The association of plasma micronutrients with the risk of cervical dysplasia in Hawaii.

Limited data from hematological studies suggest that certain nutrients, including carotenoids, tocopherols, and vitamin C, may protect against malignant change in cervical tissue. Recognizing that human papillomavirus (HPV) infection induces most neoplastic transformation of cervical tissue, the authors conducted a case-control study to examine the association of plasma micronutrient concentrations with the risk of cervical dysplasia after careful adjustment for HPV infection, using a sensitive and reliable HPV detection method. The sample included 147 multiethnic women, between 18 and 65 years of age, with biopsy-confirmed squamous intraepithelial lesions (SILs) of the cervix and 191 clinic controls identified between 1992 and 1996. Cases were identified through cytology and pathology logs in three clinics on Oahu, Hawaii. Controls were selected randomly from admission logs of the participating clinics. In-person interviews were conducted in the subjects' homes, and a fasting blood sample was drawn to measure plasma levels of lutein, lycopene, cryptoxanthin, total carotene, retinol, tocopherol, ascorbic acid, and cholesterol. The presence and type of HPV was determined in exfoliated cell samples using PCR dot blot hybridization. Mean plasma lycopene, total cryptoxanthin, and alpha-cryptoxanthin levels were lower among cases than controls. We found an inverse dose-response of alpha-cryptoxanthin, total tocopherol, and alpha-tocopherol to the odds ratios for cervical SIL after adjustment for HPV and other confounders. The odds ratio among women in the highest compared with the lowest quartile was 0.3 (95% confidence interval, 0.1-0.7) for alpha-cryptoxanthin and 0.3 (95% confidence interval, 0.1-0.8) for alpha-tocopherol. Negative trends in the odds ratios were suggested for other carotenoids and vitamin C, but these were weak, and confidence intervals were wide. Our results support existing evidence that high plasma levels of antioxidants may reduce the risk of cervical SILs independent of HPV infection. These findings are significant because diet is potentially modifiable, and nutrition education and dietary intervention might be targeted at specific high-risk groups.

Surgery and prognosis in stage III epithelial ovarian cancer.

The results of this retrospective case study indicate that a composite of tumor grade, pattern of spread and substage at the time of opening affects the outcome most in the treatment of stage III epithelial tumors of the ovary. The poorest prognosis was associated with grade 3 histology, a pattern of spread requiring extensive and often difficult surgery for removal and a high substage. The best prognosis was usually associated with grade 1, with either very easily removed, isolated spread or low substage. The extent of tumor defined the degree of primary cytoreduction possible. If the tumor was minimally extensive, primary cytoreduction results were excellent. The same conclusions were reached in the case of secondary cytoreduction at the time of second-look procedure. There was no statistically significant difference (z = 1.481, P = 0.069) in 5-year survival between patients with microscopic only disease (59%) at second-look, and patients with gross disease not cytoreduced (36%).

Diagnostic value of the Hemalog D-90 in classifying acute childhood leukaemias.

Accurate classification of the acute leukaemias is dependent not only on morphological characteristics, but also on cytochemical staining properties of the blasts in peripheral blood and bone marrow. This study was undertaken to evaluate the Hemalog D-90, an automated cytochemistry system for white cell differential counts, as an adjunct to conventional microscopy in the classification of acute childhood leukaemias. Fifty-two patients were classified according to morphology and cytochemical reactions of the cells obtained from peripheral blood. In 29 with classical acute lymphoblastic leukaemia (ALL), the Hemalog D showed the lymphoblasts to be non-peroxidase staining and these were recorded mainly as lymphocytes. In contrast, the blasts of eight patients with acute myeloblastic leukaemia (AML) were peroxidase positive, being recorded as neutrophils. Of the remaining 15 patients, 10 were classified as "Probably ALL' because they lacked some of the morphological or cytochemical criteria for classical ALL, while five were unclassifiable. However, in all these 15 patients the Hemalog D results were similar to those obtained in patients with classical ALL. We concluded that the Hemalog D was a useful adjunct in distinguishing ALL from AML, including the morphologically indistinct types.