Biomedical subjects

P Strang

Publications and source records attributed to P Strang.

87 records · Page 5Linked to original sources

PubMedDate not supplied

Age, menopausal status and DNA-content in endometrial adenocarcinoma.

In a prospective study of 283 women with endometrial carcinoma, 29 of whom were premenopausal and 254 postmenopausal, the DNA content and S-phase rate were measured by flow cytometry. Over 90% of the tumors in premenopausal women were peri-diploid and the remaining tumors were tetraploid, whereas 23% of the tumors in post-menopausal women were grossly aneuploid (p less than 0.01). Similar differences were found between women younger or older than 50 years. The results indicate that the hormonal status and/or age are of importance for the development of genetically different forms of endometrial carcinomas, as judged from the DNA-distribution.

Adenocarcinoma↗

PubMedDate not supplied

Differences in DNA content and proliferation rate between adenocarcinomas of the uterine cervix and corpus.

The DNA content and the S-phase rate of 26 cervical adenocarcinomas and 100 endometrial adenocarcinomas, determined by flow cytometry, were compared. Statistically significant differences in DNA patterns were found, although only pure adenocarcinomas were studied in both groups. Peri-diploid values (1.8c-2.2c) were less common in cervical adenocarcinomas (38%) than in endometrial carcinomas (65%) (p less than 0.05). Six (23%) of the cervical carcinomas and 8 (8%) of the endometrial carcinomas had two detectable stem lines. The mean S-phase rate was significantly higher in adenocarcinomas of the uterine cervix than in endometrial carcinomas (p less than 0.02). The dominance of aneuploid values, the high proportion of polyclonal tumors and the high S-phase rates of the cervical adenocarcinomas have more similarities with the DNA patterns of cervical squamous cell carcinomas than with those of endometrial adenocarcinomas.

Adenocarcinoma↗

PubMedDate not supplied

Flow cytometry in invasive endometrial carcinoma. Correlations between DNA content S-phase rate and clinical parameters.

In a prospective study including 185 women with endometrial adenocarcinoma, the DNA-content and the S-phase rate were measured by flow cytometry. The tumors of 138 (75%) patients were peridiploid and those of 47 (25%) were grossly aneuploid. Aneuploid tumors were more common in poorly differentiated tumors than in well and moderately differentiated tumors (p less than 0.0001). S-phase rates were evaluable in 148 (80%) tumors. High S-phase rates were more frequent in stages III + IV than in stages I + II (p less than 0.05) and were also more common in poorly differentiated tumors than in moderately and well differentiated tumors (p less than 0.05). Ploidy levels and S-phase rates were not significantly correlated with age or menopausal status. During the follow-up time (6 to 38 months), 19 patients died of their disease. The number of deaths registered was significantly higher among patients with aneuploid tumors than among patients with peridiploid tumors (p less than 0.002). The proportion of tumors with high S-phase rates was significantly higher than that of tumors with low S-phase rates (p less than 0.0001). These preliminary results indicate that patients with aneuploid tumors or tumors with high S-phase rates are at high risk for early recurrences.

Aged↗

PubMedDate not supplied

Residual myometrial invasion after intracavitary irradiation of endometrial adenocarcinoma stages I and II. Relations to DNA content and S-phase rate.

The DNA content and the S-phase rate were determined by flow cytometry in 129 women with endometrial adenocarcinoma in stages I and II. Aneuploidy and elevated S-phase rates were statistically correlated to loss of histopathologic differentiation. After preoperative intracavitary irradiation and surgery, the occurrence of residual myometrial invasion was studied. Residual myometrial invasion was found in 28 (22%) cases. In 17 (17%) of the peri-diploid (1.8c-2.2c) and in 11 (38%) of the aneuploid tumors, respectively, the myometrium was invaded (p less than 0.05). No statistical correlation was found between mean S-phase rate and myometrial invasion. The difference in residual myometrial invasion found between aneuploid and peri-diploid tumors after intracavitary treatment may reflect a primary difference in the tendency to invade the myometrium or a difference in responsiveness to radiotherapy.

Adenocarcinoma↗

PubMedDate not supplied

Blood group antigens in relation to DNA content, S-phase rate and heterogeneity, and their prognostic values in cervical carcinoma.

Evaluations were made of the expression of blood group antigens, DNA content and S-phase rate in a prospective study of 97 patients with squamous cell carcinoma of the uterine cervix. No correlation was found between loss of ABH expression and ploidy level or the degree of proliferation, whereas correlations were found to age and stage. In 11 (42%) of 26 tumors with two or three detectable stemlines, distinct areas with disparate ABH staining patterns were found, indicating genotypic and phenotypic heterogeneity within these tumors. In tumors with one stemline significantly fewer such tumors were found (p less than 0.01). Twenty-four early recurrences (within 20-36 months) after treatment were found. High S-phase rates (greater than 20%) were associated with a significantly increased recurrence rate (p less than 0.05). Loss of ABH antigen expression or ploidy level were not statistically correlated to early recurrences.

ABO Blood-Group System↗

PubMedDate not supplied

S-phase rate as a predictor of early recurrences in carcinoma of the uterine cervix.

Flow cytometric measurements of ploidy level and S-phase rate were performed in a prospective study of 165 patients with cervical squamous cell carcinoma. Patients were followed-up for 24 months after initial treatment. There was no significant difference in recurrence rate between patients with peri-diploid tumors (1.8c-2.2c) and aneuploid tumors. The S-phase rate (evaluable in 133 cases), which previously has been studied only occasionally in cervical carcinomas, was correlated with early relapses. Significantly more relapses were found in tumors with S-phase rates greater than or equal to 20% than among tumors with S-phase rates less than 20% (chi 2 = 9.54, p less than 0.01). A higher relapse rate among tumors with S-phase rates greater than or equal to 20% was found even after taking staging into consideration (Cochran-Mantel-Haenszel test, p less than 0.01). Thus, besides staging, evaluation of the S-phase rate yielded additional prognostic information.

Carcinoma↗

PubMedDate not supplied

Polyclonal cervical tumors detected by flow cytometry.

In a prospective study, the tumors of 167 patients with invasive squamous cell carcinomas of the uterine cervix were investigated by flow cytometric measurements of the DNA-content. In 37 patients (22%) 2 or more stemlines could be detected, indicating clonal heterogeneity. The proportion of multiple stemlines was equal in stages IB to III but significantly higher in stage IV (p less than 0.01). In 14 of the 37 polyclonal tumors the DNA-value of the second peak was twice the value of the first peak, suggesting possible polyploidization. For those tumors with evidence of polyploidization that had values in the diploid, tetraploid or octaploid region (n = 9) the mean age was 35.6 +/- 11.7 years and for grossly aneuploid tumors (n = 5) the mean age was 73 +/- 12.6 years. The differences of mean age between the two groups differed significantly (p less than 0.001). Flow cytometry proved to be a useful, rapid, and sensitive method for detection of multiple stemlines.

Adult↗

PubMedDate not supplied

Sex steroid hormones and receptors in relation to S-phase fraction and ploidy level in endometrial carcinoma.

Although endogenous hormones exert an effect on the proliferation of endometria adenocarcinoma, there also seems to be an autonomous proliferation of the malignant cells. Simultaneous measurement of endocrine and cell proliferation related variables in endometrial adenocarcinoma specimens are expected to increase the understanding of factors responsible for progression or regression of this form of cancer. Sixty patients with endometrial adenocarcinoma were examined. The following parameters were analysed: endogenous plasma concentration of oestradiol, oestrone, progesterone, androstenedione and testosterone; S-phase fraction (SPF) and ploidy level, by flow cytometry; oestrogen and progesterone receptors, by immunohistochemistry. The oestrogen receptor positive tumours had a lower S-phase fraction that receptor negative tumours (p < 0.05), but SPF was still under the mean for the whole group. ER positive tumours were all diploid, while progesterone receptors were found also in aneuploid tumours. The presence of PR did not relate to lower SPF, but in an earlier study increased progesterone concentration was found to relate to lower SPF, and the antiproliferative effect of progesterone was also seen in more malignant tumours.

Adenocarcinoma↗

PubMedDate not supplied

Ki-67 immunostaining and DNA flow cytometry as prognostic factors in epithelial ovarian cancers.

Samples from malignant epithelial ovarian tumors were examined for expression of Ki-67, DNA ploidy and S-phase fraction (SPF). In addition, normal ovary, benign and borderline tumors were immunostained with Ki-67 to examine its role in ovarian carcinogenesis and to estimate the prognostic significance. For both Ki-67, ploidy and SFP a significant correlation to survival in malignancy was observed. Furthermore, SPF above 10% showed significant correlation to decreased survival in both stage subgroups I-II and III-IV, while for aneuploidy a decrease in survival could be detected only in localized disease. Ki-67 expression was present in tumor cells in the main part of borderline and malignant tumors and even in 2 benign counterparts, which might indicate an active state in these commonly believed dormant neoplasms. In the malignant group the Ki-67 correlation to survival seemed to be independent of staining intensity, although the observed decay in survival seemed to be faster in the strongly stained group.

Antibodies, Monoclonal↗

PubMedDate not supplied

Microangiopathic hemolytic anemias (MAHA) in cancer. A case report and review.

Microangiopathic hemolytic anemia in cancer, MAHA, a rare complication seen in connection with malignancies, exists in two forms. One form is associated with a disseminated disease and the other with chemotherapy, especially use of mitomycin-C in patients with limited disease or in patients in clinical remission. Both forms give rise to a severe, hemolytic anemia and the latter form also to renal insufficiency. MAHA is a life-threatening condition with poor prognosis unless it is identified early and treated. The two forms of MAHA are reviewed below and a case report is included.

Anemia, Hemolytic↗

PubMedDate not supplied

Endometrial carcinoma: the prognostic impact of papillary serous carcinoma (UPSC) in relation to nuclear grade, DNA ploidy and p53 expression.

In a histopathological review of 266 women with stage I-IV endometrial carcinoma, the prognostic significance of uterine papillary serous carcinoma (UPSC) and clear cell carcinoma (CCC) of the endometrium was compared with that of ordinary adenocarcinoma and adenoacanthoma. UPSC and CCC were diagnosed in 31/266 (12%) and 6/266 (2%) of the patients respectively. The median follow-up time was 79 months (range 3 to 133 months). 49% of the patients with UPSC or CCC died of their cancer compared with 31% in the adenocarcinoma + adenoacanthoma group (RH=2.25; p=0.0022). Strong expression of the mutated p53 gene product was significantly more common in the UPSC + CCC group than in the reference group (64% vs. 19%), (p<0.0001). In a Cox multivariate analysis including histopathological and clinical variables, UPSC and CCC were still significant predictors of survival (p<0.05). When nuclear grade was added to the analysis, UPSC + CCC as well as the degree of differentiation lost most of their prognostic impact. In a final multivariate analysis, DNA ploidy was found to be the strongest predictor of outcome besides age and clinical stage.

Adenocarcinoma↗

PubMedDate not supplied

The effect of megestrol acetate on anorexia, weight loss and cachexia in cancer and AIDS patients (review).

Weight gain is a well-known side-effect of megestrol acetate (MA) treatment. This effect has been studied systematically in cancer and AIDS patients with involuntary weight loss, anorexia or manifest cachexia, situations in which weight gain is desirable. Significant, positive effects on weight gain and on certain quality of life aspects, such as appetite, nausea, body image and mood have been reported for cancer patients treated with 160 mg to 1.600 mg daily and similar effects have been registered in AIDS patients if doses of about 400-800 mg are used. Maximal weight gain is normally achieved within 8 weeks. The weight gain is, unfortunately, mainly due to an increase in fat mass and partly due to edema and, therefore, no significant effects are reported as regards the Karnovsky index. If anorexia, nausea and a negative body image are major concerns and if the patient has a life expectancy of more than 3 months, MA is a reasonable treatment option. However, if the central problem is fatigue and a low Karnovsky index, especially in a patient with a short expected survival, MA, which is not inexpensive, is not likely to be of significant help.

Acquired Immunodeficiency Syndrome↗

PubMedDate not supplied

The analgesic efficacy of clodronate compared with placebo in patients with painful bone metastases from prostatic cancer.

Fifty-five patients with hormone refractory prostate cancer and painful bone metastases were randomised either to placebo or to clodronate 300 mg i.v. for 3 days, followed by oral clodronate 3200 mg for four weeks. Pain intensity was assessed using Visual Analogue Scales (VAS). Mean overall pain as well as mean pain during the best and worst periods were recorded. Forty-six patients were evaluable for efficacy. No significant differences were found between the two treatments. As regards mean worst pain a substantial numerical fall was registered for the treatment group, 21 mm, but the improvement was not significant compared to that of the placebo group. This was probably due to the limited number of patients (the study was prematurely ended due to problems recruiting patients). In conclusion, no significant differences were found between the treatment arm and the controls, in contrast to results from previous studies. Possible explanations are that the doses in this study were generally lower than in previous studies, the mean baseline pain was substantially lower and that the current study was placebocontrolled. Our data indicate that if clodronate is to be used for the alleviation of bone pain in prostate cancer, patients with high baseline should be selected and high intravenous doses should be given at start of the treatment.

Aged↗

PubMedDate not supplied

Pain figures are unsuitable for determination of palliative radiotherapy portals in patients with hormone refractory prostatic cancer.

We aimed to compare bone scintigraphy with pain extension and other quality of life (QoL) factors in order to evaluate QoL and the appropriateness of using pain figures and a subjective pain description as the basis for palliative radiotherapy (RT) portals. Twenty-three patients with progressive hormone-refractory prostatic adenocarcinoma were investigated with bone scintigraphy and completed pain figures, VAS (visual analogue scales) and a comprehensive self-questionnaire concerning QoL. The Soloway score was significantly correlated with Impaired overall QoL (p = 0.05), and especially with questions regarding restriction of movements (p = 0.001). Weight bearing regions were significantly more often affected at bone scintigraphy than other locations in the group of patients reporting incidental pain during exercise. Surprisingly, a poor level of correlation existed when comparing location of pain with location of uptake on bone scintigraphy, even if an adjacent region was included in the comparison. The subjective description of pain extension in pain figures correlates poorly with the uptake patterns at bone scintigraphy--an interesting finding since pain extensions is regularly used for the definition of palliative RT portals. Furthermore, it appears that the tumour burden itself is not and indicator of the pain score at rest, but affects aspects of QoL. Moreover, it would appears as though the location of metastases in the skeleton significantly affects physical quality of life aspects. It is probably more important to irradiate weight bearing regions of skeleton in order to increase QoL.

Adenocarcinoma↗

PubMedDate not supplied

Prognostic index models in stage I and II endometrial carcinoma.

BACKGROUND: In most studies, authors recommend the use of independent variables in clinical decision-making, but no guidelines are given about how to use all the extracted information. MATERIALS AND METHODS: By combining two or three prognostically independent variables and using their relative prognostic impact (results from Cox analyses), a novel way of identifying high- and low-risk groups was developed. A total of 336 women with stage I-II endometrial carcinoma of medium or high risk were included. Twenty-one clinico- pathological variables, were initially studied in univariate analyses and significant variables were used for the construction of prognostic indices. Six prognostic indices were constructed, which then were used to calculate individual index values for each patient. RESULTS: The index values were highly prognostic and used for the identification of a limited high-risk group (10% of the patients) and a large low-risk group (90% of the patients). Indices 1-3 were constructed for pre-treatment situations and included age, degree of differentiation, nuclear grade and S-phase fraction in various combinations. They identified a high- and a low-risk group with a 5-year disease-specific survival of 31-37% and 74.79%, respectively. Indices 4 and 5 were constructed using variables available after treatment and index 6 for patients with no evidence of disease (NED) after treatment completion. The 5-year survival for the latter indices were 30-52% and 75-85%, respectively. CONCLUSION: The use of prognostic indices in different clinical situations was generally superior to the use of single variables for the identification of well-defined high- and low-risk groups.

Adult↗