Sequential overexpression of LRP and MRP but not P-gp 170 in VP16-selected A549 adenocarcinoma cells.

Chemoresistance remains the major obstacle to successful therapy of lung cancer. In order to understand drug resistance mechanisms, the expression of three proteins involved in multidrug resistance (P-gp, MRP and LRP) was studied, using the non-small cell lung cancer (NSCLC) A549 cell line. In addition, 3 levels of resistance were obtained by continuous exposure of cells to etoposide (VP16), which led to a 22-fold increase of the resistance index. The wild-type A549 strongly expressed the LRP protein while MRP protein was found at a moderate level. Induction of resistance paralleled an increase of the expression of the mrp gene and a decrease of the lrp gene; the mdr1 gene was not expressed. Taken together, these results indicate that intrinsically resistant NSCLC cells exhibit a complex pattern of MDR proteins, still susceptible to evolve under treatment. Such a fact would have to be considered in clinical situations.

Evaluation of the monoclonal antibody antithyroperoxidase MoAb47 in the diagnostic decision of cold thyroid nodules by fine-needle aspiration.

Fine needle aspiration (FNA) of cold thyroid nodules has become the first line diagnostic decision for electing which patients need surgery. In order to improve FNA accuracy, the monoclonal antithyroperoxidase (TPO) antibody (MoAb47) was tested. A total of 554 patients were included in this study and among them, 208 were referred to surgery. The results of FNA compared to the final histological diagnosis revealed a sensitivity and a specificity of 94 and 55% respectively, while the sensitivity and specificity of TPO immunodetection on the same cases reached 98 and 83% respectively. By combining the two methods, the 3 false-negative of FNA and 60% of suspicious cytology corresponding to histological benign lesions were correctly identified by immunocytochemistry. With better results than FNA alone, TPO immunodetection with MoAb47 represents a useful adjunct to conventional cytology for selecting patients for surgery.

Quantitative cytology and thyroperoxidase immunochemistry: new tools in evaluating thyroid nodules by fine-needle aspiration.

Fine-needle aspiration (FNA) of cold thyroid nodules is proposed to be the most useful diagnostic test for deciding which patients need surgery. A retrospective study of standard cytology (SC) performed in 776 patients who had been operated on, showed a sensitivity of 94% and a specificity of 80%. Quantitative cytology (QC) was carried out with a cell image analyzer, which classified the cases as benign or not benign. In 87 cases, sensitivity and specificity of QC alone were 100 and 76%. When SC and QC were combined, there were no false negative reports. A new monoclonal antithyroperoxidase (TPO) antibody (MoAb47) was tested. The sensitivity and specificity of TPO alone were 97 and 81%. When SC and TPO were combined, specificity rose 90%. As adjuncts to SC, QC and TPO represent useful tools for selecting patients for surgery.

Epidermal growth factor receptors in breast cancer: comparison of radioligand and immunocytochemical assays.

Epidermal growth factor receptors (EGFR) are part of second generation biological factors that clinicians caring for breast cancer patients wish to evaluate for their prognostic value. This aim requires the standardization of methods: the radioligand assay (RLA) for the quantification of EGF binding sites was performed on membrane pellets from 261 breast cancer samples (ligand binding and hydroxylapatite separation as recommended by the EORTC Receptor Study Group); the immunocytochemical assay (ICA) for the staining of EGFR antigenic sites was performed on fine needle aspiration (FNA) cytology or touch imprints from 97 surgical specimens. The percentage of EGFR positivity by RLA (specific binding higher than 1% of total radioactivity) and the EGFR positive rate by ICA (more than 5% of stained cells) were respectively 43% and 38%. For 61 cases assayed on the same patient both methods revealed a concordance of 85%. Our results show that both methods are complementary and give quantitative data and information on tumor heterogeneity when they are performed in parallel. The next step of this study will be to determine the prognostic value of EGFR in these subpopulations of tumors for the adjustment of adjuvant treatment.

[Ultrasound-guided fine-needle punctures of abdominal masses: cytology or histology? Comparative prospective study]. / Ponctions échoguidées de masses abdominales à l'aiguille fine: cytologie ou histologie? Etude comparative prospective.

The aim of this study has been for one part to assess the obtaining of cytological and histological material from the same patients with the minimum amount of injections using a fine needle (diameter less than 1 mm) and also to evaluate the histological and cytological supply, individually and jointly in the diagnosis of abdominal tumors. Seventy lesions of which 58 hepatic have been punctured with fine needles of 20 (0.9 mm) to 22 G (0.7 mm). Material has been obtained in 98.6 per cent of cases for cytology and 54 per cent of cases for histology. Their respective sensitivity in the diagnosis of malignant tumors was 96.8 per cent and 86.8 per cent and was not improved by adjoint analysis. The specificity was 1 for cytology. The differential diagnosis in malignant hepatic tumors between hepatocarcinoma and metastasis was existent in 94.3 per cent of cases for cytology and 90 per cent for histology with no benefit coming from the association of two. In the group having hepatic metastasis without known primary cancer having found histological confirmation of the primary lesion, the cellular type has been revealed in exactitude in 94.4 per cent of cases with cytology and in 63.6 per cent with histology. No complications have been observed. The fine needle cytological aspiration ponction gives very satisfying results, comparable with regard to the diagnosis contribution to results of published studies, obtained with the use of coarse needle biopies. We suggest that fine needle ponction should be used preferentially and that coarse needle biopsy should be restricted to the few cases in which the former does not yield sufficient information.

Sonographic appearance and ultrasound-guided fine-needle aspiration biopsy of breast carcinomas smaller than 1 cm3.

The purpose of this study was to review the sonographic appearance and the results of ultrasound-guided fine-needle aspiration biopsies of a series of 49 breast carcinomas smaller than 1 cm3. No tumor was found to be hyperechoic. Contours were irregular in 69% of cases. In 53%, an echogenic rim was present, and the echotexture was nonhomogeneous in 41%. Sound beam attenuation was present in 39%. The ratio of longitudinal diameter to anteroposterior diameter ranged from 0.67 to 2.25 (mean, 1.08 +/- 0.28). Fine-needle aspiration biopsy under continuous real-time sonographic guidance was performed on 36 patients and yielded 30 positive and four suspicious results (sensitivity, 94%), one inadequate specimen, and one false-negative result. With high-resolution hand-held transducers, breast sonography can depict small carcinomas and provides accurate, cost-effective guidance for fine-needle aspiration biopsy.

Evaluation of morphological criteria in the cytological diagnosis of thyroid cold nodules. A preliminary study.

Although cytological diagnosis plays a significant role in the management of thyroid cold nodules, the rather high rates of false negative cases diminishes its usefulness. The purpose of this preliminary study is to evaluate the utility of numerous morphological criteria used by the cytologist to exclude benign tumours. Thirty-one cytological criteria were routinely scored as binary (yes/no) or as categories: 6 referred to the general arrangement and frequency of thyroid cells, 9 to the associated cellular and cell product elements, and 16 to the morphological features of the cells. We examined the manner in which these criteria, alone or combined, contributed to the diagnosis. The data base consisted of 171 intraoperative imprint cytological samples (143 histologically benign, 1 atypical adenoma and 27 cancers), as well as 257 thyroid cold nodule aspirates from another set of patients (198 histologically benign, 7 atypical adenomas and 52 cancers). For the imprint cytology, the diagnostic power of each criterion was individually assessed by the likelihood ratio (LR) which eliminated 11 as being undiscriminatory. The remaining independent criteria were subjected to logistic regression analysis to determine the most discriminant. Three were selected: Cellular clustering organisation, nuclear hypertrophy and colloid quantity with the latter being somewhat less powerful. Furthermore, it appears that the diagnostic power of the criteria was significantly lower when there was at least one nucleolus (number of nucleoli greater than 0). The smears gave essentially the same results as the imprints.(ABSTRACT TRUNCATED AT 250 WORDS)

[Imprint cytology in the diagnosis of tumors of the thyroid]. / Apports de la cytologie d'apposition dans le diagnostic des tumeurs de la thyroïde.

We have correlated imprint cytology findings in thyroid tumors to the results of preoperative fine needle aspiration and operative specimen histology. Specificity of imprint cytology proved greater than that of fine needle aspiration cytology and topographic correlations were particularly helpful. Imprint cytology can improve the intraoperative histologic diagnosis. Because abundant cells are available, imprint thyroid cytology is ideal for teaching and training cytologists. Imprint cytology provides enough cells to perform special techniques, such as quantitative cytology, that are useful for the diagnosis of some tumor varieties (e.g. follicular tumors).

Breast masses: US-guided fine-needle aspiration biopsy.

Real-time ultrasonography (US) was used to guide fine-needle aspiration biopsy of 111 breast masses and three axillary lymph nodes. The masses included 51 (45%) nonpalpable lesions. Two different guidance techniques were used, with satisfactory results. Lesions less than 1 cm in diameter could be accurately aspirated, and the method allowed quick and accurate cytologic characterization of solid breast masses. The sensitivity of the cytologic diagnosis of malignancy was 92%, and the specificity was 93%. US-guided fine-needle aspiration biopsy of breast masses should be routinely performed, since it can lead to earlier and cost-effective diagnosis of breast carcinoma at virtually no risk. Because of the accuracy of real-time US guidance, negative cytologic findings (i.e., satisfactory smears with benign cells) should be considered highly reliable in ruling out malignancy.

[Contribution in oncology of fine needle puncture-aspiration of abdominal organs under echographic guidance in real time. Apropos of 265 cases]. / Apport en cancérologie de la ponction-aspiration à l'aiguille fine d'organes abdominaux sous contrôle échographique en temps réel. A propos de 265 observations.

The authors report a 3-year experience in the field of real-time ultrasonically-guided fine-needle aspiration biopsies of abdominal lesions in a Cancer Institution. The procedure is performed using a linear-array electronic biopsy transducer. Results obtained in a series of 265 aspirations are analyzed. Major benefits and applications of this technique in oncology are discussed while emphasis is put on the economical aspects of this diagnostic "shunt".