Ethnic specific differences in endocrine neoplasms: The role of susceptibility genes

Ethnic disparity in disease incidence, prevalence, and outcome has been documented for a variety of diseases and cancers. Dr. LaSalle D. Leffall was one of the first to note that genetic susceptibility is one important aspect that needed to be studied to better understand cancer disparity. In this article, we cover disparity in endocrine neoplasm presentation and new, emerging genetic data that may explain this disparity.     

Serum glycoproteins in head and neck squamous carcinoma: correlations with tumor extent, clinical tumor stage, and T-cell levels during chemotherapy.

In patients with solid malignancies, serum levels of specific acute phase proteins (haptoglobin, α₁-acid glycoprotein, and α₁-antitrypsin) have been correlated with parameters of both tumor extent and cellular immunity, while α₂HS-glycoprotein and prealbumin have been correlated with parameters of cellular immunity. To determine the relation of the glycoproteins to these parameters in head and neck squamous carcinoma, serum levels were measured in 90 untreated patients, 51 cured patients, 11 patients with recurrent carcinoma, and 20 patients during preoperative chemotherapy. The control patients were 139 chronic cigarette smokers.Haptoglobin levels were significantly increased in patients with stage I through IV tumors (AJC-1977), but levels were similar for each stage. Serum levels of α₁-antitrypsin and α₁-acid glycoprotein increased progressively with increasing tumor stage. Serum α₂HS-glycoprotein, prealbumin, and albumin levels were decreased in all patients, and α₁HS-glycoprotein levels decreased progressively with increasing tumor stage. When patients were classified into those with local tumors only and those with regional metastases, and further subclassified by extent of local or regional tumor, the acute phase proteins generally increased with increasing local or regional tumor extent and α₂HS-glycoprotein levels tended to decrease in the same groups. In cured patients, haptoglobin and α₁-acid glycoprotein levels were significantly lower and α₂HS-glycoprotein and prealbumin significantly higher than in untreated patients. Protein levels in patients with recurrent tumors were similar to levels in untreated patients. During acute immunosuppressive chemotherapy, levels of T-cells and α₂HS-glycoprotein decreased significantly and similarly, and after completion of chemotherapy, rebounded to pretreatment levels, while α₁-antitrypsin levels increased and haptoglobin and α₁-acid glycoprotein levels did not change.The data show that α₁-antitrypsin and α₁-acid glycoprotein correlate better with AJC tumor stage than cellular immune parameters previously studied and that α₂HS-glycoprotein levels may be as useful as T-cell levels for monitoring immune reactivity in patients with squamous cancer of the head and neck. These results suggest the potential of these biologic parameters as adjuncts in the derivation of improved staging systems and as indicators of tumor status and immune reactivity in patients with squamous carcinoma of the head and neck.     

Viral-specific humoral immunity to herpes simplex-induced antigens in patients with squamous carcinoma of the head and neck.

Serum antibodies to herpes simplex virus-induced antigens (HSVIA) were quantitated in 122 patients with head and neck squamous carcinoma, 93 patients tumor-free after treatment for these malignant lesions, 27 patients with nonsquamous malignant lesions, 30 heavy smokers, and 36 nonsmokers. Serum IgA anti-HSVIA antibodies were detected in a greater percentage of sera of patients with squamous carcinoma (61 per cent), patients previously treated for these malignant lesions (56 per cent), and heavy smokers (57 per cent) than in patients with nonsquamous malignant lesions (11 per cent) or nonsmokers (8 per cent). Furthermore, titers of these antibodies were higher in patients with squamous carcinoma than in smokers. In patients tumor-free more than three years after treatment, the percentage of positive sera was significantly lower than that in untreated patients and in patients three years or less after treatment. This study demonstrates for the first time a high frequency of antibodies to HSV-induced antigens confined to subjects at high risk of developing head and neck squamous carcinoma and in patients with these malignancies as well as a correlation between the levels of these antibodies and clinical course after treatment.     

自噬在肿瘤治疗中的研究进展

自噬是广泛存在于真核细胞内的一种溶酶体依赖性的降解途径,细胞质内形成空泡为其特征.近年来研究发现,肿瘤细胞面对自身新陈代谢或外部人为干预诱导的应激反应时,自噬表达升高并对细胞有保护作用,这可能有助于发现新的肿瘤治疗方法.本文对自噬与肿瘤发生发展的关系及其在肿瘤治疗中的作用进行综述.     

Operation duration and adrenal gland size,but not BMI,are correlated with complication rate for posterior retroperitoneoscopic adrenalectomy for benign diseases

Background

We sought to determine whether obesity is correlated with complications after posterior retroperitoneoscopic adrenalectomy for benign diseases and to develop surrogate markers of abdominal fat in preoperative computed tomography.

微血管密度与胃癌复发转移相关性研究

目的　探讨微血管密度（ ＭＶＤ） 与胃癌复发转移及预后的相关性。方法　４５ 例手术切除标本应用ＦⅧ相关抗原抗体免疫组化染色，观察癌灶、癌旁及正常组织中ＭＶＤ，分析其与复发转移及预后的关系。结果　ＭＶＤ 在癌组织为３８－１２ ±１２－８７ ，癌旁为２４－６７ ±１１－０９，正常组织为１３－１１ ±７－５６（ Ｐ＜ ０－０５） 。复发转移组和无复发转移组的ＭＶＤ 分别为３８－３１ ±９－６７ 和２１－９８ ±１２－２３（ Ｐ＜ ０－０１） 。两组在淋巴结转移、浸润深度、肿瘤分期三方面差异也有显著性（ Ｐ＜ ０－０５） 。结论　微血管的生长与肿瘤的血行和淋巴结转移有关。除淋巴结转移、浸润深度、肿瘤分期具有预后意义外，胃癌组织中ＭＶＤ 也具有判断预后价值。     

Reoperative parathyroid surgery.

Reoperative parathyroid surgery is associated with a high mortality and morbidity. Morbidity consists of uncorrected hypercalcemia, hypoparathyroidism, and recurrent nerve injury. Initial operative failure is most frequently a result of not identifying four parathyroid glands. On reoperation, parathyroid glands are most often found in the neck and are usually hyperplastic. It is recommended that before attempting rexploration for parathyroid disease, all the patient's records especially the operative note and the previous pathology material should be reviewed. Preoperative localization by selective venous catheterization is of great use in the management of this type of patient.     

Adult intussusception: Case report of recurrent intussusception and review of the literature

An unusual case of lymphoma is presented in which small bowel intussusception due to a lymphomatous nodule caused an acute abdomen, requiring small bowel resection. Four weeks later a second intussusception caused intestinal obstruction, necessitating a second laparotomy and bowel resection. The high incidence of malignant tumor in adult cases leads us to recommend primary resection without manual reduction in all but rectosigmoid and selected small bowel cases.     

肝细胞癌侵入胆管致梗阻性黄疸的诊断和鉴别诊断

我院自1987至1994年收治的肝细胞癌侵入胆管致梗阻性黄疽患者28例，占同期住院肝癌患者487例的5．7％，其中癌管型13冽，癌血栓型15例。根据手术和病理学发现，癌管型特点为胆管内赘生物与原发灶呈哑铃形相连，与胆管壁无粘连，胆管壁薄，原发灶多在肝中心，邻近较大胆管，癌管型切片见肝癌组织；场血栓型特点为胆管内癌血栓与原发灶不相连，胆管可呈节段狭窄梗阻，癌血栓与胆管壁粘附，壁增厚，原发灶多在外周肝叶，血栓组织内含肝癌细胞。     

Congenital duplication of the gallbladder associated with an anomalous right hepatic artery

A case report describing the incidental finding of a double gallbladder associated with an anomalous anteriorly displaced right hepatic artery has been presented. The literature has also been reviewed and the appropriate surgical intervention for supranumerary gallbladder suggested.