The clinical role of micrometastatic disease in sentinel lymph nodes in breast cancer.

PURPOSE: Complete axillary lymph node dissection (cALND) is the standard procedure in treating the patients with tumor-positive sentinel nodes (SLNs). However, approximately half of these patients have not additional metastases in their axilla and therefore do not benefit from cALND. Our aim was to examine the outcome of patients with tumor-positive SLNs without cALND. METHODS: All patients (n=591) were women with clinically T1-2N0-1M0 breast cancer. SLN marking was performed with blue dye (Patentblau V) and radiotracer (antimony sulfide marked with Tc99m). Both contrast media were applied peritumorally or periareolarly. After SLN biopsy all patients underwent breast-conserving surgery or mastectomy with or without lymph node dissection of level I and II (depending on SLN status). RESULTS: In 37 (17.84%) out of 185 patients cases SLNs contained micrometastases. In 19 of 37 cases (57.58%) cALND was performed, and in 14 (42.42%) was not. The mean and median duration of follow-up were 50.59 and 55 months, respectively (range 4-108). Two cases without cALND developed ipsilateral enlarged lymph nodes at 26 and 59 months. Biopsy showed that the enlarged nodes were tumor-free. In all other cases with micrometastases in SLNs neither axillary lymphadenopathy nor distant metastases were seen. After performing surgical treatment, all patients received adjuvant chemotherapy or hormonotherapy and radiotherapy. CONCLUSION: Patients with SLN micrometastases who had not undergone cALND showed no regional recurrence and distant metastases. ALND is not necessary for regional control in patients with micrometastatic or isolated tumor cells in SLNs. By avoiding cALND the number of complications was reduced and the quality of life was improved.

AdoP assay detection of mycoplasmal contamination in biological media.

The AdoP assay has been shown to be reliable in controlling the absence of mycoplasmas in filtered sera. We therefore compared its effectiveness with that of other tests in the detection of animal cell contamination by mycoplasmas.

Assay for detection of adenosine phosphorylase from mycoplasmas.

A microtechnique is described which permits simple evaluation of the activity of the enzyme adenosine phosphorylase (AdoP), present in all mycoplasmas tested thus far. The good solubility and stability of AdoP and the sensitivity of the assay should be advantageous in detecting mycoplasmas in biological samples such as animal sera, cell cultures and vaccines.

Cross-reactive antibodies to mycoplasmas found in human sera by the enzyme-linked immunosorbent assay (ELISA).

Antibodies against Mycoplasma pneumoniae in patients' sera with M. pneumoniae infection were measured by the complement fixation (CF) test and enzyme-linked immunosorbent assay (ELISA). Many patients' sera cross-reacted with heterologous mycoplasmal ELISA antigens such as M. hominis, M. hyorhinis, M. orale, M. pulmonis and M. salivarium. The sera with high CF (CF greater than or equal to 40) titers gave significantly higher ELISA values to M. hyorhinis (P less than 0.001) and M. pulmonis (P less than 0.001), which are not parasitic for humans, than those with low CF (CF less than 20) titer. Human normal immunoglobulin G (human normal IgG) containing 98% or more IgG, prepared from pooled plasma of at least 500 normal human donors, showed ELISA reactions with all mycoplasmal strains used. The nonspecific adsorption of human normal IgG on the surface of plate wells and on medium components which might contaminate mycoplasmal ELISA antigens could be disregarded. These results suggest that cross-reactive antibodies to mycoplasmas exist in human sera, and they affect the results of ELISA for serodiagnosis of M. pneumoniae infection.

Demonstration of cross-reactive antibodies to mycoplasmas in human sera by ELISA and immunoblotting.

Varying levels of cross-reactivity to some mycoplasma species were observed in the sera of patients infected with Mycoplasma pneumoniae and even in normal human sera by enzyme-linked immunosorbent assay (ELISA). The absorption of the patients' sera with M. pneumoniae lysate showed the decrease in ELISA titers not only to M. pneumoniae, but also to other mycoplasma species. These results suggested the existence of cross-reactive antibodies to mycoplasmas in human sera. Cross-reactive antibodies to M. pneumoniae and other mycoplasmas in the patients' sera were also demonstrated by Western blotting technique.

[In vitro activity of nitroxoline on urogenital mycoplasmas]. / Activité in vitro de la nitroxoline sur les mycoplasmes uro-génitaux.

The product nitroxoline was studied in vitro for its activity towards Ureaplasma urealyticum and Mycoplasma hominis. In view of the low MIC values obtained, it seems nitroxoline could be used in the treatment of urinary infections. It is bactericidal, and should not produce resistant strains.

Adenosine phosphorylase activity as a technique for detection of mycoplasmas in biological media.

The importance of cell culture contamination by mycoplasmas is well recognized, but the means used to detect such contamination still need improvement. Most mycoplasmas possess an enzyme, adenosine phosphorylase, which is not found in cell lines. We used the ultramicromethod of Uitendaal et al. to detect the presence of mycoplasmas in sera and in tissue culture medium. The absence of adenosine phosphorylase activity seems to be the best guarantee that a serum is not contaminated by mycoplasmas. This test is also most efficient for the detection of mycoplasmas in tissue or cell cultures in vitro.

[Effect of lymecycline on pathogenic mycoplasmas]. / Activité de la lymécycline sur les mycoplasmes pathogènes.

Results of sensitivity to antibiotic in vitro and results of antibiotic treatment in vivo seem to recognize so far lymecycline as the tetracycline to prescribe in infections by mycoplasmas.