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Biomedical subjects

J Andersen

Publications and source records attributed to J Andersen.

At least 91 records · Page 5Linked to original sources
PubMed1988

Immunohistochemical analysis of estrogen receptors (ER) using formalin-fixed paraffin-embedded breast cancer tissue: correlation with clinical endocrine response.

A new immunohistochemical assay utilizing anti-ER monoclonal antibodies (H 222, Abbott) for detection of ER in formalin-fixed paraffin-embedded breast cancer tissue has been clinically evaluated. It is shown that tumors containing immunoreactive epithelial cells are much better candidates for hormonal manipulation than those without. In addition, primary tumors and corresponding regional lymph node metastases contain qualitatively the same ER pattern. The potentials and limitations of the present method are discussed in relation to other well-known ER assays.

Breast Neoplasms↗
PubMed1988

Relationship between radioligand binding assay, immunoenzyme assay and immunohistochemical assay for estrogen receptors in human breast cancer and association with tumor differentiation.

We have studied the merit of a new enzyme immunoassay (EIA) in relation to the results obtained with a conventional dextran-coated charcoal assay (DCC) of estrogen receptors (ER) in cytosols and nuclear extracts of human breast cancer tissue. The results of the two assays were related to cytosolic progesterone receptor content (PgR), semiquantified ER content in formalin-fixed paraffin embedded tissue specimens and tumor differentiation. The EIA was found stable at low cytosol protein concentrations (0.5 mg/ml). The EIA and DCC assays were highly correlated both in cytosols (r = 0.92, n = 57) and nuclear extracts (r = 0.82, n = 25), but the EIA slightly overestimated the ER values in both ER fractions. A significant correlation between ER in nuclear (ER(N] and cytosolic (ER(C] fractions was established with both assays (DCC: r = 0.90, n = 56; EIA: r = 0.83, n = 24). A qualitative relationship was established between PgR and ER fractions as determined with both assays, the best quantitative association was between PgR and ER(N(DCC] (r = 0.58, n = 34, P less than 0.001). A significant qualitative and quantitative relationship was found between semiquantified ER content in formalin-fixed, paraffin-embedded tissue and ER(C(DCC] (r = 0.88), ER(N(DCC] (r = 0.86], ER(C(EIA] (r = 0.60), ER(N(CIA] (r = 0.64) and PgR (r = 0.65). Finally, we found tumor differentiation to be significantly associated with ER content as determined with all assays except for ER(N(EIA]. We recommend the use of the DCC assay for routine analysis of ER until the clinical correlation of EIA results has been established.

Breast Neoplasms↗
PubMed1988

Adjuvant systemic treatment and the pattern of recurrences in patients with breast cancer.

The aim was to analyze the impact of adjuvant systemic treatment (AST) on the anatomical distribution, the number, and the temporal relationship of the first metastases in 635 patients (pts) with breast cancer. These patients participated in the prospective studies of AST of the Danish Breast Cancer Cooperative Group (DBCG) 77-program. All patients had primary high-risk breast cancer (i.e. node positive or local invasion or tumor size greater than 5 cm). The initial treatment was mastectomy with axillary sampling, followed by postoperative radiotherapy. The types of AST and the number of patients with recurrence were: chemotherapy (CT), 134 pts; levamisole (LEV), 96 pts; tamoxifen (TAM), 154 pts. The pattern of recurrence in these patients was compared with the pattern of recurrence in 251 pts who did not receive AST (controls). Although CT reduced the total number of metastatic sites (P = 0.04), the incidence of liver metastases was increased compared to untreated controls (P = 0.02). The median number of metastatic sites was equal in TAM- and LEV-treated pts compared to controls. The incidence of lung metastases was increased in TAM-treated pts (P = 0.03), and LEV-treated pts had a decreased incidence of lymph node (P = 0.01) and pleural recurrences (P = 0.01) compared to controls. The results may suggest that mechanisms of clonal selection during the metastatic process involve differences in sensitivity to antineoplastic treatments of metastases at various anatomical locations.

Antineoplastic Agents↗
PubMed1988

Histological grade and steroid receptor content of primary breast cancer--impact on prognosis and possible modes of action.

The clinical course of breast cancer was related to degree of anaplasia (DA) and steroid receptor (SR) content of primary tumours in 743 patients (pts) with clinical recurrence, initially enrolled in the DBCG-77 protocols. The oestrogen receptor (ER) and the progesterone receptor (PgR) content was known in 110 and 67 pts. The recurrence-free interval, survival after recurrence, and the overall survival were all prolonged in patients with well differentiated tumours or with high SR content. The tumour growth rates were estimated as clinical rates of progression (i.e., the time elapsed from a single distant metastasis until dissemination). The progression rate was prolonged in relatively well differentiated as well as in receptor rich tumours. The extent of dissemination, as indicated by the number of metastatic sites, was not associated with either DA or SR content. However, the anatomical distribution of metastases varied with both DA and SR content: signs of poor prognosis (high DA or low SR content) were associated with occurrence of visceral metastases. In contrast, SR rich tumours had a propensity for recurrence in bone. The results suggest that the impact on prognosis of the features examined here includes both variations in growth rate and metastatic pattern.

Breast Neoplasms↗
PubMed1988

Urinary excretion of albumin and retinol-binding protein in lithium-treated patients.

Urinary excretion of albumin and retinol-binding protein was measured by means of sensitive and specific immunochemical methods in a transverse study of 20 lithium-treated patients and 24 apparently healthy individuals. Albumin creatinine clearance ratios were significantly higher in the lithium-treated patients, which may indicate glomerular lesions. Microalbuminuria correlated highly to duration of lithium therapy. No significant difference between the retinol-binding protein creatinine clearance ratios in the two groups could be shown. This suggests that the catabolism of low-molecular-mass proteins in the proximal tubules was normal.

Adult↗
PubMed1988

Radial keratotomy for pseudophakic myopia.

Cataract extraction with implantation of a standard power IOL occasionally gives rise to considerable post-operative myopia. When operation of the second eye is indicated, the question may arise whether the patient should be made strongly myopic in both eyes, be made anisometropic, or have the already implanted IOL exchanged for a weaker one. We report here on 3 patients made isometropic and low-grade myopic after radial keratotomy in the myopic pseudophakic eye followed by cataract extraction and implantation of an IOL of predicted power in the second eye.

Aged↗
PubMed1988

Immunohistochemical demonstration of estrogen receptors (ER) in formalin-fixed, paraffin-embedded human breast cancer tissue by use of a monoclonal antibody to ER.

We describe an immunohistochemical method using a monoclonal antibody to localize estrogen receptors (ER) in formalin-fixed, paraffin-embedded tissue. The avidin-biotin-peroxidase complex method was used, preceded by trypsin treatment to expose antigenic sites. In 111 breast cancer specimens studied simultaneously by a dextran-coated charcoal (DCC) assay and the paraffin section method, agreement on receptor status was found in 101 (91%) specimens. Quantitative staining features showed a high degree of correlation with the results of the steroid binding assay (r = 0.81). Studies on the influence of fixation on ER localization done in rabbit uteri showed that fixatives mainly composed of coagulating reagents (Carnoy's, Zenker's, Bouin's, Lilly's AAF, Helly's, ethanol) precluded ER staining, whereas cross-linking fixatives (formaldehyde, glutaraldehyde) preserved antigenic sites, although the immunoreactivity of the receptor was somewhat decreased. Studies on the effect of enzyme preincubation showed this to increase antigenic expression of ER in formaldehyde-fixed breast tumors and in formaldehyde-, glutaraldehyde-, and Zamboni-fixed rabbit uteri.

Animals↗
PubMed1988

Identical 24-hour gastric pH profiles when using intragastric antimony or glass electrodes or aspirated gastric juice.

Intragastric pH was continuously measured over 24 h with a monocrystalline antimony electrode system and was compared with pH measured in simultaneously aspirated gastric juice and with pH measured by using a conventional intragastric glass electrode. There was a marked correlation between the pH readings obtained with the monocrystalline antimony electrode and the pH values measured in aspirated gastric juice (r = 0.92, p less than 0.001) and with the pH readings obtained with the intragastric glass electrode (r = 0.92, p less than 0.001). Both readings of pH with glass electrode and of pH after aspiration can be predicted by readings of pH with antimony electrode by using linear regression lines with slopes close to 1. Intragastric pH measurement is an alternative to aspiration of gastric juice, and the result obtained with an electrode of monocrystalline antimony is comparable to that obtained with a conventional glass electrode.

Antimony↗
PubMed1988

Recurrent unexplained haematuria and risk of urological cancer. A follow-up study.

To evaluate the risk of urological cancer in patients with unexplained haematuria, 93 patients, who had undergone complete urological examination and who were classified as having unexplained haematuria, were followed. Mean age was 46 years, range 16-84 years. Seventy-seven patients had gross haematuria and 16 patients had microscopic haematuria. Mean follow-up time was 62 months (range 6-360 months). Urological neoplasms were found in 7 of 38 patients (18%; 95% confidence limits 8-34%) with recurrent haematuria after primary urological examination, and in 1 of 36 patients (3%; 95% confidence limits 0.07-14%) without additional haematuria after primary examination. Regular urological examination of patients with recurrent unexplained haematuria is justified. In patients without additional incidents of haematuria after primary urological examination the risk of urological cancer is not significantly increased.

Adolescent↗
PubMed1988

Diagnostic strategy in the management of patients with breast symptoms. A recommended design and present experience.

The diagnostic problems in patients with breast symptoms have increased as the referral pattern has changed. Patients with vague symptoms and atypical palpatory findings are increasing in number. At the same time, the doctor is faced with the demand for greater diagnostic accuracy and, paradoxically, restraint in the use of diagnostic methods. Accordingly, high priority must be given to an effective diagnostic strategy without unnecessary investigations and delaying procedures. Above all, efforts must aim at reducing the number of 'unnecessary' benign biopsies. We are presenting a suggestion for an integrated diagnostic system based upon close collaboration between the general practitioner on one hand and radiologist, surgeon, and pathologist as the expert hospital team on the other. This design has not only entailed greater diagnostic accuracy, it also complies with the demand for conservation of resources.

Breast Neoplasms↗
PubMed1988

In situ carcinomas of the female breast. Incidence, clinical findings and DBCG proposals for management.

In situ carcinomas of the female breast (CIS) include lobular carcinoma in situ (LCIS) and ductal carcinoma in situ (DCIS). Also associated are controversial forms of epithelial hyperplasia, lobular cell atypia (ALH) and ductal cell atypia (ADH). Based upon recent Danish autopsy studies, it has been estimated that about 25% of all women will develop in situ carcinoma, predominantly in the form of DCIS. Only a fraction of these lesions will evolve into a clinical manifest form, however. Thus, in a clinical setting, the frequency of CIS is 0.09 cases per 1,000 woman-years for a Danish female population aged twenty years or more. The lifetime risk of having CIS demonstrated is estimated at 0.53% for women in this age group. CIS makes up a few per cent of all newly diagnosed breast cancers in Denmark. Enforced employment of mammography in the early detection of breast cancer will increase CIS incidence from about 4-6% to about 9-10% of all newly diagnosed breast cancers, and aggressive DCIS growths will mainly constitute the increment. In concurrence with the new DBCG protocols in 1988, new strategies for the management of in situ carcinomas, based upon histogenetic types and growth patterns, are being introduced. The aim will be breast-conserving treatment whenever it can be achieved.

Breast Neoplasms↗
PubMed1988

Adjuvant therapy of premenopausal and menopausal high-risk breast cancer patients. Present status of the Danish Breast Cancer Cooperative Group Trials 77-B and 82-B.

From September 1977 to November 1987 high-risk (i.e. with positive axillary lymph nodes, or tumor size greater than 5 cm or skin/facia invasion) premenopausal and menopausal breast cancer patients have been included in 2 randomized trials. In both trials the primary surgical treatment was total mastectomy with axillary sampling. In the first trial (DBCG 77-B) 1034 patients all received postoperative radiotherapy (RT) and were further randomized to 1) no systemic treatment (0), 2) cyclophosphamide (C), or 3) cyclophosphamide + methotrexate + 5-fluorouracil (CMF). The chemotherapy was given for 1 year. With a median observation time of 7 years the actuarial survival after 9 years is 50, 60 and 65% respectively. Retrospectively, the survival benefit was observed to be most pronounced in patients with tumor size less than or equal to 5 cm and with less than or equal to 3 positive lymph nodes. In the subsequent study initiated in 1982 (82-B) all patients received CMF for 9 months. Furthermore they were randomized to 1) RT, 2) no further treatment, or 3) tamoxifen (TAM) for 1 year. As of November 1, 1987, 1308 patients have been included. At 4 years and with a median observation time of 2 years the survival is similar in the 3 groups. In conclusion, in high-risk premenopausal and menopausal patients adjuvant chemotherapy combined with RT resulted in a 20-30% relative reduction in mortality at 9 years compared with RT alone. Preliminary analysis of adjuvant CMF + RT, compared with CMF alone or with CMF + TAM, shows after a median observation time of more than 2 years no significant survival differences.

Adult↗
PubMed1988

The pattern of metastases in human breast cancer. Influence of systemic adjuvant therapy and impact on survival.

Of the 3,802 patients enrolled in the DBCG 77 protocols, 863 developed clinical recurrence within a median follow-up time of 4.9 years (range 2.0-7.0). More than 69% of these had their first recurrence confined to a single anatomical site and 12% had more than two metastatic sites. The most common sites were bone (35%), lung (23%), skin (22%), and regional lymph nodes (16%). The observation period after first recurrence was 3.6 years (range 0.8-6.4). Survival after recurrence was significantly related both to the location and the number of metastases. Patients who were given adjuvant chemotherapy (n = 134) had significantly fewer metastatic sites and significantly more frequent liver metastases than untreated patients (n = 50). Patients who received adjuvant tamoxifen (n = 154) had the same number of metastatic sites, but more often had lung metastases than untreated patients (n = 201). These results probably reflect that metastases in different anatomical locations differ with respect to sensitivity to antineoplastic treatments.

Antineoplastic Agents↗
PubMed1988

Relationship between estrogen receptor status in the primary tumor and its regional and distant metastases. An immunohistochemical study in human breast cancer.

Treatment of metastatic breast cancer based on the estrogen receptor content (ER) of the primary tumor builds on the assumption that the ER status of the primary tumor and the metastases are largely equal. Studies addressing this question have used ligand-binding assays for ER determination and have consequently been subject to the limitations of this technique. Reported disparity rates have been 20%. In order to avoid some of these limitations, we used an immunohistochemical assay in paraffin-embedded tissue. Among a total of 92 examined regional lymph node metastases, ER status was equal with that of their 37 primaries in 84 cases (91%). Semiquantified ER content was significantly correlated in primary tumor and the metastases (r = 0.67, p less than 0.001). Among a total of 51 distant metastases, equal ER status was found in 44 (86%) cases and a quantitative relationship could not be established. Disparities can be due to methodological errors in the histochemical assay or tumor heterogeneity.

Abdominal Neoplasms↗