IL-10 contributes to the suppressive function of tumour-associated myeloid cells and enhances myeloid cell accumulation in tumours.

Studies have revealed that tumour-associated myeloid cells (TAMC) are one of the major sources of IL-10 in tumour-bearing mice. However, the significance of TAMC-derived IL-10 in tumour immunity is poorly understood. Here, we show that IL-10 blockade or IL-10 deficiency reduces the capacity of TAMC in suppressing the proliferation of P1A-specific CD8 T cells. In the spleen, IL-10-deficient and wild-type (WT) mice bearing large tumour burdens have similar TAMC populations. The tumours from IL-10-deficient mice, however, have reduced numbers of TAMC compared with tumours from their WT counterparts. IL-10⁻/⁻ RAG-2⁻/⁻ mice also had reduced numbers of TAMC compared with tumours from IL-10⁺/⁺ RAG-2⁻/⁻ mice; therefore, the reduction in TAMC in IL-10-deficient tumours was not because of adaptive immune response in tumours. Adoptively transferred tumour antigen-specific CD8 T cells expanded more efficiently within tumours in IL-10⁻/⁻ RAG-2⁻/⁻ mice than in tumours from IL-10⁺/⁺ RAG-2⁻/⁻ mice. Cytotoxic T lymphocyte adoptive transfer therapy prevented tumour evasion in IL-10⁻/⁻ RAG-2⁻/⁻ mice more efficiently than in IL-10⁺/⁺ RAG-2⁻/⁻ mice. Thus, IL-10 enhances the accumulation of myeloid cells in tumours, and TAMC-derived IL-10 suppresses the activation and expansion of tumour antigen-specific T cells.

Colposcopic evaluation of patients with abnormal cytologic smears during pregnancy.

One-hundred thirty-two patients with abnormal Papanicolaou smears of the cervix uteri during pregnancy underwent colposcopic evaluation. Seventy-five patients had biopsies during pregnancy, and 34 patients had colposcopic evaluation without performing any biopsy. Postpartum colposcopic evaluation was performed on 95 patients. In 93 patients of this group, the postpartum cytologic and histologic information obtained was the same or less than that obtained in antepartum evaluation. In only 1 case, antepartum colposcopically guided biopsy at 38 weeks' gestation revealed moderate dysplasia, and postpartum cold conization showed carcinoma in situ. In another case, colposcopic evaluation and biopsy during pregnancy showed mild dysplasia while colposcopic biopsy as well as examination of a hysterectomy specimen taken at 16 months after delivery revealed severe dysplasia. No case of invasive carcinoma was missed during pregnancy. The results of this study, in support of previous reports, show that colposcopic evaluation is a simple, safe, and accurate method of investigating abnormal Papanicolaou smears during pregnancy.

Diethylstilbestrol-related clear-cell adenocarcinoma in women with initial examinations demonstrating no malignant disease.

The DES Screening Center of Queens, Nassau, and Suffolk counties has screened approximately 2000 diethylstilbestrol (DES)-exposed women since its inception in 1979. Four women, who at their initial visit were noted to have only nonmalignant DES-related changes, subsequently developed clear-cell adenocarcinoma while under observation, between 18-81 months after their first colposcopy. The age at diagnosis ranged from 16-31. Three patients had been receiving close follow-up; one had not. These cases emphasize the need for frequent follow-up for these patients using careful inspection and palpation, vaginal and cervical cytology, colposcopy, and colposcopically directed biopsy of suspicious areas.

Colposcopic evaluation of patients with abnormal cervical cytology.

A total of 1580 new patients underwent colposcopic evalution in the Dysplasia Clinic at Nassau County Medical Center. Of these patients, 186 had abnormal Papanicolaou smears associated with pregnancy, 150 were referred because of in utero exposure to diethylstilbestrol, and 1244 were referred because of abnormal cervical cytologic smear or suspicious cervical or vaginal lesion. Further analysis of this latter group revealed that 1184 (95%) patients had satisfactory colposcopic evaluation, and directed biopsy showed the following: 10 cases of invasive cervical carcinoma, 9 of carcinoma in situ with microinvasion, 118 of cervical carcinoma in situ, 110 of severe dysplasia, and 424 cases of mild to moderate cervical dysplasia. All of these patients subsequently were treated accordingly. Evaluation of final histologic specimen revealed a very high correlation with colposcopically guided biopsies. In 54 patients, where colposcopic evaluation was unsatisfactory, diagnostic cold knife conization was performed. Final histologic diagnosis disclosed a more advanced lesion in 30 patients (or 56%) of this group. The result of this study shows that satisfactory colposcopic evaluation is a highly accurate method of evaluation of abnormal cervical and vaginal cytologic smear.

Coloscopy clinic: an evaluation of 500 new patients.

Among the many responsibilities of the gynecologist in modern practice is the detection of neoplasia at the earliest possible opportunity. The advances made in the field of cytology as related to the practice of gynecology are well known and have significantly changed the detection of cervical carcinoma. The resurgence of colposcopy in the evaluation of patients with abnormal cervical cytology has added valuable new dimensions in the understanding of early cervical neoplasia and our ability to diagnose and treat these lesions. The complete acceptance of colposcopy as an essential step in the study of such patients requires a re-education and alteration in the philosophy of management which has been prevalent in American gynecologic practice to date.

The combined use of cytology and colposcopy in enhancing diagnostic accuracy in preclinical lesions of the uterine cervix.

In an attempt to evaluate the accuracy of cytologic and colposcopic findings (alone and in combination) in detecting preclinical lesions of the uterine cervix, diagnoses made in 170 consecutive patients referred for colposcopic examination at Nassau Hospital because of an abnormal Papanicolaou smear were reviewed. We found that of the investigative methods available prior to biopsy, a combined cytologic and colposcopic evaluation is preferred since it is highly accurate in predicting the degree of severity of a lesion (84.6% of all cases reviewed) and, in our experience, eliminates the problem of false negatives, which are encountered when either method is used to the exclusion of the other.