Mutations of p53 in gallbladder carcinomas in high-incidence areas of Japan and Chile.

Gallbladder adenocarcinomas from patients in two high-prevalence areas, Niigata (Japan) and Santiago (Chile), were analyzed for acquired mutations in exons 5-8 of the p53 tumor suppressor gene, and the characteristics of p53 alterations in the two groups were compared. Of 42 tumors, 22 (52.4%) harbored 25 alterations identified by PCR amplification and direct sequencing (13 of 22 tumors from Niigata and 12 of 20 tumors from Santiago). All alterations were single base pair substitutions, 20 (80%) leading to an amino acid substitution or a chain-termination signal, and 5 (20%) were silent. Immunohistochemically, 55 of 84 cases (65.5%) showed overexpression of p53 protein, with no significant difference in frequency between the two areas. Missense mutations correlated highly with overexpression of the p53 protein (93.4%). Mutations of p53 occurred in all four exons examined, most commonly in exon 5, but in no particular "hot spot." In base-change spectra, all 12 mutations from Santiago showed transitions, with 4 arising at the CpG dinucleotide (33.3%). In contrast, no such transition was found at CpG sites in Niigata, and 4 of 13 mutations (30.8%) were transversions. The data indicated that p53 mutations are highly important in carcinogenesis in the gallbladder. In addition, the difference in p53 mutational spectra in Niigata and Santiago indicate a likely regional difference in mutagenesis.

Prevalence and standardized incidence rates of preclinical cervical pathology among 1,061 women sterilized with transcervical quinacrine hydrochloride pellets.

OBJECTIVE: To determine whether the incidence of in situ cervical carcinoma was increased among a cohort of women who received transcervical insertions of quinacrine hydrochloride pellets into the uterine cavity as a method of nonsurgical sterilization. DESIGN: Retrospective review of Papanicolaou (Pap) test results, comparing incidence of high-grade lesions among quinacrine acceptors with a comparison population. SETTING: Outpatient clinics, Santiago, Chile. SUBJECTS: Women attending a family planning clinic (quinacrine acceptors) and a comparison population from another area of Santiago. MAIN OUTCOME MEASURE: Incidence of in situ cervical carcinoma. RESULTS: During 3,668 woman-years of follow-up, 8 women in the quinacrine group were found to have in situ carcinomas for an age-adjusted rate of 2.62 per 1,000 woman-years. The incidence in a comparison population was 1.62 per 1,000 woman-years, but the difference was not statistically different. CONCLUSIONS: The age-standardized incidence of in situ carcinoma among the quinacrine sterilized women was not significantly different from the rate in a comparison population of women in Santiago. However, the study has a number of limitations.

PIP: To determine whether transcervical quinacrine hydrochloride sterilization increases the risk of in situ cervical cancer, Papanicolaou smear data from 1061 women who underwent this procedure in Santiago, Chile, in 1977-90 were compared to those from a similar group of nonsterilized Santiago women. The average length of follow-up was 3.5 years in the quinacrine group and 2.4 years among controls. The 3285 woman-years of exposure recorded in the quinacrine group yielded 8 cases of in situ cervical carcinoma; among controls, there were 22 cases in 12,355 woman-years of observation. The crude incidence rates of high-grade cervical pathology were 2.18/1000 woman-years in the quinacrine group and 1.78/1000 among controls, for a crude rate ratio of 1.37 (95% confidence interval, 0.61-3.07). The age-standardized rates were 8.62/3285 or 2.62/1000 woman-years and 19.96/12.355 or 1.62/1000 woman-years, respectively, yielding a nonsignificant rate ratio of 1.62 (95% confidence interval, 0.73-3.61). Although this study suggests that quinacrine sterilization is not associated with an increased risk of cervical carcinoma, the analysis was limited by differences in the length of follow-up between the two groups, the non-uniformity of recruitment and follow-up procedures, and an absence of data on other risk factors for cervical cancer. Additional research on the toxicity of quinacrine is planned to better assess its possible carcinogenicity.

[Lymphomatoid granulomatosis: a clinical case]. / Granulomatosis linfomatoidea: caso clínico.

A 49 year old woman with a fluctuating painful ophthalmoplegia and a history of polyarthralgia is reported. On examination, additional findings included a maxillary subcutaneous infiltration, sphenoidal sinusitis and pulmonary nodes. Lung and sinus biopsy demonstrated findings compatible with lymphomatoid granulomatosis. The patient was treated with prednisone and cyclophosphamide, with good response of neurological and dermatological findings.

[Populational research of gastric cancer in digestive symptomatic patients, from 1996 to 2000]. / Pesquisa poblacional de cáncer gástrico en pacientes sintomáticos digestivos, período 1996-2000.

BACKGROUND: Gastric cancer is the first cause of death due to malignant tumors in Chile. Its mortality rates have stabilized in the last two decades and its prognosis is closely associated to the degree of tumor invasion at the moment of surgery. AIM: To study the frequency of gastric cancer among symptomatic patients subjected to an upper gastrointestinal endoscopy at a secondary care health center. PATIENTS AND METHODS: All upper gastrointestinal endoscopies performed to patients derived from public primary care clinics were recorded. RESULTS: In the study period, 4,145 endoscopies were done to 818 men and 2,128 women. Seventy one percent of patients were aged over 40 years of age. Fifty one carcinomas and one lymphoma were detected. Of these, 10 tumors were incipient. Thirty one patients were operated on and in 22 a total gastrectomy was performed. One patient, that required an esophageal resection, died. CONCLUSIONS: Gastric cancer was detected in 1.2% of symptomatic adult patients subjected to an upper gastrointestinal endoscopy.

[Standardized rates of incidence and prevalence of cervical preclinical pathology in 1,061 women sterilized with intrauterine quinacrine]. / Tasas estandarizadas de incidencia y prevalencia de patologia cervical preclínica en 1061 mujeres esterilizadas con quinacrina intrauterina.

The use of intrauterine quinacrine, as a esterilization method in women during the period of fertility age, demonstrated no relation whatsoever with increase in cervical cancer comparative with the rest of the population. This study was done in 1061 patients.

Tratamiento del carcinoma cervicouterino: Evaluacion de una experiencia de 3 anos / Treatment of cervix uteri carcinoma: evaluation of a 3 years' experience

Se analizan 130 pacientes portadoras de un carcinoma cervicouterino tratadas en la Unidad de Oncologia Ginecologica, Servicio de Obstetricia y Ginecologia, Hospital Dr.Sotero del Rio, desde abril de 1978 a abril de 1981. Se estudia su distribucion por edad, por estadios y tipos histologicos. Se presenta un protocolo de tratamiento quirurgico para estadios Ib con lesiones de menos de 2 cms. de diametro, y, un protocolo de terapia combinada (R.T. + histerectomia total simple) en pacientes con estadio Ib con tumores mayores de 2 cms. de diametro (Ic), y tumores endofiticos ("barrel shape"). Se plantea la posibilidad de extender este ultimo tipo de terapia a estadios IIa y IIb con gran volumen tumoralcervical. Llama la atencion el alto porcentaje de lesion persistente en cuello (57%) en aquellos casos sometidos a cirugia post R.T. En estadios II el tratamiento es con radioterapia local y externa, y en los estadios III y IV, fundamentalmente con R.T. externa. La morbilidad quirurgica tanto en las pacientes con cirurgia exclusiva como en aquellas con terapia combinada, esta dentro de los rangos senalados en la literatura nacional y extranjera. Las curvas de sobrevida para todos los estadios en esta evaluacion a 3 anos tambien estan de acuerdo a las publicaciones senaladas