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Wild-type p53 suppresses angiogenesis in human leiomyosarcoma and synovial sarcoma by transcriptional suppression of vascular endothelial growth factor expression.

Our recent studies (R. Pollock et al., Clin. Cancer Res., 4: 1985-1994, 1998; M. Milas et al., Cancer Gene Ther., in press, 2000) have shown that the restoration of wild-type (wt) p53 enhances cell cycle control in vitro and inhibits the growth of human soft-tissue sarcoma in severe combined immunodeficient mice. We hypothesized that the antitumor effect of wt p53 overexpression in sarcoma cells is attributable not only to enhanced cell cycle control but also to inhibition of angiogenesis. We evaluated the effect of restoring wt p53 function on angiogenesis in human soft-tissue sarcoma harboring mutant p53. Restoration of wt p53 expression in human leiomyosarcoma SKLMS-1 cells that contain mutant p53 markedly inhibited angiogenesis induced by tumor cells in vivo. Angiogenesis assays using an in vivo Matrigel plug assay demonstrated that less neovascularization in severe combined immunodeficient mice was observed with conditioned medium (CM) from human synovial sarcoma cells expressing wt p53 compared with CM from human synovial sarcoma cells expressing mutant p53. Microvessel density and microvessel counts were lower in tumor xenografts from cells containing wt p53 than in tumor xenografts from cells containing mutant p53. The growth and migration of murine lung endothelial cells were decreased when cells were treated with CM from sarcoma cells expressing wt p53 compared with CM from sarcoma cells expressing mutant p53. The introduction of wt p53 into sarcoma cells containing mutant p53 significantly reduced the expression of vascular endothelial growth factor (VEGF), which is a key mediator of tumor angiogenesis. Stimulation of endothelial cell migration by CM from cells expressing mutant p53 was significantly reduced after anti-VEGF neutralizing antibody was added to the CM. Using luciferase as the reporter of VEGF promoter activity, we found that wt p53 inhibited VEGF promoter activity in SKLMS-1 cells. Deletion analysis defined an 87-bp region (bp -135 to -48) in the VEGF promoter that is necessary for inhibiting VEGF promoter activity by wt p53. The transcription factor Sp1 may be involved in the repression of VEGF promoter activity by wt p53 in SKLMS-1 cells. These data indicated that wt p53 can suppress angiogenesis in human soft-tissue sarcomas by transcriptional repression of VEGF expression.

Animals↗

Effect of injection of nuclear fraction from Rhodamine sarcoma on turnover of liver catalase.

1) When nuclear fraction prepared from Rhodamine sarcoma (sarcoma nuclear fraction) was injected into mice three times every 24 hr, the catalase activity of the liver decreased to one-third of the original activity. 2) By the injection of sarcoma nuclear fraction into mice, the catalase activity with the soluble fraction from homogenates of the liver decreased more significantly than that with the particulate fraction from them. 3) Immunological titration proved that the decrease of catalase activity in the liver of mice injected with sarcoma nuclear fraction was brought about by decrease in the amount of catalase protein. 4) In the mice, whose liver catalase activity had been irreversibly inhibited by injection of 3-amino-1,2,4-triazole, the initial rate for the restoration of the liver catalase activity was significantly showed by further injection of sarcoma nuclear fraction. 5) When the inhibitor of catalase biosynthesis, allylisopropylacetamide, was injected into mice, the activity level of the liver catalase decreased. The extent of decrease by the injection of the inhibitor was slightly lower than that by the injection with sarcoma nuclear fraction, which was almost the same as the extent of decrease by the injection of sarcoma nuclear fraction plus allylisopropylacetamide. 6) It is conceivable that the catalase biosynthesis in the liver was inhibited by the injection of sarcoma nuclear fraction in almost the same manner as by the injection of allylisopropylacetamide. However, it is not certain whether the degradation of liver catalase was slightly stimulated by the injection of sarcoma nuclear fraction.

Allylisopropylacetamide↗

[Detection of SYT-SSX fusion gene in paraffin-embedded tissues and its clinicopathologic significance for synovial sarcoma].

OBJECTIVE: To investigate the feasibility of detecting SYT-SSX fusion gene in paraffin-embedded tissues and its diagnostic significance for synovial sarcoma (SS). METHODS: Formalin-fixed, paraffin-embedded samples of 38 cases of SS and 40 cases of control tumors (including spindle cell sarcoma and metastatic adenocarcinoma) were retrived from archival materials. SYT-SSX fusion transcripts were detected in all samples by RT-PCR. House-keeping gene Porphobilinogen Deaminase (PBGD) was used to detect the quality of mRNA. RESULTS: PBGD mRNA was detected in 64 of the 78 tumor cases (82.1%). SYT-SSX fusion transcripts was detected in 33 of the 38 synovial sarcoma specimens. No SYT-SSX mRNA expression was found in control tumors. SYT-SSX mRNA expression rate reached 89.2% (33/37) in synovial sarcomas after exclusion of 1 case which was negative for both SYT-SSX and PBGD. In 33 SYT-SSX positive synovial sarcomas, 22 had SYT-SSX1 and 6 had SYT-SSX2 fusion transcripts. In 5 cases, the fusion type could not be distinguished. There was an association between SYT-SSX fusion type and histologic subtype. All 10 biphasic synovial sarcoma cases had the SYT-SSX1 fusion, whereas 12 of 18 monophasic synovial sarcoma had the SYT-SSX1 and 6 had the SYT-SSX2 fusion gene (P < 0.05). CONCLUSIONS: (1) Detection of SYT-SSX fusion gene in paraffin-embedded tissues was found to be a sensitive and specific method for the diagnosis and differential diagnosis of synovial sarcoma. (2) There was an association between SYT-SSX fusion type and histologic subtype.SYT-SSX2 fusion transcript could only be found in monophasic synovial sarcomas.

Adolescent↗

Detection of SYT-SSX fusion transcripts in paraffin-embedded tissues of synovial sarcoma by reverse transcription-polymerase chain reaction.

OBJECTIVE: To assess the feasibility of detecting SYT-SSX fusion transcripts in paraffin-embedded tissues of synovial sarcoma by reverse transcription-polymerase chain reaction (RT-PCR). METHODS: RT-PCR was used to amplify the SYT-SSX fusion transcripts using archival formalin-fixed paraffin-embedded tumor specimens from a series of 37 synovial sarcoma cases. To investigate the specificity of the SYT-SSX fusion transcripts, a variety of non-synovial sarcoma tumors were included in the study as negative controls. The detected messages derived from fusion genes were confirmed by subsequent sequence analysis. RESULTS: SYT-SSX fusion transcripts were detected in 33 of 37 (89.2%) synovial sarcomas. None of the 34 cases of non-synovial sarcoma tumors showed amplified products of SYT-SSX fusion transcripts, although PBGD mRNA was detected in all specimens. Among 33 SYT-SSX-positive synovial sarcomas, 22 tumors had an SYT-SSX 1 fusion transcript, whereas 6 tumors had an SYT-SSX2 fusion transcript. Fusion types can not be distinguished in the remaining 5 cases. There was a significant relationship between SYT-SSX fusion type and histologic subtype. All 10 biphasic synovial sarcomas had the SYT-SSX1 fusion, whereas all tumors with SYT-SSX2 were of monophasic morphology (P < 0.05). CONCLUSIONS: RT-PCR can be applied to archival formalin-fixed paraffin-embedded tumor tissues as a sensitive and reliable technique for the diagnosis and differential diagnosis of synovial sarcoma. There is an association between SYT-SSX fusion type and histological subtype. SYT-SSX2 fusion transcripts can only be found in monophasic synovial sarcoma.

Adolescent↗

[Detection of HHV8 latent nuclear antigen by immunohistochemistry. A new tool for differentiating Kaposi's sarcoma from its mimics].

UNLABELLED: The purpose of this work was to study the value of HHV8 latent nuclear antigen 1 detection by immunohistochemistry in Kaposi sarcoma and its mimics. MATERIALS AND METHODS: : We used the mAB LNA53 against the latent nuclear antigen 1 of HHV8 to study its expression by immunohistochemistry in paraffin embedded biopsy of Kaposi and its mimics. We also performed in vitro PCR for HHV8 DNA, extracted from the same paraffin embedded biopsies. We studied characteristic lesions of 26 Kaposi sarcoma; 20 cutaneous lesions raising problems of differential diagnosis. We also studied 11 biopsies of skin, mucosa, or lymph nodes of patients infected by HHV8 but without Kaposi sarcoma, and 22 lesions initially classified by histological analysis as uncertain Kaposi sarcoma . RESULTS: : In all cases of Kaposi, HHV8 was detected in the majority of tumor cells, with no expression in other adjacent cells. In these biopsies HHV8 DNA, was identified by in vitro PCR. None of the 20 Kaposi sarcoma mimics and the 11 lesions of patients infected by HHV8 but without any Kaposi sarcoma, were HHV8+ on immunohistochemistry sections or by PCR. From the 22 cases of uncertain Kaposi sarcoma, only the 14 lesions HHV8 PCR+ and with a clinical evolution in accordance with a Kaposi sarcoma, were HHV8+ on immunohistochemistry. In contrast, the 8 cases negative for HHV8 on immunohistochemistry were also PCR- and had a self-healing evolution in accordance with the diagnostic of pyogenic granuloma. CONCLUSION: : Detection of the latent nuclear antigen 1 of HHV8 by immunohistochemistry is a specific and sensitive diagnostic tool for differentiating Kaposi sarcoma from its mimics.

Antibodies, Monoclonal↗

High grade sarcomas are associated with microsatellite instability (chromosom 12) and loss of heterozygosity (chromosom 2).

BACKGROUND: The genetic changes in DNA microsatellites - short, tandem repeat segments dispersed throughout the human genome - probably play a role in carcinogenesis. Microsatellite instability (MSI) is reflected in alterations in the patterns of these polymorphic repeat segments. In our study, human sarcomas were analyzed for the presence of microsatellite instability and loss of heterozygosity (LOH). MATERIAL/METHODS: Studies were performed on tissue specimens obtained at surgical resection from 20 patients with malignant and non-malignant soft tissue tumors (8 G1 sarcomas, 8 G3 sarcomas, 2 lipomas and 2 fibromas). Samples of venous blood from the patients served as respective controls. DNA was isolated using organic extraction. Additional microcolumn purification was performed. Fluorescent multiplex polymerase chain reaction (PCR) was used to amplify 10 microsatellite loci included in commercially available human identification kits. Microsatellite marker BAT 26 was amplified in separate PCR reactions. RESULTS: All the G3 sarcomas manifested MSI. MSI was detected on 12p in all the specimens except for recurrent synovial sarcomas. LOH in BAT 26 analysis (chromosome 2) was present in 75% of G3 sarcomas. No MSI or LOH was found in G1 sarcomas or in benign tumors. CONCLUSIONS: Genomic instability may contribute to tumorgenesis in sarcomas, and both MSI and LOH may reflect genomic instability in sarcomas. These parameters may be helpful in the differential diagnosis of malignant versus nonmalignant lesions.

Chromosomes, Human, Pair 12↗

Upregulation of the oncogenic helix-loop-helix protein Id2 in Ewing sarcoma.

AIMS AND BACKGROUND: Id helix-loop-helix proteins function as regulators of cell growth and differentiation. However, they can induce malignant transformation when overexpressed. The EWS/ETS chimeric proteins in Ewing sarcoma act as aberrant transcription factors leading to tumorigenic processes. An enhanced expression of the Id2 gene in Ewing sarcoma cells was previously shown by gene array techniques. We investigated the expression of Id2 at the protein and gene level in Ewing sarcoma. METHODS: We evaluated the expression of Id2 protein using immunohistochemistry in formalin-fixed, paraffin-embedded specimens from a total of 71 cases of Ewing sarcoma. Additionally, a Ewing sarcoma cell line was examined by real-time quantitative PCR. RESULTS: Id2 expression was observed in 65 cases (91.5%) of the 71 total cases examined and a high level of Id2 expression was observed in 45 of these cases (63.8%). In tumor cells, Id2 proteins displayed cytoplasmic as well as nuclear localization. The amplification of the Id2 gene was not noted in a Ewing sarcoma cell line using real-time quantitative PCR. The crossing points of Id2 in the Ewing sarcoma cell line, control fibroblast, and osteosarcoma cell line were 18.54 +/- 0.16, 18.25, and 18.34, respectively. CONCLUSIONS: Our data support a role for increased Id2 protein expression in Ewing sarcoma. However, this overexpression of the Id2 protein could not be confirmed by a corresponding change at the gene level in a Ewing sarcoma cell line.

Biomarkers, Tumor↗

[Chronological changes of lung sarcoma and lung cancer incidence based on the annual of the pathological autopsy cases in Japan (1958-1986)].

One hundred and sixty-three male and 78 female cases of lung sarcoma, registered over 29 years from 1958 to 1986, were selected and analyzed, and were compared with lung cancer cases. The incidence of the lung sarcoma cases was one per 2,600 in males and one per 3,600 in females among all autopsy cases, and one per 1,400 in males and one per 1,800 in females among all autopsied cases of fatal malignancies. The relative incidence of lung sarcoma was one per 240 lung cancer cases in males and one per 170 in females and gradually decreased with each decade (1st to 3rd periods). The male/female ratio was 2.1 overall and 2.6 in the 3rd period. In the 3 decades, the average age at detection 55, 55 and 66 years in males and 38, 51 and 49 years in female lung sarcoma cases. Female sarcoma cases were significantly younger than male cases, except for the 2nd period. In the 3rd period male cases were almost the same as lung cancer cases in terms of average age. Significant elevation was observed in lung sarcomas. The most frequent lung sarcomas in males were rhabdomyosarcoma, leiomyosarcoma, and malignant lymphoma in the 3 decades. In females, the above three sarcomas were most frequent in each chronological period. Malignant fibrous histiocytomas appeared remarkably in the 3rd period in both sexes. The peak and mean ages for each type of lung sarcoma were higher than other reports. In malignant lymphoma and rhabdomyosarcoma, male cases were significantly older than female cases.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

[Soft tissue sarcoma in the head and neck--analysis of 87 patients].

From 1964 to 1984, 87 patients with soft tissue sarcoma (excluding lymphreticulum system sarcoma) in the head and neck were treated in our hospital. All were proved by pathology. The incidence rate of fibrosarcoma was the highest (36.8%), hemangiosarcoma the lowest (5.8%). There was no liposarcoma or synovial sarcoma in this group. The most frequently involved site was the area near the nasal cavity and maxillary sinus for fibrosarcoma (66%), the base of tongue for hemangiosarcoma (60%), scalp for dermatofibrosarcoma protuberans (54%), parapharyngeal space and soft tissue of the neck for neurogenic sarcoma (45%). Metastasis rate to the lymph nodes was 16-20% for rhabdomyosarcoma, hemangiosarcoma and malignant fibrohistiocyte tumor. No distant metastasis was found in dermatofibrosarcoma protuberans and malignant fibrohistiocyte tumor. Distant metastasis rate was 10-20% for the other types. Local recurrence rate was 9.1% for dermatofibrosarcoma protuberans, 88.9% for malignant fibrohistiocyte tumor, 30-66.7% for the other sarcomas. The 5- and 10-year survival rates were 20% and 0%, 37.5% and 0%, 91.6% and 91.6% for rhabdomyosarcoma, malignant fibrohistiocyte tumor and dermatofibrosarcoma protuberans. There were differences in clinical behavior for soft tissue sarcomas in the head, neck and in the trunk. Highly malignant sarcomas, such as liposarcoma, synovial sarcoma and rhabdomyosarcoma were rare in the head and neck but the low malignant sarcomas in the head and neck were 3-10 times as common as those in the trunk. Distant metastasis rate of the fibrosarcoma was 20% in head and neck and 6.7%in trunk, the 5- and 10-year survival rates were 36% and 77.9%, 25% and 73.6%, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

Flow cytometric analysis of human uterine sarcomas and cell lines.

Flow cytometric techniques were used to characterize multiple human uterine sarcomas and cell lines derived from some of these tumors. Analysis of DNA content showed that 9 of the 11 uterine sarcomas investigated were composed of at least one aneuploid population as well as a distinct diploid population. These data indicate that aneuploidy, as measured by flow cytometry, is a characteristic more common to uterine sarcomas than that previously reported for uterine adenocarcinomas. Unlike the original tumors, the cell lines established from three of the sarcomas contained predominantly diploid populations with only minor aneuploid populations. Treatment of one of the sarcoma cultures with tumor promoters did not result in an increase in the aneuploid populations. Tumors which arose in nude mice upon transplantation of two of the sarcomas did not contain the same distribution of tumor subpopulations as found in the original sarcomas. Apparently, the in vitro culture and and in vivo nude mouse conditions were not appropriate for maintaining the original equilibrium between the aneuploid and diploid subpopulations but instead provided a selective environment that resulted in the preferential growth of only certain tumor populations. Dual-parameter analysis of DNA content and alkaline phosphatase levels of one of the sarcomas were useful for distinguishing the aneuploid from the diploid population coexisting in this tumor. Our data suggest that flow cytometry is a valuable tool to analyze the characteristics of the tumor populations residing in primary uterine sarcomas as well as to determine which of these tumor subpopulations survive in culture and transplantation to nude mice.

Alkaline Phosphatase↗

Pulmonary Kaposi's sarcoma. Premortem histologic diagnosis.

Nine open lung biopsies and nine transbronchial biopsies from 10 patients with pulmonary Kaposi's sarcoma were reviewed to define the pattern of involvement in the lung by Kaposi's sarcoma and to determine the usefulness of transbronchial biopsy in making the diagnosis. There were nine patients with acquired immune deficiency syndrome (AIDS) and one patient with sporadic pulmonary Kaposi's sarcoma. A lymphatic distribution was seen in all cases. A spectrum ranging from distinctive polymorphous cellular infiltrates ultimately interpreted as Kaposi's sarcoma to "classic" Kaposi's sarcoma was found. Recognition of the former enabled retrospective recognition of Kaposi's sarcoma in four of eight transbronchial bronchial biopsies. The diagnosis of pulmonary Kaposi's sarcoma in one other patient was made solely on the basis of transbronchial biopsy. Eight patients died from pulmonary Kaposi's sarcoma; two patients are alive with extensive pulmonary Kaposi's at last follow-up. We believe that transbronchial biopsy may be useful in establishing a diagnosis of pulmonary Kaposi's sarcoma in many more patients than is generally appreciated.

Acquired Immunodeficiency Syndrome↗

p53 immunostaining in the differentiation of inflammatory pseudotumor from sarcoma involving the lung.

Inflammatory pseudotumor (IPT) of the lung is a non-neoplastic process that consists of proliferating spindle cells (fibroblasts and myoblasts), with variable numbers of mitoses, and inflammatory cells, particularly plasma cells. These lesions clinically, radiographically, and grossly mimic malignant neoplasms but are usually easily distinguished from malignancy on routine histopathology. However, in occasional cases the proliferating spindle cells may histopathologically mimic sarcoma, particularly on small biopsies and needle aspirates. Strong intranuclear immunopositivity for p53 protein is presumed to be indirect evidence of mutation of the p53 tumor suppressor gene and can be detected in many malignancies. In order to determine the utility of p53 immunostaining in differentiating IPT occurring in the lung from sarcoma involving the lung, we immunostained eight solitary IPTs, one IPT that recurred repeatedly over a 10-year period, six sarcomas (two malignant fibrous histiocytomas, two metastatic high-grade sarcomas, one metastatic alveolar soft part sarcoma, and one fibrosarcoma) involving the lung, and one IPT from which a sarcoma arose 10 years after radiation therapy. Immunohistochemistry was performed on 5-microns formalin-fixed sections using a commercially available antibody to the p53 protein (Biogenex, monoclonal 1:200) and a standard antigen retrieval technique. Weak intranuclear staining occurring in less than 10% of proliferating cells was not considered a true immunopositive. All eight of the solitary IPTs were immunonegative for p53 protein by our criteria. The IPT that recurred a number of times and the IPT from which a sarcoma later developed were also immunonegative for p53 protein. Four of the six sarcomas were immunopositive, as was the postradiation sarcoma arising from a p53-immunonegative IPT.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

Insulin-like growth factor 1 (IGF-1) receptors, IGF-1, and IGF-2 are expressed in primary human sarcomas.

A variety of bone and soft-tissue sarcoma cell lines have been shown to express receptors for insulin-like growth factor-1 (IGF-1) and to respond mitogenically to IGF-1 in vitro. We have recently demonstrated evidence of IGF dependency in murine MGH-OGS and RIF-1 sarcomas, which express relatively high and intermediate levels of IGF-1 receptors. Overexpression of IGF-1 receptors and/or IGF ligands might, therefore, be a mechanism by which human bone and soft-tissue sarcomas obtain a proliferative advantage over normal adjacent tissues. Therefore, we evaluated 29 human sarcoma specimens for expression of IGF-1 receptor, IGF-1, and IGF-2 by competitive binding and reverse-transcription polymerase chain reaction (RT-PCR) techniques. Twelve of 29 sarcomas examined by RT-PCR and 13 of 25 examined by affinity-binding studies expressed IGF-1 receptor levels equal to or greater than levels determined in the IGF-responsive MCF-7 breast carcinoma cell line. DNA amplification of the IGF-1 receptor gene was not identified in this group of sarcomas that expressed high levels of IGF-1 receptor. Evaluation of IGF ligand expression by RT-PCR revealed that 22 of 28 sarcomas expressed IGF-1 levels comparable to or above those of the RPMI 7666 control line, and 17 of 27 sarcomas expressed significant levels of IGF-2 compared with the NCI H69 control cell line. These results suggest that autocrine/paracrine regulatory mechanisms might be responsible for the growth of some sarcomas.

Base Sequence↗

Specificities and functions of CD4+ HLA class II-restricted T cell clones against a human sarcoma: evidence for several recognized antigens.

CD4+ T cells play an important role for tumor immunity in animal tumor models, yet there are few reports about the role of CD4+ HLA class II-restricted T cells in the immune response against human tumors. Against a human sarcoma exclusively CD4+, T cell clones could be established. These T cell clones were cytotoxic and secreted TNF and additional cytokines in response to the IFN-gamma-treated, HLA class II-positive autologous sarcoma cells. Several Ags were recognized by representative T cell clones: an Ag presented by HLA-DR and specific for the sarcoma; Ags presented by both HLA-DR alleles of the sarcoma, HLA-DR4 and -15, and shared by allogenic HLA-DR matched cell lines of different tissue lineages, including B cell blasts; and a sarcoma Ag presented by HLA-DP or DQ. Cytokine profiles of sarcoma-reactive T cell clones were dependent on the cytokine environment present during establishment of the T cell clones. The addition of exogenous IL-4 shifted the cytokine patterns of sarcoma-reactive T cell clones from Th1-like patterns to Th0/Th2-like patterns and decreased IL-10 production. TNF, IFN-gamma, IL-4, and supernatants of T cell clones induced HLA-DR expression on the sarcoma cells and, thus, were able to enhance Ag presentation. This autologous T cell response to a human sarcoma represents a new model for HLA class II-restricted T cell responses to human tumors.

Abdominal Neoplasms↗

Anti-herpesvirus treatment and risk of Kaposi's sarcoma in HIV infection. Royal Free/Chelsea and Westminster Hospitals Collaborative Group.

OBJECTIVE: With the recent identification of a new herpesvirus in patients with Kaposi's sarcoma (human herpesvirus-8 or Kaposi's sarcoma-associated herpesvirus), there have been several reports on the use of anti-herpesvirus therapy (foscarnet, ganciclovir and aciclovir) and risk of developing Kaposi's sarcoma. We therefore investigated the association between use of anti-herpesvirus drugs and Kaposi's sarcoma in a large unselected group of patients with AIDS. PATIENTS AND METHODS: We studied a group of HIV-positive patients at the Chelsea and Westminster Hospital, for whom details on all AIDS-defining diagnoses made during follow-up, treatment and regular CD4 counts were available. Cox proportional hazards models with time-dependant covariates were used to assess the association between treatment with aciclovir, foscarnet and ganciclovir and risk of Kaposi's sarcoma. RESULTS: A total of 3688 patients have been followed up for a median period of 4.2 years, during which time 598 patients (16.2%) developed Kaposi's sarcoma. After adjustments for sex, exposure category, age, treatment with antiretrovirals or Pneumocystis carinii pneumonia prophylaxis, the development of AIDS-defining conditions (including separate adjustment for the development of cytomegalovirus and herpes simplex virus) and CD4 count, there was a decreased risk of developing Kaposi's sarcoma with foscarnet [relative hazard (RH), 0.38; 95% confidence interval (CI), 0.15-0.95; P = 0.038] and with ganciclovir (RH, 0.39; 95% CI, 0.19-0.84; P = 0.015), but not with aciclovir (RH, 1.10; 95% CI, 0.88-1.38; P = 0.40). CONCLUSIONS: These results suggest that both foscarnet and ganciclovir may have some activity in preventing the occurrence of Kaposi's sarcoma, but that aciclovir has no benefit. Further studies of the effect of these drugs on the risk of Kaposi's sarcoma is warranted.

Acyclovir↗

[Detection of human herpesvirus 8 (HHV 8) in Kaposi sarcomas of the gastrointestinal tract].

Involvement of Kaposi's sarcoma in the gastrointestinal tract is common in AIDS patients. The disease is, however, usually asymptomatic and, due to the tumor growth primarily in the submucosa, biopsy diagnosis is possible in under 25%. The recently described human herpes virus 8 (HHV8) is closely associated with all forms of Kaposi's sarcoma. Detection of HHV8 in the tissue samples may therefore improve the diagnosis of gastrointestinal Kaposi's sarcoma. In the present study we analyze autopsy samples of tumor and non-tumor tissue from the gastrointestinal tract in patients with and without Kaposi's sarcoma for the presence of HHV8 DNA using a nested polymerase chain reaction (PCR) assay. HHV8 DNA was present in all 15 tissues with Kaposi's sarcoma. In contrast, HHV8 DNA was present only in 3 (18.8%) of 16 gastrointestinal tissues of patients with Kaposi's sarcoma but without histologically detectable tumor. No HHV8 DNA was present in 15 tissue samples of AIDS patients without Kaposi's sarcoma. Our data show that detection of HHV8 DNA using a nested PCR assay is a highly sensitive and specific diagnostic test for Kaposi's sarcoma in autopsy tissue samples from the gastrointestinal tract. It should therefore be possible to use detection of HHV8 DNA in biopsy material as an assay for the diagnosis of Kaposi's sarcoma.

Acquired Immunodeficiency Syndrome↗

[Sarcomas in syrian hamster, induced by an oncorna virus and cellfree transmissible (author's transl)].

1. Application of hamster papova virus to newborns of Syrian hamster has produced some s.c. sarcomas after a 5 to 6 month latency period, by virtue of the strong inducer effect of this papova virus to endogenous (latent) oncorna viruses. 2. Cellfree filtrates from a polymorphorus-cell sarcoma produced in this way, when applied to newborn hamsters of the spontaneously tumour-free hamster line HaP, again lead to sarcoma formation after a latency period of 3--8 months in about 20% of the animals; the same holds for cellfree filtrates of these cellfree induced sarcomas and their transplantation generations. 3. In these tumours C-type oncorna viruses, but no papova virus, could be demonstrated regularly. 4. The hamster specificity of this sarcoma virus is suggested by the complete absence of a tumorigenic effect of the cellfree filtrates from these hamster sarcomas in mice and rats. The preferential induction of hamster sarcomas by sarcoma filtrates, in conjunction with the fact that filtrates from hamster leukoses, indicates a certain difference between hamster leukemia and hamster sarcoma viruses.

Animals↗

Late effects of radiotherapy for pediatric extremity sarcomas.

PURPOSE: To determine the long-term effects of radiotherapy (RT) in children treated for extremity sarcoma. PATIENTS AND METHODS: Between 1964 and 1997, 15 of 33 children treated with RT for extremity sarcomas at the University of Iowa have survived with a median follow-up was 20 years (range, 6-36 years). There were 10 boys and 5 girls with a median age of 13 years (range, 3.5-20 years) at the time of irradiation. The diagnosis was Ewing's sarcoma in 8 (53%), synovial sarcoma in 4 (27%), alveolar rhabdomyosarcoma in 2, and fibrosarcoma in 1. Location of primary tumor was lower extremity in 10 (67%) and upper extremity in 5 (33%). RT was given as the definitive therapy for 9 children (median dose, 55.8 Gy; range, 45-66 Gy) and as an adjuvant postoperative treatment in 6 (median, 63 Gy; range, 41.4-66.4 Gy). (60)Co was used in 6 (40%), 4 mV in 4, 6 mV in 2, and 250 kV photons in 2 patients; 1 child was treated with a combination of 12 and 15 MeV electrons for a Ewing's sarcoma of the distal femur. Another child had a 25 Gy intraoperative RT boost after 41.4 Gy conventional RT. Late effects to the muscle, soft tissue, and growing bone were assessed using the objective portion of the LENT-SOMA scale proposed by the Late Effects Consensus Conference. RESULTS: Late effects were seen in all patients and included atrophy in 12 (80%), fibrosis in 12 (80%), bone growth abnormalities in 10 (67%), impairment of mobility and extremity function in 6 (40%), edema in 3 (20%), and peripheral nerve injury in 2 (13%). Ten of 15 (67%) children had Grade 1 or 2 growing bone, muscle, soft tissue, or peripheral nerve complications. Two patients (13%) had a Grade 3 mobility and extremity function score and had moderate to severe limitation of movement. Two children (13%) required epiphysiodesis because of a shorter treated leg. The patient who received an intraoperative RT boost of 25 Gy developed sensory dysfunction of the ulnar nerve 11 years after RT. Another developed radial nerve palsy 3 years after marginal resection and postoperative RT and required tendon transfer repair. One patient had radiation-induced vasculitis with popliteal artery thrombosis 23 years after RT. Five (33%) developed a fracture of the irradiated bone at a median time of 8 years after RT (range: 9 months to 22.2 years); all had Ewing's sarcoma, and 3 of these patients were subsequently found to have a secondary bone cancer (osteosarcoma 2, malignant fibrous histiocytoma 1) in the RT field. One of these patients also developed breast cancer 26 years after lung RT for metastatic Ewing's sarcoma. Overall, 11 surgical procedures in 8 children were performed to correct a limb preservation treatment toxicity. CONCLUSIONS: Although most children treated with RT for a pediatric extremity sarcoma have minimal late toxicity by LENT-SOMA scale, approximately half required a surgical procedure to correct a late effect. A fracture in the irradiated bone may be the presenting sign or may precede a radiation-induced bone malignancy, as seen in 3 of the patients in this study.

Adolescent↗