Expression of oncofoetal marker carcinoembryonic antigen in oral cancers in South India--a pilot study.

Expression of the oncofoetal glycoprotein, carcinoembryonic antigen (CEA), has been observed in a number of malignancies and is also being pursued as a target for anti-cancer therapy. This study explored the status of this biochemical entity in the oral squamous cell carcinoma (SCC) in South India caused by extensive chewing habits. Squamous cell carcinoma in the study belonged to grade I and grade II. Tumour staging of the patients recruited in the study ranged from T2N1M0 to T4N3M0. Of the grade II cases studied, 88% (7 out of 8) showed expression of CEA. The 2 cases of grade I SCC of buccal mucosa also showed positive anti-CEA staining. If the results from this pilot study can be validated with a larger sample size, a role can be attributed to this tumour marker in oral neoplasia, thereby opening up avenues for using CEA as an additional diagnostic marker in oral SCC in this population and as a possible target for anti-cancer therapy.

Persistence of chromosomal aberrations in blood lymphocytes 11 years after cessation of CMF therapy in a breast cancer patient.

Chromosomal aberrations were examined in a breast cancer patient 11 years after cessation of cyclophosphamide methotraxate and 5-fluorouracil (CMF) therapy. This indicates that they may well be derived from a population of genetically damaged progenitor cells, from which abnormal and possibly malignant cell clones may have been generated, and a fraction of these randomly occurring chromosome rearrangements appear to be 'stable'.

Lymphatic invasion in pigmented nevi.

All 124 pigmented nevi registered at the Canadian Tumour Reference Centre between July 1958 and May 1969 were reviewed. Nevus cells invading endothelial lined spaces were observed in serial sections from five cases. The significance of this finding is discussed in relation to published reports of the presence of nevus cells in lymph nodes.

Squamous cell carcinoma arising in endometriosis of the ovary.

Squamous cell carcinoma arising in ovarian endometriosis is extremely rare, but a case is reported in a 62 year old woman. If such an ovarian tumour is discovered evidence of teratoma, Brenner tumour, or endometriosis should be sought. Extensive sampling is mandatory as the developing tumour often overgrows the foci of endometriosis, thus obliterating evidence of its origin.

Cytogenetic damage in peripheral blood lymphocytes of cancer patients prior to radiotherapy.

In a study comprised of 79 cancer patients selected for determining chromosomal damage to peripheral blood lymphocytes before, during, and after radiotherapy, four patients revealed chromosome aberrations prior to radiotherapy in 5% of the cells examined. The most common anomalies were dicentric chromosomes and translocations of unidentified chromosomal material on the long or short arm. We attribute this high incidence of chromosomal aberrations before radiotherapy to a combination of various external factors that are known to cause such cytogenetic injury.

Double minute chromatin bodies in carcinoma of the human cervix uteri.

In direct G-banded preparations of 150 cases of cervical cancer, double minutes (dmin) were observed in 43% (64 cancers) of the patients, including a case of carcinoma-in-situ (CIS). The incidence of dmin varied from 1 to over 20 per cell. The karyotypic findings in the tumors containing dmin did not reveal any similarities and the prognosis of the patients with dmin was significantly worse compared to those without dmin. The presence of dmin in cytogenetic preparations of primary tumors may indicate a role in the maintenance and/or progression of malignancy, particularly as dmin have been suggested to represent amplified genes.

Chromosomal abnormalities in the lymphocytes of a male patient with breast cancer.

Blood lymphocyte cultures of a male with carcinoma of the breast revealed both numerical (hypodiploidy and hyperdiploidy) and structural abnormalities. Only few cases of male breast cancer have been cytogenetically characterized. Earlier studies revealed normal karyotypes in peripheral blood cultures of male breast cancer patients and abnormalities only in the tumor tissue. The present report describes 16.6% abnormal metaphases detected in the peripheral blood lymphocytes. Numerical abnormalities were loss of chromosome 9 and 19 and gain of chromosome 7. Structural abnormalities were a cell with marker, del(11)(q22-23) and dic(7;19)(q36;p13). These abnormalities are compared with male and female tumor karyotypes reported in the literature.

Premature chromosome condensation in human cervical carcinoma.

Premature chromosome condensation was observed in 22 of 150 cases (15%) of cervical cancers studied with G-banding. The percentage of premature chromosome condensation in the tumors ranged from 1.5% to 8.9%. Premature chromosome condensation was present in greater frequency (16 of 22 cases) in tumors showing hyperdiploidy, suggesting that this could be a major mechanism of induction of polyploidy in addition to other operative mechanisms, such as endomitosis and endoreduplication. No relationship, either with the disease stage or prognosis, was evident.

Double minutes and premature chromosome condensation in blood lymphocytes of four breast cancer patients.

Double minutes (dmin) and premature chromosome condensation (PCC) were observed in the peripheral blood lymphocytes (PBL) of four breast cancer patients using GTG banding. Among 53 breast cancer patients studied, four cases revealed dmin of which one case had PCC along with dmin. PCC might be an indicator of the spontaneous proliferative potential of tumor cells manifested in lymphocytes as a rare phenomenon. The presence of dmin represents amplified genes (well documented in different types of tumors), but their presence in PBL has rarely been reported in the literature. These findings in PBL might indicate that defective genetic/molecular mechanisms expressed generally in tumor tissue are also manifested in a similar manner in the circulating lymphocytes of patients at a lower frequency.

Melanotic neuroectodermal tumor of infancy initially diagnosed by fine needle aspiration cytology.

A five-month-old male child presented with a tumor of the maxilla, which was clinically diagnosed as an eruption cyst or a rhabdomyosarcoma. Fine needle aspiration smears showed two types of cells: neuroblastlike cells and cells containing melanin pigment. A cytologic diagnosis of melanotic neuroectodermal tumor of infancy was made. This diagnosis was confirmed by histopathologic examination of the subsequently excised mass.

Chromosome analysis in effusions as a diagnostic adjunct to cytology.

Cytogenetic analysis using G-banding techniques for the diagnosis of malignancy in pleural and peritoneal effusions is compared with the results of traditional cytomorphology. The studies indicate that the yield of mitotic cells in malignant effusions is quite high when compared to fluids with no cytological evidence for malignancy. Chromosome criteria for malignancy are of special value in the differential diagnosis of reactive cells versus malignant cells, which pose problems when cytological evaluation alone is considered. Cytogenetic analysis can be performed rapidly and used side by side with conventional cytological procedures to obtain higher sensitivity for cancer diagnosis.

Sister chromatid exchange studies in oral cancer patients.

Sister chromatid exchange (SCE) was studied in PHA-stimulated peripheral blood lymphocytes from 81 untreated patients with squamous cell carcinoma of the oral cavity and 50 age and sex matched controls. The SCE frequencies were found to be 10.80 +/- 1.38 and 4.15 +/- 1.15 in cancer cases and controls respectively. The SCE values of cancer cases deviate significantly from that of controls. The SCE frequency in patients who were addicted to the single habit of betel with tobacco chewing or bidi/cigarette smoking or combined habits of chewing and smoking was 9.38 +/- 1.28, 12.28 +/- 1.68 and 13.12 +/- 2.13 respectively. The SCE frequency in patients who were habituated to alcohol and tobacco usage was 13.43 +/- 2.16. These values were significantly higher as compared with the SCE values observed in normal controls. Single habit of bidi, cigarette and combined habit of bidi and cigarette smokers had a mean SCE per cell of 12.98 +/- 2.11, 10.18 +/- 1.25 and 13.48 +/- 1.32 respectively, which were significantly higher than the mean value of 4.15 +/- 1.15 found in controls. Higher frequencies of SCE were also observed in individuals who smoked more than 10 bidis or cigarettes per day compared with people who smoked less than 10 bidis or cigarettes per day. Individuals who smoked bidis or cigarettes for more than 10 years also showed an increased frequency of SCE as compared with those who smoked bidis or cigarettes for less than 10 years. Among chewers a significant difference was observed with regard to duration and frequency of chewing when compared to controls. An increase in the mean frequency of SCE for each cancer patient group is directly proportional to the clinical stage of the disease. Interchromosomal distribution of SCE revealed an increased frequency of SCE in almost all the groups of chromosomes in cancer patients when compared to controls.

Extraskeletal myxoid chondrosarcoma--a review of three cases.

During a ten year period, only three cases of extraskeletal myxoid chondrosarcoma were seen at Kidwai Memorial Institute of Oncology, South India. All were adults; the youngest patient was twenty-six years old and the oldest was seventy five years old. The tumours arose in the soft tissues of the extremities Our findings indicated that tumour size, site and morphology had no bearing on prognosis. With surgery radiotherapy and chemotherapy, two patients survived for four years and nine months respectively and one patient is still on follow up, five months after treatment.

Neck metastasis from an occult primary--the Kidwai experience.

This study highlights our treatment policy in 26 cases of epidermoid metastatic carcinoma in the neck from a primary deemed occult after exhaustive examination of the Upper Aero-digestive Tract (UADT). Planned Radical Neck Dissection (RND) and post-operative radiotherapy (RT) has been the favoured approach in all neck nodes deemed resectable and a loco-regional control rate of 64% was obtaining using this combined modality approach. Pre-operative RT was utilised in three cases with nodal disease of borderline resectability and loco-regional control was achieved in one case. Three cases of massive neck metastasis initially deemed unrectable became amenable to surgical salvage after Radical RT with concurrently administered chemotherapy. Only one of these remained disease free. Overall loco-regional control rate of 55 per cent could be achieved in 20 evaluable patients followed up for two years--three years (mean 30.5 months). Regional failures were noted in 25 per cent of patients while distant spread occurred in 15 per cent, thus accounting for an overall failure rate of 40 per cent. Manifest primaries were documented in 20 per cent, half of which could be salvaged and successfully controlled.

Frozen sections--a retrospective study.

Two hundred and forty-four (244) specimens were examined by frozen section (FS) from 1987 through 1988 at the Kidwal Memorial Institute of Oncology. Of these, eleven (11) were performed for evaluation of the surgical margin of tumours and fifty four (54) for detection of lymph node metastasis. All these examinations (65) proved to be hundred percent (100%) accurate. The remaining 179 frozen sections were performed for the diagnosis of an unknown pathologic process. Of these, 44.69 percent were precisely diagnosed, in 41.9 percent the pathologic process was correctly but not precisely diagnosed, in 11.17 per cent the diagnosis was deferred and remaining 2.24 percent were incorrectly diagnosed with no harmful consequences to the patients. By eliminating the cases where diagnosis was deferred and combining results of "precise diagnosis" with those of "correct pathologic process", the overall accuracy rate was 98.2 percent. Thus, FS has greater benefit when used for the general diagnosis of an unknown pathologic process rather than for an exact or precise diagnosis.