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At least 19 recordsLinked to original sources

[Clinical management and prognostic analysis of primary peritoneal neoplasms].

OBJECTIVE: To investigate the clinical management strategies and prognostic factors of primary peritoneal neoplasms. METHODS: We retrospectively reviewed the clinical and pathological records of 24 cases with primary peritoneal neoplasms treated in the People's Hospital, Peking University during May 1995 and April 2004. RESULTS: Among 24 cases, 15 patients were diagnosed as serous papillary adenocarcinoma (9 highly and intermediately differentiated, and 6 lowly differentiated), 6 as mixed epithelial carcinoma and 3 as mixed malignant Mullerian tumor (MMMT). All patients underwent cytoreductive surgery, 21 cases having, suboptimal debulking one. Then they received a platinum-based chemotherapy. Thirteen cases received paclitaxel + cisplatin (TP) and 9 received cisplatin + doxorubicin + cyclophosphamide (PAC) combination chemotherapy. The primary response reached 80% (complete response 55% and partial response 25%). The median survival of all patients was 42 months (95% CI = 22-62 months). Survival for patients with primary peritoneal serous papillary carcinoma (PPSPC), mixed epithelial carcinoma and MMMT was 44, 19 and 13 months respectively, with a significant difference between PPSPC and MMMT (P < 0.05). Patients receiving TP combination also exhibited longer survival than those receiving PAC regimen (mean survival 75 vs 28 months, P < 0.05). CONCLUSIONS: Patients with primary peritoneal neoplasms should be treated with appropriate cytoreductive surgery. A primary surgical protocol is bilateral salpingo-oophorectomy and omentectomy. Overestimating an optimal debulking surgery may have no benefit on the survival. TP combination therapy may bring longer survival than PAC regimen. Histopathologic types and chemotherapy regimens are the essential factors of the prognosis.

Antineoplastic Combined Chemotherapy Protocols↗

Histopathological studies on experimentally induced pulmonary, pleural and peritoneal neoplasms in mice by intraperitoneal injection of chrysotile asbestos and N-methyl-N-nitrosourethane.

The cocarcinogenic effects of asbestos are presented. In lung carcinomas induced in mice, the number of carcinomas and the time of detection of the first carcinoma per tumor-bearing animals were greater and faster in the group with chrysotile plus MNU than either chrysotile or MNU alone. This suggested that chrysotile asbestos had a promoting or cocarcinogenic effect on some carcinogens in the respiratory tract. In the group treated with chryotile alone, a tumor was found in the right pleural cavity at 15 months. This tumor microscopically was similar to the biphasic form of the human diffuse mesothelioma. Microvilli, basement membrane, and junctional apparatus were seen by electron microscope, but other cytoplasmic organelles of the tumor cells were relatively scanty. Two peritoneal tumors developed in gastric and intestinal serosa at 11 and 12 months. Light and electron microscopic studies suggested that the tumors were probably myosarcomas or fibrosarcoms.

Adenocarcinoma↗

Cytologic identification of serous neoplasms in peritoneal fluids.

BACKGROUND: Recognition of serous neoplasms in peritoneal fluids and their subclassification into serous borderline tumors (SBT) and serous carcinomas (SCA) may be difficult. The objective of this study was to determine whether morphologic criteria can distinguish reactive mesothelial cells (RM), SBT, and SCA (grades 1-3) in peritoneal fluids. METHODS: A blinded review of 42 peritoneal fluids from 40 patients with histologically confirmed RM (n = 10 patients), SBT (n = 7 patients; 3 with primary ovarian tumors and 4 with primary peritoneal tumors), and SCA (n = 23 patients; 7 with grade 1 tumors, 6 with grade 2 tumors, and 10 with grade 3 tumors; 12 with primary ovarian tumors and 11 with primary peritoneal tumors) evaluated papillae presence and size, intercellular windows, group contours, dyshesion, nuclear atypia, size and overlap, cell size, and nucleoli and nuclear-to-cytoplasmic ratios. From these parameters, specimens were classified as RM, SBT versus grade 1 SCA, or grade 2 SCA versus grade 3 SCA. RESULTS: RM were identified as groups of small cells with minimal nuclear atypia and overlap, intercellular windows, and irregular group borders without papillae. No features differentiated SBT from grade 1 SCA. Grade 2 and 3 SCA showed more nuclear atypia and overlap with larger nuclei and cells. Thirty-nine of 42 specimens (95%) were correctly identified as RM or serous neoplasm. Two SBT specimens and one grade 1 SCA specimen were overcalled, and three SCA specimens (two grade 2 and one grade 3) were undergraded. CONCLUSIONS: The distinction of RM from serous neoplasms in peritoneal fluids is possible in most patients by examination of cell group architecture, nuclear atypia, and nuclear size. Differentiation of SBT from grade 1 SCA is not reliable, meriting a differential diagnosis. Most high-grade SCA specimens can be identified by increased nuclear atypia, overlap, and size.

Adult↗

Ascitic fluid alpha 1-antitrypsin.

Ascitic fluid alpha 1-antitrypsin (AF-AAT) was compared with ascitic fluid total protein (AF-TP) and the serum-ascites albumin gradient (SAAG) in the differential diagnosis of ascites. The study included 82 consecutive patients of which 42 had cirrhosis, 8 hepatoma (with cirrhosis), and 27 malignant ascites (peritoneal 18, liver 9). The concentration of AF-AAT (milligrams per deciliter) was significantly elevated (P less than 0.001) in hepatoma (174 +/- 123), malignant liver disease (232 +/- 119) and peritoneal neoplasms (376 +/- 106) in comparison with cirrhotics (66 +/- 33). In separating ascites caused by cirrhosis or malignancy, AF-AAT (discriminating limit of 120 mg/dl) had a 96% sensitivity, 95% specificity, and 96% diagnostic efficacy, which was superior to the 87% observed for AF-TP and 86% for the SAAG. Similar results were obtained for the A/S AAT ratio but this test was not available in all patients. AF-AAT was particularly useful in patients with malignancy causing portal hypertension as assessed by SAAG (hepatoma, malignant liver disease). We conclude that AF-AAT may be a valuable parameter in the differential diagnosis of ascites.

Ascites↗

Rare diffuse peritoneal malignant neoplasms: CT findings in two cases.

In the peritoneal cavity, diffuse serosal replacement by tumor is demonstrated usually by extensive carcinomatous involvement from gastric, colonic, or pancreatic tumors or less frequently by mesothelioma. Primary tumors other than mesothelioma are extremely rare in the peritoneum. The computed tomographic appearances of two cases of rare peritoneal tumors, epithelioid hemangioendothelioma and desmoplastic small round cell tumor, are described.

Adult↗

Primary neoplasms of peritoneal and sub-peritoneal origin: CT findings.

Peritoneal carcinomatosis is a common metastatic manifestation of many organ-based malignancies, particularly carcinomas of the gastrointestinal tract and ovaries. Primary neoplasms of peritoneal and sub-peritoneal origin occur much less frequently than metastatic peritoneal involvement from a known or occult primary tumor; however, these rare primary lesions (peritoneal mesothelioma, papillary serous carcinoma, desmoplastic small round cell tumor, benign and malignant mesenchymal tumors, lymphoproliferative disorders) are often first detected at computed tomography (CT) and should be considered in the absence of a known or suspected organ-based malignancy. A precise diagnosis based on imaging findings alone is often not possible. Furthermore, distinguishing a benign from a malignant process and a primary from a metastatic process is also challenging. Nevertheless, CT features combined with the patient's relevant clinical and demographic data can help narrow the differential diagnosis for a peritoneum-based neoplasm in many cases. CT is useful not only for the detection, characterization, and staging of primary neoplasms of peritoneal and subperitoneal origin, but also for guiding biopsy for tissue diagnosis.

Humans↗

Appendiceal neoplasms with peritoneal dissemination: outcomes after cytoreductive surgery and intraperitoneal hyperthermic chemotherapy.

BACKGROUND: Appendiceal neoplasms frequently present with peritoneal dissemination (PD) and have a clinical course marked by bowel obstruction and subsequent death. Few data have correlated outcome with appendiceal histology after cytoreductive surgery and intraperitoneal hyperthermic chemotherapy (IPHC). We have reviewed our experience with cytoreductive surgery and IPHC for PD from the appendix. METHODS: A total of 110 cases of PD from proven appendiceal neoplasms treated with IPHC were identified from a prospectively managed database. Tumor samples were classified on pathologic review as disseminated peritoneal adenomucinosis (n = 55), peritoneal mucinous carcinomatosis (PMCA) with intermediate features (n = 18), PMCA (n = 29), or high-grade nonmucinous lesions (n = 8). A retrospective review was performed with long-term survival as the primary outcome measure. RESULTS: A total of 116 IPHCs were performed on 110 patients for appendiceal PD between 1993 and 2004. The 1-, 3-, and 5-year survival rates for all cases were 79.9% +/- 4.1%, 59.0% +/- 5.7%, and 53.4% +/- 6.5%, respectively. When stratified by histology, disseminated peritoneal adenomucinosis and intermediate tumors had better 3-year survival rates (77% +/- 7% and 81% +/- 10%) than PMCA and high-grade nonmucinous lesions (35% +/- 10% and 15% +/- 14%; P = .0032 for test of differences between groups). Age at presentation (P = .0134), performance status (P < .0001), time between diagnosis and IPHC (P = .0011), resection status (P = .0044), and length of hyperthermic chemoperfusion (P = .0193) were independently associated with survival. CONCLUSIONS: The data show that long-term survival is anticipated in most patients who are treated with cytoreduction and IPHC for appendiceal PD. The findings presented herein underscore the important prognostic characteristics that predict outcome after IPHC in patients with PD. In all, this work establishes a framework for the consideration of IPHC in future trials for appendiceal PD.

Adenocarcinoma, Mucinous↗

Diallyl disulfide suppresses growth of HL-60 cell through increasing histone acetylation and p21WAF1 expression in vivo and in vitro.

AIM: To examine the differentiation induction and growth inhibition of HL-60 cells by diallyl disulfide (DADS), and its relationship with the alterations of histone acetylation and p21(WAF1) expression in vitro and in vivo. METHODS: Differentiation was studied by nitroblue tetrazolium (NBT) reduction of HL-60 cell in vitro. HL-60 cells 5x10(6) were injected into the right side of the peritoneal cavity of severe combined immunodeficiency (SCID) mice. When the peritoneal neoplasms were detected, the SCID mice were randomly divided into 3 groups and received an ip injection of vehicle alone (NS), DADS or sodium butyrate (SB). The growth inhibition of peritoneal neoplasms induced by DADS was observed by a growth curve. The cycle distribution of HL-60 cells in SCID mice was monitored by flow cytometry. The expression of acetylated histone H3, H4 and p21(WAF1) were measured by Western blot. RESULTS: After treatment with DADS for 0-72 h, the NBT reduction ability of HL-60 cells increased in a time-dependent manner, compared with no treatment of HL-60 cells. In the HL-60 cells treated with DADS for 24 h, the expression of acetylated histone H3, H4, and p21(WAF1) increased obviously. After treatment with DADS, tumor growth was markedly suppressed. HL-60 cells from mice treated with DADS were blocked in the G1 phase, from 25.4% to 63.4%. The tumors from the mice treated with DADS showed an increase of acetylated histone H3, H4, and p21(WAF1). CONCLUSION: DADS could induce differentiation and inhibit the growth of HL-60 cells through increasing the expression of acetylated histone H3, H4, and p21(WAF1) in vitro and in vivo.

Acetylation↗

[X-ray computed tomography in the diagnosis of peritoneal and retroperitoneal neoplasms].

CT findings of peritoneal and retroperitoneal neoplasms were evaluated in 24 patients. The accuracy of CT in locating peritoneal and retroperitoneal tumors was 87% and in differentiating benign from malignant ones 96%. It is difficult to evaluate the tumors histopathologically. We suggest that CT scan be preferable in diagnosis of tumors in that area.

Adolescent↗

[Mortality study of a cohort of insulation workers].

Cause specific mortality was investigated in a cohort of insulators employed by a company which operated in various parts of Italy. Follow-up covered the years 1960-1996. The cohort, which included 893 subjects, was derived from company files of relatively poor quality, which resulted in a high rate of lost to follow-up (10.1%) and of deaths with unknown cause (12.4%). The mortality experience of the cohort was contrasted with that of the Italian population. Overall mortality (SMR 141, 90% CI 118-167, 97 observed), and cancer mortality (SMR 165, 90% CI 123-216, 38 observed) were significantly increased. Among neoplasms, significant increases were observed for lung cancer (SMR 202, 90% CI 124-311, 15 observed), pleural neoplasms (SMR 2667, CI 90% 911-6103, 4 observed), and peritoneal neoplasms (SMR 1853, 90% CI 329-5832, 2 observed). The excess mortality for lung cancer was especially pronounced in subjects with latency time longer than ten years (SMR 237.1, 90% CI 140-377, 13 observed).

Adult↗