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[Evaluation of the "squamous cell carcinoma antigen" as marker of epidermoid cancer of the anal canal].

The authors studied the value of Squamous Cell Carcinoma Antigen (SCC) in squamous carcinoma of the anal canal in 66 patients. Assays were made at the time of diagnosis, before any treatment and during follow-up. A total of 353 assays were made. The positive threshold was selected at 2 ng/ml. At the time of diagnosis, sensitivity of the marker was 44 per cent and its specificity 92 per cent. In our series, pre-treatment SCC levels were not correlated with T by the Papillon classification, but were correlated with lymph node involvement (p less than 0.05). They had no prognostic value at the time of the initial diagnosis. During follow-up, at the time of recurrence, SCC levels were 20.3 +/- 43 ng/ml. This rise was significant (p less than 0.01), the sensitivity of the marker being 77 per cent. In patients who had a recurrence, the outcome was correlated with SCC levels and the latter were of prognostic value (p less than 0.01). In conclusion, SCC levels should form part of the clinical monitoring of patients with a squamous carcinoma of the anal canal.

Adult↗

A comparison between the macrophage migration inhibition test (MMI) and the leucocyte adherence inhibition test (LAI) in patients with melanoma and carcinoma of the colon.

Patients with progressing tumours have circulating leucocytes which are sensitised to tumour specific antigens and their serum contains blocking factors. Patients who have tumours which have been successfully destroyed do not have circulating blocking factors although their lymphocytes continue to remain sensitised to the tumour antigens. Two tests, known to detect cellular sensitisation and serum blocking activity, the leucocyte adherence inhibition test (LAI) and the macrophage migration inhibition test (MMI) have been compared in a small group of patients with malignant melanoma and carcinoma of the colon. There was agreement between the results of both tests in over three-quarters of the tests performed and in those which failed to agree neither test was favoured in relation to the known tumour state of the patient. Thirty-two tests were performed in 22 patients, there was one false positive with MMI testing, seven false negative results for the LAI test and six for the MMI test.

Animals↗

[Congenital fibrosarcoma. Apropos of 2 cases].

Two cases of congenital fibrosarcoma are presented. Both tumors showed histological features of malignancy, but were successful treated with simple resections. Recurrent tumor does not seem to predispose to metastatic disease. Local excision is the initial treatment of choice for lesions occurring in newborns and infants.

Abdominal Neoplasms↗

Immunohistochemical study of mammary and extramammary Paget's disease.

Immunophenotypes of mammary (MPD) and extramammary Paget's disease (EPD) are still not well understood. Thirty-four formalin-fixed paraffin-embedded tissue sections from 33 patients with 6 MPD and 28 EPD were studied immunohistochemically with the use of polyclonal c-erbB-2 and pS2 antisera, and monoclonal nm23, B6.2, GCDFP-15, and p53 antibodies. Cases of MPD expressed a high incidence of c-erbB-2 and nm23 compared with those of EPD (100% vs. 29%; p < 0.01, and 83% vs. 29%; p < 0.05, respectively). Although high expression of B6.2 (> 83%) and moderate expression of GCDFP-15 (33-39%), pS2 (33-46%) and p53 (39-50%) were seen, the positivity was not significantly different between MPD and EPD. These findings indicate that MPD and EPD share immunohistochemical features but partially differ in their patterns of antigen expression.

Antigens, Neoplasm↗

CEA, TPA, CA 19-9, SCC and CYFRA at diagnosis and in the follow-up of anal canal tumors.

The authors evaluated serum CEA, TPA, CA19-9, SCC and CYFRA at diagnosis and in the follow-up of 18 anal canal tumors. Sensitivity at diagnosis was 38.8% for CEA, 55.5% for TPA, 16.6% for CA19-9, 50% for SCC and 5.5% for CYFRA. In the follow-up CEA showed 0% sensitivity and 73.3% specificity, TPA 33.3% sensitivity and 86.6% specificity, CA19-9 0% sensitivity and 80% specificity, SCC 0% sensitivity and 93.3% specificity, CYFRA 0% sensitivity and 100% specificity. The authors consider the usefulness of serum SCC and TPA at diagnosis of squamocellular anal cancer and of CEA in the diagnosis of cloacogenic tumors. Nevertheless these serum markers did not detect recurrences in the follow-up.

Aged↗

Neoplasms of the anus.

Anal cancers can be grouped into three major categories. First, anal margin lesions are usually well-differentiated, keratinized squamous cell carcinomas that are amenable to local treatment measures. Second, anal canal cancers distal to the dentate line are mostly epidermoid, nonkeratinizing, moderately differentiated tumors. They are usually best treated with a multimodality approach using chemoradiotherapy and reserving surgery for clinical failures. Third, cancers arising in the ATZ are usually adenocarcinomas, and their treatment depends upon local factors. APR is in order for locally aggressive lesions, but newer protocols are studying multimodality therapy for this entity as well. Other, less common cancers of this region should be evaluated based upon their biologic potential and local involvement, with treatments selected accordingly.

Anus Diseases↗