The importance of IL-6 protein expression in primary human renal cell carcinoma: an immunohistochemical study

AIMS: Interleukin 6 (IL-6) is produced by some renal carcinoma cell lines in vitro. This might be biologically important because IL-6 is a cytokine of particular interest, owing to its involvement in the growth of renal cell carcinoma. In this study, the expression of IL-6 protein in tissue samples from primary renal cell carcinoma was analysed, and then its clinical importance was examined. METHODS: The distribution of IL-6 in renal cell carcinoma was examined by means of an immunohistochemical method in 47 untreated primary renal cell carcinoma samples. The search for a significant difference between histological patterns, Furhman's grading system, TNM classification, and IL-6 protein expression was carried out. RESULTS: Immunohistochemistry demonstrated that IL-6 is expressed in 70% of primary tumours. There was no significant difference in the tumour size and grade between renal cell carcinomas with or without IL-6 expression. However, a relatively large number of high grade tumours expressed IL-6. CONCLUSION: The importance of IL-6 expression with regard to tumour size/local growth is questionable because IL-6 has been correlated with the development of metastatic disease. These data suggest that the production of IL-6 could exert a growth inhibitory effect on primary renal cell carcinoma.     

Investigating the inequalities in route to diagnosis amongst patients with diffuse large B-cell or follicular lymphoma in England

Introduction Diagnostic delay is associated with lower chances of cancer survival. Underlying comorbidities are known to affect the timely diagnosis of cancer. Diffuse large B-cell (DLBCL) and follicular lymphomas (FL) are primarily diagnosed amongst older patients, who are more likely to have comorbidities. Characteristics of clinical commissioning groups (CCG) are also known to impact diagnostic delay. We assess the association between comorbidities and diagnostic delay amongst patients with DLBCL or FL in England during 2005–2013.Methods Multivariable generalised linear mixed-effect models were used to assess the main association. Empirical Bayes estimates of the random effects were used to explore between-cluster variation. The latent normal joint modelling multiple imputation approach was used to account for partially observed variables.Results We included 30,078 and 15,551 patients diagnosed with DLBCL or FL, respectively. Amongst patients from the same CCG, having multimorbidity was strongly associated with the emergency route to diagnosis (DLBCL: odds ratio 1.56, CI 1.40–1.73; FL: odds ratio 1.80, CI 1.45–2.23). Amongst DLBCL patients, the diagnostic delay was possibly correlated with CCGs that had higher population densities.Conclusions Underlying comorbidity is associated with diagnostic delay amongst patients with DLBCL or FL. Results suggest a possible correlation between CCGs with higher population densities and diagnostic delay of aggressive lymphomas.Subject terms: Epidemiology, Non-hodgkin lymphoma, Epidemiology, Cancer epidemiology     

Les interféronopathies de type I. Mise au point et revue de la littérature

Thanks to the tremendous progress of genetics, a new field of inherited inflammatory disorders related to an overproduction of interferon has recently emerged. The so-called type I interferonopathies represent an heterogeneous group of Mendelian diseases presenting with various features starting in childhood, although the diagnosis can also be made later in life. Several clinical and biological characteristics are shared across these patients such as a positive interferon (IFN) signature and neurological and cutaneous involvement, some of which display organ specificity. Treatment is challenging, but IFN-targeting therapies represent a promising option in these severe diseases.     

Postoperative pain after hysterectomy through vaginal routes using electro surgical bipolar vessel sealing versus conventional suture ligature

OBJECTIVES: The purpose of the study was to compare the postoperative pain of patients who had a hysterectomy through vaginal route according to the process of binding: wire or electrosurgical bipolar vessel sealing. PATIENTS AND METHODS: Retrospective study carried out in the 60 last patients who underwent a hysterectomy by vaginal route for a benign pathology in the gynaecological service of surgery of the CHI Poissy-Saint-Germain-en-Laye until March 2006. Among these patients, 32 had profited from a binding by wire and 28 of the electrosurgical bipolar vessel sealing. The studied criteria were the post-operative pain, total morphine consumption and the durations of the analgesic treatment, the hospitalisation and intervention time. RESULTS: The postoperative pain in the first 24 hours was twice lower using thermofusion; it was valid in immediate post-operative period and after 24 hours. In addition, total morphine consumption was also significantly lower using thermofusion. DISCUSSION AND CONCLUSION: This pilot study shows that the electrosurgical bipolar vessel sealing allows a reduction in the pain into the immediate postoperative period. Other prospective and randomised studies would allow it and conclude on the duration of hospitalisation, the quality of life from the patients and the cost in terms of public health.     

Unbiased estimates of long‐term net survival of hematological malignancy patients detailed by major subtypes in France

Long‐term population‐based survival data detailed by cancer subtype are important to measure the overall outcomes of malignancy managements. We provide net survival estimates at 1, 3, 5 and 10‐year postdiagnosis on 37,549 hematological malignancy (HM) patients whose ages were >15 years, diagnosed between 1989 and 2004 and actively followed until 2008 by French population‐based cancer registries. These are, to our knowledge, the first unbiased estimates of 10‐year net survival in HMs detailed by subtypes. HMs were classified according to the International Classification of Diseases‐Oncology 3. Net survival was estimated with the unbiased Pohar‐Perme method. The results are reported by sex and age classes. The changes of these indicators by periods of diagnosis were tabulated and the trends of the net mortality rates over time since diagnosis graphed. In all, 5‐ and 10‐year age‐standardized net survivals after HMs varied widely from 81 and 76% for classical Hodgkin lymphoma (CHL) to 18 and 14% for acute myeloid leukemia (AML). Even in HMs with the most favorable prognoses, the net survival decreased between 5‐ and 10‐year postdiagnosis. Women had better prognoses than men and age at diagnosis was an unfavorable prognostic factor for most HMs. In patients <55 years old, the net mortality rate decreased to null values 5‐year postdiagnosis in AML and 10‐year postdiagnosis in CHL, precursor non‐HL, chronic myelogenous leukemia, diffuse large B‐cell lymphoma and follicular lymphoma. The prognoses improved for various HMs over the study period. The obtained unbiased indicators are important to evaluate national cancer plans.