ISSN:0022-4790    

DOI:10.1002/jso.2930450203

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1990

数据来源: WILEY

摘要:

AbstractA panel of six monoclonal antibodies (MAbs) was employed to evaluate antigen expression in pulmonary adenocarcinomas and mesotheliomas. Monoclonal anti‐human milk fat globulin (HMFG‐2), anti‐carcinoembryonic antigen (NP‐2), antiepithelial membrane antigen (EMA), anticytokeratin (PKK‐ l), anti‐tumor‐associated antigen 72 (B72.3), and anti‐human myelomonocytic antigen (Leu M‐1) antibodies were used to localize their respective antigens in formalin‐fixed, paraffin‐embedded tumors by using the avidin‐biotin‐complex immunoperoxidase technique. In all, 28 mesotheliomas obtained from Ohio State University Anatomic Pathology files and from a Southwest Oncology Group (SWOG) protocol were compared to 22 pulmonary adenocarcinomas by using this MAb panel. None of the mesotheliomas demonstrated positive staining with MAbs NP‐2 (anti‐CEA) or Leu M‐1. However, 95% (21/22) of adeno‐ carcinomas stained with one of these two antibodies. Although neither of these two MAbs stained all adenocarcinomas, each antibody demonstrated positive immunostaining in more than 90% of the adenocarcinomas studied. Therefore, MABs NP‐2 and Leu M‐1 are, individually, quite useful for distinguishing mesothelioma from adenocarcinoma. However, in our study, no single MAb could be used to distinguish these two tumor types in every case. MAb B72.3 stained 91% (20/21) adenocarcinomas but also stained 7% (2/28) of mesotheliomas. MAb HMFG‐2 reacted positively with 95% of adenocarcinomas, but also stained 39% of the mesotheliomas, usually in a membranous pattern. MAbs EMA and PKK‐1 were not found useful in distinguishing mesothelioma from adenocarci‐noma. We conclude that MAbs Leu M‐1 and NP‐2 were both useful in distinguishing mesothelioma from pulmonary adenocarcinoma in that positive staining was demonst

ISSN:0022-4790    

DOI:10.1002/jso.2930450204

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1990

数据来源: WILEY

摘要:

AbstractWe present here our findings on patients with an elevated lesion of the duodenal bulb. All these patients were treated in our clinics between the years 1984 and 1988. These lesions were present in 36 of 8,802 patients who underwent upper gastrointestinal pan‐endoscopy. Two patients had a duodenal carcinoma, 2 an adenoma, and 1 a Brunner's gland adenoma. There were 15 with a hyperplastic polyp, 3 with a heterogenic gastric mucosa, 3 with Brunner's gland hyperplasia, 6 with duodenitis, and 4 with regenerative mucosa. Among these 36 lesions, only 69% (25 lesions) were evident on the upper gastrointestinal X‐ray series. Adenoma and Brunner's gland adenoma were of a pedunculated form of the gross type and had an irregular surface mucosa. Both duodenal carcinomas were detected by endoscopic biopsy and were resected. Histologically, these lesions were limited to the submucosal layer and were of the non‐pedunculated polypoid form, but there were no other characteristic endoscopic features, in comparison with other elevated lesions. Thus, upper gastrointestinal endoscopy with routine observations of the duodenal bulb plus endoscopic biopsy will lead to a definite diagnosis of these elevated lesions and to the early detection and treatment of this rare malignant l

ISSN:0022-4790    

DOI:10.1002/jso.2930450205

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1990

数据来源: WILEY

摘要:

AbstractSeventy‐four adult patients with localized soft tissue sarcomas were treated with radiation therapy following surgery between 1965 and 1988. Fiftythree were treated after the first excision of their tumor with 6 (11.3%) local recurrences. Twenty‐one received radiation after excision of recurrent disease with 11 (52.4%) local failures (P<.0005). Metastatic disease occurred in 14 (26.4%) of the primary tumors and 8 (38.1%) with multiple previous excisions (P<.48). Of those patients treated for primary sarcoma, there were no local failures with pathologically wide margins or if a single margin was microscopically positive. Local failure occurred in 4 of 26 (15.4%) if the tumor was merely enucleated and in 2 of 11 (18.2%) who had grossly positive surgical margins (Pnot significant). Local failure was also more common in truncal locations (33.3%) as compared with extremity locations (8.7%,P=.1359). Additional factors analyzed which adversely affected prognosis included tumor grade, stage, and inadequate radiation d

ISSN:0022-4790    

DOI:10.1002/jso.2930450206

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1990

数据来源: WILEY

摘要:

AbstractOne hundred eight‐five patients with acral melanoma treated since 1972 were reviewed. These included 53 subungual lesions, 123 plantar lesions, and 9 palmar lesions. Eighty percent presented with stage I disease. Mean age was 57 years. Males outnumbered females 1.1:1. Seventeen percent (17%) were blacks. Actuarial 10‐year survival was 58% for stage I patients and 35% for stage II patients. Univariate Cox regression analyses identified 5 prognostic variables affecting survival: stage at diagnosis (P<0.00l), race (P<0.00l), ulceration (P=0.012), Clark's level (P=0.014), and thickness of the primary lesion (P=0.013). Factors unrelated to survival included sex of the patient, site (volar vs. subungual), histology, and treatment with amputation. Multivariate analysis for patients with stage I lesions identified race (P=0.00l) and ulceration (P=0.018) as significant variables, with thickness approaching significance (P=0.094). In an additional series of 71 patients with melanomas arising from extremity sites near the junction of glabrous and non‐glabrous skin, survival was significantly poorer for those arising from glabrous skin (P=0.024), and reflects a higher incidence of metastatic disease at diagnosis. Specific active immunotherapy was the principal adjuvant used for these patients, and survival was comparable to that reported with regional perfusion therapy. Acral melanoma a) has a strong racial predilection, b) carries a grave prognosis, and c) arises from glabrous skin. It is a clinical entity distinct from other extremity melanomas. Surgical management with either wide excision or amputation is appropriate for the primary l

ISSN:0022-4790    

DOI:10.1002/jso.2930450207

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1990

数据来源: WILEY

摘要:

AbstractLong‐term experience with totally implanted catheter systems (TICS) is limited. We retrospectively evaluated the performance and long‐term complications of TICS for intravenous infusion in cancer patients; 134 systems were implanted in 128 patients. The median duration of implantation was 144 weeks with 49 systems implanted for more than one year. Complications related to surgical factors included malposition of reservoir (2%), skin perforation or wound dehiscence (1.5%) and pneumothorax (<1%). Complications not related to surgical factors included: drug extravasation (1.5%), mechanical malfunction (1.5%), vein thrombosis (<1%), clotting of the reservoir or catheter (2%), skin infection (1.5%), and sepsis (<1%). The total complication rate was 13%. Most complications resolved spontaneously or with medical treatment and only 6 patients (4.6%) required re‐implantation of a second system. We conclude that with long‐term usage of TICS, the complication rate remains low, making it a safe and viable alternative for patients requiring long‐term intravenou

ISSN:0022-4790    

DOI:10.1002/jso.2930450208

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1990

数据来源: WILEY

摘要:

AbstractWe performed a prospective study on the correlation of various parameters of the immune response with the 5‐year survival rate in patients with bronchogenic carcinoma. Parameters were initially examined before starting treatment. Delayed hypersensitivity skin tests, lymphoblastogenesis, natural killer (NK) cell activity, and interleukin‐2 (IL‐2) production were employed to assess immune competence. Each reaction was classified into four or five grades in accordance with intensity; the 5‐year survival rate of the patients showing each grade of the immune response was calculated. A correlation between response before treatment and the survival rate was most clearly noted for lymphoblastogenesis. The skin tests and the NK cell activity showed poorer correlations, and no exact correlation was noted between the IL‐2 production and the immune

ISSN:0022-4790    

DOI:10.1002/jso.2930450209

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1990

数据来源: WILEY

摘要:

AbstractProstaglandin E (PGE) has long been incriminated as a cause of the immunosuppression seen in cancer patients and for the increased rates of tumor growth due to the impairment of the immunologic response to the tumor. We have investigated the effect of PGE on tumor‐host interaction by utilizing a parenterally administered long‐acting PGE derivative, 16,16‐dimethyl‐prostaglandin E (dPGE). Administration of dPGE was found to decrease the rate of tumor growth but at a cost of decreasing tumor‐free body mass. The dPGE did not alter resting metabolic rates but did alter some parts of brain dopamine metabolism and significantly decreased the serum level of multiple amino acids. In conclusion, elevated PGE levels may significantly alter metabolism in tumor

ISSN:0022-4790    

DOI:10.1002/jso.2930450210

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1990

数据来源: WILEY

摘要:

AbstractMedical records of seven patients treated within a 20 year period for malignant melanoma during pregnancy were reviewed. No significant detrimental prognostic effects could be attributed to pregnancy. The current literature on melanoma and pregnancy is discussed. Based on this, pregnancy seems not to be contraindicated in melanoma patients.

ISSN:0022-4790    

DOI:10.1002/jso.2930450211

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1990

数据来源: WILEY

摘要:

AbstractDuring the years 1975‐1988, twenty lung cancer patients with symptomatic pericardial effusion were treated conservatively at our center. Echocardiography demonstrated small pericardial effusion in 2 patients, medium size effusion in 3 patients and large amount of fluid in 15 patients. Fifteen patients developed cardiac tamponade; in three of these patients, this was the presenting manifestation of lung cancer. Pericardiocentesis resulted in prompt, though temporary, symptomatic relief in all patients. Fluid cytology demonstrated suspected malignant cells in 2 patients and malignant cells in 13 patients. Based on cytology, the diagnosis of adenocarcinoma was established in six patients, small cell carcinoma in three patients, and epidermoid carcinoma in one patient. All patients were dead within 9 months from the time of diagnosis of pericardial effusion; 17 died within less than 3 months. It is concluded that pericardial effusion in lung cancer is indicative of rapid tumor progression and short survival. Fluid cytology provides an immediate and accurate means of diagnosi

ISSN:0022-4790    

DOI:10.1002/jso.2930450212

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1990

数据来源: WILEY