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Diffusion-weighted imaging of malignant breast tumors: the usefulness of apparent diffusion coefficient (ADC) value and ADC map for the detection of malignant breast tumors and evaluation of cancer extension.

The authors used breast diffusion-weighted imaging (DWI) to diagnose breast cancer and identify cancer extension. Isotropic DWI was performed with EPI. The apparent diffusion coefficient (ADC) value was calculated and displayed on an ADC map. The authors compared between the distribution of low ADC values and pathologic cancer extension. The mean ADC value of breast cancer was 1.12 +/- 0.24 x 10(-3) mm/s, which was lower than that of normal breast tissue. The ADC value for invasive ductal carcinoma was lower than that of noninvasive ductal carcinoma. The sensitivity of the ADC value for breast cancer using a threshold of less than 1.6 x 10(-3) mm/s was 95%. Seventy-five percent of all cases showed precise distribution of low ADC value as cancer extension. The causes of underestimation were susceptibility artifact from bleeding and the limit of spatial resolution. Benign proliferative change showed a low ADC value. The authors conclude that DWI has a potential for clinical appreciation in detecting breast cancer.

Adult↗

Antigen retrieval: p53 staining in benign, pre-malignant and malignant tissues of the larynx.

Antigen retrieval techniques have been reported to increase p53 detection. Using an antigen retrieval technique applied to immunohistochemistry, a study was performed on 67 laryngeal lesions (21 benign, 16 carcinoma in situ, 30 squamous cell carcinoma). p53 staining was observed in 30% of carcinoma in situ specimens and 53% of squamous cell carcinomas but was not detected prior to antigen retrieval in any benign lesion. However, over-expression of p53 was identified in 92.5% of benign lesions after antigen retrieval using the microwave oven heating. There was also increased p53 staining in both the carcinoma in situ (43.7%) and squamous cell carcinomas (30.0%) after antigen retrieval. We conclude that antigen retrieval using microwave oven heating increases immunohistochemical detection of p53 such that positive staining is observed in benign conditions. We postulate that this apparent over-expression is a manifestation of the wild-type protein, which may be found in more evidence in basal cells than suprabasal cells. Our results thus offer a cautionary note to such studies involving squamous cell cancers that attempt to correlate p53 over-expression with clinical parameters.

Antigens, Neoplasm↗

Serological studies of seromucoids from normal subjects and patients with malignant and non-malignant diseases.

During investigations of serum from patients with carcinoma, elevated levels of two proteins were observed. The larger (MW approximately 44,000) was identified as (alpha-acid glycoprotein. The smaller MW approximately 20,000) has not yet been identified. Further investigation of alpha-acid-glycoprotein-containing seromucoid showed that many red blood cell and tissue antigens were present, for example, I, i, P1, Tja (P+P+Pk), H, A, B, Lea, Leb1, M and N. Differences in antigen content between normal serum and serum from carcinoma patients could be demonstrated quantitatively and qualitatively. Seromucoid preparations from patients with Hodgkin's lymphoma inhibited phytohaemagglutinin-induced lymphocyte transformation more often than seromucoid preparations from normal subjects.

ABO Blood-Group System↗

Trends in survival of childhood malignancy for the past three decades. II: Neoplasms of the respiratory, skeletal, genital, skin and endocrine organs and malignant teratomas. The Committee for the Studies of the Treatments and the Biological Characteristics of Childhood Cancers.

Survival of childhood neoplasms has improved considerably during the past three decades. Improvement in survival rate for relatively infrequent neoplasms was assessed based on data obtained from the largest children's hospital in Japan. Using the data of the cancer registry of the hospital which recorded all the patients from 1965 to 1993 totalling 1026 cases, survival rate was analyzed for each type of neoplasm categorized by the S-classification for Childhood Neoplasms, a modification of the International Classification of Diseases. Survival was assessed for three 10 year periods from 1965 for infrequent neoplasms and for two 15 year periods for rare neoplasms. Improvement of survival was considerable in the neoplasms of the respiratory organs, genital organs and germ cell tumors, moderate in bone tumors and poor in the muscle and connective tissues. In conclusion, in some types of relatively infrequent neoplasms, survival improved considerably. But in soft parts and connective tissues (mostly rhabdomyosarcoma) improvement of survival was poor.

Bone Neoplasms↗

Interobserver reliability in the histopathologic diagnosis of oral pre-malignant and malignant lesions.

BACKGROUND: The histologic classification of pre-cancerous and cancerous oral lesions has generally shown poor agreement between pathologists, but lesion and patient characteristics that may affect diagnostic reliability have not been explored. METHODS: Eighty-seven clinically suspicious oral lesions biopsied from 81 patients with previous upper aerodigestive tract cancer were independently classified by their local pathologist and a central pathology committee. Interobserver reliability between the local pathologist and the central pathology committee was measured with weighted kappa (kappa w) statistics and corresponding 95% confidence intervals (CI). RESULT: The kappa w for pathologic diagnosis was 0.59 (95% CI: 0.45, 0.72), and was higher for lesions without inflammation (0.67 (95% CI: 0.53, 0.80) than inflamed lesions (-0.10 (95% CI: -0.27, 0.07)). Greatest agreement was seen for lesions located in the buccal mucosa/vestibule (kappa w = 0.68 (95% CI: 0.46, 0.91)) and tongue (kappa w = 0.62 (95% CI: 0.40, 0.84)). Least agreement was found for lip/labial mucosa lesions (kappa w = -0.04 (95% CI: -0.34, 0.27)). Punch biopsies (kappa w = 0.67 (95% CI: 0.54, 0.80)) had greater interobserver reliability than wedge biopsies (kappa w = 0.38 (95% CI: 0.12, 0.64)). CONCLUSIONS: These data suggest that the presence of inflammation, lesion site, and biopsy technique modifies the reliability of oral lesion histologic diagnoses.

Alcohol Drinking↗