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PubMed2001

Incidence of malignant disease in biopsy-proven inflammatory myopathy. A population-based cohort study.

BACKGROUND: The validity and magnitude of an association between myositis and malignant disease continue to be debated. Such issues as the legitimacy of a myositis diagnosis and distinction among myositis subgroups in previous population-based studies remain unresolved. OBJECTIVE: To determine the risk for malignant disease in patients with biopsy-proven inflammatory myopathies. DESIGN: Population-based, retrospective cohort study. SETTING: Victoria, Australia. PATIENTS: 537 patients in whom a biopsy-positive idiopathic inflammatory myopathy was first diagnosed from 1981 through 1995. MEASUREMENTS: Standardized incidence ratios were calculated to compare the incidence of malignant disease in patients with inflammatory myopathy and the general population. RESULTS: A total of 116 cases of malignant disease were found in 104 patients. Seventy-four cases were identified concurrently with (within 7 days) or after diagnosis of myositis. The highest risk for malignant disease was associated with dermatomyositis (standardized incidence ratio, 6.2 [95% CI, 3.9 to 10.0]). The risk was also increased in polymyositis (standardized incidence ratio, 2.0 [CI, 1.4 to 2.7]), although the relative risk for malignant disease in dermatomyositis compared with polymyositis was 2.4 (CI, 1.3 to 4.2). An increased risk for malignant disease was also found in inclusion-body myositis (standardized incidence ratio, 2.4 [CI, 1.2 to 4.9]). The excess risk for malignant disease diminished with time (standardized incidence ratio, 4.4 [CI, 2.7 to 7.1] in the first year; 3.4 [CI, 2.3 to 5.1] between 1 and 3 years; 2.2 [CI, 1.3 to 3.9] between 3 and 5 years; and 1.6 [CI, 1.0 to 2.6] beyond 5 years [ P for trend, 0.002]). CONCLUSION: The risk for malignant disease is increased in biopsy-proven dermatomyositis and polymyositis and also appears to be increased in inclusion-body myositis.

Adult↗

PubMedDate not supplied

[Diagnosis of malignant and benign insulinoma. Experience of the National Institute of Nutrition].

INTRODUCTION: Insulinomas are uncommon tumors, their incidence is approximately one case for 1 million population per year. OBJECTIVE: To expose our experience in the diagnosis of these tumors at the Instituto Nacional de la Nutrición Salvador Zubirán. MATERIAL AND METHODS: All patients with histologic diagnosis of insulinoma were reviewed; the period was from 1959 to 1996. The methods used for diagnosis and localization as well as the clinical picture according to the benignity or malignity of the tumor were registered. RESULTS: Eighteen patients were included, four of them with malignant tumors. In two patients islet cell tumors occurred in association with MEN type I, one of them benign and the other malignant. The mean age of patients with benign tumor was 38.2 +/- 13.5 years, in those with malignant tumors it was 51.5 +/- 16.2 years. The median period between symptoms and diagnosis was 34.4 +/- 15 months for benign tumors and 6 +/- 1.1 months for those with malignant tumors (p = 0.02). Patients with increasing weight had benign tumors. The 24 hours fasting test was not done in patients with malignant tumors because of the severity of hypoglycemia. The insulin/glucose ratio in patients with a malignant tumor was 5.2 +/- 4.7, while in patients with a benign tumor it was 1.82 +/- 1.7. The imaging studies showed that three patients with malignant tumors had hepatic metastasis and one had lymph node metastasis. The low accuracy of localization by radiological methods is due to the size of the tumor (> 2 cm). CONCLUSIONS: Malignant insulinomas are more aggressive and the delay of diagnosis is shorter that in cases with benign tumors. Selective arteriography remains the best preoperative localization procedure.

Adenoma, Islet Cell↗

PubMed1999

Expression of folate receptor type alpha in relation to cell type, malignancy, and differentiation in ovary, uterus, and cervix.

The folate receptor (FR) type alpha is known to be frequently overexpressed in ovarian cancer and is the target for a number of novel experimental cancer therapies. The relative levels of FR expression among specific cell types and its relationship to malignant transformation have not been adequately established because of several inherent limitations of the immunocytochemical approaches used previously. We used a quantitative in situ hybridization method to examine the expression of the mRNAs for the known isoforms of FR in paraffin-embedded tissue sections of multiple samples of the various subtypes of ovarian, uterine, and cervical cancers. Benign lesions, as well as the various normal cell types in the ovary, the uterus, and the cervix, were examined similarly. FR mRNA levels were quantitated relative to the transcript levels for beta-actin using NIH Image 1.57 computer software. The results show that the ovary, the uterus, and the cervix present different patterns of FR regulation in differentiation and in malignancy. In the ovary, benign differentiation of the germinal epithelium into mucinous or serous tumors or malignant transformation into mucinous tumors is associated with down-regulation of FR-alpha, whereas FR-alpha expression is retained in malignant lesions of serous and endometrioid differentiation. In contrast, malignant transformation of the glandular epithelial cells of the uterine endometrium is associated with de novo expression of FR-alpha. Heterogeneity in FR expression within malignant ovarian and uterine tumors is related to differentiation. In contrast to the uterus, malignant transformation of glandular epithelial cells in the cervix may frequently result in down-regulation of FR-alpha. These results shed new light for the identification of malignancies suitable for FR-mediated therapies and for prognostic/diagnostic applications of FR. They also provide a phenomenological basis for molecular studies of FR regulation in malignant cells.

Carrier Proteins↗

PubMed1975

Gastroscopy with directed biopsy and routine x-ray examination in the diagnosis of malignancies of the stomach. A retrospective study.

The examinations were performed in 418 patients with malignancy or an ulcer of the stomach. In all cases the Cancer Registry of Norway was asked for the final diagnosis and date of death. The diagnosis of malignancy was based on histology on operated or autopsy specimens, and the surviving cases were re-examined by answering a questionnaire. At the time of the primary examination a total of 103 cases of malignancies were found, of whom 41 were women. 84 patients had not been operated on previously. Among these 7 cases of early carcinoma were found. In 19 patients a partial gastrectomy had been performed. A false diagnosis of benign lesion was given on biopsy in 2 per cent, by gastroscopy in 8, and by X-ray examination in 31 per cent. A definite diagnosis of malignancy was made correctly by the same procedures in 95, 53 and 16 per cent, respectively. After 30 months of observation 16 cases of malignant lesions were reported among the patients (315) who had an ulcer of the stomach with benign histology on directed biopsy at the primary examination. A false benign diagnosis had been made in 33 per cent of 119 with malignancy by X-ray examination, in 10 per cent by gastroscopy, and in 15 per cent by histology on biopsy. The corresponding percentages in the total material of cases with benign and malignant lesions were 10.2, 2.9, and 4.3, respectively. In cases with previous partial gastrectomy, and in those with early cancers much higher rates of false negative diagnosis of malignancy has so far been suggested in 12 per cent of cases with benign ulcers, a gastroscopical diagnosis has been suggested in 22 per cent, and a bioptical in none. A combination of diagnostic procedures provided a correct diagnosis of malignancy in 118 out of 119 patients.

Adolescent↗

PubMed2001

Differential sensitivity of normal and malignant breast epithelial cells to genistein is partly mediated by p21(WAF1).

Genistein, a soy metabolite, is a potential chemopreventive agent against various types of cancer. There are several studies documenting molecular alterations leading to cell cycle arrest and induction of apoptosis in a variety of cancer cells; however, no studies, to date, have shown the effect of genistein in isogenic normal and malignant breast epithelial cells. In this study, we investigated whether genistein shows any differential sensitivity to normal (MCF10A and MCF12A) and malignant (MCF10CA1a and MDA-MB-231) breast epithelial cells. We found that genistein causes a greater degree of G(2)-M arrest and induces apoptosis in malignant cell lines compared with normal breast epithelial cells. After genistein treatment, flow cytometric analysis revealed a hyperdiploid population in malignant cells that was not observed in normal cells. Cell cycle regulator p21(WAF1), which is known to be up-regulated by genistein treatment, was greatly induced at RNA and protein levels in normal cells, whereas its level was only slightly induced in malignant MDA-MB-231 cells and not detectable in malignant MCF10CA1a cells. Therefore, we investigated the causal role of p21(WAF1) in the differential sensitivity of genistein among these cell lines. We examined the effects of genistein on p21(WAF1) -/- and p21(WAF1) +/+ HCT116 cells, which were used as controls prior to studies on breast cancer cells. We found that there was a greater degree of cell cycle arrest and apoptosis in p21(WAF1) -/- cells compared with p21(WAF1) +/+ HCT116 cells after genistein treatment. Flow cytometric analysis after genistein treatment showed a significant number of p21(WAF1) -/- cells in the hyperdiploid population, which are probably programmed to die through apoptotic processes. To further confirm the causal role of p21(WAF1) in genistein-mediated cell cycle arrest and apoptosis, we down-regulated p21(WAF1) by antisense p21(WAF1) cDNA transfection experiments. We found that both normal and malignant p21(WAF1) antisense (AS)-expressing clones became more sensitive to G(2)-M arrest after genistein treatment. Flow cytometric analysis showed an increase in the hyperdiploid population in the AS clones. Further evaluation showed an increase in apoptosis in malignant AS clones but not in normal breast epithelial AS clones. These results suggest that p21(WAF1) may play an important role in determining the sensitivity of normal and malignant breast epithelial cells to genistein.

Antineoplastic Agents↗

PubMed1975

Lack of correlation between malignancy and sensitivity to killing by concanavalin A.

Eight mouse cell lines and seven hybrid clones, both malignant and nonmalignant, were tested for possible correlations between malignancy and sensitivity to killing by concanavalin A (Con A). These cells included six highly malignant and two less malignant cell lines, two malignant and three nonmalignant hybrid clones derived from five different crosses, and two malignant hybrid clones segregated from a cross between malignant and nonmalignant cells. The malignancy of the cells was determined by their ability to grow progressively in irradiated, syngeneic newborn mice and to kill the host. All these cells, except one, showed similar sensitivities to killing by Con A. No correlation could be established between the malignancy of a cell line or of a hybrid clone and its sensitivity to the lectin.

Animals↗

PubMedDate not supplied

Comparison of technetium-99m tetrofosmin and gallium-67 citrate scintigraphy for detecting malignant lymphoma.

The aim of this study was to compare the value of technetium-99m tetrofosmin (Tc-TF) scintigraphy with that of gallium-67 citrate (Ga-67) scintigraphy for detecting malignant lymphoma. In this study, 50 patients with malignant lymphoma underwent Tc-TF and Ga-67 scintigraphy before receiving any therapy. Tc-TF scintigraphy detected malignant lymphoma in 44 (88%) patients, but was false-negative in 4 cases of infradiaphragmatic malignant lymphoma and in 2 cases of malignant lymphoma with chemotherapy resistance. Ga-67 scintigraphy detected malignant lymphoma in 45 (90%) patients, but was false-negative in 3 cases of low-grade non-Hodgkin's lymphoma and in 2 cases of malignant lymphoma with bone marrow involvement. There was no significant difference in sensitivity between Tc-TF and Ga scintigraphy. However, a combination of Tc-TF and Ga-67 scintigraphy detected malignant lymphoma in all 50 patients (100%). We conclude that it is necessary to combine Tc-TF and Ga-67 scintigraphy to accurately detect malignant lymphoma.

Adult↗

PubMed2002

Conversion of laparoscopy to laparotomy due to adnexal malignancy.

PURPOSE: The purpose of the present report was to assess the conversion rate from laparoscopy to laparotomy due to adnexal malignancy and to identify factors that might assist in the selection of the appropriate operative approach in patients with suspicious adnexal masses. METHODS: A retrospective review of the medical records of women who underwent laparoscopy due to ultrasonically complex adnexal masses. Ninety-five consecutive patients fulfilling these criteria, were identified. A comparison of patients with benign tumors who had laparoscopy only to those with invasive malignancies in whom laparoscopy was converted to laparotomy was performed. RESULTS: Malignancy was diagnosed in 18 (18.9%) patients. In 13 patients with malignancy (two borderline and 11 invasive), comprising 72.2% of the malignancies and 13.7% of the total group with complex adnexal masses, the laparoscopy was converted to laparotomy. Age of more than 50 years and a serum CA125 level above 35 U/ml were significantly more common in the malignant than in the benign group (90.9% vs. 15.6% and 63.6% vs. 11.6%, respectively; p < 0.0001 and p < 0.003, respectively). When both factors were present, the sensitivity and specificity for malignancy were 73.3% and 93.2%, respectively, and the positive and negative predictive values 73.3% and 95.6%, respectively. CONCLUSION: When an ultrasonically complex adnexal mass is encountered, predictive factors for malignancy should be taken into account before the mode of intervention is chosen. The conversion from laparoscopy to laparotomy because of an invasive malignant tumor is acceptable, if it is performed immediately and a gynecologic oncologist is on stand-by.

Adnexal Diseases↗

PubMed2001

[A retrospective clinical study of 6539 cases of malignant oral-maxillofacial tumors].

OBJECTIVE: The aim of this study is to obtain the general information of post-operation malignant oral-maxillofacial tumor patients in forty-seven years. METHODS: A total of 6539 patients with malignant oral-maxillofacial tumors in the hospital of stomatology, west china university of medical sciences, from 1953 to 2000 were retrospected. RESULTS: The average age of patients with malignant oral-maxilloficial tumor is 48.7 years old. The ratio of male to female is 2.31:1. The most common original malignant tumors in this oral-maxillofacial region are malignant oral tumors, malignant maxillary tumors, malignant mandibular tumors, and malignant sialoma successively. As to the original tissues of tumors, there were 5869 cases of epithelial tumors, and made up 89.75% of all the investigated patients. Tumors came from lymphatic and hematopoietic systems and mesoderm were much less those came from epithelia. There were 4177 cases of squamous cell carcinomas and the percentage was 63.88%. CONCLUSION: The incidence rate of malignant tumors in oral-maxillofacial region tends to increase, and the average age of patients also rose. The ratio of male to female decreases gradually. Epithelial tumors, especially squamous cell carcinomas are very common tumors happening in this region.

Adolescent↗

PubMed2003

HLA-G is a potential tumor marker in malignant ascites.

PURPOSE: Molecular approaches as supplements to cytological examination of malignant ascites may play an important role in the clinical management of cancer patients. HLA-G is a potential tumor-associated marker and that one of its isoforms, HLA-G5, produces a secretory protein. This study is to assess the clinical utility of secreted HLA-G levels in differential diagnosis of malignant ascites. EXPERIMENTAL DESIGN: We used ELISA to assess whether secretory HLA-G (sHLA-G) could serve as a marker of malignant ascites in ovarian and breast carcinomas, which represent the most common malignant tumors causing ascites in women. RESULTS: On the basis of immunohistochemistry, 45 (61%) of 74 ovarian serous carcinomas and 22 (25%) invasive ductal carcinomas of the breast demonstrated HLA-G immunoreactivity ranging from 2 to 100% of the tumor cells. HLA-G staining was not detected in a wide variety of normal tissues, including ovarian surface epithelium and normal breast tissue. Revese transcription-PCR demonstrated the presence of HLA-G5 isoform in all of the tumor samples expressing HLA-G. ELISA was performed to measure the sHLA-G in 42 malignant and 18 benign ascites supernatants. sHLA-G levels were significantly higher in malignant ascites than in benign controls (P < 0.001). We found that the area under the receiver-operating characteristic curve for sHLA-G was 0.95 for malignant versus benign ascites specimens. At 100% specificity, the highest sensitivity to detect malignant ascites was 78% (95% confidence interval, 68-88%) at a cutoff of 13 ng/ml. CONCLUSIONS: Our findings suggest that measurement of sHLA-G is a useful molecular adjunct to cytology in the differential diagnosis of malignant versus benign ascites.

Ascites↗

PubMed1992

Malignancies of undetermined primary origin.

Unknown primary malignancy (UPM) is not a disease entity. Rather, it represents a variety of different metastatic, malignant neoplasms all presenting with either an occult primary or having such a highly undifferentiated histologic appearance that an accurate pathologic classification on routine hematoxylin-eosin section is not possible. UPM is a spectrum of malignancies that includes those that are treatable and curable and those for which no specific treatment exists. For the physician, a diagnosis of UPM represents a beginning rather than an end. The minimal workup of such patients includes a thorough history and physical examination, complete blood counts, urine analysis, multichannel chemistries, a chest radiograph, and computed tomography of the abdomen and pelvis. Having completed this workup, further tests are unnecessary and unwarranted unless specific symptoms or physical signs exist. Once the aforementioned workup is completed, the physician must communicate frequently and freely with the pathologist as further diagnostic tests will be laboratory based and include electron microscopy, histochemical stains, and immunocytochemistries. Immunocytochemistries are relatively new laboratory procedures which have made a significant contribution in the accurate pathologic diagnosis of a tissue specimen that in years past would have been classified as an unidentified malignant neoplasm. An initial panel of immunocytochemistries (vimentin, cytokeratin, CEA, and common leukocyte antigen) should be performed on the tissue block in patients with UPM as they provide direction in the accurate classification of the malignant neoplasm. Chromosomal analysis of tissue is useful in the recognition of lymphomas or soft-tissue sarcomas which would otherwise be classified as UPM. In years to come, when specific DNA probes capable of identifying specific chromosomal rearrangeaments are widely available, pathologic classification of UPM will be performed on a molecular level. Some unknown primary malignancies are treatable and potentially curable. These include large cell lymphoma, extragonadal germ cell malignancies, squamous cell carcinoma metastatic to cervical lymph nodes without an obvious primary, metastatic adenocarcinoma to axillary lymph nodes in women (invariably on occult breast primary), and malignant ascites in women, which usually represents ovarian cancer. Metastatic adenocarcinoma of unknown primary origin, with the exception noted above and the rare presentation of an occult prostate cancer as UPM, is an ultimately fatal malignancy with a relatively shor clinical course.(ABSTRACT TRUNCATED AT 400 WORDS)

Biomarkers, Tumor↗

PubMed2004

The number of malignant neoplasm in Sarajevo region during the period 1998-2002.

UNLABELLED: Due to the specific war and post-war situation in Bosnia and Herzegovina it is possible to notice some differences in the number, type, advancement, biological course, treatment and its outcome. The actual situation which appeared in connection to depleted uranium has additionally raised questions about its influence on human health and about eventual increase in the number of malignant diseases in Bosnia and Herzegovina. In public, we often see that there are claims about enormous increase in the incidence of cancer. In order to achieve a realistic picture of actual condition and to avoid panic and ignorant attitude, correct and constant data of malignant tumors are necessary. THE AIM OF THE STUDY: To collect and analyze data on population with malignant tumors in the region of Sarajevo city, which represents a symbol of difficult times in our country in the recent past. MATERIAL AND METHODS: We have collected and analysed data on, population with malignant tumors which included persons with permanent residence in Sarajevo Canton during 5-year period, from 01.01.1998, until 31.12.2002. Results were compared to regional and world indicators, and were observed in the light of specific local situation. RESULTS: During period of 5 years (1998-2002) 7733 new cases of malignant tumors were registered in Sarajevo Canton; 3940 among men and 3809 among women. Mostly registered tumors were: lung cancer, amelanotic skin tumors, breast cancer, colorectal cancer, cervical and uterine cancer, urinary bladder cancer, prostate cancer and cancer of larynx. CONCLUSIONS: Number of all malignant tumors in the region of Sarajevo Canton correlates to those in South European countries and the one estimated by GLOBCAN 2000. High number was registered in 1998, possibly due to normalization of the health services (diagnostics and treatment of malignant tumors), which didn't exist during the war and early post-war period. After 2000, there is a gradual increase in the number of people with malignant tumors. The most common tumors are lung and breast cancer. Significant differences to estimation and data registrated in other South European counties is high number of laryngeal cancer, urinary bladder cancer, bone and cartilage sarcoma, brain tumors and malignant lymphomas among both genders. Cervical cancer is extremely high up on the list, which correlates with data in developing countries. The incidence of smoking in Bosnia and Herzegovina is extremely high, almost complete, which can influence not only the appearance of lung cancer but also laryngeal and urinary bladder cancer. It is hard to say whether the war and post-war stress, irregular and insufficient nutrition during and after the siege of the city or some other factor have influenced their appearance among exposed population and differences in the observed incidence.

Bosnia and Herzegovina↗

PubMed2005

Patients with spontaneous bacterial peritonitis, and malignant and cirrhotic ascites.

BACKGROUND: Cytokines play a key role in the regulation of cells of the immune system and also have been implicated in the pathogenesis of malignant diseases. METHOD AND PATIENTS: We studied tumor necrosis factor-alpha, tumor necrosis factor receptor and C-reactive protein levels in both ascitic fluid and serum in patients with spontaneous bacterial peritonitis (SBP) (n = 22), and in the malignant (n = 38) and cirrhotic (n = 32) ascites. RESULTS: C-reactive protein, tumor necrosis factor-alpha and tumor necrosis factor receptor levels in the ascitic fluid were found to be elevated in the SBP (p < 0.001) and malignant groups (p < 0.005) when compared with the sterile cirrhotic group. C-reactive protein levels in the serum were found to be elevated in the SBP group when compared with the sterile cirrhotic (p < 0.001) and malignant group (p < 0.005). Tumor necrosis factor-alpha in the serum was significantly elevated in the SBP when compared with the cirrhotic (p < 0.005) and malignant ascites (p < 0.001). Sensitivity and specificity of ascitic fluid CRP in discriminating malignant 84% and 67% and SBP from sterile ascites were 90% and 76%, respectively. Sensitivity and specificity of ascitic fluid TNF-alpha in discriminating malignant 77% and 60% and SBP from sterile ascites were 82% and 66%, respectively. Sensitivity and specificity of TNF-r p60 in discriminating malignant 74% and 70% and SBP from sterile ascites were 80% and 76%, respectively. CONCLUSION: The sensitivity and specificity of ascitic fluid CRP, TNF-alpha and TNF-r values were found to be similar. Ascitic fluid Creactive protein to differentiate SBP and malignant ascitic from cirrhotic ascites are cheap, practical and safe tests used in the differential diagnosis of ascites.

Adult↗

PubMed2005

Malignant melanoma--future prospects.

As the incidence and already high mortality rates of malignant melanoma have been steadily increasing in recent decades, the early detection and excision of malignant melanoma have imposed as the most important task. Staging of malignant melanoma is determined according to the level of invasion (Clark level) and vertical thickness (Breslow scale). Besides operative therapy, which is the only effective treatment for malignant melanoma, postoperative adjuvant chemotherapy, immunotherapy, radiotherapy, and biologic therapy also are of great importance. In recent years, immunologic strategies including tumor vaccine and adjuvant therapy with interferon-alfa have been attempted to improve survival of patients with more advanced malignant melanoma. A recent melanoma research has focused on target therapy such as immunotherapy (vaccines, monoclonal antibodies, dendritic cells) and gene therapy. Genetic immunization has become an attractive strategy for the development of melanoma vaccines, because a number of antigens recognized by cellular components of the immune system have been identified at the molecular level. Numerous chemotherapeutic agents have shown activity in the treatment of metastatic malignant melanoma, such as dacarbazine (dimethyl triazene imidazole carboxamide); other agents have been used, however, with less success. However, a very modest effect was recorded in advanced malignant melanoma. There are many experimental trials using combined therapy for malignant melanoma, including chemotherapy (dimethyl triazene imidazole carboxamide) and biologic therapy (interleukin (IL)-2, interferon (IFN)-gamma, IFN-alfa). The results obtained open particularly interesting prospects in the field of malignant melanoma with high relevance for its development and progression. Molecular therapeutics and vaccine development will probably be an important focus for the future melanoma treatment.

Antigens, Neoplasm↗

PubMed2005

[Second cancers in hematologic malignancies (epidemiologic observations from a 20-year period)].

INTRODUCTION: The incidence of malignant tumours have increased steadily worldwide. Prior reports indicate that patients with some hematologic malignancies (for example chronic lymphocytic leukemia, non-Hodgkin's lymphoma) may be at increased risk of second neoplasms. AIM: The aim of the authors was to explore the possible association between hematologic malignancies and subsequent solid tumours. PATIENTS, METHODS: Between January 1, 1983 and December 31, 2002, in the county of Szabolcs-Szatmár-Bereg 151 cases with both malignant hematologic diseases and cancers were registered by the authors. In their 60 patients (50 with lymphoid and 10 with myeloid malignancies) the first tumour was the hematologic malignancy. Among these cases the number of second cancers was 64. RESULTS: The most common kind of second tumours was lung cancer. There was a significant connection between lymphoid malignancies and second cancers as compared to myeloid malignancies and subsequent cancers (p < 0.05). CONCLUSIONS: Analysing the epidemiologic data the authors established the following conclusions: the association of second cancers with hematologic malignancies in most of the cases is not accidental. The age of patients with second cancers seemed to be not too important, but it was of crucial importance in patients with Hodgkin's disease and non-Hodgkin's lymphoma. The role of immunodeficiency in the development of second cancers may be important in patients with Hodgkin's disease, non-Hodgkin's lymphoma and chronic lymphocytic leukemia (the number of second cancers in their patients with multiple myeloma and hairy cell leukemia was too small do draw a conclusion).

Age Factors↗

PubMed2005

Risk of malignancies in patients with insulin-treated diabetes mellitus: results of a population-based trial with 10-year follow-up (JEVIN).

BACKGROUND: Studies involving diabetes mellitus and malignancies show contradictory results: Many of them have found incidences of malignancies that are comparable or lower, other studies have found higher rates than those of non-diabetic subjects. Hence, the goal of the present trial was to study the possible association between diabetes mellitus and the incidence of malignancies and its outcome in a selection-free population over a longer period of time. - PATIENTS AND METHODS: All the patients (n=291) who participated in the JEVIN (Jena's St. Vincent)- trial (a prospective, 10 year follow-up, population-based intervention survey of all insulin-treated patients with type 1 and type 2 diabetes mellitus aged 16 to 60 years and living in the city of Jena [about 100,000 inhabitants], Thuringia, Germany) were assessed. The baseline examination took place in 1989/90, follow-up examinations were performed in 1994/95 and 1999/2000. - RESULTS: Up to 1999/2000, 2 patients with type 1 and 5 patients with insulin-treated type 2 diabetes mellitus developed a malignancy (incidence 0.0241). The most frequent malignancies were cancer of the colon and rectum (3 of 291 patients, incidence 0.0103). Comparing these data with the incidence of carcinoma of the colon and rectum reported by the Robert-Koch-Institute of Germany (incidence 0.0012) diabetic patients showed a 9.9-fold increased risk (p=0.042). There were no significant differences regarding incidence of total malignancies or carcinoma of the breast, the lung, renal cells or gonads. Correlation and multivariate analyses revealed no associations between the development of malignancies and patients' outcome and diabetes duration, the duration of insulin therapy, insulin dosage, the quality of diabetes control or the presence of diabetes-related long-term complications. - CONCLUSIONS: Conclusive to other data derived from selected cohorts, population-based the JEVIN-trial demonstrate an increased incidence of malignancies of the colon and rectum in insulin-treated patients with diabetes mellitus. However, for further confirmation of these interesting results more studies in larger populations over longer periods of time are necessary to explain the heterogeneous findings in patients with diabetes mellitus of an increased incidence for some cancer entities, but not for others. Knowledge of these mechanisms should have important implications for the direction of strategies to prevent the development of malignancies, or to enhance ability to make an earlier diagnosis and more effective therapies.

Adenocarcinoma↗

PubMed2006

Low efficacy of 18F-FDG PET for detection of uveal malignant melanoma compared with 123I-IMP SPECT.

UNLABELLED: Earlier investigations showed that N-isopropyl-p-123I-iodoamphetamine SPECT (123I-IMP SPECT) is useful for the diagnosis of uveal malignant melanoma, whereas the feasibility and usefulness of 18F-FDG PET in uveal malignant melanoma have not yet been established. We compared the usefulness of 123I-IMP SPECT and 18F-FDG PET for the detection of uveal malignant melanoma on the same subjects. METHODS: Nineteen patients (10 men, 9 women) with suspected uveal malignant melanoma were examined by 123I-IMP SPECT. Thirteen of them were also examined by 18F-FDG PET. 123I-IMP SPECT was performed at 15 min or at 3 and 24 h after intravenous administration of 123I-IMP. RESULTS: In 12 of 19 study patients, 123I-IMP SPECT obtained at 24 h after intravenous administration of 123I-IMP delineated an area of increased uptake in the site corresponding to the ocular tumor. All of the ocular tumors in the 12 123I-IMP SPECT-positive patients were confirmed histopathologically and clinically to be uveal malignant melanoma. The other 7 123I-IMP-SPECT-negative patients have been monitored under the diagnosis of choroidal nevus, choroidal hemangioma, hyperplasia of the pigment epithelium of the retina, or idiopathic inflammatory lesions without any complications. In a total of 13 patients examined by 18F-FDG PET, 9 of whom were 123I-IMP SPECT positive and 4 were negative, only 1 patient showed abnormal uptake of 18F-FDG PET in the site corresponding to the ocular tumor. Therefore, 8 of 9 patients with uveal malignant melanoma showed false-negative results in 18F-FDG PET. The 18F-FDG PET-positive patient with uveal malignant melanoma had the largest tumor mass with a short diameter of 12 mm, a long diameter of 17 mm, and a height of 7 mm. In the other 8 18F-FDG PET-negative patients, the tumors had a dimension of 11 x 13 x 7 mm or less. CONCLUSION: 123I-IMP SPECT is a sensitive and accurate method for the detection of uveal malignant melanoma, whereas the efficacy of 18F-FDG PET for this purpose is low because of a high incidence of false-negative results. 123I-IMP SPECT is far more superior in comparison with 18F-FDG PET in detecting uveal malignant melanoma.

Adult↗

PubMedDate not supplied

Distribution of malignancies in head and neck regions and their management.

A retrospective, cross sectional, series of cases were currently studied in the department of ENT-Head & Neck Surgery of Tribhuvan University Teaching Hospital (TUTH) Kathmandu, Nepal to find out the distribution of different malignancies in head and neck regions and to identify their treatment modalities during the period of one year from January 2003 to December 2003. Altogether 159 new cases of histopathologically/cytopathologically confirmed malignancies of head and neck regions and their treatment modalities were analyzed. Out of 159 cases, malignancies of larynx (41), pharynx (31) and oral cavity (30) were found to be the commonest head and neck malignancies where as malignancies of ear (1), and salivary glands (4) were found to be the least common. Likewise surgery with or without radiotherapy and/or chemotherapy was found to be the commonest treatment modality. Of the 159 cases seven were occult primary. As the laryngo-pharyngo-oral malignancies are the commonest malignancies and surgery with or without radiotherapy and/or chemotherapy the commonest treatment modalities for these head and neck malignancies. A well equipped head and neck unit is needed at TUTH along with proposed radiotherapy and medical oncology support for better management of these malignancies.

Adolescent↗