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Inhibition of granulocyte-macrophage (GM) colony formation by sera of patients with neoplasma of digestive tract in the course of surgical treatment.

The effect of sera from patients with neoplasm of the digestive tract obtained during intervention has been tested on granulocyte-macrophage (GM) colony formation. Independently of the source of blood (peripheral or tumour draining vein) and the time of sampling (during or 2-3 weeks after operation) the tested sera suppressed GM colony formation. The highest decrease was caused by blood sampled from the vein draining the tumour. It is concluded that tumour cells may be a source of the GM colony formation inhibitory activity. The possible character of the activity is discussed.

Adult↗

[Epidemiology of malignant neoplasms of the respiratory and upper digestive tract in Austria].

Between 1981 and 1985 the incidence of malignant tumours of the buccal cavity and mesopharynx, the larynx and hypopharynx and of the oesophagus in males was higher in the mainly rural Burgenland and Lower Austria than in Vienna. In lung tumours a slight urban-rural gradient tended to level out (Tables 1-4). In women, the cancer incidence on all locations showed an urban-rural gradient, steeper in the buccal cavity and mesopharynx, in the larynx and hypopharynx and in the oesophagus than in lung tumours (Tables 1-4). Cancer incidence in the nasal and paranasal cavities, middle ear, epipharynx, salivary glands and lips was low. Sex ratios, lips excepted, were lower than in other sites studied (Tab. 6). In Eastern Austria the mortality of malignant neoplasms of the mouth and pharynx in males increased steadily from 1960 to 1987. In laryngeal and oesophageal cancer no persistent trend was discernible. The lung cancer mortality decreased from the mid-seventies onwards (Figs. 1-2). In women, the lung cancer mortality increased continuously, and for some years now also that of the mouth and pharynx. Cancer of the oesophagus decreased, and laryngeal cancer mortality showed nearly constant rates (Figs. 5-6).

Adult↗

Carcinogenic effect of N-nitroso(2-hydroxypropyl)(2-oxopropyl)amine, a postulated proximate pancreatic carcinogen in Syrian hamsters.

N-Nitroso(2-hydroxypropyl)(2-oxopropyl)amine (HPOP) proved to be a potent carcinogen in Syrian golden hamsters. The compound is an in vivo metabolite of N-nitrosobis(2-hydroxypropyl)amine, N-nitrosobis(2-oxopropyl)amine (BOP), and N-nitroso-2,6-dimethylmorpholine and a postulated proximate pancreatic carcinogen in hamsters. As with BOP, HPOP induced a higher incidence of pancreatic ductular adenocarcinomas than did N-nitrosobis(2-hydroxypropyl)amine and N-nitroso-2,6-dimethylmorpholine, and these neoplasms showed a great tendency for invasion and metastasis. Also, HPOP induced tumors of the forestomach, liver, gallbladder, kidneys, and vagina (as did BOP). However, HPOP [unlike BOP, but like N-nitrosobis(2-hydroxypropyl)amine and N-nitroso-2,6-dimethylmorpholine] led to tumor development in the nasal cavity, larynx, trachea, intestine, Harderian gland, lips, and flank organ. The possible mechanisms of HPOP carcinogenicity are discussed.

Animals↗

Chemotherapy as treatment of choice in extrapulmonary undifferentiated small cell carcinomas.

Extrapulmonary undifferentiated small cell carcinomas, especially those arising in the upper aerodigestive tract, form a group of neoplasms with a clinical behavior which resembles small cell carcinoma of the lung. In 11 patients treated by combination chemotherapy an objective response rate of 82% was achieved for a median duration of 8+ months. Median survival for all patients was 12 months. Long-term survival was observed in those patients with limited disease who achieved a complete response after chemotherapy followed by radiotherapy.

Adult↗

Observations on the pathology of non-alimentary lymphomas in the horse.

A retrospective study was carried out on post-mortem and biopsy tissue samples from 26 horses with non-alimentary lymphoma. On the basis of their histopathology and cytology, the cases were grouped into several categories: (1) Lymphoblastic lymphomas (6 cases) and primary lymphoblastic leukaemia (2 cases). (2) Histiolymphocytic lymphomas involving the skin (6 cases) or lymph nodes (3 cases). (3) Lymphomas showing follicular development (4 cases). (4) Plasmacytic lymphomas (4 cases). (5) Lymphocytic lymphoma (1 case). Most affected horses were middle-aged or old but lymphoblastic neoplasms tended to affect younger horses than other forms. The course of the disease was highly variable. The most rapidly progressive forms were of lymphoblastic cytology, whereas some cases with histiolymphocytic skin nodules appeared to be only slowly progressive. Further information is needed on the pathology and clinical behaviour of some types of lymphoma, particularly those manifesting in the skin. Elucidation of the histogenetic relationships of the different cytological types of lymphoma will involve the development of immunohistochemical and other techniques which are specifically applicable to the horse.

Animals↗

Obesity: effects on the liver and gastrointestinal system.

Obesity, or the presence of a body mass index exceeding 30 kg/m2, has assumed epidemic proportions in the United States. More than a cosmetic issue, obesity is associated with many comorbidities that contribute to multiple organ dysfunction, illness, and shortened life span. This review covers new and emerging information on the relationship of obesity to common and debilitating hepatic and gastrointestinal disorders, including nonalcoholic steatohepatitis, gastroesophageal reflux, gallstones, and increased risk of colon cancer. Understanding the role of obesity in these disorders should lead to new insights into the pathogenesis of common liver and gastrointestinal diseases and to new treatment strategies for the practicing gastroenterologist.

Animals↗

[P53 tumor suppressor gene in digestive neoplasms].

Malignant diseases of the digestive tract cause more than 50% of deaths due to cancer in Chile. There is a high incidence of gastric and gallbladder cancer and an increasing frequency of colorectal cancer. P53 tumor suppressor gene has a great importance in carcinogenesis and its alterations are specially important in digestive tract tumors such as colorectal cancer. There is contradictory evidence about the frequency of p53 gene or protein alterations or their biological significance. There is little information about p53 in Chile and it is mostly limited to immunohistochemical studies. This revision analyzes the frequency of p53 alterations in digestive tract tumors in Chile, using immunohistochemical and molecular biology methods. A special emphasis is given to the prognostic importance of this gene.

Digestive System Neoplasms↗

Survival rates in 548 patients with multiple neoplasms of the upper aerodigestive tract.

The high incidence of multiple primary carcinomas occurring in the upper aerodigestive tract is well documented, with the accepted incidence being as high as 20-30%. The full clinical significance of this phenomenon is, however, only now becoming apparent. Herein 548 cases of documented multiple primary neoplasms, presenting initially in the upper aerodigestive tract, are evaluated retrospectively to establish the survival in these patients. The overall 5 years survival rate after diagnosis of the second neoplasm was found to be 22.3% which was significantly lower than a control group. The reasons for this poor survival are considered. These include: 1. the high incidence of second cancers developing in the lung and esophagus which have an extremely poor survival rate; 2. the frequent late diagnosis of the second lesions, with resultant advanced staging, and therefore poor prognosis; 3. inability to institute the appropriate therapy for these lesions due to the effects of previous radical therapy utilized for the first tumor. The clinical implications of this problem are discussed.

Carcinoma, Squamous Cell↗

Peroxydase activity of the granulocytes in the course of surgical treatment of neoplasm of the alimentary tract.

Granulocyte peroxidase activity of patients with alimentary tract neoplasms has been investigated by using the histochemical method. Blood samples were collected before surgical treatment and anaesthesia, during surgical intervention from vessels draining the neoplasms, and 2-3 weeks after surgery from peripheral vessels. The activity of myeloperoxidase in the polymorphonuclear granulocytes of patients was evidently lower in comparison to the activity of this enzyme in the granulocytes of normal individuals. The excision of the tumour did not evidently increase the tested activity in blood from peripheral vein in comparison to the same sample and to the blood from vein draining of tumour. We can suggest that granulocytes may release myeloperoxidase to the surrounding media in the course of neoplasmatic diseases and in this case the cells are exhausted in this enzyme.

Digestive System Neoplasms↗

Localization of vascular endothelial growth factor and its receptors in digestive endocrine tumors: correlation with microvessel density and clinicopathologic features.

Angiogenesis, a process related to tumor growth and malignancy, is stimulated by several growth factors. Among these is vascular endothelial growth factor (VEGF), which acts on endothelial cells by binding with 2 specific receptors, VEGFR1 and VEGFR2. Recent studies have demonstrated that VEGF expression is correlated with microvessel density (MVD) and tumor progression. Digestive endocrine tumors are heterogeneous neoplasms exhibiting variable biological aggressiveness and behavior that often are not predictable on morphologic grounds alone. The aims of this study were to evaluate the expression of VEGF, VEGFR1, and VEGFR2 in digestive endocrine tumors and to examine its correlation with MVD and malignancy. A total of 84 specimens from endocrine neoplasms and normal gut and pancreatic tissue were immunohistochemically studied using specific antibodies directed against VEGF, VEGFR1, VEGFR2, endothelial antigens, and gastroenteropancreatic hormones. Ultrastructural immunocytochemistry was performed to identify the cellular localization of VEGF and the VEGFRs. In normal tissues, VEGF immunoreactivity was detected in G cells and PP cells. Ultrastructurally, VEGF was localized within secretory granules. The VEGFRs were not significantly expressed by normal endocrine cells. VEGF-immunoreactive (IR) cells were detected in 40 of 83 tumors, mainly G cell and enterochromaffin cell neoplasms. VEGFR1-IR cells were found in 44 of 82 tumors, and VEGFR2-IR cells were found in 55 of 82 tumors, with no predilection for any specific tumor type. The expression of VEGF and its receptors did not correlate with MVD or malignancy. These results suggest that in normal tissues, endothelial functions may be regulated by VEGF produced by some endocrine cells and that a VEGF/VEGFR binding mechanism may be involved in tumorigenesis, but not in tumor progression and aggressiveness.

Adolescent↗

[Effects of branched-chain amino acids (BCAA) in complete hypocaloric nutrition of surgical patients with neoplasms of the digestive tract].

One of the generic indications of parenteral peripheral malnutrition is the immediate postoperative period following surgery of the digestive tract. In the series presented, fifty patients with digestive neoplasia of different locations were studied, with slight or moderate malnutrition upon admittance. After the operation, feeding was done using hypocaloric parenteral solutions for the first seven days of the postop. period. In the qualitative intake of nitrogen in this type of nutrition, branched chain amino acids are important due to their beneficial effects on metabolism, and for this reason two complete hypocaloric solutions containing 45% and 15.5% of these amino acids were administered to each respective group under study. To justify the effect of improving the proteic synthesis attributed to these amino acids, the levels of rapid turnover proteins, transferrin, prealbumin and retinol-binding protein were determined.

Aged↗

[Resection of lung neoplasm in patients aged 70 years and over. Apropos of a series of 193 resections].

Lung cancer in the elderly is an active cancer. Due to the poor tolerance of radiotherapy and chemotherapy, and the ever increasing life expectancy of patients over the age of 70 years, surgery remains the treatment of choice for these lesions. We report a series of 193 patients over the age of 70 years, the high postoperative mortality of 19% during the first month was counterbalanced by a 5-year survival of more than 20%. The criteria of operability must be rigorous and based on objective elements, especially lung function and the patient's good psychological state.

Adenocarcinoma↗

History of cirrhosis and risk of digestive tract neoplasms.

BACKGROUND: Cirrhosis is strongly related to liver cancer. Data on the possible association between cirrhosis and risk at other cancer sites are scanty. PATIENTS AND METHODS: We analysed data from a network of case-control studies conducted in Italy between 1983 and 1997, including patients with cancers of the oral cavity and pharynx (520), oesophagus (405), stomach (731), colon (943), rectum (613), liver (425), gallbladder (63) and pancreas (395). The controls were 4297 patients admitted to hospitals for acute non-neoplastic conditions. RESULTS: After strict allowance for alcohol drinking, tobacco smoking and history of hepatitis, the multivariate odds ratios for a history of cirrhosis were 4.7 [95% confidence interval (CI) 2.2-9.8] for neoplasms of the oral cavity and pharynx, 2.6 (95% CI 1.2-5.7) for the oesophagus, 1.0 (95% CI 0.4-2.5) for the stomach, 1.0 (95% CI 0.4-2.4) for the colon, 1.7 (95% CI 0.7-4.1) for the rectum, 20.5 (95% CI 12.3-34.2) for the liver, 2.1 (95% CI 0.3-16.8) for the gallbladder and 0.9 (95% CI 0.3-3.0) for the pancreas. CONCLUSIONS: Our study confirms and further quantifies the increased risk of liver cancer in cirrhotic patients and is compatible with an increased risk of oral, pharyngeal and oesophageal cancers.

Adult↗

Endoprosthetic insertion for malignant obstructive jaundice: a retrospective review.

We reviewed 13 cases of biliary endoprosthetic insertion for malignant obstructive jaundice from August 1983 to May 1987, and recorded (1) location and etiology of the obstruction, (2) length of time the endoprosthesis remained functional, and (3) complications related to the endoprosthesis, its insertion, or its long-term function. Of the 13 patients, 3 had pancreatic carcinoma, 3 had cholangiocarcinoma, and 3 had metastatic disease to the porta hepatis. The underlying malignancy was not histologically proved in four patients despite evidence of neoplasm by percutaneous cholangiography and computerized tomography. These four patients were not considered good surgical risks and were referred for percutaneous therapy. The longest endoprosthetic patency was 3.5 years. Three patients experienced obstruction of the endoprosthesis at 3, 4, and 9 months after insertion, respectively. Two of the endoprostheses were subsequently removed endoscopically, while the third was extracted through a new percutaneous tract with use of a balloon angioplasty catheter. Complications related to endoprosthetic insertion included bilous hydro pneumothorax (1 patient), subcutaneous and subcapsular liver abscess (1 patient), postinsertion cholangitis (4 patients), and reflex ileus (1 patient).

Aged↗

The acute abdomen in individuals with AIDS.

Both AIDS-related infections and neoplasms of the gastrointestinal tract may be manifest by a clinical picture of acute abdominal disease. Severe abdominal pain may be seen in this population even in the absence of true surgical complications such as perforation, abscess formation, or obstruction. Localizing signs and symptoms are frequently misleading due to underlying immunosuppression, debilitation, and prior or current antibiotic use. CT assumes a critical role in evaluation of the symptomatic AIDS patient, providing evaluation of the entire abdomen and pelvis including lymph nodes, solid viscera, and the bowel itself. CT is thus the modality of choice for characterization of AIDS-related abdominal disease and for direction of appropriate therapy.

AIDS-Related Opportunistic Infections↗

Diagnosis, management and prognosis of obstructive jaundice in Ile-Ife, Nigeria.

A 5-year review of 50 patients, 28 males, 22 females, with a mean age of 42 years, operated for obstructive jaundice at Ile-Ife, Nigeria was undertaken. Neoplasms of the pancreas, liver, and bile duct were the common causes. Percutaneous Transhepatic Cholangiography (PTC) with hypotonic duodenography was excellent in determining the underlying lesions. Pancreatic carcinoma accounted for 28% of cases, cholelithiasis 24%, hepatoma 22%, metastatic cancer 14%, bile duct carcinoma 10%, and traumatic pancreatic pseudocyst 2%. The patients with malignancies were older than those with biliary calculi. Biochemically, elevated alkaline phosphatase, and conjugated hyperbilirubinaemia, particularly in malignant obstructions, were diagnostic. Benigh bile ductal obstructions were surgically managed without any mortality. Malignant obstructions were surgically managed without any mortality. Malignant obstructions with their advanced presentations were less successfully managed. Biopsy alone or palliative bypass procedure could only be offered and the survival rate was dismal.

Adolescent↗

Glutathione S-transferase activity in patients with cancer of the digestive tract.

Glutathione S-transferase (GST) and carcinoembryonic antigen were measured in the plasma of 95 patients with neoplasm of digestive tract, in 40 patients suffering from non-neoplastic diseases and in 40 healthy subjects. The mean value of the GST activity was significantly (P < 0.001) elevated in patients with gastric, liver and colorectal cancer (10.4 U/l, 14.1 U/l and 12.3 U/l respectively) as compared with the reference population (3.2 U/l). GST elevations above normal were observed in 26 (90%) patients with gastric cancer, in 18 (100%) with liver cancer and in 25 (89%) with colorectal cancer. Carcinoembryonic antigen appeared less sensitive. In 15 patients the postoperative levels of serum GST were increased after surgery then gradually declined and after 1 month showed a normalization in 10 patients. Our data suggest that GST measurement may be useful as a tumour marker in gastric, liver and colorectal cancer. Moreover the combined determination of GST and other markers increase the sensitivity for cancer detection.

Biomarkers, Tumor↗

Family history of cancer provided by hospital controls was satisfactorily reliable.

OBJECTIVE: Our aim was to investigate the reliability of the information on family history of cancer in first-degree relatives in a hospital-based case-control study. STUDY DESIGN AND SETTING: We re-interviewed at home 294 controls of an Italian hospital-based case-control study on digestive tract neoplasms using the same questionnaire and compared the responses reported by these patients in the two settings. RESULTS: A satisfactory agreement between the two interviews was reported for family history of any cancer (kappa=0.7) and of cancers of the digestive tract (kappa=0.8). The agreement was apparently higher for esophageal and stomach cancers (kappa>0.8) than for intestinal cancers (kappa=0.6) and lower for lung cancer (kappa=0.5). We found a systematic tendency to report a history of cancer more frequently in the hospital setting than in the home setting. CONCLUSION: The present study showed a good reliability of data on family history of all cancers, including cancers of the digestive tract, provided by hospital controls through a structured interview-administered questionnaire. It suggests, moreover, that controls in the hospital setting tend to recall more often, and presumably more completely, a family history of cancer.

Adult↗