The prognostic significance of growth pattern and its relation to tumor cell nuclear DNA content in endometrial carcinoma.

Hysterectomy specimens from 21 endometrial carcinoma patients, who died from their disease, and 23 patients selected at random from 307 survivors, were analysed for tumor growth pattern and tumor cell nuclear DNA content. The results indicate that tumor growth pattern, reflected by the mode of infiltration, is significantly correlated to the clinical course of the disease. Patients with carcinomas exhibiting contiguous growth pattern had a better outcome than patients with discontiguously growing carcinomas. It was also found that tumor growth pattern correlated well with tumor nuclear DNA content. It is suggested that the pattern of infiltration of the tumors is a sensitive predictor of prognosis and that this prognostic information, which only can be obtained postoperatively, to a large extent is reflected by tumor cell nuclear DNA content in curetted diagnostic material, obtained prior to treatment.

Influence of intravenous injection of sclerosing agents on the respiratory function.

Severe lung injury (ARDS) has occasionally been observed after sclerotherapy for bleeding oesophageal varices. In order to study the effects of sclerosing agents, which may escape into the systemic circulation during treatment, seven sheep were given either ethanolamine oleate (n = 4) or sodium tetradecyl sulfate (n = 3) intravenously. A control group (n = 3) was treated identically with the others except it did not receive any sclerosing agent. The study showed that both sclerosing agents caused an immediate and severe fall in total respiratory compliance and arterial oxygen tension. There was a marked trapping of platelets in the lungs, which was also reflected by a drop in platelet count in peripheral blood. The lungs from the animals receiving sclerosing agents appeared moderately to severely congested and the wet/dry weight ratio of the lungs was significantly increased compared with untreated normal lungs (p less than 0.01). Histopathological examination revealed severe damage to the alveolar membranes, intraalveolar fibrino-haemorrhagic exudate, collapse of alveolar spaces and numerous eosinophilic leukocytes in the broadened, oedematous alveolar walls. It was concluded that the sclerosing agents used in this study, ethanolamine oleate and sodium tetradecyl sulphate, cause severe lung injury if given intravenously in sheep in doses corresponding to 25-50% of what is normally used during sclerotherapy in patients. The mechanism of this action may be that of an increased microvascular permeability causing marked alveolar damage and destruction of the blood gas barrier of the lungs.

The prognostic significance of DNA measurements in endometrial carcinoma.

DNA analysis was performed in 71 cases of endometrial carcinoma, selected from a retrospective series of 445 cases registered at the Department of Gynecology, Radiumhemmet, Karolinska Hospital, Stockholm, during 1973-1975. The histological material from 37 patients surviving more than eight years was compared with that from those who died from cancer within two years. The prognostic value of the DNA distribution pattern of the tumors in relation to the clinical stage and the histological grade of the tumors was evaluated. Patients with near-diploid or -tetraploid tumors were found to have a significantly lower death rate than those with aneuploid tumors. The DNA distribution pattern was also found to correlate better with the survival rate than the clinical stage or the histological grade of the tumors.

Cellular immunity to transitional cell carcinoma of the urinary bladder. III. Effects of hydrostatic pressure therapy.

The effects of hydrostatic pressure therapy on in vitro cellular cytotoxicity responses have been studied in 19 patients with transitional cell carcinoma of the bladder (TCC). Cytotoxicity was quantitated against allogeneic targets in a microplate assay or by 51chromium isotope release. Two types of reactivity were detected, the most common being a differential cytotoxicity for targets derived from TCC, in either short-term or long-term tissue culture. This reaction is operationally termed "tumor-specific". Less frequently, a general cytotoxicity for targets of diverse histogenic origins was observed. For the present, this is termed "non-specific". Nine patients were tested before pressure therapy and of these only two gave a specific reaction and one a non-specific reaction, while six were non-reactive. Eighteen patients were tested at varying intervals after treatment and of these 11 gave a specific reaction and one a non-specific effect, while six were non-reactive. Three individuals who were non-reactive prior to therapy had a specific reaction post therapy. Two who reacted specifically before therapy became non-reactive post therapy. The results of serial in vitro testing for cytotoxicity are presented with individual case histories, tumor staging and grading and the clinical outcome of hydrostatic pressure therapy.

Squamous cell carcinoma of the gingiva. Histological classification and grading of malignancy.

A histological classification and grading of malignancy has been performed on the initial biopsies from 124 patients with squamous-cell carcinoma of the gingiva treated during the period 1958-69 at the Karolinska hospital. Six different morphological parameters were evaluated with respect to the tumour cell population and the tumour-host relationship estimated in terms of a four-point scale. This permitted grading with total points ranging from 6-24. A strong correlation was found between the degree of histological malignancy and the fatal outcome of the disease. Thus a tumour with a point value of 16 almost always led to the death of the patient while the best results were achieved with surgery alone in the group of small cancers (T1 + T2) with low total malignancy points.