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Frequency of H-ras mutations in human bladder cancer detected by direct sequencing.

OBJECTIVE: To determine the frequency of mutations of the H-ras gene in transitional cell carcinomas of the human urinary bladder using direct DNA sequencing based on the polymerase chain reaction (PCR) method and to compare the results with those of other methods. In addition, the relationship of the mutation frequency to tumour stage and grade was examined. PATIENTS AND METHODS: Bladder tumour samples, taken by cystoscopic resection from 50 patients with newly diagnosed transitional cell carcinoma of the urinary bladder, were analysed by PCR-based direct DNA sequencing for point mutations in the H-ras gene at codon 12. RESULTS: Point mutations were found in 9 of 50 tumours examined (18%). The most frequent mutation (8/9) was a G to T transversion converting GGC to GTC, which would result in a glycine to valine substitution. The remaining mutations was a G to A transition altering GGC to GAC, producing a glycine to aspartic acid substitution, which has not previously been reported in bladder cancer. In all tumour samples examined the wild-type allele (GGC) was also evident. Variation in the proportion of wild-type to mutated sequence was found within tumour samples. No relationship between mutations and tumor grade and stage was apparent. CONCLUSION: The frequency of H-ras mutations detected in this first large scale study using the highly sensitive and rapid PCR-based sequencing method was comparable to that reported by earlier studies with the nude mouse tumorigenesis variation of the 3T3 transfection assay. H-ras mutations can be early events in the development and progression of a significant proportion of human bladder cancer cases.

Base Sequence↗

Gel fiberglass membranes for affinity chromatography columns and their application to cancer detection.

The development of mechanical supports for biochemically active compounds serving as immunochemical sensors has been the goal of many studies. A new compound in the form of gel fiberglass (GFG) membranes was recently developed as an example of such supports. These membranes prepared from glass fibers covered with oxysilanes to create a matrix 'gel fiberglass' (R. Zusman, USA Patent #08/112,087, 1993) were used to prepare affinity chromatography columns for the isolation of soluble p53 protein from the serum of cancer patients. A thin layer of protein, trapped in gel glass during its preparation, was deposited on a lattice of glass fibers. Derivatization of the support eliminated nonspecific adsorption of proteins. Under such conditions, external agents percolating through a membrane may contact a maximum number of protein molecules trapped in the gel glass. The membranes are very stable, and can be stored in dry conditions for several months at room temperature. Affinity chromatography columns were prepared from the GFG membranes and used to isolate various proteins, including tumor-associated antigens (TAA). The capacity of the columns was calculated as the amount of protein (mg ml(-1)) isolated from TAA-containing solution, and amounted to up to 9 mg ml(-1) of serum in colon cancer patients. The cytoplasmic p53 protein was one of the main components of TAA isolated in our experiments. Its concentration was determined by HPLC. This protein was isolated from the serum of cancer patients in the highest concentration yet reported, up to 5 mg ml(-1). The described method allows an easy and highly effective isolation of TAA and can be used for important goals including cancer diagnosis.

Antigens, Neoplasm↗

Elevated urinary levels of 6-hydroxymethylpterin during malignancy of liver regeneration: a simple, noninvasive test for cancer detection.

A simple and rapid method for determining urinary 6-hydroxymethylpterin levels is described. It involves adsorption of the pterin compound from deproteinized urine samples on activated charcoal under acidic conditions and its subsequent elution under alkaline conditions in a concentration suitable for its spectrophotofluorometric quantitation. The major blue fluorescent compound being measured was identified as 6-hydroxymethylpterin in thin layer chromatography on combined Silica gel-G and cellulose. While 30 healthy human subjects excreted 6-hydroxymethylpterin at a mean levels of 0.121 microgram/ml of urine, 120 patients with various types of cancer excreted vary significantly higher levels ranging from 0.3 to 2.0 microgram/ml. The mean excretion level for 19 patients with various nonmalignant diseases was 0.134 microgram/ml which was not significantly different from that for the healthy control subjects. In two experimental model systems described, following partial hepatectomy and the induction of Yoshida ascites tumors in rats, the peak periods of liver regeneration and maximal tumor growth were accompanied, respectively, by four and 40-fold increases in urinary 6-hydroxymethylpterine excretion. Ingestion of multivitamin tablets containing 5 mg of folic acid (but not rich dietary sources of folates) resulted in temporary elevation of urinary 6-hydroxymethylpterin levels. The method described for determining urinary 6-hydroxymethylpterin provides a simple, noninvasive means of detecting prevailing malignancies.

Adolescent↗

Loss of heterozygosity of p53 gene of oral cancer detected by exfoliative cytology.

The p53 tumor suppressor gene is a 16-20-kb section of cellular DNA located on the short arm of human chromosome 17 at position 17 P 13.1. Allelic deletions and/or point mutations in p53 gene are now known to be associated with the development of carcinogenesis. A hallmark of p53 is that both alleles are generally altered during transformation, which usually represents a loss of heterozygosity (LOH). In this study 30 normal dental students and 22 oral cancer patients were collected from the affiliated hospital of Chung Shan Medical and Dental College, Taichung, Taiwan. Extractions of DNA from the buccal mucosa or cancer surface were sampled by cytology brush. The two polymorphic restriction sites exon 4 and intron 6 within the p53 gene were amplified with polymerase chain reactions followed by restriction fragment length polymorphism assay. In heterozygous individuals, 66% of oral cancers demonstrated loss of p53 gene heterozygosity at the exon 4 site, and 50% showed LOH at the intron 6 site. These results indicate that inactivation of p53 gene is associated with development and/or progression of oral cancer. The essential advantages of oral exfoliative cytology are the non-invasiveness, painlessness, rapidity, ease and cost-effectiveness of cell sampling and DNA extraction. Furthermore, this experimental assay might be useful for preliminary screening of carcinogenesis in human beings.

Carcinoma, Squamous Cell↗

Disturbance of circadian gene expression in endometrial cancer: detection by real-time quantitative RT-PCR.

Circadian genes control the daily changes of the circadian rhythms in a variety of physiological processes, which in turn regulate many functions in the human body. Disruption of circadian rhythms can have a profound influence on our well-being. We established a set of PCR primers and fluorescent probes to analyze the mRNA levels of nine different circadian genes, and used immunohistochemical methods to study four important circadian proteins in 35 endometrial cancers and their paired non-cancerous tissues. Of these, 13 cases showed reduced expression in all nine circadian genes in the cancerous tissues relative to the paired non-cancerous tissues; the remaining cases showed similar reduced expression in 4-8 of the genes analyzed. Conversely, 3 non-cancerous tissues showed reduced expression in all nine circadian genes in comparison with their respective adjacent cancerous tissues, whereas 6 other non-cancerous tissues showed reduced expression in 6-8 of the circadian genes. These results were also confirmed by immunohistochemical study. Expression of the circadian genes is perturbed in endometrial cancer. Based on these results, we suggest that different circadian rhythms occur in endometrial cancer and non-cancerous tissues. Our results may provide the molecular basis for chronotherapy of endometrial cancer.

Adult↗

Loss of chromosome 17 loci in prostate cancer detected by polymerase chain reaction quantitation of allelic markers.

Using a polymerase chain reaction/microsatellite marker system, we demonstrated that 6 of 22 (27%) clinical stage B (early) primary prostate tumors showed loss of heterozygosity at one or more of five loci on chromosome 17. The sensitivity of this study was increased by use of a PhosphorImager and statistical analysis of replicate tumor-normal DNA pairs. Two patients showed tumor-specific interstitial loss at a locus in close proximity to the familial breast cancer gene BRCA1. These findings suggest that genes on the proximal long arm of chromosome 17 play a pivotal role in the early development of at least a subset of prostatic tumors.

Alleles↗

Fluorescent nanocrystals for use in early cervical cancer detection.

BACKGROUND: Quantum dots (qdots) are a promising alternative to organic fluorophores for biological imaging. Advantages of quantum dots over organic fluorophores include broad excitation coupled with narrow, tunable emission, high resistance to chemical and metabolic degradation, a higher photobleaching threshold and finally the ability to be modified with a targeting ligand. These many properties allow quantum dots to be used in conjunction with optical detection methods for imaging. METHODS: We are investigating the use of quantum dots to detect precancerous biomarkers. We have directly targeted epidermal growth factor receptors with quantum dots conjugated to anti-EGFR antibodies. RESULTS: Compared to appropriate controls, we do see specific labeling of EGF receptors. CONCLUSIONS: Quantum dots provide a promising alternative to conventional organic dyes for biological imaging. Combined with optical imaging technologies, quantum dots can help visualize changes in cervical cancer at the molecular level. This ability may alert health care providers to the need for intervention before a cancer can metastasize.

Animals↗

[Early cancer detection in the oro-pharyngo-laryngeal area: analysis of a regional screening project (author's transl)].

During a six months lasting screening project 6866 persons were examined free of cost. Inspection of the mouth, endoscopy of the naso-hypopharynx and larynx with the Wolf-endoscope after v. Stuckrad, and palpation of the neck were included. Every sixth person required further diagnosis or treatment. Precanceroses were found in almost 3%, and up to now malignomas were found in 0.3% of the screened persons. Among these 14 cases of cancer were 9 carcinomas of the larynx. This comparatively high percentage of precanceroses and cancer favors the endoscopic screening of patients with organ-related symptoms and of high risk groups.

Adult↗

Cancer detection in biopsy specimens taken from different types of gastric lesions.

From January 1974 to October 1983, 5072 gastroscopies were performed in 3351 patients with a total of 14,554 biopsy specimens taken from 2565 lesions in the stomach. The endoscopic diagnoses and their histologic counterparts were recorded and the diagnostic yield of specimens from each type of lesion analyzed. Gastric adenocarcinoma was finally diagnosed in 139 patients. The diagnosis was delayed, from 1 to 4 months, in five patients because of false-negative diagnoses. These patients all had ulcerating cancers. Moreover, early gastric cancer was mainly of the ulcerating type. Accordingly, an ulcer lesion is the most important one to biopsy. Only four cancers were found in 959 benign-appearing gastritic lesions. Twenty-one patients with negative biopsy results at the first endoscopy were later shown to have cancer. When these biopsy specimens were re-examined, malignant lymphoma was found in one and adenocarcinoma in three cases. In spite of false-negative endoscopic findings, nonrepresentative biopsy material and false-negative histologic reports, the combination of biopsy results and clinical judgement led to correct and timely treatment in nearly all patients.

Adenocarcinoma↗

Metastatic lung cancer detected by lumbar bone densitometry: a case report.

A lumbar bone densitometry examination was performed in a patient with severe low back pain but no pathologic findings on initial laboratory and radiologic investigations. The bone mineral density of the spine was in the low-normal range (90.5% age matched), with the L4 vertebra bone mineral density less than the others, whereas image analysis showed a defect in the right part of its body. Additional radiographs confirmed this finding, which was proved to be a metastatic lesion from a primary lung cancer. Although not intended for diagnosis, the results of image analysis of bone densitometry should be evaluated carefully.

Carcinoma, Non-Small-Cell Lung↗

Can traditional epidemiology detect cancer risks caused by occupational exposure to pesticides?

In order to investigate the possible relationship between cancer and occupational exposure to pesticides, we reviewed the latest literature of the epidemiological studies in this area coming to the conclusion that, while several studies indicate a link between certain pesticides and certain tumors, this information is still insufficient, and further research on the health consequences of exposure to pesticides is needed. Moreover, provided there is a risk, it is often too limited to be detected by available epidemiological techniques. Therefore, in addition to the epidemiological studies, the development of new biology, gene technology and medical biotechnology methods may significantly enhance the specificity of the epidemiological studies. Thus, the fusion of molecular biology and epidemiology into molecular epidemiology may provide more specific methods for monitoring the occupational dependent carcinogenic risk of individuals and groups.

Humans↗

[A case of breast cancer detected by MRI mammography after Hollywood syndrome].

A-64-year-old woman, who had been treated with augmentation mammaplasty 40 years ago, came to our hospital complaining of left breast pain. The mass was ill-defined, located in the upper outer quadrant area of her breast, and was 2 cm in diameter. MRI examination showed that the tumor had a spiculation and an irregular edge. There were no regional lymph nodes in her axilla and supra-subscapular. The diagnosis was Class IV by the fine needle aspiration biopsy cytology. We diagnosed the left breast cancer being in T2N0M0, Stage IIA, then we carried out Bt (Auchincloss method) and Sentinel lymph node biopsy (SLNB). There were metastatic cancer cells in the sentinel lymph node. So, we added level II lymph nodes dissection. The histological diagnosis was papillotubular carcinoma, f+, n+ (8/11). The endocrine receptor status of the tumor was ER+, PgR+ and the HER2/neu score was 0. There was paraffinoma in the non-cancer area. We dosed 6 cycles of FEC chemotherapy (CPA 800 mg, EPI 80 mg, 5-FU 750 mg/body x 1 cycle). We recognized no side effects of the chemotherapy for the patient.

Adenocarcinoma↗

Serum peptidome for cancer detection: spinning biologic trash into diagnostic gold.

The low molecular weight region of the serum peptidome contains protein fragments derived from 2 sources: (a) high-abundance endogenous circulating proteins and (b) cell and tissue proteins. While some researchers have dismissed the serum peptidome as biological trash, recent work using mass spectrometry-based (MS-based) profiling has indicated that the peptidome may reflect biological events and contain diagnostic biomarkers. In this issue of the JCI, Villanueva et al. report on MS-based peptide profiling of serum samples from patients with advanced prostate, bladder, or breast cancer as well as from healthy controls. Surprisingly, the peptides identified as cancer-type-specific markers proved to be products of enzymatic breakdown generated after patient blood collection. The impact of these results on cancer biomarker discovery efforts is significant because it is widely believed that proteolysis occurring ex vivo should be suppressed because it destroys endogenous biomarkers. Villanueva et al. now suggest that this suppression may in fact be preventing biomarker generation.

Biomarkers↗

Nonrandom changes of chromosome 10 in bladder cancer. Detection by FISH to interphase nuclei.

Fluorescence in situ hybridization (FISH) to interphase nuclei has been a valuable method for examining the chromosome copies in tumor cells in clinical practice. Twelve cases of transitional cell carcinoma (TCC) of the bladder were investigated with a biotin-labeled repetitive DNA probe to detect numerical aberrations of chromosome 10 in interphase nuclei. The cells containing one fluorescent signal were screened in two of seven non-invasive tumors and in four of five invasive tumors. Two patients presented two FISH spots of different sizes. More than two signals were seen in one invasive tumor. The findings suggest that partial or complete loss of a chromosome 10 is a nonrandom aberration in bladder cancer.

Carcinoma, Transitional Cell↗

Accuracy of frozen section diagnosis in breast cancer detection. A review of 4436 biopsies and comparison with cytodiagnosis.

Frozen section diagnosis (FSD) given in 4436 consecutive breast biopsies performed in 5 years in a single pathology laboratory were checked against the final pathological report. In 4284 cases (96.57%) there was no difference between the FSD and the definitive diagnosis. There were 74 (1.66%) false negative reports and no false positive diagnoses. The diagnosis was deferred to paraffin sections in 78 cases (1.75% of biopsies). The predictive value for positive results was 100% and for negative results 97.5%; the specificity was 100%, the sensitivity 94.6% and the accuracy 98.3%. Minimal breast cancer, in situ (CIS) especially, was the main source of false negative reports. In non minimal invasive cancers (NMIC) FSD was correct in 99.42%. In minimal invasive cancers (MIC) FSD was correct in 80.21%, false negatives and deferred diagnosis increased to 8.79% and 10.98%. In CIS false negatives increased to 76.82% and deferred diagnoses to 12.19%. The sensitivity of fine needle aspiration, performed before biopsy in a portion of the patients, was lower than FSD in NMIC (71.39% versus 99.21%) and in MIC (41.66% versus 80.55%), identical to FSD in CIS (7.40% versus 7.40%). The value of cytodiagnosis in addressing surgery is discussed.

Biopsy↗

Fourier transform infrared spectroscopy in cancer detection.

The rapid developments in the field of infrared spectroscopy in the past decade have demonstrated a potential for disease diagnosis using noninvasive technologies. Several earlier studies have highlighted the advantage of using infrared spectroscopy both in the near- and mid-infrared regions for diagnostic purposes at clinical levels. The areas of focus have been the distinction of premalignant and malignant cells and tissues from their normal state using specific parameters obtained from Fourier transform infrared spectra, making it a rapid and reagent-free method. While it still requires pilot studies and designed clinical trials to ensure the applicability of such systems for cancer diagnosis, substantial progress has been made in incorporating advances in computational methods into the system to increase the sensitivity of the entire setup, making it an objective and sensitive technique suitable for automation to suit the demands of the medical community. The development of fiber-optics systems for infrared spectroscopy have further opened up new and modern avenues in medical diagnosis at various levels of cells, tissues and organs under laboratory and clinical conditions.

Fiber Optic Technology↗

Imaging in breast cancer: diffuse optics in breast cancer: detecting tumors in pre-menopausal women and monitoring neoadjuvant chemotherapy.

Diffuse optical spectroscopy (DOS) and diffuse optical imaging (DOI) are non-invasive diagnostic techniques that employ near-infrared (NIR) light to quantitatively characterize the optical properties of centimeter-thick, multiple-scattering tissues. Although NIR was first applied to breast diaphanography more than 70 years ago, quantitative optical methods employing time- or frequency-domain 'photon migration' technologies have only recently been used for breast imaging. Because their performance is not limited by mammographic density, optical methods can provide new insight regarding tissue functional changes associated with the appearance, progression, and treatment of breast cancer, particularly for younger women and high-risk subjects who may not benefit from conventional imaging methods. This paper reviews the principles of diffuse optics and describes the development of broadband DOS for quantitatively measuring the optical and physiological properties of thick tissues. Clinical results are shown highlighting the sensitivity of diffuse optics to malignant breast tumors in 12 pre-menopausal subjects ranging in age from 30 to 39 years and a patient undergoing neoadjuvant chemotherapy for locally advanced breast cancer. Significant contrast was observed between normal and tumor regions of tissue for deoxy-hemoglobin (p = 0.005), oxy-hemoglobin (p = 0.002), water (p = 0.014), and lipids (p = 0.0003). Tissue hemoglobin saturation was not found to be a reliable parameter for distinguishing between tumor and normal tissues. Optical data were converted into a tissue optical index that decreased 50% within 1 week in response to neoadjuvant chemotherapy. These results suggest a potential role for diffuse optics as a bedside monitoring tool that could aid the development of new strategies for individualized patient care.

Adult↗

Model selection for a medical diagnostic decision support system: a breast cancer detection case.

There are a number of different quantitative models that can be used in a medical diagnostic decision support system (MDSS) including parametric methods (linear discriminant analysis or logistic regression), non-parametric models (K nearest neighbor, or kernel density) and several neural network models. The complexity of the diagnostic task is thought to be one of the prime determinants of model selection. Unfortunately, there is no theory available to guide model selection. Practitioners are left to either choose a favorite model or to test a small subset using cross validation methods. This paper illustrates the use of a self-organizing map (SOM) to guide model selection for a breast cancer MDSS. The topological ordering properties of the SOM are used to define targets for an ideal accuracy level similar to a Bayes optimal level. These targets can then be used in model selection, variable reduction, parameter determination, and to assess the adequacy of the clinical measurement system. These ideas are applied to a successful model selection for a real-world breast cancer database. Diagnostic accuracy results are reported for individual models, for ensembles of neural networks, and for stacked predictors.

Algorithms↗