[Breast cancer associated with cancer of other organs].
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A monosialoganglioside antigen of gastrointestinal adenocarcinomas defined by murine monoclonal antibody was demonstrated by immunoperoxidase (IP) assay in fixed paraffin-embedded tumors in 59% of colonic adenocarcinomas, 86% of pancreatic adenocarcinomas, and 89% of all gastric adenocarcinomas. In all patients with detectable levels of antigen in circulation, the resected tumors also expressed the antigen in IP assay. Six of eight individuals with no detectable levels of antigen in their serum samples expressed the antigen in the tumor tissue. Removal of the sialic acid residue of the antigen abolished the IP reaction. The successful use of the IP assay on fixed tissue to demonstrate the specific sites of gastrointestinal cancer antigen localization in human tumors and normal tissues provides an important tool for the study of developing neoplasia.
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The adequate appraisal of precancerous changes is of the utmost importance in our everlasting fight against cancer, and its socio-medical relevance is acknowledged world-wide. In every country where epidemiologists register a rising incidence of malignant neoplasms, endeavours must focus not only on the early diagnosis of existing cancer, but even more on detecting the signs of coming tumors. That is why today the precancerous lesions are a main point of interest in cancer research all over the world for pathologists, radiologists, surgeons, obstetricians, etc.
Two 131-Iodine radiolabelled monoclonal antibodies were used to perform tomoscintigraphy in 42 patients: 11 patients bearing medullary thyroid cancers and 19 patients bearing gastrointestinal cancers received an antibody directed against carcino-embryonic antigen; 12 patients bearing gastro-intestinal cancers received an antibody directed against a non circulating antigen expressed by human colorectal cancers cell lines. Tomoscintigraphy is particularly useful for analysing the complex biodistribution of radiolabelled antibodies and the low contrast images encountered in immunoscintigraphy; the problems related to the true positive rate and to the clinical specificity of the method are discussed.
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Five cases of metastatic cancer in the pituitary gland are reported, four of which were revealed by chiasmatic syndrome and one by diabetes insipidus. Transphenoidal surgical treatment was possible in three cases. This site of metastasis is considered exceptional because of its customary inactivity. It is probable that the metastasis most often remain unrecognized and so, it requires careful study of the slightest sign because of treatment possibilities.
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Recent endoscopy has made startling progress. Consequently, now endoscopists can diagnose minute (or micro) cancer less than 5 mm in diameter in the digestive organs, particularly in the stomach and the colon. However, early detection of esophageal, biliary tract, or pancreatic cancer is still insufficient in spite of application of a new apparatus or subsidiary method. Among them, regarding recent increment of the cases with pancreatic cancer, it is absolutely necessary for the improvement of a prognosis to reveal small cancer less than 2 cm in diameter, endoscopically. Usefulness of laparoscopy for the diagnosis of hepatocellular cancer is less as compared with hepatic angiography. In this paper, we summarize the present status of gastro-enterological endoscopy in Japan and point clearly the issue to solve in the future.
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The small bowel can be successfully investigated by enteroscopy techniques. Several types of enteroscopes with different technical characteristics have been developed. In this paper we explain the respective advantages and disadvantages of the different techniques. Results of several series using these two enteroscopes are summarized and commented. The review of different series make clear that enteroscopes, especially those including an operating channel represent an attractive alternative diagnostic tool to angiography and small bowel barium studies in patients presenting obscure digestive bleeding. The series reviewed in this paper confirm the high diagnostic efficacy of this type of endoscopy. Most of the lesions found are arteriovenous malformations especially in the elderly. Small bowel tumours are more likely to be found in younger patients. New indications for enteroscopy should be evaluated carefully. Obscure digestive bleeding represents the main indication of enteroscopy. However clinical situations suggesting Crohn's disease or malabsorption syndromes may be effectively evaluated by this special endoscopic technique.
Numerous clinical studies suggest that the combination of the fluoropyridimine fluorouracil and radiation is a more effective treatment for many cancers, especially gastrointestinal tumors, than is either modality alone. Also, the combination of fluorouracil and radiation has greatly expanded the possibilities for organ-preserving treatments, for example, in patients with bladder cancer. Another fluoropyridimine, floxuridine, administered via the hepatic artery, has been used in combination with irradiation in the treatment of patients with intrahepatic cancers and may prolong survival in patients with unresectable hepatobiliary malignancies. The beneficial effects of combining fluoropyrimidines and radiation are thought to be due to radiosensitization. More studies are needed to clarify the mechanism(s) of radiosensitization so as to optimize regimens in which the fluoropyrimidines are used.
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Medical laboratory immunology can be useful, for the overall study of patients with gastrointestinal and hepatic diseases, at three different levels. In those diseases where an abnormal immune response has been through to contribute to the pathophysiological process, the specialized laboratory may yield useful information regarding the activation or presence of such mechanisms; in infectious diseases of the liver and/or gastrointestinal tract, the immunology laboratory can contribute- sometimes decisively- to the etiological diagnosis and, finally, in malignant gastrointestinal diseases, immunological studies might provide information that is useful for the diagnosis, and the most importantly, for the follow-up and prognosis of such patients.
The breast cancer is the common cancer in female. The metastasis may occur any where in the body. The common sites are in the lymph nodes, the bones, the chest, the liver and the brain. Other sites of metastasis have little importance, rarely researched and constitute the objective of this article.