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Usefulness of aspiration cytology in prostate cancer detection.

Aspiration cytology and core needle biopsy were performed in 79 patients who were suspected of having prostate cancer. Aspiration cytology and TURP were done in 77 cases not suspected of the disease. In the former group, they were both positive in 13 cases, aspiration cytology was negative and core needle biopsy positive in 4, and the reverse in 3 cases in whom cancer was confirmed by repeat core biopsy. All of the latter group were judged by aspiration cytology as being benign. Three cancers were detected by TURP. Aspiration cytology is a recommendable method in subjects with suspected prostate cancer.

Adenocarcinoma↗

[Place of contrast imaging in prostate cancer detection].

Contrast imaging of the prostate is based on rapid-sequence MRI after dynamic Gadolinium injection and contrast ultrasound after injection of microbubbles. MRI can be performed routinely on all available machines. Contrast ultrasound requires specific software not yet available on all machines. The two techniques are designed to improve the reliability of imaging, as a complement to MR spectroscopy, to localize prostate cancer MRI can detect suspicious enhancement in the peripheral zone, but especially in the transitional zone after one or a series of negative posterior biopsies to target a new series of biopsies. The sensitivity and specificity of the technique have yet to be determined. The objective of contrast ultrasound is to improve cancer detection on the first series of biopsies by multiplying sextant biopsies in sites where the contrast kinetics are suggestive of a primary lesion. However, this technique cannot yet be recommended in routine practice, as the modalities of injection of the latest generation of microbubbles (bolus or infusion) need to be evaluated.

Contrast Media↗

The role of the reference radiologist. Estimates of inter-observer agreement and potential delay in cancer detection in the national breast screening study.

The Canadian National Breast Screening Study (NBSS) is a randomized controlled trial to assess the effect of screening on breast cancer mortality. The NBSS designated a single reference radiologist who blindly reviewed over the course of the study 5200 randomly selected two-view mammographic examinations of women not known to have breast cancer. He also reviewed 575 screening-detected breast cancer (SBC) cases and 102 interval breast cancer (IBC) cases. All cancers were histologically proven. As a result of the reviews, comments on inter-observer agreement, interpretation, and technical quality were conveyed on an ongoing basis to radiologists appointed to 15 NBSS screening centers. Agreement of the reference radiologist with center radiologists was better for breast cancer cases (kappa = 0.511, P less than .002) than for those not known to have breast cancer (kappa = 0.307, P less than .002). Observer error and technical problems led to delayed detection in 22% of SBCs and 35% of IBCs. Another 11% of SBCs and 58% of IBCs were probably mammographically occult. No similarly comprehensive review of mammography during a screening program has been published. Suggestions arising from the NBSS review were sometimes resisted by center radiologists. Measures are suggested which might facilitate acceptance of recommendations arising from audit mechanisms in mammography screening programs, thereby enhancing opportunities for mammographic excellence.

Breast Neoplasms↗

[Annual chest X-ray in patients after treatment for laryngeal or oral cancer: only a limited number of second primary lung cancers detected].

OBJECTIVE: To evaluate the detection of second primary lung cancer in patients treated for laryngeal or oral cancer by means of the current annual chest radiography screening program. DESIGN: Retrospective follow-up. METHOD: In a source population of Utrecht University Hospital consisting of patients treated for laryngeal or oral cancer, the occurrence of non-simultaneous second primary lung cancer was analysed. The charts of the patients who developed second primary lung cancer were reviewed with respect to diagnosis (either by means of routine annual chest radiography or triggered by symptoms and signs) and treatment of lung cancer. A Kaplan-Meier survival analysis was performed for both routes of diagnosis and for each form of lung cancer treatment. RESULTS: The source population consisted of 2067 patients. Second primary lung cancer was diagnosed in 44 patients (37 with laryngeal and 7 with oral cancer). In 21 patients lung cancer was diagnosed by means of annual chest radiography (routine group). The remaining 23 patients presented with symptoms and signs (symptomatic group). In 13 patients, surgery with curative intent was performed. These patients had the best prognosis. Of the surgical cases, 12 out of 13 patients (27% of the total of 44) were in the routine group. Patients in the routine group had better survival than those in the symptomatic group. CONCLUSION: In view of the limited number of patients with second primary lung cancer and the small percentage of patients eligible for curative surgical treatment detected by annual radiography, screening in its present form is of little benefit.

Humans↗

Thyroid cancer detected by ultrasound-guided fine-needle aspiration biopsy.

A greater percentage of thyroid cancers can be detected by ultrasound-guided fine-needle aspiration biopsy (UG-FNAB) than by ordinary FNAB. A group of 678 patients were selected sequentially as having been diagnosed with benign nodules by the conventional FNAB method. We reexamined these patients by UG-FNAB and investigated the types of thyroid cancer that were missed by the conventional FNAB. Of the 678 patients diagnosed with benign nodules (using conventional FNAB), 571 (84.2%) demonstrated the same diagnosis when UG-FNAB was used. The remaining 107 patients (15.8%) studied were suspected of having a malignancy after UG-FNAB had been performed. Surgical specimen histology proved thyroid cancer in 99 of the 107 patients: 93 had papillary carcinoma, 4 had follicular carcinoma, 1 had medullary carcinoma and 1 had anaplastic carcinoma. Two drawbacks were noted when conventional FNAB was used: (1) cancer lesions difficult to palpate (n = 55) (e.g., small cancers with or without benign lesions or cancers associated with Hashimoto's thyroiditis or Graves' disease); and (2) palpable cancers with insufficient cell material for analysis (n = 44) (e.g., cystic carcinoma and cancers with calcified lesions. UG-FNAB is a powerful technique for detecting microcancers, cystic carcinomas, cancers associated with benign nodules, Hashimoto's thyroiditis, or coarse calcifications.

Adenocarcinoma, Follicular↗

Fractional allele loss is a valuable marker for human lung cancer detection in sputum.

Using PCR-based microsatellite DNA analysis with 48 markers we examined sputum and bronchial washing for genetic alterations compared with lymphocyte extracted DNA from 124 lung cancer patients and 36 healthy donors as normal control. Microsatellite alterations (MA) in at least one locus were detected in all cancer patient-derived specimens but only in 22.2% of the healthy donors. Loss of heterozygosity (LOH) was detected in bronchial washings from 101 non-small cell lung cancer (NSCLC) predominantly on 17p13.1-p13.3 (69.7%), 9p13.3-p24.1 (63.3%), 1p34.2-p36.22 (48.5%), 13q12.1-q13.1 (47.7%) and 3p22.3-p23 (42.7%). In bronchial washings from 23 small cell lung cancer (SCLC) LOH was detected mostly on 3p22.3-p23 (88.6%), 17p13.1-p13.2 (82.3%), 5q32-q33.1 (66.6%), 13q12.2-q13.1 (65.6%) and 9q22.33-q31.3 (52.9%). The different LOH patterns indicate that different genetic background may be responsible for the different physiology of NSCLC and SCLC. The fractional allele loss (FAL) mean value of all cancer specimens was 0.243+/-0.021 compared with 0.007+/-0.008 of healthy donors with a confidence interval (CI) 99.5%. Only seven out of 124 lung cancer specimens (5.2%) exhibited FAL value less than 0.083, the highest was observed in the healthy donors group. FAL appears to be a likely indicator for lung cancer detection. Microsatellite instability (MIN) was detected in 8.7% of SCLC and 4.0% of NSCLC bronchial washings in at least three loci tested. LOH and MIN detection in sputum and bronchial washing from the same patient was 77.6%. Calculation of these indexes per marker exhibits significant variations that could be attributed to diffuse lung disorders or non-cancer specific genetic alterations.

Adenocarcinoma↗

NMR metabolomics and glycomics for cancer detection in patients with non-specific symptoms: a prospective observational cohort study.

BACKGROUND: Early cancer diagnosis in patients with non-specific symptoms is limited by the lack of discriminatory tests. Within the Oxfordshire Suspected CANcer (SCAN) pathway, exploratory biomarker work showed that serum 1H NMR-based metabolomics can identify cancer with high accuracy. SCAN2 evaluated whether integrating metabolomics with glycomics provides complementary molecular information and improves discrimination in a clinically complex, real-world population. METHODS: Serum from 369 SCAN patients (59 cancers) was analysed using AXINON® System-derived NMR metabolomics and HPLC-MS glycomics. Machine-learning models were trained to predict cancer status, with performance assessed by receiver operating characteristic (ROC) analysis of pooled cross-validated predictions. To place cancer risk in a broader clinical context, a second classifier modelling alternative non-cancer diagnosis was incorporated, and mean predicted probabilities from both models were jointly projected into a two-dimensional space, maintaining strict separation of training and test data. FINDINGS: In the full cohort, integration of glycomics with metabolomics achieved an AUC of 0.814 (95% CI 0.808-0.820). In a refined sub-cohort excluding major comorbidities and selected cancer types (32 cancers, 277 non-cancers), performance improved to an AUC of 0.884 (95% CI 0.879-0.890). Discriminatory features included cancer-associated biantennary fucosylated glycans alongside amino acid metabolites (glutamate, histidine) and lipoprotein-related measures. A classifier distinguishing metastatic from non-metastatic disease (n = 29 vs. 30) achieved an AUC of 0.80. Joint probability analysis in the full cohort preserved cancer-associated signatures across comorbidity burden, with projection-based classification achieving an accuracy of 89.2% (95% CI 85.7-92.6). INTERPRETATION: These findings validate the SCAN1 metabolomic signature in a more clinically complex cohort and indicate that integrating glycomics with metabolomics provides complementary biological information for cancer discrimination. Joint probability analysis provides an interpretable framework for cancer risk stratification within multimorbid diagnostic pathways, supporting the clinical potential of scalable multi-omics blood testing. FUNDING: EPSRC, EU Horizon 2020, Wellcome/MLSTF, Novo Nordisk Foundation.

Humans↗

Breast cancer detection: experience in a suburban community.

Six hundred sixty-nine breast biopsies performed at the Methodist Hospital of Southern California and the Arcadia Outpatient Surgery Center during 1987 and 1988 were reviewed. Three hundred twenty-eight biopsies were performed for clinical indications (lump, thickening, or nipple discharge). Three hundred forty-one biopsies (51%) were performed because of mammographic abnormalities and required preoperative x-ray localization. Of the 341 localized biopsy specimens, 261 were varieties of fibrocystic mastopathy, fibroadenoma, papilloma, or hyperplasia. An additional 31 cases showed atypical ductal or lobular hyperplasia. One hundred fifty-one breast cancers were detected in this series of 669 breast biopsies. One hundred two (68%) of these were detected as a result of a clinical finding, and 49 were detected as a result of mammographic abnormalities (a 32% incidence of occult breast cancers). Among the 341 x-ray localization biopsies performed, breast cancer was detected in 14%.

Adult↗

Effects of sextant transrectal prostate biopsy plus additional far lateral cores in improving cancer detection rates in men with large prostate glands.

PURPOSE: To determine whether additional, far lateral cores improve the diagnostic performance of transrectal sextant biopsy in men with large prostate glands. METHODS: Men with prostate volumes of 50 mL or greater in transrectal ultrasonography who were suspected of prostatic adenocarcinoma were prospectively enrolled. Biopsy criteria were defined as 2.0 ng/mL or greater of serum total prostate-specific antigen and/or abnormal findings on digital rectal examination. Four cores of far lateral biopsies were added to the standard sextant technique. RESULTS: Of 104 patients enrolled in the present study and undergoing biopsy, 14 (13.5%) were diagnosed as having prostate cancer and 27 (26.0%) were diagnosed as having prostatic intraepithelial neoplasia (PIN) or an atypical gland. There were no cases where cancer was only detected in the additional cores, whereas PIN/atypical gland was uniquely detected from the additional, far lateral sites in eight of the 27 patients who were diagnosed with this condition. CONCLUSIONS: Although the number of patients diagnosed as having PIN/atypical gland might increase with the addition of far lateral cores, this additional sampling does not improve cancer detection rates in men with large prostate glands.

Adenocarcinoma↗

Minimal Residual Cancer Detection in Hematopoietic Stem Cell Products and Its Prognostic Significance in Patients With Breast Cancer, Lymphoma, or Multiple Myeloma.

BACKGROUND: Despite the initial success of high-dose therapy and bone marrow transplant, the major reason for posttransplant failure is relapse of disease. Reinfusion of tumor cells may contribute to relapse in autologous stem cell transplants. We now have ultra-sensitive methods of tumor cell detection that can determine the presence of minimal residual cancer (MRC) in marrow and peripheral blood stem cells. METHODS: The author has conducted a critical review of the literature on this issue. Results: The factors that are associated with an increase in contamination of the graft include (1) the number of cycles of induction therapy, (2) the type of mobilization regimen used, (3) the presence of tumor cells in the marrow, and (4) the number of phereses. A number of studies show that the presence of occult breast cancer in the marrow and/or stem cell product predicts for a poor posttransplant clinical outcome. The presence of clonogenic breast cancer or lymphoma cells in the graft is also associated with a very poor outcome. Published data regarding contamination in graft and outcome for patients with myeloma are limited. CONCLUSIONS: Testing for minimal MRC in the oncology patient provides prognostic information that may be useful to the transplant physician.

Journal Article↗

[Pros and cons of early cancer detection in breast carcinoma].

Mammography is an appropriate method for the detection of early forms of cancer of the breast, and for reducing mortality. Whether this actually succeeds depends upon the quality of the early detection strategies employed. Currently the data on reduction of mortality by mammographic screening remain ambivalent.

Adult↗

Peritoneal recurrence of colon cancer detected by positron emission tomography: report of a case.

Increased glucose metabolism has been reported to occur in association with colorectal cancer. As positron emission tomography (PET) using [18F]fluorodeoxyglucose is able to depict hypermetabolic sites, it can therefore be used to detect colorectal cancer. A 69-year-old male patient with a recurrent solitary liver metastasis from colon cancer underwent whole-body PET which revealed high [18F]fluorodeoxyglucose uptake in the lesion. Furthermore, PET revealed peritoneal metastases that had not been detected by conventional imaging methods. Consequently, PET proved useful in helping us to avoid performing unnecessary treatment for the liver metastasis. Although it is uncertain whether early identification of recurrence can prolong survival, it may help to prevent unnecessary treatments being carried out. Thus, the application of PET in carefully selected patients could be beneficial to the management of recurrent colorectal cancer.

Aged↗

Initial radiographic findings of early gastric cancer detected in health check programs and human "dry dock" (multiphasic screening) collective health checks and treated by endoscopic mucosal resection.

BACKGROUND: The purpose of this study was to evaluate the capacity of detection (detectability), by radiographic examination, of minute gastric cancer that was indicated for endoscopic mucosal resection (EMR). METHODS: Fifty-five lesions in 55 patients with minute gastric cancer were endoscopically resected between 1992 and 2000 at the Foundation for Detection of Early Gastric Carcinoma. Of these 55 patients, 33 patients underwent indirect (with image intensifier and 100-mm roll film) and/or direct radiographic examination of the upper gastrointestinal tract as the initial screening examination, and subsequent upper gastrointestinal endoscopy. The remaining 22 patients underwent upper gastrointestinal endoscopy as the initial screening examination. As the first step, radiographic (indirect and direct) images were reviewed, and the abnormalities which had eventually led to the detection of the minute early gastric cancer (EGC) were reconfirmed. Then, they were analyzed in terms of the reproducibility of abnormal findings which enabled the detection of such a minute EGC, and in terms of whether they could be treated by EMR. The size, morphology, and location of the radiographically detected lesions were analyzed. RESULTS: Seventeen lesions of EGC were detected in the group in which indirect radiography was initially performed. Of these 17 lesions, some abnormality corresponding to the site of the lesion was pointed out in 7 lesions (2 lesions of type IIa and 5 lesions of type IIc). On the other hand, the remaining 10 lesions (type IIa, 3; type IIc, 5; type IIa + IIc, 1; and type IIb, 1) were detected by endoscopy, which was carried out to confirm the other abnormalities in the indirect radiographic images. Sixteen lesions of EGC were detected in the group in which direct radiography was initially performed. Of these 16 lesions, some abnormality corresponding to the site of the lesion was pointed out in 8 lesions (4 lesions of type IIa and 4 lesions of type IIc). The remaining 8 lesions (3 lesions of type IIa and 5 lesions of type IIc) were not detected by direct radiography. CONCLUSION: Indirect and direct radiographic examination enabled the detection of approximately 50% of EGCs which could be treated by endoscopic resection. The significance of radiographic examination should not be underestimated, even in the detection of EGCs which can be endoscopically resected.

Gastric Mucosa↗

The University of Rochester model of breast cancer detection and survival.

This paper presents a biologically motivated model of breast cancer development and detection allowing for arbitrary screening schedules and the effects of clinical covariates recorded at the time of diagnosis on posttreatment survival. Biologically meaningful parameters of the model are estimated by the method of maximum likelihood from the data on age and tumor size at detection that resulted from two randomized trials known as the Canadian National Breast Screening Studies. When properly calibrated, the model provides a good description of the U.S. national trends in breast cancer incidence and mortality. The model was validated by predicting some quantitative characteristics obtained from the Surveillance, Epidemiology, and End Results data. In particular, the model provides an excellent prediction of the size-specific age-adjusted incidence of invasive breast cancer as a function of calendar time for 1975-1999. Predictive properties of the model are also illustrated with an application to the dynamics of age-specific incidence and stage-specific age-adjusted incidence over 1975-1999.

Age Factors↗