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Malignancy grading of epithelial bladder tumours. Reproducibility of grading and comparison between forceps biopsy, aspiration biopsy and exfoliative cytology.

107 bladder tumours cystoscopically suspected to be malignant were examined morphologically by forceps biopsy, aspiration biopsy and exfoliative cytology. The malignancy was graded from 0 through 4. The reproducibility of each method was established, and was found to be 80%, 65% and 90%, respectively. Exfoliative cytology underestimated the malignancy grade as compared with histopathology (59% of the malignant tumours were not jduged as malignant in the cytological grading), but showed no tendency towards overestimation and gave no falsely postiive diagnoses of malignancy. It is concluded that diagnosis of bladder tumours requires both biopsy and cytological techniques, since they proved complementary in a number of cases. Grading by aspiration biopsy is less reliable but may be of benefit in selected cases where forceps biopsy is less suitable.

Biopsy

The prognosis of breast cancer based on histological assessment.

Histopathology data from 298 patients with breast cancer have been stored in a computer, and features influencing survival have been analysed by the life table method and presented in survival curves. Prognostic features assessed were the size, type, and grade of neoplasm, the amount of stromal elastosis and lymphocytic infiltrate, and the presence and number of axillary metastases. The most reliable indications of short survival are the presence of axillary metastases and a high tumour grade. These two features are correlated, as high-grade tumours are much more likely to have metastases at presentation. No statistical difference is found in the survival of patients with metastases in one or two axillary nodes compared with those with larger numbers involved. There are differences in survival in different types of carcinoma; the well-differentiated infiltrating duct carcinoma with tubular pattern has the best prognosis, followed by the medullary carcinoma. The size of the tumour has some prognostic significance, but this is outweighed by its grade.

Adenocarcinoma

Tumours of the renal pelvis and ureter. Symptomatology, diagnosis, treatment and prognosis.

Forty-two cases of tumour of the renal pelvis and/or ureter are presented. The primary tumour was in the renal pelvis in 25 cases and in the ureter in nine. A co-existent tumour elsewhere in the uroepithelium was found in 16 of these 34 patients. In the remaining eight patients, tumour of the urinary bladder was the initial diagnosis, but tumours of the upper urinary tract subsequently appeared. The principal symptom (38 of 42 cases) was haematuria, but flank pain and a mass in the kidney region also occurred. In most cases the diagnosis was indicated by the urograms and was confirmed by retrograde pyelography. Nephro-ureterectomy was done in most of the patients. The possibility that local tumour resection may be sufficient is briefly discussed. The tumours were classified as papillary in 24 patients and as solid in nine. There was no histologic classification in nine cases. The mean observation time was 29 months. Since new growths tend to arise at other sites in the uro-epithelium, follow-up examination should always include cystoscopy and urography. The prognosis was particularly poor in solid tumours: two-thirds of these patients died in the first postoperative year. Survival was clearly dependent on the tumour differentiation. High-grade tumours carried a poor prognosis.

Adult

Malignant tumours of bone: clinical aspects and natural course.

An accurate pathological diagnosis must be made prior to treatment of a primary malignant bone tumour. Consideration must be given to the clinical and radiologic aspects as well as the histology. Both benign and malignant tumours occur more frequently in certain decades. A search should be made for precursor lesions such as Paget's disease. The presenting manifestations of pain, a mass and dysfunction are not specific for tumours. Laboratory tests may be helpful, especially in distinguishing tumours from infections and metabolic diseases. Metastasis is usually via the blood stream to the lungs and bones. The low survival rate following amputation for osteosarcoma and radiation therapy for Ewing's sarcoma has been improved by chemotherapy. The lower-grade tumours such as aggressive giant cell tumour and low-grade chondrosarcoma can often by treated successfully by resection and insertion of an autograft, an allograft or a metallic implant.

Age Factors

Histological grading of transitional cell tumours of the bladder. Value of histological grading (WHO) in prognosis.

Mortality among 139 patients with transitional cell tumour of the bladder was studied. Tumours were reevaluated according to the grading system recommended by WHO. The absolute 5-year survival of histologically benign papilloma cases was 68%, of grade I carcinoma cases 64%, of grade II carcinoma cases 42% and of grade III carcinoma patients 34%. Clinical staging (UICC), however, would have been more effective than histological grading (WHO) for prognostic purposes. 3 of the 14 patients with histologically benign papilloma in this study developed grade I carcinoma during follow-up periods of between 4.5 and 24 years. Following radical treatment all recurrences were papillomas. The study suggests that histological grading should be used to complement clinical staging in prognosis and that with half-yearly check-ups and elimination of any tumours thus detected, patients with papilloma rarely develop carcinomas of higher grade than grade I.

Aged

The efficacy of urinary cytology in the detection of urothelial tumours. Sensitivity and specificity of urinary cytology.

The sensitivity and specificity of urinary cytology in the detection of urothelial tumours using voided urine and applying simple smear preparation and staining techniques have been assessed. Of the 2704 patients under investigation 207 had urothelial tumours. The first urine analysis was positive in 66% of the patients with urothelial carcinoma; an additional 23% of the patients showed positive cytology in repeat smears, resulting in a sensitivity of 89%. The efficacy of urinary cytology depends on the tumour type: for grade 2 tumours, 79% were cytologically positive, 92% of grade 3 and 98% of the grade 4 tumours. The diagnostic efficacy in cases of carcinoma-in-situ, squamous cell carcinoma and adenocarcinoma was comparable with that of grade 4 carcinomas. Grade 0-1 tumours did not result in positive cytology. In eleven cases of lithiasis and in two cases of cyclophosphamide therapy the cytological diagnosis was positive but no neoplasm could be established histologically; these represent true false positive diagnoses. Thus, the false positive rate, 13 out of 165, was 7.88% and the false negative rate, 61 out of 207, was 29.4% when grades 0-1 were included, but 8.75% (14 our of 160) when grades 0-1 were excluded.

Cytological Techniques

A review of the behaviour of chondrosarcoma of bone.

Sixty-two cases of chondrosarcoma of bone were reviewed and histologically graded as low, medium or high-grade tumours. After excluding patients dead from unrelated causes or lost to follow-up, forty cases were available for ten-year follow-up and fifty-eight for five-year follow-up. The rates of survival, recurrence and metastasis were analysed according to the histological grading. Recurrence was further analysed according to the adequacy of treatment. The results were compared with those previously reported in the literature. There was a ten-year survival rate of 58 per cent. Recurrence developed in 58 per cent and was uncontrollable in 29 per cent. The recurrence rate was 87 per cent with inadequate treatment and 15 per cent with adequate treatment. Recurrences outside the limb bones usually proved uncontrollable; recurrences in the limb bones were amenable to further, and if necessary repeated, operations. High-grade chondrosarcoma had a metastatic risk of 75 per cent and eventual mortality of 88 per cent. Medium-grade chondrosarcoma had a metastatic risk of 14 per cent and a mortality of 60 per cent. Low-grade chondrosarcoma had a metastatic risk of 5 per cent and a mortality of 29 per cent.

Adult

[Medical evaluation and rehabilitation following intensive therapy of malignomas in the female genitalia and breast].

The selective therapy of malignant tumours of the female genital tract has led to the abandonment of radical procedures in the treatment of early stages of carcinomas. The histological diagnosis, including tumour localisation, tumour grading, applied therapy, early and late complications are criterion to be taken into consideration in laying down the degree of infirmity. In the light of functional gynaecology, principles for such patients care are laid down, taking into account the time of disablement as well as problems of rehabilitation, not only for patients with malignant tumours of the female genitals but for those with mammary tumours as well.

Aftercare

The results of surgical treatment for carcinoma of the rectum of St Mark's Hospital from 1948 to 1972.

The surgical treatment of 3163 patients seen at St Mark's Hospital with a single adenocarcinoma of the rectum in the years 1948-72 is described and the results analysed. In 2948 patients (93-2 per cent) the primary tumour was removed. The operative mortality fell from 7-0 per cent in the years 1948-52 to 2-1 per cent in 1968-72. The proportion of restorative operations has risen steadily over the years to a level of 41-1 per cent in the years 1968-72. There were 2410 operation survivors in the years 1948-67. The crude 5-year survival rate in the whole group was 47-1 per cent (corrected figure 56-7 per cent), and 56-6 per cent (corrected figure 68-4 per cent) for the 1931 survivors of radical operations. Comparison of results for patients surviving radical synchronous combined excision and radical anterior resection shows a significant difference in the two groups: in the former the crude 5-year survival rate was 52-7 per cent (corrected figure 63-8 per cent), and in the latter group the respective figures were 66-7 and 79-4 per cent. A higher proportion of Dukes' A and B cases and of low grade tumours are shown as the pathological background to the more favourable prognosis for patients surviving radical anterior resection.

Adenocarcinoma

MET expression by immunohistochemistry as a biomarker in pancreatic neuroendocrine tumours.

INTRODUCTION: MET (c-MET) is a receptor tyrosine kinase implicated in numerous cancers, including pancreatic neuroendocrine tumours (pNETs), by promoting cell proliferation, survival, invasion and angiogenesis. Recognizing its oncogenic potential, there is significant interest in MET-targeted therapies for malignancies like pNETs, which often develop treatment resistance. Immunohistochemistry (IHC) has become a practical method for detecting MET overexpression in cancers. This study evaluates MET expression in pNETs by IHC and assesses its correlation with prognostic variables and survival outcomes. METHODS AND RESULTS: Tissue microarrays containing well-differentiated neuroendocrine tumours from the gastrointestinal tract were analysed. The study included 125 pNET cores from 112 patients after application of inclusion criteria. MET expression was determined using the H-score system. Different variables were assessed for H-score distribution and cross-tables. Survival analyses were conducted based on progression-free survival and overall survival. Positive MET expression was found in 83.5% of cases. Higher MET H-scores were seen in patients with lymphovascular invasion (LVI), distant metastases and higher tumour grade (P&#x2009;<&#x2009;0.05). When assessing different variables for higher MET H-scores, a significant association emerged at the 150-cut-off-point for LVI, perineural invasion, radiological evidence of progression and overall survival. For survival analysis, at a MET H-score threshold of 200, high MET expression was significantly associated with shorter progression-free survival (mean 8.7 versus 13.4&#x2009;years, P&#x2009;<&#x2009;0.05) and overall survival (mean 3.6 versus 7.7&#x2009;years, P&#x2009;<&#x2009;0.05). CONCLUSION: Elevated MET expression is linked to adverse histopathological features and worse clinical outcomes in pNET. Standardizing MET IHC evaluation is critical as anti-MET therapies develop, and identifying patients likely to benefit from these treatments remains essential.

MET protein

Plasma spermine concentrations of patients with benign and malignant tumours of the breast or prostate.

A radioimmunoassay has been developed for the measurement of plasma spermine concentrations. The sensitivity of the method is 1 pmol spermine/100 microliters plasma and the crossreactivity was 12% with spermidine and 0.18% with putrescine. Plasma spermine levels of patients with benign and malignant tumours of the prostate or breast were measured using this technique. Concentrations were only occasionally elevated in patients with prostatic tumours compared to normal individuals and there was no difference between those men with benign (mean concn. 0.21 +/- 0.14 nmol/ml plasma) or malignant (mean concn. 0.21 +/- 0.11 nmol/ml plasma) tumours. Only 17% of the patients with breast carcinoma had elevated levels of spermine, although there was a significant difference in the concentrations of the breast cancer group of patients compared to normals. No correlation was found between elevated plasma spermine concentrations and tumour grade or presence or spread of metastases in those patients.

Adolescent

Decoding cancer with artificial intelligence: Transforming research, diagnosis, and therapy with future insights.

Cancer remains one of the leading global health burdens, with increasing complexity in genomic, imaging, and clinical datasets presenting significant challenges for effective management. Artificial intelligence (AI) has emerged as a powerful tool to address these challenges by enabling pattern recognition, knowledge integration, and data-driven decision-making. This review highlights recent advances in the application of AI across cancer research, diagnosis, and therapy. In research, AI accelerates drug discovery and repurposing, enhances genomic data interpretation, and facilitates biomarker identification through multi-omics integration. In diagnosis, AI has demonstrated high technical performance in radiology for lesion detection and image segmentation, in pathology for tumour grading and molecular prediction, and in liquid biopsy for non-invasive biomarker analysis. In therapy, AI supports precision medicine by predicting treatment responses, monitoring disease progression, and optimizing clinical trial design. Despite these advances, barriers such as data heterogeneity, algorithmic bias, interpretability, and regulatory challenges remain. Future directions, including explainable AI, federated learning, multimodal modelling, and digital twins, hold promise for translating AI-driven innovations into routine oncology practice. Significance Statement This review provides a timely synthesis of recent (2020-2025) advances in artificial intelligence across cancer research, diagnosis, and therapy, highlighting applications in drug discovery, genomics, multi-omics biomarker identification, and clinical decision-making. By integrating technological progress with translational and clinical relevance, this work serves as a valuable resource for bridging AI innovation with precision oncology practice. As a narrative review, the literature was identified through targeted PubMed, Scopus, and Google Scholar searches, combining terms for artificial intelligence, machine learning, and deep learning with cancer-related keywords, with priority given to peer-reviewed studies published between 2020 and 2025, seminal earlier works, and official regulatory or guideline documents. Within each domain, representative studies were selected to illustrate methodological diversity, clinical context, and current translational readiness rather than to provide exhaustive coverage of an extremely rapidly evolving field.

Artificial intelligence

Cavernosography in the management of prostatic cancer.

Cavernosograms were used in the investigation of 22 patients with prostatic cancer to determine the incidence of venous invasion. There were 21 patients with T3/T4 category tumours and one with a T2 tumour. All but one, a T3 tumour, had the radiological features of periprostatic venous malignant thrombosis. An attempt was made to correlate these findings with lymphography and tumour grade but no correlations could be made and the clinical relevance of these findings remains uncertain.

Humans

Cystectomy for carcinoma of the bilharzial bladder: 138 cases 5 years later.

Our experience is outlined with 138 cases of bilharzial bladder cancer treated by radical cystectomy and followed for 5 years. The operative mortality was 13.7%. The 5-year survival rate was 32.6%. Analysis of survival figures revealed that the tumour grade was the most important prognostic factor. Most treatment failures were due to local recurrence which developed early after treatment. It was concluded that improvement in survival might be obtained by some form of pre-operative irradiation augmented by the use of a hypoxic cell sensitiser.

Adult

Allogeneic transplantation in low-grade malignant bone tumours. A new operative technique to avoid amputation.

A massive allografting of deep-frozen cadaver bone or hemi-joint was performed in 11 patients with tumours which were diagnosed as aggressive, low-grade malignancies. One patient died from a pre-existing hepatic insufficiency. The other 10 patients have been followed up from 1 to 8 years. These patients received two bone grafts and eight hemi-joint grafts around the knee joint. The operative procedure consisted of fixation of the graft by stable osteosynthesis, surrounding the graft-host junction with an autogeneic iliac chips cuff and, in cases of hemi-joint grafts, reconstruction of the ligaments. X-ray, scintigraphy and biopsy were used to judge the incorporation of the graft. The patients had to be prepared to face a considerable morbidity with long non-weight-bearing periods and possibly further operations. A full restitution of function was achieved in the bone graft cases. The patients with hemi-joint grafts were also able to retain their limb with a good or satisfactory function. No metastases or recurrences were experienced. The allograft procedure appears to be useful for younger adults, whose long life expectancy makes this operation justifiable, although the fate of cartilage still is unpredictable.

Adolescent

The pattern of spread and survival in 596 cases of breast cancer related to clinical staging and histological grade.

Carcinoma of the breast in 596 patients diagnosed between 1949 and 1966 at the Reading group of hospitals has been evaluated. All operable cases were treated by simple mastectomy and post-operative radiotherapy to the chest wall and regional nodes. Tumours were graded for malignancy either routinely or retrospectively on all patients with carcinoma simplex or scirrhous carcinoma, and the relation of grading to the subsequent development and distribution of metastases studied. Recurrence developed in 348 patients, 184 of whom suffered local recurrence. Eighty-three per cent of locally recurrent cases developed generalised metastases. The incidence of pulmonary and liver metastases was significantly increased in Grade II and III tumours compared with Grade I. Very significant differences in the survival rates between grades were noted, unfavourable to the higher grade tumours; and the influence of grading on prognosis is discussed.

Adenocarcinoma, Scirrhous

Myxofibrosarcoma. A study of 30 cases.

A series of 30 myxofibrosarcomas is described. These malignant soft tissue tumours are characterized by a mucoid and nodular appearance, a coarse plexiform capillary pattern, and they are mostly seen subcutaneously (26 out of 30) in the extremities (24 out of 30) and trunk (4 out of 30) elderly people. Histochemical studies, comprising staining with Alcian blue and toluidine blue at different pH's with and without preceding digestion with testicular hyaluronidase and with the Scott technique, indicated the presence of hyaluronic acid but not sulphated glycosaminoglycans as chondroitinsulphates. Myxofibrosarcoma is believed to belong to the general category of fibroblastic and histiocytic malignant soft tissue tumours. The median diameter of the tumours was 7 cm. They were divided into 4 grades according to cellularity, cell atypia and mitotic activity. The grade III and IV tumours showed pronounced atypia, often with the bi- and multinucleated giant tumour cells and occasionally with giant cells of Touton's type, suggesting a relationship to malignant fibroxanthoma. All of the patients were treated surgically and one received also pre- and post-operative irradiation. None of the 2 grade I myxofibrosarcomas recurred, while 2 out of 7 grade II tumours, 6 out of 10 grade III tumours, and 7 out of 11 grade IV tumours recurred once and up to 9 times. Metastasis appeared in 7 out of 30 patients; grade I tumours were not seen in any of these cases. By the time of follow-up after intervals ranging from 1 month up to 27 years, 14 patients had died; 6 of these had died post-operatively or of intercurrent disease. The differential diagnosis between myxofibrosarcoma and other myxoid soft tissue tumours is discussed.

Adult

Grading of transitional cell tumours of the urinary tract by urinary cytology.

1122 cytological diagnoses have been made on 2500 Papanicolaou stained cytological slides from Patients with urothelial carcinomas. The cytological accuracy was 78% for G1 tumours, 94% for G2 and 96% for G3 carcinomas. A histologically diagnosed G1 carcinoma was cytologically G1 in 81% of cases, a G2 carcinoma was recognized in 64% and G3 carcinoma in 48%.

Carcinoma, Transitional Cell