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Biomedical subjects

H B Neel

Publications and source records attributed to H B Neel.

121 records · Page 7Linked to original sources
PubMedDate not supplied

Antibodies to Epstein-Barr virus in patients with nasopharyngeal carcinoma and in comparison groups.

One hundred fifty-one patients with nasopharyngeal carcinoma (NPC) were enrolled in a prospective collaborative study of North American patients (most were white). Serum samples were collected concurrently from 903 Mayo patients for comparisons of serologic analyses. Both IgA antiviral capsid antigen [VCA (IgA)] and the anti-early antigen [EA (D)] antibody responses were associated with diagnosis, but not always in the same way. Both responses were positive in 85% of patients with World Health Organization types 2 and 3 NPC. Only 16% with WHO type 1 NPC had positive IgA responses and only 35% had positive EA (D) responses, prevalences close to those in the comparison groups. Increased titers were found in the squamous carcinoma comparison group with tumors of the tongue and in the group with benign nasal polyps (p less than 0.01). We believe that the tests are specific, sensitive, and useful in diagnosis and treatment planning in patients with NPC, particularly those with occult primary NPC.

Antibodies, Viral↗
PubMedDate not supplied

Prognostic determinants and a new view of staging for patients with nasopharyngeal carcinoma.

There is no agreement on the single best staging system for patients with nasopharyngeal carcinoma. We have evaluated prospectively several staging systems and have assessed the predictive value of many variables on survival and found that the most important are extensive tumor within the nasopharynx or regional extension, nodes in the lower portion of the neck, and cranial nerve involvement. Other variables that have not been used in traditional extent of disease staging systems but that have an adverse bearing on survival have been studied by multiple regression techniques in the Cox proportional hazards model. Two prognostic scores, which can be used for classifying patients into survival groups, ranging from excellent survival (low score) to poor survival (high score), have also been presented. With these schemes, patients who are at high risk for recurrence after conventional therapy can be reliably selected.

Carcinoma↗
PubMedDate not supplied

Neural and neuroendocrine tumors of the larynx.

Benign and malignant neural and neuroendocrine tumors of the larynx are uncommon enough that knowledge about them is sparse, coming from single case reports and literature reviews. We have reviewed the clinical behavior, pathologic findings, treatment, and outcome in 42 patients seen at one institution from 1907 to 1986. In some cases, electron microscopy or immunocytochemistry, or both, may be needed to reach the correct diagnosis. Treatment is largely determined by the histopathologic features, size, and location of the tumor. The most common sites are the supraglottic region and posterior larynx. Most tumors are treated by conservation surgery, including transoral excision; however, some are aggressive and require larger surgical procedures, including wide-field laryngectomy and complete neck dissection.

Adolescent↗
PubMedDate not supplied

Immunovirologic assessment of American patients with nasopharyngeal carcinoma and occult primary tumors.

The Epstein-Barr virus (EBV) is closely associated with nasopharyngeal carcinoma, suggesting an etiologic relationship. We have under-taken studies (1) to quantitate the relationship between antibody titers to EBV-associated antigens and nasopharyngeal carcinoma in American patients since most of the patients in previous studies were of either Asian or African descent and (2) to determine the relationship between antibody titers and the clinical course of the disease. Sera from patients with primary or recurrent nasopharyngeal carcinoma and from patients in remission, from patients with various other head and neck tumors (including occult primary lesions and lymphomas), and from normal controls were titrated for IgG antibodies to viral capsid antigen (VCA) and early antigen and IgA antibodies to VCA, using indirect immunofluorescence procedures previously detailed. High titers of antibodies to EBV-induced early antigens and VCA in the IgG fraction and VCA in the IgA fraction were frequently found in the sera of patients with nasopharyngeal carcinoma. A significant reduction in these titers was observed with clinical remission of the disease in treated patients. Preliminary findings suggest that EBV serology may be useful in the evaluation and treatment of patients with nasopharyngeal carcinoma and also in patients with cervical metastases from clinically occult promary sites in order to identify those with occult nasopharyngeal carcinoma.

Antibodies, Viral↗
PubMedDate not supplied

Immunoglobulin A antibody to Epstein-Barr viral antigens and prognosis in nasopharyngeal carcinoma.

IgA immunoglobulin fractions containing antibodies to Epstein-Barr virus (EBV)-induced membrane antigens were isolated from the sera of two patients with nasopharyngeal carcinoma (NPC), from one non-NPC patient, and from three persons with sera negative for IgA antibodies. IgA antibodies were not cytotoxic against cells expressing EBV-induced membrane antigens in the antibody-dependent cellular cytotoxicity (ADCC) assay. However, IgA antibodies blocked IgG-mediated ADCC, which indicated that these antibodies could serve as a blocking "factor" in patients with disease and, therefore, were potentially detrimental to the host.

Antibodies, Viral↗
PubMedDate not supplied

Correlation of preoperative immunologic test results with recurrence in patients with head and neck cancer.

Numbers and percentages of T and B cells in peripheral blood; blastogenic responses to PHA, Con A, and PWM; and serum levels of albumin, total protein, and IgA were assessed in patients with stages I to III operable squamous cell carcinoma of the upper aerodigestive passageways in the head and neck. The patients were categorized into two groups: those who remained tumor free and those in whom cancer recurred. It was found that pretreatment PHA- and Con A-induced blastogenesis was often depressed in patients in whom clinically apparent recurrences developed regardless of stage or nodal involvement. This point is consistent with the idea that cellular immune function (blastogenesis) can identify, within the clinical staging system (TN), subpopulations of patients who are less likely to survive after conventional therapy.

B-Lymphocytes↗
PubMedDate not supplied

Laryngofissure and cordectomy for early cordal carcinoma: outcome in 182 patients.

At the Mayo Clinic from 1962 to 1974, 182 patients with early squamous cell cancer of the true vocal cord were treated by laryngofissure and cordectomy. Seven patients (4%) had recurrences: four in the larynx and three in the neck (although the larynx was free of disease). The case histories of these patients are reported. Only three (2%) of the patients died as a consequence of their laryngeal cancer. The data substantiate our belief that the laryngofissure and cordectomy operation, and its minor variations, is an expeditious and highly successful means of eradicating glottic cancers.

Adult↗
PubMedDate not supplied

Nasal manifestations of allergic granulomatosis and angiitis (Churg-Strauss syndrome).

The tetrad of bronchial asthma, nasal disease, eosinophilia, and systemic vasculitis is the main feature of allergic granulomatosis and angiitis. Twenty-two of 32 patients (69%) with this disorder had nasal manifestations, including nasal polyps, thick crusts, rhinitis, sinusitis, and occasionally septal perforations. Histopathologic study of involved tissue from the nose or subcutaneous nodules in conjunction with clinical evaluation will aid in establishing the correct diagnosis. Treatment with corticosteroids favorably influences symptoms and prognosis.

Adolescent↗
PubMedDate not supplied

Immunologic detection of occult primary cancer of the head and neck.

Because antibody titers against Epstein-Barr virus (EBV) antigens often are elevated in patients with active undifferentiated and nonkeratinizing nasopharyngeal carcinoma, anti-EBV serologic tests have been applied as a diagnostic aid in patients who have metastatic lymphadenopathy in the neck without an obvious source. IN this study of 44 patients, the serologic testing procedure proved useful in identifying six patients with nasopharyngeal carcinoma that was initially occult but was eventually confirmed by biopsy.

Adolescent↗
PubMedDate not supplied

Immunologic studies on cancer of the upper aerodigestive tract.

Two interesting findings have emerged from these studies. First, the NK susceptibility of EBV-related cell lines is dependent upon the state of the virus within the cells. EBV-positive cells were more competitive than their EBV-negative counterparts, and induction of the viral cycle in the EBV-positive cells further increased their ability to inhibit NK reactivity against K562. The implications of this finding with regard to surveillance against, and treatment of, EBV-related disease were discussed. Second, the preliminary data concerning the NK status of patients with head and neck cancer appear interesting, with the patients falling into two relatively distinct clusters of either high or low reactivity. The significane of this clustering will be determined by enlarging the study sample and performing longitudinal NK studies of the patients.

Animals↗