1,721,015 research outputs found
Prognostic value of tumor infiltrating lymphocytes in the vertical growth phase of primary cutaneous melanoma
No full textBACKGROUND, Primary cutaneous melanoma is often infiltrated by lymphocytes that provide the opportunity to study what may be the local immunologic reaction to the tumor and to correlate the presence of these lymphocytes with overall survival. In an attempt to delineate the histologic diagnostic criteria, to classify different categories of lymphocytic infiltrates, previously described by Elder et al. as brisk, nonbrisk, and absent, and to verify their prognostic significance, we reviewed 285 consecutive cases of primary cutaneous melanomas (American Joint Committee on Cancer Stage I and II).
METHODS, In addition to clinical variables (age, sex, and location of tumor) and the presence of tumor infiltrating lymphocytes in the vertical growth phase, the histopathologic attributes reviewed included mitotic rate, thickness, and regression. The results were derived from independent histopathologic review by two pathologists (C.G.C., M.C.M., Jr.) on separate occasions. A multivariate analysis of survival was performed with the Cox's regression model.
RESULTS. The 5- and 10-year survival rates for melanoma with a vertical growth phase and a brisk infiltrate were 77% and 55%, respectively. For tumors with a nonbrisk infiltrate, the 5- and 10-year survival rates were 53% and 45%, respectively, and for tumors with absent tumor infiltrating lymphocytes, the 5- and 10-year survival rates were 37% and 27%, respectively. Mitotic index, thickness, and tumor infiltrating lymphocytes were statistically (univariate analysis) significant prognostic factors (P = 0.003, 0.000001, 0.0003, respectively), whereas the presence or absence of regression is not. In the univariate statistical analysis, the sex of patients and site of melanoma also were statistically significant (P = 0.00001 and 0.002 respectively), whereas age (P = 0.98) was not statistically significant. The multivariate analysis of thickness, mitotic rate, and tumor infiltrating lymphocytes showed chat thickness and presence of tumor infiltrating lymphocytes were significant and independent histologic prognostic factors. With regard to the clinical factors, sex retained its independent prognostic significance. The histologic characteristics of melanoma with vertical growth phase (brisk, nonbrisk, and absent) are exemplified.
CONCLUSIONS. We demonstrated that when categories of tumor infiltrating lymphocytes are strictly defined, they indeed have very strong predictive value for primary cutaneous melanomas with a vertical growth phase. This work confirms the work of Clark et al. and fully illustrates the brisk, nonbrisk, and absent categories of infiltration. Finally, a multivariate analysis comparing thickness, mitotic rate and presence of tumor infiltrating lymphocytes showed that only thickness and presence of tumor infiltrating lymphocytes are significant and independent positive histologic prognostic factors
Phenotypic heterogeneity of HLA products on human melanoma cells
No full textThe expression of class I and class II HLA antigens has been studied on primary and metastatic human melanomas, and on cell clones derived from the latter. A panel of monoclonal antibodies and flow cytofluorometric analysis were used to evaluate the presence of HLA-A, B, C and -DR, DQ antigens on freshly isolated tumour cells. HLA class I antigens were present on 91% and 93% of primary and metastatic tumours, respectively. Sixty per cent of primary and 50% of metastatic melanomas expressed HLA-DR antigens, whereas 38% and 21% of cases were positive for HLA-DQ. A marked heterogeneity was evident among primary and metastatic lesions for expression of class I and II antigens. Similar findings were obtained by analysing the phenotype of melanoma clones which indicates that a marked antigenic heterogeneity for class I and II HLA antigens occurs even among clones isolated from short-term cultures of metastatic melanomas
Hemostatic alterations are unrelated to the stage of tumor in untreated malignant melanoma and breast carcinoma
No full textA study of hemostatic variables was carried out in 80 untreated patients with breast adenocarcinoma or malignant melanoma, chosen as examples of tumors that can be accurately staged for localization or spread. The most marked abnormalities were high levels of clotting factors V and VIII, plasminogen, von Willebrand factor and fibrogen-fibrin degradation products. These abnormalities occurred in both types of tumors, albeit slightly more markedly in melanomas, and were also present in localized tumors. Our data indicate that in tumors, abnormalities of the hemostatic system are an early phenomenon unrelated to the presence of widespread malignancy
Changes in fibrinolysis in patients with localized tumors
No full textAn array of fibrinolysis tests was applied to the plasmas of 125 untreated patients with breast carcinoma and malignant melanoma, localized or spread to regional lymph nodes with no detectable distant metastases, to see whether or not there may be changes related to the type or to the stage of malignancy. Breast carcinoma (a mucin secreting tumor) and melanoma (a neuroectodermal tumor) were chosen as examples of tumors that can be accurately staged for localization or spread. Forty healthy subjects matched for age served as controls. The most marked differences between malignant tumors and controls were elevated plasma levels of tissue plasminogen activator antigen (P less than 0.005), plasminogen activator inhibitor (P less than 0.01), cross-linked fibrin degradation products (P less than 0.001), fragment B beta 15-42 (P less than 0.001) and histidine-rich glycoprotein (P less than 0.005). For no fibrinolysis test were results significantly different between patients with localized and spread tumors. Our data indicate that in these tumors fibrinolytic alterations are an early phenomenon unrelated to spreadin
HER-2-positive breast carcinomas as a particular subset with peculiar clinical behaviors
No full textThe association between HER-2-positivity, and prognostic variables and survival have been addressed in many studies with still controversial results because of the small series analyzed
Chromosome abnormalities and fragile sites in human melanoma
No full textChromosome analysis in short-term lines of three primary and seven metastatic malignant melanomas showed aneuploid karyotypes with recurrent abnormalities of chromosomes 1 (five cell lines), 6 (nine cell lines), and 7 (six cell lines). The breakpoints observed on the rearranged chromosomes frequently coincided with loci of known oncogenes and fragile sites. Two of the cell lines were analyzed after xenograft into nude mice and showed the presence of the same chromosomal changes observed in the parental cell lines, indicating the stability of the karyotype. A tendency toward an increased chromosomal fragility in peripheral blood lymphocytes was observed in five melanoma patients compared to ten normal individuals. However, there was no increased level of expression of specific fragile sites corresponding to the breakpoints observed in melanoma cells. © 1990
Mucosal malignant melanoma of head and neck: Forty-eight cases treated at Istituto Nazionale Tumori of Milan
No full textA series of 48 cases of malignant mucosal melanomas treated at the Milan Cancer Institute from 1975 to 1990 is retrospectively reviewed. There were 34 males and 14 females, and their ages ranged from 21 to 79 years (mean, 58). The site of origin of the tumor was the nasal cavity in 26 cases, the oral cavity in 15, larynx in two, lip mucosa in two, pharnyx in two upper esophagus in one. At presentation, the neoplasm was limited to the primary site in 60.4% of the patients. Most patients (34) were treated with surgery alone. Nine were treated with surgery combined with chemo- and/or radiotherapy and five with radiotherapy combined with chemotherapy and/or immunotherapy. Only when surgery was part of the treatment (42 of 48 cases) the patients were rendered disease free, but no further relapse of disease was documented in only five of these patients. The observed 2- and 5-year survival rate of the entire group was 45% and 21% respectively. The 4-year disease-free survival rate was 7%. The median interval between therapy and the first relapse was 8.5 months (range, 1-66). In 44% of the patients the first recurrence of the tumor was at the primary site
EARLY PRESENCE OF ACTIVATED (EXHAUSTED) PLATELETS IN MALIGNANT-TUMORS (BREAST ADENOCARCINOMA AND MALIGNANT-MELANOMA)
No full textTo evaluate whether or not the finding of platelet activation in patients with tumors is related to the stage of malignancy, a study of biochemical markers indicative of the presence of circulating activated ('exhausted') platelets was carried out in 95 untreated patients with breast adenocarcinoma or malignant melanoma, localized or spread to regional lymph nodes with no detectable distant metastasis. These tumors were chosen as examples of tumors which can be accurately staged for localization or spread, and as examples of mucin-secreting tumors (breast adenocarcinoma) or neuroectodermic tumors (malignant melanoma). Results were compared with those for 26 patients with benign breast disease, 23 blood donors and 50 hospital workers. The most frequent abnormalities were low levels of intraplatelet ADP and 5-hydroxytryptamine and high ATP ADP ratios. Although these abnormalities occurred with both types of tumor, they were more frequent and marked for melanomas and breast carcinomas spread to regional lymph nodes. Our data indicate that the presence of exhausted platelets is an early finding in patients with malignant tumors
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