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Biomedical subjects

M A Luna

Publications and source records attributed to M A Luna.

At least 55 records · Page 3Linked to original sources
PubMed1995

c-erbB-2/neu oncogene and Ki-67 analysis in the assessment of palatal salivary gland neoplasms.

To evaluate the role of the Ki-67 proliferation antigen and c-erbB-2/neu oncogene expression in the clinical assessment of salivary gland tumors, we followed up 71 patients with minor salivary tumors of the palate. All benign neoplasms (n = 18) showed low Ki-67 scores (< 12%), whereas 26% (14 of 53) of malignant neoplasms manifested high Ki-67 scores (> 12%). A significant statistical difference between Ki-67 scores for benign and malignant neoplasms was observed (p < 0.001). Ki-67 index also correlated significantly with malignant tumor grade (p = 0.04) and patient survival (p = 0.02). Only 1 of the 18 benign tumors had c-erbB-2/neu oncogene overexpression. A significant difference between c-erbB-2/neu overexpression in benign and malignant tumors was observed (p = 0.01). Overexpression of c-erbB-2/neu oncogene was noted in 38% (16 of 42) of malignant tumors and was significantly associated with aggressive tumor behavior (p < 0.001). Multivariate analysis of significant factors revealed that gender, tumor stage, and c-erbB-2/neu oncogene overexpression were jointly predictive of survival. Our data indicate that although the Ki-67 proliferating antigen and c-erbB-2/neu oncogene expression may reflect certain intrinsic biologic properties of these neoplasms, only c-erbB-2/neu overexpression is significantly associated with their biologic aggression.

Adolescent↗
PubMed1995

Terminal duct adenocarcinomas of the parotid gland.

The major salivary glands are considered to rarely be the sites of primary terminal duct adenocarcinomas, a neoplasm with a considerable predilection for origin from intraoral minor salivary glands. We present a clinicopathological study of 22 terminal duct adenocarcinomas of the parotid gland, the largest single series to date. A comparison between the parotid neoplasms and over 200 minor salivary gland terminal duct adenocarcinomas indicates there is little difference in biological behaviour and confirms the low-grade quality of the carcinomas, regardless of site of origin.

Adenocarcinoma↗
PubMed1995

Epithelial-myoepithelial carcinoma of salivary glands. A clinicopathologic, DNA flow cytometric, and immunohistochemical study of Ki-67 and HER-2/neu oncogene.

Thirty-one salivary gland epithelial-myoepithelial carcinomas from 26 patients were studied by DNA flow cytometry, and immunostaining for Ki-67 and HER-2/neu oncogene product. The results were correlated with clinicopathologic factors and patient outcome. The tumor most commonly involved the parotid gland, and mainly affected patients in their 6th to 8th decades. The clinical course was characterized by a high incidence of local recurrence (50%) and not infrequent distant metastasis (25%). None of the patients in this cohort died of disease. DNA content analysis revealed 21 neoplasms with DNA diploidy and 5 tumors with DNA aneuploidy; all aneuploid cases were near-diploid (hyperdiploidy) and showed low proliferative activity. All aneuploid and 60% of the diploid neoplasms developed recurrences and/or metastases. Immunohistochemical analysis of Ki-67 proliferation markers also showed low overall growth fractions. Interestingly, Ki-67 immunoreactivity was largely restricted to myoepithelial cells, suggesting a central role for this cell in the development of these tumors. HER-2/neu oncogene analysis failed to demonstrate overexpression in any of the tumors examined. This study indicates that epithelial-myoepithelial carcinoma is a low grade malignant neoplasm with a high propensity for recurrence. HER-2/neu oncogene and Ki-67 offer no additional advantages over current factors in the biologic evaluation of these neoplasms. DNA aneuploidy may allow for the identification of a subset of tumors that is more prone to recurrence and metastasis, but further studies with extended follow-up are needed.

Adolescent↗
PubMed1995

Respiratory syncytial virus pneumonia in hospitalized adult patients with leukemia.

Respiratory syncytial virus (RSV) has been demonstrated to be an important cause of life-threatening pneumonia in adult bone marrow transplant recipients; however, its role in other immunocompromised adults has not been defined. We prospectively studied all adult patients with leukemia who were hospitalized at M. D. Anderson Cancer Center (Houston) during a 1-year period (November 1993 through October 1994). During a 19-week period when RSV was prevalent in the community, it was isolated from 9 (10%) of 87 patients with leukemia who developed an acute respiratory illness. In 6 (75%) of 8 patients with profound chemotherapy-induced myelosuppression, the RSV infection was complicated by pneumonia, with an 83% mortality rate. RSV appears to be an important cause of severe and often fatal pneumonia in myelosuppressed patients with leukemia.

Acute Disease↗
PubMed1995

"Inflammatory pseudotumor": what is it? How does it behave?

Inflammatory pseudotumor, as a histologic diagnosis and carrying with it the prospect of a benign clinical course, is rather firmly entrenched as a pulmonary lesion. Extrapulmonic forms, however, are farraginous and, as reported, have included lesions having few, or even none, of the histologic features of those in the lungs. For those more closely aligned with the fibroblastic or myofibroblastic phase of the lung lesions, their biologic behavior can belie their histology in that they can be locally aggressive and metastasize as sarcomas. For those tumors in the upper airway, and especially in the abdomen, pathologists should be very circumspect in the use of inflammatory pseudotumor as a diagnosis, and clinicians should not be lulled into denying the extrapulmonic forms their due respect.

Granuloma, Plasma Cell↗
PubMed1995

Teratomas of the head and neck with emphasis on malignancy.

The great majority of teratomas of the head and neck present in the neonate or infant and are biologically benign and yet with a high mortality because of their space-occupying and obstructive character. Teratomas in the adult neck and sinonasal tract are histologically and biologically malignant, with an often unpredictable response to therapy.

Adult↗
PubMed1995

Minor salivary gland tumors of the palate: clinical and pathologic correlates of outcome.

Minor salivary gland tumors of the palate are rare and may pose a diagnostic and therapeutic dilemma for the head and neck surgeon. The authors reviewed their 46 years of experience with minor salivary gland tumors of the palate to determine the factors that influence outcome and their implications for treatment. Malignant tumors were seen in 116 patients (78%) and benign tumors were found in 33 patients (22%). Adenoid cystic carcinoma was the most common malignant tumor, occurring in 43 patients, and pleomorphic adenoma was the most common benign tumor, occurring in 30 patients. Univariate analysis on the malignant lesions showed that grade 3 tumor histology (P < .001), tumor size greater than 3 cm (P < .001), perineural invasion (P = .031), bone invasion (P = .012), positive surgical margins (P < .001), and positive initial but negative final margins (P = .004) were all associated with decreased survival. With multivariate analysis, tumor size, margin status, and grade were shown to be independently associated with decreased survival (P < .05). The recurrence rate at the primary site was significantly higher for adenoid cystic carcinoma than for other histologies (P = .0059). The 2-, 5-, and 10-year disease-specific survival rates for patients with malignant disease were 96%, 87%, and 80%, respectively. Wide surgical excision with adequate margins is essential for a favorable outcome in patients with malignant minor salivary gland tumors. Postoperative radiotherapy is reserved for patients with grade 3 tumor histology, large primary lesions, perineural invasion, bone invasion, cervical lymph node metastasis, and positive margins, although a clear-cut survival advantage has not been proven. Recurrence, especially regional and distant metastasis, portends an extremely poor prognosis.

Adenoma, Pleomorphic↗
PubMed1995

Small-cell epidermoid carcinoma with melanocyte colonization arising in a mature ovarian cystic teratoma.

A case of small-cell epidermoid carcinoma, a rare tumor of the aerodigestive tract, is presented arising in a mature cystic teratoma of the ovary in a 69-year-old woman. Microscopically the small-cell epidermoid carcinoma had a uniform cell population with focal differentiation into keratinous cells. Both the small and keratinized cells were positive for epithelial membrane antigen and CAM 5.2 but negative for vimentin and neuroendocrine markers. This tumor is different from other recently described primary and metastatic small-cell tumors of the ovary. Furthermore, this small-cell epidermoid carcinoma behaved in a nonaggressive fashion. Melanocyte colonization seen in the small-cell epidermoid carcinoma areas of the tumor was a result of its invasion of preexistent areas of a teratoid blue nevus. The staining pattern of HMB-45 demonstrated that pigment was transferred to, but not produced by, the neoplastic small cells.

Aged↗
PubMed1995

Combination therapy with aerosolized ribavirin and intravenous immunoglobulin for respiratory syncytial virus disease in adult bone marrow transplant recipients.

Respiratory syncytial virus (RSV) infections in adult BMT recipients are frequently complicated by fatal pneumonias. Therapy of RSV pneumonia with aerosolized ribavirin alone has been reported to be associated with a 70% mortality rate. Because immune globulin therapy has been reported to be beneficial, we conducted a prospective trial of combination therapy with aerosolized ribavirin and intravenous immunoglobulin (IVIG). Aerosolized ribavirin was administered at 20 mg/ml for 18 h a day and IVIG was administered at 500 mg/kg every other day for the length of ribavirin therapy. Four lots of IVIG were chosen with RSV microneutralization Ab titers of 1:2048 to 1:8102. Between 8 January and 3 March 1993, during a community outbreak, 19 (45%) of 42 hospitalized adult BMT recipients with an acute respiratory illness were documented to have RSV disease. Two-thirds of these infections were hospital-acquired. All 19 patients presented with signs and symptoms of an upper respiratory tract illness. Sixteen patients developed pneumonia. The mortality was 22% in nine patients with pneumonia in whom therapy was initiated prior to the onset of profound respiratory failure. In contrast, the mortality was 100% in three patients with pneumonia in whom therapy was initiated within 24 h of respiratory failure requiring mechanical ventilation and in four untreated patients. We conclude that RSV may cause devastating outbreaks of severe pneumonia among hospitalized adult BMT recipients. Early diagnosis and combination therapy with ribavirin and IVIG was associated with a favorable outcome.

Administration, Inhalation↗
PubMed1994

PRAD-1 (CCND1)/cyclin D1 oncogene amplification in primary head and neck squamous cell carcinoma.

BACKGROUND: Abnormalities in chromosome 11q13 regions have been frequently found in head and neck squamous carcinoma. Recent studies indicate that the PRAD-1 (also CCND1), which encodes cyclin D1, is a putative oncogene that is an important component of this region. METHODS: DNA was extracted from 32 snap-frozen specimens from primary head and neck squamous carcinomas. DNA from peripheral blood lymphocytes, normal mucosa, and salivary gland tissue were used as controls. A genomic DNA probe containing the first exon of PRAD-1 was used for hybridization with specimen DNAs by the Southern technique. A 5.6-kb genomic DNA probe of immunoglobulin heavy chain was used as an internal standard for assessing PRAD-1 amplification. RESULTS: Eleven (34.4%) squamous carcinoma specimens showed PRAD-1 amplification (2- to 10-fold). Although no significant statistical correlation among amplification status, grade stage, and DNA ploidy was observed in this small cohort, amplification was more noted in high grade, high stage, and aneuploid tumors. A highly statistical correlation between PRAD-1 amplification and proliferative activity was noted (P > 0.001). CONCLUSION: The results of this study indicate that PRAD-1 amplification appears to be a late event in the tumorigenesis of head and neck carcinoma and is associated often with a subset of aggressive tumors and high proliferation neoplasms.

Aneuploidy↗
PubMed1994

Prognostic factors in mucoepidermoid carcinomas of major salivary glands: a clinicopathologic and flow cytometric study.

Mucoepidermoid carcinomas (MEC) of the major salivary glands from 48 patients who received their treatment at a single institution were studied for prognostic indicators. Uni- and multivariate statistical analyses were performed on several clinicopathologic factors and also on flow cytometric (FCM) DNA content data of the carcinomas. Clinical prognostic factors associated with decreased survival included age > 60 years (P = 0.01), male gender (P = 0.002), symptoms at diagnosis (P = 0.03), stage of disease (P < or = 0.0001), type of surgery (P = 0.0006), and recurrence (P = 0.0001). Histopathological prognostic factors associated with decreased survival included MEC tumour grade (P = 0.0001), tumour size > 3.0 cm (P = 0.02), lymph node involvement (P = 0.0004) and positive surgical margins (P = 0.007). DNA FCM factors associated with decreased survival included aneuploid tumours (P = 0.08) and proliferative activity (S+G2M > 5%, P = 0.07). Multivariate analysis indicated that histological grade, proliferative activity, symptoms at diagnosis, clinical stage of disease and type of surgery were significant (P < or = 0.05) prognostic/survival factors in the biological assessment of this neoplasm.

Adolescent↗
PubMed1994

Hyalinizing clear cell carcinoma of salivary origin.

The recently described hyalinizing clear cell carcinoma of salivary tissues joins other clinicopathologic entities in its segregation from the formerly nondescript and heterogeneous classification "clear cell neoplasms." The carcinoma is preponderantly an intraoral (palate and base of tongue) neoplasm that is always infiltrative and capable of regional lymph node metastasis. To date, it has responded to locoregional control treatments and has not been life-consuming.

Adenocarcinoma, Clear Cell↗
PubMed1993

Polymerase chain reaction-based restriction fragment length polymorphism analysis of the short arm of chromosome 3 in primary head and neck squamous carcinoma.

BACKGROUND: Deletion or loss of heterozygosity (LOH) at the polymorphic loci on the short arm of chromosome 3 has been reported in a large number of renal cell, small cell lung, non-small cell lung, and cervical carcinomas, suggesting the presence of one or more putative tumor suppressor genes at chromosome 3p. Similar studies in primary head and neck carcinoma are lacking. METHODS: To investigate the possibility of chromosome 3p deletions, the authors applied a polymerase chain reaction (PCR)-based, restriction fragment length polymorphism analysis, in conjunction with conventional Southern blot techniques, to DNA samples of matched normal mucosa and head and neck squamous cell carcinomas from 18 patients. The authors also assessed the merit of the PCR-based assay as a rapid screening tool, particularly in assaying limited tissue samples. RESULTS: Constitutional heterozygosity at the polymorphic loci varied in the 18 normal samples that the authors studied: 12 at the D3F15S2 locus (on telomeric 3p21), 7 at the D3S32 locus (on centromeric 3p21), and 9 at the THRB locus (on 3p24). In 18 matched carcinoma specimens, LOH (deletion) was observed at D3S32 in 0 of 7, at D3F15S2 in 9 of 12 (75%), and at THRB in 3 of 9 cases (33%). CONCLUSIONS: The results of the PCR-based assay and Southern blotting were completely concordant in all specimens the authors studied. This study indicates that deletion at 3p is a frequent abnormality in primary head and neck carcinoma and that the most common deletion region is telomeric to D3S32. The authors also observed an apparent correlation among poor histologic differentiation, DNA aneuploidy, and 3p deletions. Most poorly and moderately differentiated and aneuploid carcinomas manifested the 3p deletion. Therefore, the authors suggest an association between deletion at 3p and aggressive biologic behavior.

Aged↗
PubMed1993

Regression of oral leukoplakia with alpha-tocopherol: a community clinical oncology program chemoprevention study.

BACKGROUND: Oral leukoplakia is an important model for developing chemoprevention approaches for lesions in the upper aerodigestive tract. These lesions most often result from exposure to carcinogens such as tobacco and alcohol and may precede development of invasive cancer. The potent antioxidant alpha-tocopherol (vitamin E) has prevented the development of cancers of the oral cavities in animal models. PURPOSE: The objectives of this study were to evaluate the toxicity and efficacy of alpha-tocopherol in patients with oral leukoplakia and to assess the feasibility of performing chemoprevention trials through the network of the Community Clinical Oncology Program (CCOP). METHODS: A single-arm phase II study using the nontoxic agent alpha-tocopherol to treat oral premalignant leukoplakia was performed at seven institutions affiliated with the CCOP through The University of Texas M. D. Anderson Cancer Center. Patients with symptomatic leukoplakia or dysplasia were treated orally with alpha-tocopherol (400 IU) twice daily for 24 weeks. Follow-up was performed at 6, 12, and 24 weeks after the start of treatment to assess toxicity and response, and serum alpha-tocopherol levels were determined at baseline and at 6 and 24 weeks. RESULTS: Of the 43 patients who have completed 24 weeks of treatment, 20 (46%) had clinical responses and nine (21%) had histologic responses. Mean serum alpha-tocopherol levels were 16.1 micrograms/mL at baseline and increased to 34.29 micrograms/mL after 24 weeks of treatment. Patient-recorded drug calendars, as well as serum drug levels, indicated excellent patient compliance; an average of 95% of the prescribed pills were taken. Treatment was extremely well tolerated; no grade 3 or 4 toxic effects were reported. CONCLUSIONS: Administration of alpha-tocopherol resulted in both clinical and histologic responses in premalignant leukoplakia lesions. The study also demonstrated that chemoprevention trials can be performed through the CCOP. The major problems were that a high percentage of patients were not assessable for response, some patients withdrew because expenses were not reimbursable, and there was limited participation within the CCOP network. These problems may reflect difficulties inherent in the implementation of multi-institutional chemoprevention trials. IMPLICATIONS: The efficacy of alpha-tocopherol alone and in combination with other chemopreventive agents for carcinogenesis in the upper aerodigestive tract should be explored in future trials.

Alcohol Drinking↗
PubMed1993

Predicting occult lymph node metastasis in parotid cancer.

To determine the factors predictive of occult cervical metastases, we retrospectively reviewed the charts of 99 previously untreated patients with a primary parotid malignancy who underwent elective neck dissection between 1960 and 1985. Univariate and multivariate analyses were performed to determine the predictive value of 11 factors. The univariate study found facial nerve paralysis, extraparotid extension, and perilymphatic invasion statistically significant. In the multivariate analysis of preoperative factors, facial nerve paralysis was most predictive of occult disease. If the variable pool was expanded to include a fine-needle biopsy, tumor grade became the most important preoperative variable. When the analysis was further expanded to include a parotidectomy, the most influential factors were patient age, perilymphatic invasion, and extraparotid tumor extension. This report identifies the variables predictive of occult neck disease in parotid cancer.

Adolescent↗
PubMed1993

Intraoral presentation of anaplastic large-cell Ki-1 lymphoma in association with HIV infection.

Persons infected with human immunodeficiency virus have an increased risk for development of high-grade, non-Hodgkin's lymphomas. Anaplastic large-cell Ki-1 lymphoma is a recently described lymphoid neoplasm characterized by cellular pleomorphism, a sinusoidal growth pattern, and Ki-1 epitope reactivity. This type of lymphoma is often mistaken for metastatic carcinoma, melanoma, or malignant histiocytosis. Although persons with acquired immunodeficiency syndrome frequently have non-Hodgkin's lymphoma at extranodal sites, the oral cavity and mandible, in particular, are unusual locations. We report two cases of anaplastic large-cell Ki-1 lymphoma that occurred in persons with the human immunodeficiency virus and with initial presentation as soft tissue masses of the posterior mandible. Immunocytochemical studies were positive for Ki-1 (CD30) in both cases. In situ hybridization for Epstein-Barr virus-deoxyribonucleic acid was positive with tumor cells in both cases. Flow cytometry on paraffin, formalin-fixed tissue revealed tetraploidy and high proliferative fractions that are characteristic of high-grade lymphomas. Intraoral presentation of rapidly enlarging, soft tissue masses may represent a high-grade non-Hodgkin's lymphoma in persons with the human immunodeficiency virus. Although rare, anaplastic large-cell Ki-1 lymphoma should be considered and requires immunocytochemical study to eliminate the possibility of other malignant conditions associated with the acquired immunodeficiency syndrome.

Adult↗
PubMed1993

Rhabdomyosarcoma of the adult head and neck: a clinicopathological and DNA ploidy study.

We investigated the DNA ploidy patterns in thirteen primary and four recurrent rhabdomyosarcomas of the head and neck from thirteen adult patients and correlated the findings with other clinicopathological factors and clinical outcome. Twelve (92.7 per cent) of the primary neoplasms manifested an aneuploid DNA pattern, five had more than one stemline, and one neoplasm displayed a diploid DNA pattern. All recurrent lesions were DNA aneuploid with DNA indices (DIs) corresponding to their primary neoplasms. No correlation between the ploidy pattern and histological subtypes, tumour location, clinical stage and patient's clinical course was found. In this study, only two patients were long-term survivors. Both patients had stage I neoplasms that were located in non-parameningeal sites which manifested an alveolar histological pattern. Our data indicate that adult rhabdomyosarcomas of head and neck are preponderantly DNA aneuploid and are highly aggressive malignant neoplasms. Our results also suggest that tumours which are low stage and in a non-parameningeal location may pursue a less aggressive course.

Adolescent↗