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Association of schistosomiasis with cervical cancer: detecting bias in clinical studies.

To investigate if Schistosoma haematobium infection increases the observed frequency of cervical cancer, data from literature were analysed in meta-analysis fashion. Results reveal that cervical cancer is statistically significantly less frequent in the presence of S. haematobium infection. A protective effect might be inferred; however, underlying bias in data collection and/or analysis is suspected. An approach to detecting bias is given, consisting of: (a) carefully stating and assessing the several components of the scientific method and; (b) identifying and contrasting the populations hypothesised and sampled. The approach is illustrated by searching for bias in the schistosomiasis-and-cancer reports. Sampling discrepancies were detected in patient geography, ages, and states of health, and suspected in disease prevalence sampled and disease prevalence reported. The conclusion is reached that effects of bias in the original studies preclude inference of a "protective" effect of S. haematobium infection against cervical cancer.

Africa↗

Possible chemoresistance-related genes for gastric cancer detected by cDNA microarray.

To identify chemoresistance-related genes of gastric cancer, we utilized cDNA microarray technology. Thirty-five gastric cancer specimens surgically resected at our institute between 1998 and 1999 were studied for quantification of expression of 6300 genes by means of oligonucleotide microarray methods, and the results were evaluated in comparison with the chemoresistance of the specimens, which was determined by MTT (tetrazolium-based 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) assay. Inhibition rates (IR) were determined for cisplatin (DDP), 5-fluorouracil (5-FU), mitomycin C or doxorubicin. IR of 60% or more was regarded as sensitive to each agent, and IR of less than 40% was defined as resistant. Clustering was successfully completed for DDP, resulting in selection of 23 candidates as DDP-resistance-related genes, including vascular permeability factor, 2 membrane transporting subunits, and retinoblastoma-binding protein-1. In addition, further selection of DDP-resistance-related genes was performed according to these criteria: 1) Expression of the gene can be detected in more than 70% of resistant tumors. 2) Expression can be detected in less than 30% of sensitive tumors. 3) Expression in tumors is more than twice that of normal mucosa in more than 50% of specimens. Then, metallothionein-IG and heparin-binding epidermal growth factor-like growth factor (HB-EGF) were identified as candidate DDP-resistance-related genes. When known DDP-resistance-related genes were analyzed according to the MTT assay result, families of glutathione-S-transferase and cyclooxygenase-2 genes were also evaluated as resistance-related genes. For 5-FU resistance, dihydropyrimidine dehydrogenase and HB-EGF-like growth factor genes were also suggested to be resistance-related genes. The present study demonstrated that oligonucleotide microarrays can provide information regarding chemoresistance factors in cancer.

Antineoplastic Agents↗

Breast cancer detection using magnetic resonance imaging in breasts injected with liquid silicone.

Two patients who had received silicone injections in their breasts several years ago presented with breast complaints. Excluding cancer in these patients was very difficult. Mammograms were very difficult to interpret, as were the physical findings. Carcinoma was successfully detected by magnetic resonance imaging. When women who underwent the injudicious injection of silicone reach the cancer-prone age, the examining physicians should have a greater awareness of the detection and management of carcinoma coexistent with silicone mastopathy. We think that MRI is potentially valuable in the evaluation of the breast lesions; it plays an important role in the detection of breast cancer in breasts augmented with liquid silicone.

Breast Implants↗

Rapidly growing small peripheral lung cancers detected by screening CT: correlation between radiological appearance and pathological features.

12 peripheral small lung cancers (< 20 mm) of rapid growth (volume doubling time < 150 days), detected by repeated low dose CT screening, were evaluated to examine their CT features and to correlate such features with histopathological findings. Each patient's CT images, including follow-up and thin section CT images, were studied retrospectively to determine tumour growth rate and CT morphological features. Nine of the tumours exhibited a solid tumour growth pattern: seven of these showed a well defined, homogeneous, soft tissue density with spicular or lobulated margin. These seven tumours included small cell lung cancer (n = 3), moderately differentiated adenocarcinoma (n = 2), poorly differentiated adenocarcinoma (n = 1) and squamous cell carcinoma (n = 1). The other two tumours, a moderately differentiated adenocarcinoma and a well differentiated adenocarcinoma, appeared as irregular, soft tissue density nodules with poorly defined margins. The latter exhibited an air bronchogram pattern and a small cavity. The remaining three tumours exhibited a lepidic tumour growth pattern. They showed ground glass opacity or ground glass opacity with a higher density central zone on CT images and were well differentiated adenocarcinomas. In conclusion, most peripheral small lung cancers of rapid growth were adenocarcinomas. They also included small cell lung cancer and squamous cell carcinoma. The majority showed solid tumour growth pattern and lacked an air bronchogram and/or small air spaces in the nodule. Some well differentiated adenocarcinomas with lepidic tumour growth pattern also showed rapid growth.

Adenocarcinoma↗

c-erbB-2 amplification in breast cancer: detection in formalin-fixed, paraffin-embedded tissue by in situ hybridization.

We describe a sensitive and practical in situ hybridization method, using a digoxigenin-labeled probe, for the detection of c-erbB-2 amplification in breast cancer in formalin-fixed, paraffin-embedded tissue sections. Forty-six primary breast carcinomas were studied. Nuclear hybridization signal was observed in 36 of 46 carcinomas. Signal was confined to malignant cells. Normal breast epithelium and stromal and inflammatory cells were uniformally negative. DNase predigestion, no-probe preparations, and competitive hybridization confirmed the specificity of the reaction. The hybridization reaction was localized to multiple discrete foci in tumor cell nuclei, suggesting multiple sites of gene copy and transcriptional activity in the nucleus. Considerable cell-to-cell variation in hybridization signal was evident within individual tumors and positive reactions were observed in several cases in which amplification could not be detected by either Southern or slot blot analysis. The high sensitivity and specificity of the reaction and its use in a tissue-based system will allow the study of a range of possible precursor lesions of breast cancer for evidence of c-erbB-2 amplification.

Breast Neoplasms↗

Complexed prostate-specific antigen improvement in detecting prostate cancer.

This article presents the current reports of complexed prostate-specific antigen (PSA) aimed for the enhancement of prostate cancer detection. Further studies are needed to ascertain the variability of complexed PSA. Comparisons of percent free PSA, potential additive value of alpha(1)-antichymotripsin-bound PSA (PSA-ACT) and Bayer complexed PSA (cPSA) remains controversial in men with intermediate elevated total PSA concentration. Volume-referenced complexed PSA (PSA-ACT and cPSA) can enhance prostate cancer detection. Preliminary results show that PSA-alpha(2)-macrobloblin (PSA-a(2)M) and PSA-alpha(1)-protease inhibitor (PSA-API) are promising assays for improving cancer detection.

Humans↗

Ovarian cancer detection by logical analysis of proteomic data.

A new type of efficient and accurate proteomic ovarian cancer diagnosis systems is proposed. The system is developed using the combinatorics and optimization-based methodology of logical analysis of data (LAD) to the Ovarian Dataset 8-7-02 (http://clinicalproteomics.steem.com), which updates the one used by Petricoin et al. in The Lancet 2002, 359, 572-577. This mass spectroscopy-generated dataset contains expression profiles of 15 154 peptides defined by their mass/charge ratios (m/z) in serum of 162 ovarian cancer and 91 control cases. Several fully reproducible models using only 7-9 of the 15 154 peptides were constructed, and shown in multiple cross-validation tests (k-folding and leave-one-out) to provide sensitivities and specificities of up to 100%. A special diagnostic system for stage I ovarian cancer patients is shown to have similarly high accuracy. Other results: (i) expressions of peptides with relatively low m/z values in the dataset are shown to be better at distinguishing ovarian cancer cases from controls than those with higher m/z values; (ii) two large groups of patients with a high degree of similarities among their formal (mathematical) profiles are detected; (iii) several peptides with a blocking or promoting effect on ovarian cancer are identified.

Algorithms↗

Patterns of chromosomal imbalances in advanced urinary bladder cancer detected by comparative genomic hybridization.

To identify genetic changes linked to bladder cancer progression we analyzed 90 invasive transitional cell carcinomas (37 pT1 and 53 pT2-4) by comparative genomic hybridization. The most frequent alterations included 1q+ (37%), 5p+ (24%), 6q- (19%), 8p-(29%), 8q+ (37%), 9p- (31%), 9q- (23%), 11p-(24%), 11q- (22%), 17q+ (29%), and 20q+ (28%). Interestingly, there were three groups of alterations that frequently occurred together (9p- and 11q13+/ 20q+ and 11q13+ or 17q+/1q+ and 3p+ or 11q-). These loci might carry genes that interact with each other in specific molecular pathways. There were remarkable genetic similarities between minimally and deeply invasive tumors of different histological grades, including a similar number of aberrations per tumor and an equal frequency of most individual alterations. However, deletions of 5q, 6q, and 15q and gains of 5p, 7p, and Xq were significantly more frequent in pT2-4 than in pT1 carcinomas. These loci may harbor genes that are important for bladder cancer progression.

Chromosome Aberrations↗

Increasing utilization of a rural cervical cancer detection program.

The Alabama Department of Public Health established, in 1973, a Cancer Screening Program (CSP). Although 66,000 women have been screened, many rural females had never used the program. After a community health organization education effort was introduced into a target rural county, an examination of CSP new user data for two intervention quarters revealed 345 and 150 per cent increases, respectively, in the pattern of use.

Age Factors↗

Dysphagia of the treated laryngeal cancer--detection of functional and morphological changes by cineradiography.

After treatment of laryngeal cancer 35 patients with dysphagia have been examined by high speed cineradiography. When compared to normal swallowing patterns, the following abnormalities were observed: Excursion of the posterior pharyngeal wall during swallowing is twice as intensive as normal. The function of the base of the tongue becomes more important for pharyngeal emptying--a fact that surgeons should take into consideration when planning laryngeal resection. Timing of pharyngeal constriction and function of the upper esophageal sphincter are definitively altered. In view of these changes we think that cineradiography can help to find better methods for functional surgery of the pharynx and the adjacent structures.

Cicatrix↗

Acceptance of repeat esophagogastroduodenoscopy to detect gastric cancer in a Chinese immigrant cohort.

GOAL: To study the feasibility of using repeat esophagogastroduodenoscopy (EGD) to screen for Helicobacter pylori infection and gastric cancer in an Asian immigrant cohort. BACKGROUND: Immigrants in the United States (US) from countries with high per capita rates of gastric cancer remain at higher risk for gastric cancer. The existence of the possibly modifiable risk factor of H. pylori infection and the poor outcomes associated with late-stage disease make screening higher-risk groups with EGD an appealing possibility. It is unknown whether Asian immigrants in the US would accept an EGD-based strategy for gastric cancer screening. STUDY: Cross-sectional study of adult Chinese immigrants in New York City with dyspepsia who underwent EGD in an earlier gastric cancer detection study, who were offered a second EGD four years later. Our main outcome measure was acceptance or refusal of repeat EGD. RESULTS: Seventy-three of the 115 Chinese participants in the earlier study were successfully contacted for this current study. Twenty-three of 73 (32%) underwent repeat EGD. Leading reasons given for declining were lack of symptoms and lack of time. Significantly associated with acceptance of repeat EGD was the belief that EGD will find stomach cancer "nearly always" in someone who has it (P=0.0054; odds ratio=14.0, 2.1 to 94.2 95% confidence interval). CONCLUSIONS: Acceptance of repeat EGD for gastric cancer detection in a cohort of Chinese immigrants was relatively low despite the mitigation of cost and language factors, 2 major barriers to healthcare access. Relocation seemed to be a factor as well. In this population, perceptions of the benefits of EGD may influence acceptance of testing for cancer detection purposes.

Aged↗

[Expression of KAI1, MRP-1, and FAK proteins in lung cancer detected by high-density tissue microarray].

BACKGROUND & OBJECTIVE: The genesis, development, invasion, and metastasis of tumor are closely correlate with alterations of multi-genes. At present, the roles of Kang-ai-1 (KAI1), motility-related protein-1 (MRP-1), and focal adhesion kinase (FAK) in lung cancer have seldom been reported. This study was designed to investigate the roles of KAI1, MRP-1, and FAK in tumorigenesis and development of lung cancer, and their values in diagnosis and predicting the prognosis of lung cancer. METHODS: The expression of KAI1, MRP-1, and FAK proteins in a high-density tissue microarray containing 240 spots were detected by SP immunohistochemistry. RESULTS: The positive rates of KAI1 and MRP-1 were significantly lower in primary lung cancer than in normal lung tissue (25.9% vs. 100%, 42.6% vs. 100%, P<0.05). The positive rate of FAK was significantly higher in primary lung cancer than in normal lung tissue (44.4% vs. 10.0%, P<0.05). The expression of KAI1, FAK, and MRP-1 in primary lung cancer had no correlation with age and gender of the patients, and macroscopic and histological type of tumor, but had correlations with tumor differentiation, clinical stage, and lymph node metastasis. In addition, the expression of MRP-1 had correlation with histological type of tumor; the positive rate of MRP-1 was significantly lower in small cell lung cancer than in non-small cell lung cancer (0 vs. 50.0%, P<0.05). KAI1 expression was negatively correlated to FAK expression (rs=-0.458, P<0.05); MRP-1 expression was positively correlated with KAI1 expression (rs=0.535, P<0.05), and negatively correlated with FAK expression (rs=-0.438, P<0.05). CONCLUSIONS: The abnormal expression of KAI1, MRP-1, and FAK proteins are related to invasion and metastasis of lung cancer. Combined detection of the 3 proteins may be useful in predicting the development and prognosis of lung cancer.

Adult↗

Unsolved problems in early breast cancer detection: focus on the underserved.

In the last decade, numerous research and programmatic efforts have attempted to improve cancer screening practices among women from diverse race/ethnic backgrounds on the assumption that observed differences in breast cancer survival were largely due to differences in early detection practices. Recent data from the 1992 National Health Interview Survey and a 1992 survey in San Francisco Bay Area multiethnic communities indicate that rates of self-reported breast cancer screening tests among African American, Hispanic, and white women no longer differ significantly. However, there are large, persistent socioeconomic differences as reflected in educational and income levels, the recency of immigration, and English language proficiency. This emphasizes the continuing need for interventions tailored specifically for the underserved, with the racial, ethnic, and cultural composition of the intended audience informing educational messages and strategies. However, effective research interventions are complex and costly throughout the spectrum of outreach, inreach, and follow-up. Thus the generalizability of these strategies to under-founded providers and agencies in low-income communities may be limited. Therefore, as ongoing research continues to refine strategies, the application of effective community-based intervention should seek out potential partnerships with programs that provide the critical access to services. Cancer control scientists are well positioned to advocate for community-based infrastructures that facilitate translation of research into practice.

Adult↗

Tumour cells in the tumour draining vein of patients with non-small cell lung cancer: detection rate and clinical significance.

OBJECTIVES: This prospective study was performed to examine whether tumour cells are detectable in the tumour draining vein of patients with non-small cell lung cancer. Furthermore, the impact of these cells on the clinical course was analysed. PATIENTS AND METHODS: Sixty-two consecutive patients with completely resected primary non-small cell lung cancer (pT1-4 pN0-2 M0) were admitted to the study. Pulmonary venous blood was drawn at the time of surgery for primary non-small cell lung cancer. The tumour draining vein was punctured subsequent to thoracotomy prior to manipulation of the tumour. The blood samples were examined for occult tumour cells by immunocytochemical staining of cytospins using the pancytokeratin antibody A45-B/B3 (murine immunoglobulin G1; Micromet, Munich, Germany). RESULTS: Disseminated cancer cells in pulmonary venous blood were observed in 11 of 62 patients (18%) and did not correlate with standard clinico-pathological parameters. In patients without involvement of mediastinal lymph nodes (pN0-pN1), detection of occult tumour cells was an independent prognostic parameter for unfavourable outcome: log rank analysis showed a significant association of occult tumour cells in pulmonary venous blood with shortened cancer-related survival (P=0.019) and multivariate regression analysis demonstrated an independently significant (P=0.004) prognostic impact. CONCLUSION: The present study shows that disseminated cancer cells in the pulmonary venous blood are detectable in about 20% of the patients with operable non-small cell lung cancer and that they are associated with a poor clinical outcome. Therefore, the detection of such cells might be useful for the identification of patients who benefit from adjuvant therapy. Furthermore, in order to avoid an additional systemic spread of tumour cells intraoperatively, the pulmonary veins should be ligated first during lung cancer surgery.

Carcinoma, Non-Small-Cell Lung↗

Early cancer detection by microsatellite marker analysis.

A major goal of tumor biology has been the development of tumor markers that are useful for the diagnosis and management of cancer. A drawback associated with many of these markers is that they are not unique to tumor cells, but rather are normal or developmental antigens which are overexpressed in tumor tissue Therefore, determination of possible malignancy is based on a designated expression level rather than a clear-cut difference. Studies have shown that DNA from tumor cells has a pattern of chromosomal deletion clearly distinguishable from normal cell DNA, and more importantly, DNA from tumor cells can be detected in the serum of cancer patients. Particular chromosomal deletion patterns are associated with specific tumor types. It is hypothesized that individuals at risk for certain genetically well-characterized cancers, could be successfully screened for those cancers by a PCR-based blood test. In this way, neoplasia could be detected at earlier, more treatable stages of development.

Humans↗