal Gland Neoplasms↗
PubMedDate not supplied

Are renal cell carcinoma cells able to modulate the cytotoxic effect of tumor infiltrating lymphocytes by secretion of interleukin-6?

BACKGROUND: Interleukin (IL)-6 can suppress the cisplatin-induced induction of apoptosis in renal cell carcinoma (RCC) in vitro. There are reports on IL-6 secretion by tumor cells. MATERIALS AND METHODS: In supermatants of RCC cultures we measured IL-6 levels by a bioassay. In a videomicroscopic microcytotoxicity assay the immunomodulating effect of secreted cytokines on the cytotoxicity of tumor infiltrating lymphocytes (TIL) was studied. RESULTS: The IL-6 concentrations in 17 supematants of healthy renal cells tended to be higher than in the supernatants of tumor cell cultures. By immunostaining we detected IL-6 in 3/6 cell cultures from healthy renal tissue, in 12/22 tumor tissue samples, and in 8/18 tumor cultures respectively. Supernatants suppressing cytotoxic activity of TIL showed higher IL-6 concentrations in tendency. Suppression of cytotoxicity could also be induced by adding discrete concentrations of IL-6. CONCLUSIONS: IL6 secreted by tumor cells seems to be tumor protecting against cytotoxic TIL. Blocking this mechanism could be an additional approach in immunotherapy of RCC.

Apoptosis↗