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A comparison between the macrophage migration inhibition test (MMI) and the leucocyte adherence inhibition test (LAI) in patients with melanoma and carcinoma of the colon.

Patients with progressing tumours have circulating leucocytes which are sensitised to tumour specific antigens and their serum contains blocking factors. Patients who have tumours which have been successfully destroyed do not have circulating blocking factors although their lymphocytes continue to remain sensitised to the tumour antigens. Two tests, known to detect cellular sensitisation and serum blocking activity, the leucocyte adherence inhibition test (LAI) and the macrophage migration inhibition test (MMI) have been compared in a small group of patients with malignant melanoma and carcinoma of the colon. There was agreement between the results of both tests in over three-quarters of the tests performed and in those which failed to agree neither test was favoured in relation to the known tumour state of the patient. Thirty-two tests were performed in 22 patients, there was one false positive with MMI testing, seven false negative results for the LAI test and six for the MMI test.

Animals

Mucinous carcinoma of anal duct origin presenting clinically as a vaginal cyst.

The vast majority of vaginal submucosal cysts are benign lesions. Primary malignant tumors of the vagina are infrequent and most are mucosal lesions. A case is described in which an unusual neoplasm, anal duct carcinoma, presented clinically as a vaginal lesion. The importance of considering anal neoplasia in the differential diagnosis of cystic vaginal lesions is noted.

Adenocarcinoma, Mucinous

Carcinoma of the large bowel in the Sudan.

Large bowel cancer is not common but is showing increased frequency in the northern part of the Sudan. It is relatively uncommon among southerners, which may be due to the socio-economic factors prevailing in the Sudan. The disease affected our population at a younger age than has been generally reported in the literature, and the lesions in nearly 30 per cent were of the mucoid and undifferentiated types. The incidence in young adults is difficult to explain in the absence of precancerous lesions, and there is not enough evidence to incriminate parasitic infestation.

Adenocarcinoma

Higher Expression of HPV16 Derived E7_LI Transcript Observed in Men With HIV and Recurrent Anal Cancer.

Squamous cell carcinoma of the anus (SCCA) or anal cancer (AC) is an understudied cancer with a high occurrence rate in people with HIV (PWH), especially men having sex with men (MSM). Furthermore, AC recurs in approximately one-fourth of patients who undergo standard care with chemoradiation therapy (CRT). Using bulk RNA sequencing data of AC obtained from 12 patients with non-recurrent (NR, N&#x2009;=&#x2009;9) or recurrent (R, N&#x2009;=&#x2009;3) cancer, we previously showed upregulated expression of key immune genes in the NR compared to the R group. Although the main causative agent of AC is high-risk human papillomavirus (HPV), association of host and viral RNA transcript expression contributing to AC recurrence has not been extensively studied. The objective of the current study was to determine whether enrichment of specific HPV genotypes and/or HPV gene expression patterns differentiate the two groups and if any specific viral (HPV) and host (human) immune mediators correlate with each other. Using bulk RNA sequencing data and VIRTUS 2, we detected viral RNA reads mapping to seven high-risk and six low-risk HPV types, of which the high-risk HPV16 observed in 83% (10/12) AC tumors (7/9 NR and 3/3 R). Rate of all HPV genomes trended toward a decrease in NR AC isolates and correlation between HPV types was more commonly observed in low-risk ones. Analysis of HPV 16 gene expression profile showed a significantly lower positivity rate for a polycistronic transcript encoding for E7^L1 in the NR group (1/9, NR vs. 3/3, R, p&#x2009;<&#x2009;0.05). An unbiased correlation analysis of HPV-human transcript expression showed a direct correlation between HPV transcripts and human genes involved in cell growth. The data also identified human transcripts showing an inverse correlation with HPV gene expression. These included genes involved in negative regulation of growth, proliferation, and immune response. Taken together, these data indicate that concurrent analyses of viral and host factors in the same tumor can identify potential new therapeutic targets to ameliorate cancer recurrence post-treatment.

Humans

Anal carcinoma: basic concepts and management.

Surgery has been the mainstay in the management of anal carcinoma. However, anal carcinomas are reasonably sensitive to ionizing radiation. By appropriate combinations of external radiation beams and interstitial implantation techniques, curative therapy with preservation of anal continence can be rendered by radiation alone. Sufficient radiation dose to the draining lymph nodes, both intraabdominal and inguinal, along with intensified dose to the primary lesions, is required for high cure and low complication rates.

Anus Neoplasms

Leiomyomas of the rectum and anal canal: report of six cases and review of the literature.

Since 1872, 168 rectal leiomyomas have been reported in the world literature. Their incidence, therefore, is very low. It is estimated that one leiomyoma may be seen for every 2,000 or more rectal tumors. Those leiomyomas located in the anal canal and sphincter are the rarest. A case is reported here that appears to be the eleventh in such a location. The incidence of these lesions is highest between the ages of 40 and 59 years. Most patients have a combination of symptoms rather than a single one, the most frequent of these being the presence of a mass, bleeding, and constipation. Almost always, the chain of events that leads to the diagnosis starts when the tumor is discovered by digital examination of the rectum. The lack of reliable criteria of malignancy and the marked tendency to recur shown by these tumors are the two main problems the surgeon faces when selecting the operative procedure to be used. We believe that those tumors with an original size of 5 cm or more in largest diameter are the ones that have shown the highest tendency to recur, mostly as sarcomas. Therefore it is thought that these lesions should be treated radically from the beginning, especially when they recur. More adequate follow-up studies are needed.

Adult

Granular-cell tumors (myoblastomas) of the anal region.

Three cases of granular-cell tumor of the perianal region are reported. The clinical and pathologic features of these tumors are reviewed. Their precise histogenesis remains uncertain. The association with pseudoepitheliomatous hyperplasia of the overlying epithelium, which was well illustrated in two of the three cases, is discussed. The lesions are nearly always benign, and the treatment of choice is local excision.

Adult

Update '77.

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Animals

Urologic complications after operations for anorectal cancer, with an evaluation of preoperative intravenous pyelography.

Urologic complications arose in 23.7 per cent of 569 patients who underwent abdominoperineal or low anterior resection for anorectal cancer. No radomization of the two operations was attempted, low anterior resection being performed whenever resection 5 cm below the tumor was possible. Complications were more frequent after abdominoperineal resection and in men. Preoperative intravenous pyelography was performed in the cases of 541 of the patients, including 60 who underwent palliative colostomy. The pyelograms of 30 per cent of these patients were abnormal. The abnormalities were anatomic variations of the urinary tract in 25 per cent and urologic diseases in 75 per cent. None of the postoperative urologic complications was related to an abnormal preoperative pyelogram. No relation was found between the radicality of abdominoperineal and low anterior resection and the pyelographic signs of tumor involvement.

Anus Neoplasms

Carcinoma of anal-ductal origin: report of a case.

A 57-year-old man who had a carcinoma proven to be of anal ductal origin is presented. Recurrent perianal fistulas were treated locally for two years until biopsy proved the malignancy. Gross and histologic examination of the specimen removed by abdominoperineal resection demonstrated the anal ductal origin of this tumor. Recurrence was seen in less than a year.

Adenocarcinoma, Mucinous

A case of rectal carcinoma concomitant with Pagetoid lesion in the perianal region--histopathological and electron microscopic observations--.

A case of extramammary Paget's disease of the perianal area adjacent to a mucinous adenocarcinoma of the rectum is presented. The histopathological examination of the case revealed that within the epidermis adjacent to the invading rectal cancer nest, the formation of glandular structures can be observed occasionally, around which so-called Paget's cells are noted to be scattered and further many points of similarity between cancer cell and Paget's cell are proved by electron microscope. Perianal skin lesion looking like Paget's disease is proved to be due to intraepidermal spread of the rectal carcinoma. Referring to the literature, this is the first report to our knowledge, to elucidate the histogenesis of perianal extramammary Paget's disease associated with a rectal carcinoma using the electron microscopy.

Adenocarcinoma, Mucinous

The conservative management of anorectal cancer by radiotherapy.

Thirteen patients with an anal or rectal carcinoma were given curative radiotherapy. Four had medically inoperable tumors, one had a surgically inoperable tumor and eight refused abdominoperineal resection. Six patients received external radiotherapy only. Seven patients received external radiotherapy and an interstitial implant. Nine of thirteen patients (60 per cent) are alive without evidence of disease from fifteen to fifty-five months (average, 30 months). Six of seven patients who received external radiotherapy combined with an interstitial implant were controlled locally, whereas three of six patients who received external radiotherapy only were controlled. Patients who underwent total excision and/or fulguration prior to irradiation had better local control than those who underwent either biopsy only or a subtotal excision. This treatment method may be offered as an alternative to abdominoperineal resection in patients who are medically unfit or who refuse surgery.

Adenocarcinoma

Bowen's disease of the anal and perianal area. A report and analysis of twelve cases.

Retrospective evaluation of twelve patients treated at the Cleveland Clinic for perianal Bowen's disease showed that these patients can be cured by wide local excision with skin grafting when necessary. No recurrence or metastasis was found during the follow-up period when the systematic technic was used. Only involved anal mucosa was removed, and normal mucosa was preserved; this aids in controlling anal continence. The margins of the resected skin must be subjected to frozen section study to be sure that total excision has been achieved. In this study a diagnosis of perianal Bowen's disease was made incidentally in six of the twelve patients during histologic examination of anorectal tissue removed for other reasons. Seven of the twelve either had had a systemic or cutaneous cancer previously or another systemic or cutaneous cancer subsequently developed, indicating the high association between Bowen's disease and other cancers. Therefore, it is important that all excised skin from anal or perianal operations be submitted for histologic examination, and if the diagnosis is Bowen's disease, the lesion must be completely removed using wide local excision. These patients should be evaluated and followed up because other malignancies may be present or evolve at a later time.

Adult