FEVER AND ELEVATED ERYTHROCYTE SEDIMENTATION RATE. A CROSS STUDY THROUGH A MEDICAL DEPARTMENT.
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Cancers of the aerodigestive tract are a major cause of worldwide morbidity and mortality. Long term survival rates for these epithelial cancers have not improved substantially in the past 20 years despite intensive efforts to improve the prevention and therapy of these diseases. Therefore, new approaches are needed. One new investigative approach is chemoprevention, the chemical prevention of cancer. Chemoprevention studies in the upper aerodigestive tract have focused on the reversal of premalignant lesions and the prevention of second primary tumors. These chemoprevention efforts have resulted from an understanding of the multistep nature of epithelial carcinogenesis and the diffuse epithelial injury that results from carcinogen exposure. Ongoing research efforts are attempting to define these processes. The interaction between carcinogen exposure and host susceptibility in the development of cancers of the aerodigestive tract is being evaluated (e.g., with an assay of chromosomal sensitivity to the clastogen bleomycin). This review discusses several new aspects of the epidemiology, biology, and chemoprevention of aerodigestive tract carcinogenesis.
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In a necropsy series at the German Primate Centre, 63 of 1132 tree shrews were found to have tumours. The youngest affected animal was < 6 months old, but the incidence of tumours increased strikingly beyond 2 years of age; of 17 animals aged > 8 years, no less than 14 (82.4%) were affected. The sites of neoplasia were the genital system (22 cases), haematopoietic system (18 cases of malignant lymphoma, many involving the digestive tract), lungs (14 cases), integument (five cases), digestive tract (three cases other than those with malignant lymphoma) and urinary bladder (one case).
Between 1981 and 1985 the incidence of malignant tumours of the buccal cavity and mesopharynx, the larynx and hypopharynx and of the oesophagus in males was higher in the mainly rural Burgenland and Lower Austria than in Vienna. In lung tumours a slight urban-rural gradient tended to level out (Tables 1-4). In women, the cancer incidence on all locations showed an urban-rural gradient, steeper in the buccal cavity and mesopharynx, in the larynx and hypopharynx and in the oesophagus than in lung tumours (Tables 1-4). Cancer incidence in the nasal and paranasal cavities, middle ear, epipharynx, salivary glands and lips was low. Sex ratios, lips excepted, were lower than in other sites studied (Tab. 6). In Eastern Austria the mortality of malignant neoplasms of the mouth and pharynx in males increased steadily from 1960 to 1987. In laryngeal and oesophageal cancer no persistent trend was discernible. The lung cancer mortality decreased from the mid-seventies onwards (Figs. 1-2). In women, the lung cancer mortality increased continuously, and for some years now also that of the mouth and pharynx. Cancer of the oesophagus decreased, and laryngeal cancer mortality showed nearly constant rates (Figs. 5-6).
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Between 1980 and 1987, 63 lung cancers associated with upper aero-digestive tract carcinomas were operated on 50% of the primary malignancies of the upper aero-digestive system were laryngeal. These tumors developed synchronously in 13% and metachronously in 87%. The operative mortality rate was 3%. The five years survival rate was 30%. Our results were found identical to those observed in a single lung cancer series. Coin lesion of the lung should be therefore considered as a second primary cancer. Thus, the best treatment is surgical resection. When the option exist, the lung cancer should be treated before the upper airway cancer to avoid the impact of previous irradiation and/or surgical treatment of the upper airway cancer upon the post-thoracotomy management.
BACKGROUND: This study was designed to evaluate the development of malignancies after renal transplantation in a single centre. The outcome was studied in patients developing a malignant neoplasm after renal transplantation. METHODS: Malignancies are registered in a database containing relevant data about the patients with a renal transplant. This database and the files of the patients developing a malignant neoplasm, have been studied as to stage at presentation, therapy and outcome. RESULTS: In 1546 patients with 2075 renal transplantations, 240 malignancies developed in 231 recipients. Skin cancers often present with more than one lesion of the same histological type. After the first skin tumour, about half of the patients developed more lesions, of the same or a different histological type. The prognosis of skin tumours is relatively good, but most malignancies in all other categories have a poor prognosis. CONCLUSIONS: Cutaneous neoplasms tend to be multiple, but can be controlled by regular examination of the skin. Most malignant lymphomas do develop outside the lymphoproliferative system and have a poor prognosis. Patients with a solid tumour of the other tracts often present in an advanced stage of disease, which makes the outcome of treatment, if possible at all, disappointing.
Four groups of 10 male and 10 female Syrian golden hamsters were given single s.c. injections of either 0.3 ml of trioctanoin or of 0.3 ml of trioctanoin containing either 1.0 mg, 3.3 mg, or 10.0 mg of the tobacco specific carcinogen, 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK). These hamsters were then exposed to cigarette smoke for the next 72 weeks. Four control groups received the same injections of NNK or trioctanoin but were treated by sham smoking. All groups treated with NNK had tumors of either the lung, nasal mucosa, and/or trachea. These tumors were not observed in hamsters injected with trioctanoin. These results demonstrate that even a single dose of NNK can induce respiratory tract tumors in Syrian golden hamsters. Smoke inhalation did not result in an increase in respiratory tract tumor incidence in most of the NNK treated groups.
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