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PubMed2006

[Expression and clinical significance of nm23-H1 and MUC-1 in peripheral T-cell lymphoma].

BACKGROUND & OBJECTIVE: Peripheral T-cell lymphoma (PTCL) is a group of heterogeneous malignancy with poor prognosis. The role of international prognostic index (IPI) in PTCL remains to be determined. It is necessary to find new molecular markers for PTCL. This study was to evaluate the clinical significance of nm23-H1 and MUC-1 in predicting the prognosis of PTCL. METHODS: The expression of nm23-H1 and MUC-1 proteins in 96 specimens of PTCL was detected by SP immunohistochemistry. The correlations of nm23-H1 and MUC-1 expression to clinical features, objective response, and overall survival of PTCL patients were analyzed. RESULTS: Of the 96 patients, 78 (81.2%) were nm23-H1-positive, 56 (58.3%) were MUC-1-positive. Neither of the expression of nm23-H1 and MUC-1 was correlated to the pathologic subtype of PTCL (P>0.05). The high expression of nm23-H1 was associated with some poor prognostic factors such as stage III-IV, performance status (PS)> or =2, extranodal involvement, and more than one site of extranodal involvement (P<0.05). The high expression of MUC-1 was only associated with stage III-IV and more than one site of extranodal involvement (P<0.05). Of the 89 patients with evaluable disease, the overall response rate was 87.8% with a complete remission (CR) rate of 56.7%. The CR rate was significantly higher in nm23-H1-negative patients than in nm23-H1-positive patients (66.7% vs. 55.4%, P<0.05), and significantly higher in the patients with low nm23-H1 expression than in those with high nm23-H1 expression (79.9% vs. 44.0%, P<0.05); the CR rate was higher in MUC-1-negative patients than in MUC-1-positive patients, and higher in the patients with low MUC-1 expression than in those with high MUC-1 expression, but the differences were not significant. The median follow-up of the whole group was 30 months (range, 2-98 months), and the median survival time was 32 months [95% confidence interval (CI)= 26-34 months]. The overall 5-year survival rate of the whole group was 35.1%. The overall 5-year survival rate was significantly higher in nm23-H1-negative patients than in nm23-H1-positive patients (86.7% vs. 24.9%, P=0.001), and significantly higher in the patients with low nm23-H1 expression than in those with high nm23-H1 expression (52.3% vs. 21.7%, P<0.001). The overall 5-year survival rate was slightly higher in MUC-1-negative patients than in MUC-1-positive patients (47.9% vs. 28.5%, P>0.05), and slightly higher in the patients with low MUC-1 expression than in those with high MUC-1 expression (46.2% vs. 22.2%, P>0.05). Multivariant analysis showed that IPI score and nm23-H1 expression were independent prognostic factors of PTCL. CONCLUSIONS: Overexpression of nm23-H1 is related to poor prognosis of PTCL; it may be a potential prognostic index of PTCL. Overexpression of MUC-1 is not related to.

Adolescent↗

PubMed2007

EGFRvIII mutation in lung cancer correlates with increased EGFR copy number.

Overexpression of the epidermal growth factor receptor (EGFR) is caused by EGFR gene amplification and is sometimes associated with expression of a variant EGFR (deletion exon 2-7 or EGFRvIII). EGFRvIII mutation has oncogenic potential and is investigated as a potential therapeutic target. We genotyped the EGFRvIII mutation status in 252 surgically treated lung cancer cases. The presence or absence of EGFRvIII mutation was analyzed by real-time quantitative polymerase chain reaction (PCR) with mutation specific sensor and anchor probes. EGFR copy number was evaluated with PCR-based assay. EGFR mutation status at kinase domain has been examined and reported. EGFRvIII mutation was found on 8 of 252 patients. All patients were male, smokers, and 7 had squamous cell carcinoma. The mutation status was significantly correlated with pathological subtypes (squamous cell carcinoma vs. adenocarcinoma, p=0.0114). Sixty EGFR mutations at kinase domain exclusively existed with EGFRvIII mutations. EGFR gene copy number was significantly higher in EGFRvIII mutant (4.711+/-4.968) than in non-EGFRvIII mutant (2.284+/-1.224) (p=0.0001). EGFRvIII gene mutation might be one of the mechanisms of increased EGFR copy number. Further studies are needed to confirm the mechanisms of EGFRvIII mutations for possible anti-EGFR therapy for lung cancer.

Adenocarcinoma↗

PubMed1991

[Primary malignant lymphoma of the testis].

Among 715 patients with non-Hodgkin's lymphoma referred to this oncology center between 1973-1989, there were 7 (0.9%) with primary lymphoma of the testis. The mean age was 55 (range 23-78). The presenting symptom in all the 7 was testicular mass or swelling. 6 of them underwent inguinal orchiectomy and 1 had a testicular biopsy. The pathological subtype of the lymphoma in all 7 was the diffuse large cell type. The disease stage was IE in 3, IIE in 3 and IVE in 1. Only 1 had bilateral testicular involvement. 6 were treated primarily with various combinations of chemotherapy and 1 by radiotherapy. 3 developed recurrent disease (2 treated primarily with chemotherapy and 1 by radiotherapy) and died 14, 19 and 27 months, respectively, after diagnosis. 3 are alive with no evidence of recurrent lymphoma. Follow-up in an additional patient has been too short for evaluation. Primary testicular lymphoma is a relatively rare form of extranodal lymphoma. It has a tendency to early systemic progression and is potentially curable by aggressive combination chemotherapy.

Adult↗

PubMed1990

Germ cell tumors of the mediastinum.

The anterior mediastinum is the most common primary extragonadal site for germinal neoplasms in adults and is second to the sacrococcygeal region for pathologially comparable tumors in children. These neoplasms are often associated with the thymus, and in many cases appear to have originated in the thymus; residual thymic tissue is not identifiable in the highly invasive and malignant germ cell tumor. Regardless of the pathologic subtype, the mediastinal germ cell tumors have a predilection for patients in the first three decades of life. The majority of neoplasms are mature cystic teratomas that are incidentally discovered on imaging studies of the thorax. Respiratory difficulties and/or chest pain are the most frequent symptoms. Among the malignant germ cell tumors, males are affected far more commonly than females, but the male to female ratio is approximately equal among mature cystic teratomas. Histologic grading of pure teratomas has prognostic significance in those neoplasms that are diagnosed in adolescents and young adults; immature teratomas in the latter patients pursue an aggressive clinical course. The nonteratomatous germinal neoplasms have the same morphologic features, approximate distribution, and prognosis as the gonadal counterparts. Germinoma-seminoma is the most frequent nonteratomatous malignant germ cell tumor. It should be remembered that mediastinal lymph nodes are metastatic sites for primary gonadal germ cell tumors, so that a thorough clinical evaluation is necessary to exclude the latter possibility.

Choriocarcinoma↗

PubMed1989

[Relapse of the stage I & II non-Hodgkin's lymphoma of the head and neck--factors relating to the chance of long-term survival].

A review has been made of 36 patients who, after initial treatment for early non-Hodgkin's lymphoma originating in the head or neck, incurred a relapse, and factors relating to their chances of long-term survival, i.e., greater than three years, have been sought. Informatively, the overall 1-year and 5-year survival after such a relapse has been 18% and 15% respectively. The factor most significantly related to long-term survival was the site of the lymphoma and the extent of the initial relapse. For those affected in the neck region alone, four out of five survived for more than 48 months after the relapse (p less than 0.0001). The pathological subtype of the initial lymphoma was the second most significant factor (p less than 0.02). Another factor drawing our attention was the history of the prophylactic adjuvant therapy. No patient survived for more than a year after relapse if they had a history of prophylactic adjuvant therapy (0/10), whereas five long-term survivors were patients with no history of such therapy (0.1 less than p less than 0.2).

Adolescent↗

PubMed1988

[Results of radiation therapy of stage I non-Hodgkin's lymphoma of Waldeyer's ring].

The treatment records of 107 patients with stage I diffuse non-Hodgkin's lymphoma of the Waldeyer's ring, who were irradiated at 7 institutions from 1972 through 1985, were analyzed. The local control rate, the 5 year actuarial survival rate and the 5 year relapse-free survival rate were 96.4%, 76.2% and 76.6%, respectively. Any high risk group could not be found in the pathological subtype, the initial site of the tumor and the tumor size. There were 17 relapse cases within the first 2 years after radiotherapy. Most relapse occurred in the distant site from the irradiated field. With these results, the treatment policy of Waldeyer's ring lymphoma of stage I was discussed.

Adolescent↗

PubMed1986

[Prognosis of follicular lymphoma in a series of 180 cases].

In this series, the prognosis and the course of 180 cases of follicular lymphomas, classified according to Kiel's classification, seen before any treatment, treated and followed in the same institution were analyzed. In the first part, 6 primary prognostic factors were identified: compression, age of patient, stage, general symptoms, pathological subtype, lymphography. The most significant parameter (p less than 10(-10], obtained secondarily, was complete remission obtained in 63.9% of patients. In the second part, a multivariate analysis permitted to identify a few groups of patients for whom the probability of complete remission varied between 25 and 100%. Knowledge of these prognostic parameters may help to tailor treatment to each case and to obtain the best survival possible.

Adult↗

PubMed1986

Study of benign breast disease in a population screened for breast cancer.

We are conducting a study to determine whether risk factors associated with specific pathologic subtypes of benign breast disease (BBD) are similar to those for breast cancer and to evaluate the relationship between clinical and mammographic features of BBD. All women participating in the Canadian National Study of Breast Cancer Screening in Vancouver, B.C., Canada (expected 10,000) are invited to complete a questionnaire designed to gather clinical and epidemiologic information on BBD. Preliminary analysis of the first 736 participants indicates that breast pain and/or tenderness is a significant problem which in its severe from is distressing, anxiety provoking, and adversely affecting quality of life. Breast pain and tenderness is also associated with an increased frequency of clinical signs of BBD and of dense mammographic patterns.

Adult↗

PubMed1985

Clinical correlations of ovarian cancer antigen NB/70K: a preliminary report.

NB/70K is a glycoprotein extracted from human ovarian cancer tissue. It was measurable postoperatively in the plasma of 89% of 127 women with epithelial cancer of the ovary; 60% of these women had levels in excess of 11 kU/mL compared with 5% of control subjects. The level of NB/70K correlated with FIGO stage and amount of residual tumor, but not with pathology subtype or tumor differentiation. Elevated NB/70K plasma levels also were found in patients with benign gynecologic neoplasms and a variety of systemic carcinomas, and modest elevation was observed in association with hepatic and renal decompensation. The highest levels, found preoperatively in women with ovarian cancer, decreased after tumor resection. These preliminary data indicate that the NB/70K assay has high sensitivity in epithelial ovarian cancer, and plasma levels appear to correlate with tumor volume.

Antigens, Neoplasm↗

PubMed1983

Radiation therapy in the management of ovarian cancer.

The present review of selected clinical trials of the use of radiotherapy in ovarian cancer indicates that this modality has a curative role in postoperative treatment. Techniques which encompass the entire peritoneal cavity produce superior survival rates and better control of occult upper abdominal metastasis than the techniques which treat only part of the peritoneum. The volume of residual tumour, its pathology subtype and grade, and the presenting stage each independently influence the outcome of therapy. An approach to planning treatment which considers all of these variables is presented. No long-term survival data exist to permit a comparison of the relative efficacies of abdominopelvic irradiation and cisplatin-based combination chemotherapy regimes, but a rational strategy for choice of treatment can be devised. Combined modality therapy is an important area for future study.

Abdomen↗

PubMedDate not supplied

cis-Diamminedichloroplatinum(II) therapy for advanced ovarian cancer.

Eleven of 32 patients (34%) with advanced ovarian cancer previously treated with conventional therapies had partial or complete responses to 5-day courses of cis-diamminedichloroplatinum(II) (CDDP) (20 mg/m2/day) with nine showing objective response prior to initiation of the second course. Median duration of response was 6 months (range, 2-18 +). Response to CDDP was not correlated with age, pathologic subtype, tumor grade, or bulk disease but was correlated with response to prior treatment. Eight of 15 patients previously responsive to either single alkylating agents or cyclophosphamide plus doxorubicin (Adriamycin) responded to CDDP. In contrast, response to CDDP was observed in only three of 17 patients showing no response to this prior chemotherapy. The highest response rate to CDDP was seen in that subset of patients sensitive to cyclophosphamide and doxorubicin (seven of ten patients).

Adult↗

PubMed1995

[Simultaneous production of parathyroid hormone-related protein (PTHrP) and granulocyte colony-stimulating factor (G-CSF) in lung cancer patients with hypercalcemia and leukocytosis].

Hypercalcemia and leukocytosis are often associated with primary lung cancer as a paraneoplastic syndrome. Recently, parathyroid hormone-related protein (PTHrP) and granulocyte colony stimulating factor (G-CSF) have been identified as major causative peptides for hypercalcemia and leukocytosis, respectively. We studied four men with advanced primary lung cancer (stages from IIIA to IV) who presented with hypercalcemia (corrected serum calcium levels: 10.5 mg/dl) and leukocytosis (WBC > 10,000 per mm3). The age of the patients ranged from 59 to 79 years old. The pathological subtypes were squamous cell carcinoma in three and adenocarcinoma in one. The mean serum calcium levels and leukocyte counts were 15.8 +/- 1.4 mg/dl (mean +/- SE) and 24,800 +/- 3,253 cells/mm3 (mean +/- SE), respectively. Abnormally high serum levels of PTHrP and G-CSF were found in three patients (mean +/- SE: 137 +/- 68 pg/ml; normal range in human serum, < 16 pg/ml), and in all four (mean +/- SE: 72 +/- 7.7 pg/ml; normal range in human serum, < 20 pg/ml), respectively. Immuno-histochemical examination of cancerous tissue obtained from these patients showed positive staining for both PTHrP and G-CSF within the cytoplasm of all the cancerous tissue. These results suggest that the association of hypercalcemia and leukocytosis in patients with advanced primary lung cancer is caused by production of both PTHrP and G-CSF by cancerous tissue.

Aged↗

PubMed1995

Molecular analysis of clonality in Castleman's disease.

Castleman's disease (CD) is a rare atypical lymphoproliferative disorder that is morphologically and clinically heterogenous and is associated with a risk of developing malignant lymphoma. We report the clonality status of CD tissues in 34 patients, including 14 patients infected by the human immunodeficiency virus (HIV). Four patients presented a localized form and 30 presented a multicentric form. Two cases were associated with B-cell lymphoma, 3 cases with Hodgkin's disease, and 9 cases (8 HIV+) with Kaposi's sarcoma. Histologically, 8 cases were of the hyaline-vascular type and 26 were of the plasma cell or mixed types. The Ig and T-cell receptor (TCR) V(D)J rearrangements were analyzed using polymerase chain reaction and Southern blot. Clonal IgH rearrangements were detected in only 4 cases, ie, 2 associated with B-cell lymphoma, 1 with Hodgkin's disease, and 1 case without malignancy. A TCR gamma rearrangement of restricted junctional size was amplified in 1 HIV+ case. Finally, polyclonal VH-JH and V gamma-J gamma rearrangements were detected in the large majority of the cases, irrespective of pathologic subtypes, clinical forms, and HIV status. The lymphoid component in CD is therefore commonly reactive, and the rare occurrence of detectable monoclonal lymphoid contingents may be caused by secondary molecular events.

Adult↗

PubMed1995

Clinical distinction between acute hemorrhagic and acute ischemic stroke by Siriraj stroke score.

BACKGROUND: The clinical distinction between hemorrhagic and ischemic stroke cannot be achieved by simple clinical evaluation, and it is impossible to submit all stroke patients to computed tomography. A simple, reliable, and safe diagnostic tool for acute stroke syndrome is needed. This study tested the Siriraj stroke score to verify its accuracy for distinguishing among the pathological subtypes of stroke. METHODS: This study included the one hundred and seventy-one patients with acute supratentorial stroke syndromes consecutively admitted to the Emergency Room of the Taichung Veterans General Hospital from April 1 to September 30, 1993. The Siriraj stroke score was calculated, then compared with results of computed tomography. The Siriraj stroke score was calculated as (2.5 x level of consciousness) + (2 x vomiting) + (2 x headache) + (0.1 x diastolic blood pressure) - (3 x atheroma markers) - 12. A score above 1 indicates supratentorial intracranial hemorrhage, while a score below -1 indicates infarction. The score between 1 and -1 represents an equivocal result needing further evaluation to verify diagnosis. RESULTS: The diagnostic sensitivities of the Siriraj stroke score for intracranial hemorrhage and infarction were 85% and 90% respectively, with an overall predictive accuracy of 88.5%. When three cases with subarachnoid hemorrhage whose scores were all above 1 were excluded, the sensitivities for cerebral hemorrhage and infarction were 83.8% and 90% respectively, with an overall predictive accuracy of 88.2%. CONCLUSIONS: The Siriraj stroke score can be used as a reliable bedside method for diagnosing acute stroke and for deciding which patients should have priority for computed tomography, it is also a valuable tool for epidemiology studies of stroke incidence and outcome.

Brain Ischemia↗

PubMed1994

Thymic carcinoma. Ten years' experience in twenty patients.

Thymic carcinoma is a rare neoplasm with extremely poor prognosis. To evaluate the outcome of treatment in thymic carcinoma, we reviewed a 10-year (1982 to 1992) experience with 20 consecutive patients in Taichung Veterans General Hospital. There were 9 men and 11 women: ages ranged from 34 to 70 years old (mean 51.4 years). None of these patients had concomitant myasthenia gravis. All of the patients received surgical intervention, and the diagnosis was made by pathologic study. Postoperative staging was made according to the modified Masaoka staging system. None of our patients were in stage I. One patient (5%) had stage II disease, 12 (60%) stage III, and 7 (35%) stage IV. The pathologic subtypes of thymic carcinoma included eight squamous cell carcinomas, seven undifferentiated carcinomas, one lymphoepithelioma-like carcinoma, one clear-cell carcinoma, 1 mucoepidermoid carcinoma, and two carcinoid tumors. Curative resection could be done in seven patients (35%). The overall cumulative survival was 45.9% at 3 years and 34.4% at 5 years. The median survival times for patients with complete and incomplete resection were 39.0 months and 14.3 months, respectively (p = 0.1752). The median survival times of patients with postoperative radiotherapy and without postoperative radiotherapy were 39.3 months and 15.0 months, respectively (p = 0.0738). The median survival times of patients with squamous cell carcinoma and undifferentiated carcinoma were 25.4 months and 11.3 months, respectively (p = 0.1464). Our data show that complete resection, postoperative radiotherapy, and squamous cell carcinoma do not indicate a significantly favorable result, even though they result in longer median survival times. Yet a positive trend of favorable outcome in patients who received postoperative radiotherapy is ambiguously shown.

Adult↗

PubMed1995

Etoposide plus cisplatin followed by thoracic radiation for stage IIIB non-small cell lung cancer: MAOP study 2188.

Thirty-five patients with stage III B non-small cell lung cancer were treated with the combination of cisplatin (CDDP) 30 mg/M2/day and etoposide (VP16-213) 75 mg/M2/day administered as a 72-hour infusion. Twenty evaluable patients (67%) received subsequent thoracic radiation as definitive regional therapy following a clinical response or stable disease status. Complete plus partial responses to chemotherapy were observed in 15 patients (5CR and 10PR or 44%). Of the 20 patients who received radiation, six responded with five transitioning from stable disease to partial (2) or complete (3) responses. The overall response rate to the combined sequential chemotherapy plus radiation was therefore 20/35 or 59% with eight complete responders. Histopathology influenced the response rate to chemotherapy (53% versus 30% for epidermoid versus adenocarcinomas, respectively), but following radiation, the response rates were similar for the two pathologic subtypes (73% versus 71%). Median overall survival was 363 days with 20% of patients alive at 13 to 45 months. The response rate for CDDP plus VP16-213 chemotherapy administered as a 72-hour infusion was superior for stage III B non-small cell lung cancer compared with stage IV disease as previously reported by the Mid Atlantic Oncology Program (44% versus 25%). This difference between stage III B and stage IV was also reflected in median survival (363 days versus 190 days). The sequential addition of radiation therapy to this chemotherapy regimen is feasible in stage III B disease with a small proportion of patients demonstrating long-term survival.

Adenocarcinoma↗

PubMed1996

Treatment of acute glomerular rejection with FK 506.

Acute glomerular rejection is a distinct pathologic subtype of rejection that is often refractory to standard therapy and is associated with significant risk of graft loss. Both cellular and humoral mechanisms have been shown to be involved in the pathophysiology of acute glomerular rejection. FK506, because of its ability to inhibit both cellular and humoral mechanisms of rejection, provides a theoretically attractive approach for treating acute glomerular rejection. This initial experience with FK 506 treatment of acute glomerular rejection occurred in a 58-yr-old woman who received a 0 AB, 2 DR-match cadaveric renal transplant. A renal allograft biopsy performed on post-transplant day 77 for renal dysfunction (serum creatine 1.3-->1.8 mg/dl) revealed moderate cellular and vascular rejection. Corticosteroid therapy provided a transient improvement in renal function; however, a repeat biopsy 7 d later revealed acute glomerular rejection with immunohistologic evidence of antibody-mediated rejection (immunoglobulin and complement deposition in glomerular capillaries). FK 506 therapy was instituted and provided prompt reversal of the acute glomerular rejection as determined by serial renal allograft biopsies. One year later, recurrent rejection has not been observed, and good renal function is present. (Current serum creatine 1.7 mg/dl, creatine clearance 35 ml/min/m2, and 24 h urinary protein 230 mg.) Successful corticosteroid withdrawal has been achieved, and current immunosuppressive therapy consists only of FK 606 and azathioprine. This experience indicates that FK 506 can provide effective therapy for acute glomerular rejection, and that simultaneous treatment with plasmapheresis and an antilymphocyte antibody preparation may not be necessary. This experience also provides further evidence of the ability of FK 506 to inhibit antibody-mediated rejection processes.

Acute Disease↗

PubMed1996

[Clinical considerations from sixteen cases with mediastinal malignant lymphoma].

Sixteen cases with mediastinal malignant lymphoma were treated in our department and a correlation made between the prognosis and other factors: first symptom, maximum diameter of the tumor, type of operation, pathological subtype, clinical stage. First symptom and compressed or invasive symptom with mediastinal mass were not related to prognosis. The cases with bulky tumor over 10 cm in diameter showed a tendency toward poorer prognosis. Complete or incomplete resection did not have significant effect. The cases of Hodgkin's disease had relatively good prognosis. Classification of clinical stage (Ann Arbor classification) did not show significant correlation with prognosis and may be inadequate for staging of mediastinal malignant lymphoma. Surgical treatment may be adapted for mediastinal Hodgkin's disease and early stages of thymic malignant lymphoma.

Adolescent↗