Micrometastases in axillary lymph nodes and bone marrow of lymph node-negative breast cancer patients--prognostic relevance after 10 years.

The long-term prognostic significance of immunohistochemically detectable occult tumor cells in bone marrow and axillary lymph nodes of breast cancer patients considered to be lymph node-negative in multilevel haematoxylineosin (H&E) lymph node sectioning was analyzed. A total of 212 patients with a median follow-up of 10.3 years were included in the study.

Role of gonadotropins in malignant progression of sex cord stromal tumors produced by sequential auto- and isogenic transplantation of ovarian tissue in ovariectomized rats.

Purpose: In this study the effect of continuous stimulation of gonadotropins on sex cord stromal tumors in the rat was examined.

Methods: Sex cord stromal tumors were induced by transplantation of ovaries under the splenic capsule of ovariectomized rats. Beginning 180 days after transplantation, these tumors were taken out and cut into several pieces, which were then retransplanted (by isotransplantation) under the splenic capsule of 80 either intact or ovariectomized rats.

[Interventional methods in breast diagnosis. Histological vs. cytological evaluation of core cut biopsies of the breast].

High speed core cut biopsies of breast tumors, sonographically or stereotactically guided, allow an histological examination of the tumor without surgery. It can be used prior to operation for the confirmation of a breast cancer and it can avoid unnecessary breast surgery in benign tumors. Unfortunately, only some centers are equipped with a pathology unit that allows an immediate histological examination.

Biological and prognostic significance of stratified epithelial cytokeratins in infiltrating ductal breast carcinomas.

The biological significance of the differential expression of cytokeratin (CK) polypeptides in breast carcinomas is unclear. We examined the CK profiles of 101 primary infiltrating ductal breast carcinomas using monoclonal antibodies directed against 11 different CKs and against vimentin. Two major CK phenotypes were distinguished: first, a phenotype expressing only the simple-epithelial CKs 7 (variably), 8, 18 and 19, and secondly, a bimodal phenotype co-expressing significant amounts of one or more of the stratified-epithelial CKs 4, 14 and 17.

[Basaloid squamous epithelial carcinoma of the mouth mucosa].

The basaloid-squamous carcinoma (BSC) that was first described in 1986 by Wain et al. for the head and neck region is a rare distinct variant of squamous cell carcinoma (SCC). The cardinal histopathologic feature is a biphasic cellular pattern of basaloid and squamous components.

Correlation of high lactate levels in head and neck tumors with incidence of metastasis.

Using quantitative bioluminescence imaging, tissue concentrations of ATP, glucose, and lactate were registered in biopsies that were taken from primary tumors of human head and neck at the time of first cancer diagnosis. From 15 patients investigated at present, 6 had locoregional lymph node metastasis, 6 had no detectable metastatic spread, 2 biopsies contained dysplasias, and 1 biopsy consisted exclusively of normal mucosal and submucosal tissue. There was no correlation between staging or grading and any of the metabolic parameters measured.

[Interventional techniques in breast diagnosis: ultrasound controlled puncture biopsy].

From May 1, 1992 to April 30, 1993, we performed 307 ultrasonic guided, high-speed core cut biopsies. In 119 of the 307 women, we dispensed with further surgical and histological procedures when the tentative diagnosis from complementary mammary diagnostic procedures revealed no pathological findings and concurred with the histological results of the core cut biopsy. In 188 women, the biopsy was followed by surgical intervention and correlation of the histological findings.

Autoimmune findings resembling connective tissue disease in a patient with Castleman's disease.

Multicentric angiofollicular lymphnode hyperplasia (multicentric Castleman's disease) may be associated with acute phase reaction and several autoimmune features. Since lymphadenopathy is a common feature in connective tissue disease, a clear distinction between the different disease entities may be difficult. We describe a 26-year-old male patient with predominant cervical lymphadenopathy, hepatosplenomegaly and polyserositis, diagnosed as collagen disease.

Association between tumor hypoxia and malignant progression in advanced cancer of the uterine cervix.

Experimental tumors contain a significant fraction of microregions that are chronically or transiently hypoxic. Experimental evidence showing that hypoxia (and subsequent reoxygenation) may have a profound impact on malignant progression and on responsiveness to therapy is growing. The clinical relevance of tumor oxygenation in human solid malignancies is under investigation.

[Stent implantation as a palliative therapeutic measure in stenosing tumors of central airways].

Purpose: Stent implantation was used to treat patient with malignant tracheobronchial obstructions to determine the effectiveness in producing symptomatic palliation.

Methods: 18 patients (15 men and three women; median age 57 years) with malignant tracheobronchial stenosis were treated by application of metal stents (15 Palmaz-, 10 Gianturco-, 4 Wallstents). The indication for stent implantation was given in 13 patients by clinically significant dyspnea, besides in 5 patients by therapy resistant postobstructive pneumonia.

[Upper inflow congestion as initial manifestation of idiopathic mediastinal fibrosis].

In about 90% of superior vena caval obstructions the cause is a neoplasm, generally a carcinoma of the right upper lobe. Fewer than 5 percent are due to inflammatory disease of the mediastinum. A case of idiopathic, fibrosing mediastinitis with occlusion of the superior vena cava is described.

Hypoxia and Radiation Response in Human Tumors.

This study demonstrates by an updated analysis of an ongoing prospective study that tumor oxygenation, as measured with a validated standardized polarographic needle electrode method before treatment, powerfully predicts the prognosis of patients receiving radiotherapy for intermediate and advanced stage cancer of the uterine cervix. First evidence for a host component in tumor oxygenation based on a significant correlation between median pO(2) values determined in normal subcutaneous fatty tissue and in cervical cancer is also presented. Further investigations are necessary to clarify whether tumor hypoxia is just a marker of intrinsic tumor aggressiveness or whether the negative impact of tumor hypoxia on survival is related to radiobiological mechanisms caused by hypoxia per se, which may include (1) the reduced oxygen enhancement effect, (2) increased radioresistance due to expression of genes for cell cycle delay and stress proteins, and/or (3) accelerated tumor progression to more radioresistant and metastatic variants by increased genetic heterogeneity.

Assessment of myometrial infiltration and preoperative staging by transvaginal ultrasound in patients with endometrial carcinoma.

In recent years, the incidence of carcinoma of the endometrium has shown an upward trend, such that it is currently the most frequently encountered malignant tumor of the female genital tract. An accurate preoperative diagnosis of the extent and spread of such carcinomas is of crucial importance for the selection of a therapeutic approach appropriate to the stage and infiltration of each particular tumor. In a prospective study of 80 patients with a carcinoma of the endometrium, performed at the Department of Obstetrics and Gynecology of the University of Mainz, we compared the preoperative findings of transvaginal sonography with the postoperative histological results with respect to the following parameters: endometrial thickness, demarcation of the boundary of the endometrium, myometrial infiltration depth and staging.

Tumor vascularity--a novel prognostic factor in advanced cervical carcinoma.

Objective: In the search for the optimal treatment of advanced cervical cancer, the identification of valid prognostic factors obtainable without histopathologic investigation of the entire tumor and the locoregional lymph nodes is of paramount interest. Tumor microvessel density has recently been demonstrated to correlate strongly with disease aggressiveness in breast cancer and other malignancies.

Methods: We established a computerized image analysis system to quantify tumor microvascularity by using the closest-individual method, which determines the distribution of distances from random points within the tumor to the closest microvessel (DTCMV).

[Effect of the proliferation rate on the course of node negative breast carcinoma].

In 250 patients with node-negative breast cancer and no systemic adjuvant therapy the impact on the prognosis of the variables age, histological tumour type, tumour size, histological grade, receptor status and localisation of the tumour within the breast, was studied. Patients were followed over a mean period of 60 (range 7-164) months. In a subset of 124 cases additional examination of the growth fraction rate, detected by immunohistochemical determination of antibody Ki-67 and semiquantitative measurement of the stained tumour cell nuclei was performed.

[In vitro NMR spectroscopy of healthy, pathologically changed and carcinomatous breast tissue samples correlated with histological findings].

Of 57 patients with clinically suspected mamma carcinoma 121 samples were analysed by in vitro 1H-NMR spectroscopy at 300 MHz and correlated with histological data. Within the relevant spectral region between 2.7 and 4.

Are pelvic side-wall recurrences of cervical cancer biologically different from central relapses?

Background: By using the Combined Operative and Radiotherapeutic Treatment (CORT) procedure, pelvic side-wall recurrences of gynecologic malignancies arising in a previously irradiated pelvis may be locally controlled. Local control of central relapses may be achieved by exenteration alone. If, in cervical cancer, both relapse patterns are biologically different (as hypothesized by some investigators), distinct disease courses after local treatment may be expected.

Value of routine abdominal and lymph node sonography in the follow-up of breast cancer patients.

Objective: The aim of this study was to review usefulness and intervals for abdominal sonography during the follow-up of breast cancer patients. Additionally, we assessed the value of regional lymph node sonography in patients with possible locoregional recurrence.

Subjects: Retrospectively, 2657 abdominal ultrasound examinations of 414 patients and 299 sonographic examinations of the regional lymph nodes in 227 patients after surgical treatment for breast cancer were evaluated.

[Reliability of imaging procedures in multi-visceral gynecologic operations of the pelvis].

Between March 1989 and December 1992, a total of 85 pelvic exenterations were performed in the Department of Gynaecology and Obstetrics of the University of Mainz. To assess the accuracy of preoperative Magnetic Resonance Imaging (MRI) and Computer Tomography (CT) with regard to tumour localisation and spread, the results of 28 MRI and 14 CT examinations were compared with the postoperative histological findings. For this widely varying patient group that had undergone a broad range of previous treatments, MRI produced an accurate forecast in 56% of cases (CT, 36%).

[Extrapulmonary manifestation of sarcoidosis in the breast].

Sarcoidosis is, pathologico-anatomically speaking, a granulomatous disease that can involve almost any organ. However, a histologically confirmed involvement of the mammary gland after exclusion by differential diagnosis of granulomatous mastitis and mycobacterial or fungal sonographic and mammographic image would rather suggest a fibroadenoma of the breast. However, a malignant process such as for instance a mucinous carcinoma of the breast should always be excluded by differential diagnosis, especially if there are concomitant general symptoms of disease.

Differential loss of E-cadherin expression in infiltrating ductal and lobular breast carcinomas.

The epithelial-specific cell-cell adhesion molecule E-cadherin was analyzed immunohistochemically on tissue sections of 89 human primary infiltrating breast carcinomas, using monoclonal antibodies 6F9 (for cryostat sections) and 5H9 (for cryostat and paraffin sections). The tumors included 41 well and moderately differentiated infiltrating ductal carcinomas (IDCs) most of which (78%) showed strong linear staining at the cell borders at a level, as high as luminal cells of normal mammary glands. The 26 poorly differentiated, more highly malignant IDCs examined also were all positive for E-cadherin, although a higher proportion of them (54%) showed reduced staining, which was heterogeneous and dotted over the cell borders.

Down-regulated beta-adrenoceptors in severely failing human ventricles: uniform regional distribution, but no increased internalization.

In chronic heart failure cardiac beta-adrenoceptors are decreased. In this study we investigated whether a) in severely failing human ventricles beta-adrenoceptors are uniformly decreased or regional variations exist, and b) the beta-adrenoceptor decrease is caused by increased internalization or is a real loss in beta-adrenoceptors. For this purpose we assessed beta-adrenoceptor number and subtype distribution in a particulate fraction (mainly sarcolemmal plasma membranes) and a light vesicle fraction of right and left ventricular segments (obtained by cutting transversal rings of 2 cm from the midventricular regions) of explanted hearts from 2 patients with end-stage congestive dilated cardiomyopathy (DCM) and one patient with end-stage ischemic cardiomyopathy (ICM).

Establishment and characterization of six new human endometrial adenocarcinoma cell lines.

The endometrial carcinoma cell lines EC-MZ-1, 2, 3, 5, 9, and 11 were established between 1986 and 1990. Four cell cultures were started from endometrial tissue, one from ascites, and one from a lymph node metastasis. Lines have to date been subcultured up to 180 times and the doubling time varies between 26 hr and 3 weeks.

Intratumoral pO2 predicts survival in advanced cancer of the uterine cervix.

Experimental evidence suggests that the hypoxic fraction in a solid tumor may increase its malignant potential and reduce its sensitivity towards non-surgical treatment modalities (e.g. standard irradiation, certain anticancer agents).