Carcinoma In Population Research Articles

Prevalence of Luminal A, Luminal B, HER2 enriched and triple negative breast carcinoma in population of Sindh

The incidence of breast cancer has increased significantly in Asian countries in comparison to Western countries, and it is now one of the leading causes of cancer-related death among women worldwide. Each year, 1.5 million women (25% of all cancer women) are diagnosed with BC around the world, and this number is expected to rise to 2.2 million by 2025. In particular, breast cancer shows biologic heterogeneity in terms of risk factors, natural histories, responses to therapy, and prognostic features that vary considerably between ethnic and geographical groups. Many studies have focused on the distinctions between tumor subtypes because of the importance they play in guiding therapeutic decision making in breast cancer. These factors include histological grade, tumor type and size, and the presence of lymph node metastasis. As a proxy for profiling gene expression, immunohistochemical examination of breast cancer tissue with various biomarkers is employed. This method is cheap, widely accessible, reliable, and technically not demanding. The purpose of this research was to analyze the relationship between molecular subtypes of breast cancer and certain pathological characteristics.

Prevalence and clinical implications of the HPV16 infection in oral cancer in Montenegro - Evidence to support the immunization program.

Oral squamous cell carcinoma (OSCC) makes 85-95% of all malignances in the oral cavity. Increasing evidence shows that the Human Papillomaviruses (HPVs) are preferentially associated with some oropharyngeal and OSCCs, namely the genotype 16. The aim of the present study was to determine the prevalence and clinical implications of HPV16 infection in oral squamous cell carcinoma in population of Montenegro. This study included 60 patients with OSCC (localized on the lower lip, tongue or/and floor of the mouth), surgically treated at the Clinical Centre of Montenegro from 2012 to 2018. Surgically obtained formalin-fixed and paraffin-embedded specimens were used for histopathological analysis and HPV16 genome detection using standard Polymerase Chain Reaction (primers for detection of E6 gene). Each individual was further followed up for the period of three years and for different clinico-pathological characteristics, including disease free interval (DFI). The prevalence of HPV16 infection in OSCCs was 23.3% and the infection was significantly more common in female patients (P = 0.038). No significant correlation was detectable between HPV16 infection and the patients' age (P = 0.302), tumor site (P = 0.125), tumor grade (P = 0.363) and disease stage (P = 0.995). Observing the total sample the DFI was not significantly different for HPV16-positive versus HPV16-negative patients (P = 0.427), but a gender-based difference in DFI was observed, with the significantly shorter DFI (Log Rank test, P = 0.003) in HPV16 positive female patients compared to male patients (P = 0.003). The results obtained in this study provide scientific evidence for the development of national HPV vaccination program in Montenegro.

Epizootic of multi-centric, squamous cell carcinomas in populations of Indo-Pacific humpbacked dolphins Sousa chinensis in Thai waters.

Over the span of several years, 3 Indo-Pacific humpbacked dolphins died and were necropsied in Thailand. These 3 animals were all captive-bred at Oasis Sea World (Chanthaburi, Thailand), and displayed similar macroscopic progressive cutaneous lesions diagnosed as squamous cell carcinomas. In 2 of the 3 animals, necropsy revealed a severe fibrinosuppurative tracheitis and pneumonia secondary to metastasis of a cutaneous squamous cell carcinoma which extended from the head throughout the trunk and flippers. The tumors were characterized by coalescing botryoid masses with severe areas of cutaneous erosion, ulceration and necrohemorrhagic dermatitis. There was evidence of metastasis to the lungs and hilar lymph nodes. Necropsy of the third animal revealed similar progressive cutaneous squamous cell carcinomas but without evidence of metastasis. DNA molecular analysis of homogenized neoplastic tissue was conducted using polymerase chain reaction for both herpesvirus and papillomavirus in 2 of the 3 cases. In the first case, the tissues were positive for a herpesvirus alone, and this was phylogenetically classified as an alphaherpesvirus. This new herpesvirus has been tentatively named Sousa chinensis alphaherpesvirus. The second animal was negative for this novel herpesvirus and the third was not analyzed. In addition to the captive population, there is photographic evidence from 2 separate wild populations of Indo-Pacific humpbacked dolphins in the Gulf of Thailand, of a macroscopically identical proliferative and ulcerative process suspected to be squamous cell carcinomas.

Association of DFNA5, SYK, and NELL1 variants along with HPV infection in oral cancer among the prolonged tobacco-chewers.

Southeast Asia, especially India, is well known for the highest use of smokeless tobacco. These products are known to induce oral squamous cell carcinoma. However, not all long-term tobacco-chewers develop oral squamous cell carcinoma. In addition, germline variants play a crucial role in susceptibility, prognosis, development, and progression of the disease. These prompted us to study the genetic susceptibility to oral squamous cell carcinoma among the long-term tobacco-chewers. Here, we presented a retrospective study on prolonged tobacco-chewers of Northeast India to identify the potential protective or risk-associated germline variants in tobacco-related oral squamous cell carcinoma along with HPV infection. Targeted re-sequencing (n = 60) of 170 genetic regions from 75 genes was carried out in Ion-PGM™ and validation (n = 116) of the observed variants was done using Sequenom iPLEX MassARRAY™ platform followed by polymerase chain reaction-based HPV genotyping and p16-immunohistochemistry study. Subsequently, estimation of population structure, different statistical and in silico approaches were undertaken. We identified one nonsense-mediated mRNA decay transcript variant in the DFNA5 region (rs2237306), associated with Benzo(a)pyrene, as a protective factor (odds ratio = 0.33; p = 0.009) and four harmful (odds ratio > 2.5; p < 0.05) intronic variants, rs182361, rs290974, and rs169724 in SYK and rs1670661 in NELL1 region, involved in genetic susceptibility to tobacco- and HPV-mediated oral oncogenesis. Among the oral squamous cell carcinoma patients, 12.6% (11/87) were HPV positive, out of which 45.5% (5/11) were HPV16-infected, 27.3% (3/11) were HPV18-infected, and 27.3% (3/11) had an infection of both subtypes. Multifactor dimensionality reduction analysis showed that the interactions among HPV and NELL1 variant rs1670661 with age and gender augmented the risk of both non-tobacco- and tobacco-related oral squamous cell carcinoma, respectively. These suggest that HPV infection may be one of the important risk factors for oral squamous cell carcinoma in this population. Finally, we newly report a DFNA5 variant probably conferring protection via nonsense-mediated mRNA decay pathway against tobacco-related oral squamous cell carcinoma. Thus, the analytical approach used here can be useful in predicting the population-specific significant variants associated with oral squamous cell carcinoma in any heterogeneous population.

VIRAL HEPATITIS

Objectives: Diabetes mellitus has been shown to be an independent risk factorfor hepatocellular carcinoma in populations at risk. Different anti-diabetic drugs have beenshown to have different effects on incidence of cancers in diabetic patients. Data Source:Outpatient and inpatient hospital records as well as fresh cases. Design of Study: Hospitalbased retrospective case control study. Setting: DHQ, Sargodha. Period: Fifteen years (10years retrospective, 5 years prospective, from the starting date of study). Materials &amp; Methods:In a hospital based study we recorded the incidence of HCC in patients otherwise consideredto be at risk. We also observed whether anti-diabetic monotherapy has any effects on HCCoccurrence in our target population. Results: We found out that incidence of HCC in diabeticpatients with a concomitant HBV or HCV infection was at least 1.5 times higher than non-diabetichepatitis patients. The incidence of HCC reduced in patients using metformin as compared tosulfonylureas. Conclusion: Diabetes is an independent risk factor for hepatocellular carcinomaand metformin use is correlated with reduced HCC occurrence in risk groups.

DIABETICS PATIENTS INFECTED WITH HEPATITIS B OR C VIRUS; METFORMIN INTAKE IS ASSOCIATED WITH DECREASED INCIDENCE OF HEPATOCELLULAR CARCINOMA

Objectives: Diabetes mellitus has been shown to be an independent risk factorfor hepatocellular carcinoma in populations at risk. Different anti-diabetic drugs have beenshown to have different effects on incidence of cancers in diabetic patients. Data Source:Outpatient and inpatient hospital records as well as fresh cases. Design of Study: Hospitalbased retrospective case control study. Setting: DHQ, Sargodha. Period: Fifteen years (10years retrospective, 5 years prospective, from the starting date of study). Materials &amp; Methods:In a hospital based study we recorded the incidence of HCC in patients otherwise consideredto be at risk. We also observed whether anti-diabetic monotherapy has any effects on HCCoccurrence in our target population. Results: We found out that incidence of HCC in diabeticpatients with a concomitant HBV or HCV infection was at least 1.5 times higher than non-diabetichepatitis patients. The incidence of HCC reduced in patients using metformin as compared tosulfonylureas. Conclusion: Diabetes is an independent risk factor for hepatocellular carcinomaand metformin use is correlated with reduced HCC occurrence in risk groups.

Serum pepsinogens and Helicobacter pylori are not associated with esophageal squamous cell carcinoma in a high-risk area in China.

The role of serum pepsinogen level and Helicobacter pylori infection in esophageal carcinoma remains controversial. It may be a risk or protective factor, or without association with esophageal carcinoma. We prospectively examined associations between serum pepsinogen status, H pylori infection and the risk of esophageal squamous cell carcinoma in the Chinese population. In the present study, 1501 subjects from a community-based general population of Northern China were included. The incidence of esophageal carcinoma among the subjects was registered during a 15-year follow-up period by annual home visit, and the risks of low serum pepsinogen level and H pylori infection in the development of ESCC were evaluated using logistic regression. The total accumulated incidence of ESCC in the cohort was 666/100,000 during the 15-year follow-up. Notably, all the cases were verified to be ESCC. Logistic regression analysis showed that age ≥60 (OR = 9.67; 95% CI, 2.797-33.423) was the only risk factor for esophageal squamous cell carcinoma in the population. There was no significant association between sex, H pylori infection, pepsinogen level (PG I ≤70 ng/ml alone, PG I/II ratio ≤3 alone, or PG I ≤70 ng/ml and PG I/II ratio ≤3) and esophageal squamous cell carcinoma. In this prospective study, neither H pylori infection nor abnormal pepsinogen status had a predictive role for the development of esophageal squamous cell carcinoma in the rural population of China.

Utility of high-throughput DNA sequencing in the study of the human papillomaviruses.

The Papillomaviridae family is probably the most diverse group of viruses that affect vertebrates. The study of the relationship between infection by certain types of human papillomavirus (HPV) and the development of neoplastic epithelial lesions is of particular interest because of the high prevalence of HPV-related carcinomas in populations of developing countries. To understand the mechanisms of infection and their association with different clinical manifestations, molecular tools play an important role in the description of new types of HPV, the characterization of effector properties of the viral factors, the specific diagnosis and monitoring of HPV types, and the alteration patterns at genetic level in the host. Technological advances in the field of DNA sequencing have led to the development of different next-generation sequencing systems, allowing obtaining a large amount of data and broadening the applications to study viral diseases. In this review, we summarize the main approaches and their perspectives where the use of massively parallel sequencing has been proved as a useful tool in the research of the HPV infection.

Hepatocellular Carcinoma in Populations Consuming Heavy Metals Contaminated Plants in North Delta, Egypt

Hepatocellular Carcinoma in Populations Consuming Heavy Metals Contaminated Plants in North Delta, Egypt

Abstract 2786: Differences in gene-specific DNA methylation in blood DNA as a biomarker for early detection of hepatocellular carcinoma in populations at risk

Abstract Hepatocellular carcinoma (HCC), the most prevalent type of primary liver cancer, is the second leading cause of cancer death worldwide. It is estimated that early HCC detection would increase the cure rate from 5% to 80%. Approximately 85% of individuals with HCC have underlying liver cirrhosis which is the main risk factor for developing HCC. Every year up to 5% of cirrhotic patients are diagnosed with HCC. The biggest challenge that physicians face today is to distinguish cirrhotic patients that will develop cancer from those that will not. Thus, early detection biomarkers that can be implemented as screening tools in populations at risk are of high interest. In our previous genome-wide study, we demonstrated that blood DNA has different DNA methylation patterns specific to HCC samples collected before diagnosis (pre-diagnostic) compared to healthy individuals without cancer. We established 10 differentially methylated probes corresponding to 10 genes that distinguish pre-diagnostic HCC blood samples from healthy controls. In the current study using pyrosequencing, we tested the diagnostic potential of these probes in blood samples from a prospective cohort of cirrhotic patients without HCC at the time of blood collection. Twenty eight of these patients developed HCC within 4 years of follow-up. These 28 cases were matched with 23 cirrhotic controls on gender, age, ethnicity, hepatitis C, and diabetes. Five out of the 10 tested probes distinguished cirrhotic patients who subsequently developed HCC (cases) from those who stayed cancer free (controls) (p&amp;lt;0.05, Mann-Whitney U test). The highest differences were observed at CpG sites located within BARD1 whose methylation was consistently lower in cases vs. controls. Using this probe, 22 cases were correctly identified as cases (79% sensitivity), whereas only 6 controls were falsely included into cases (74% specificity). Analysis of the panel of the 5 probes increased sensitivity to 86% with a threshold of 2 positive probes, while maintaining 74% specificity. Receiver Operating Characteristics (ROC) curve analysis confirmed high predictive value for the 5 probes in the cirrhotic population [Area Under the Curve (AUC) = 0.80]. The established DNA methylation biomarkers have better values of performance compared to current recommended methods for HCC surveillance, such as serum alpha-fetoprotein (AFP) that can miss up to 40% of patients. Our results establish the possible diagnostic value of gene-specific DNA methylation in blood DNA for HCC early detection in populations at risk such as individuals with liver cirrhosis. This study was supported by Showalter Trust and PCCR Awards granted to BS. Citation Format: Katarzyna Lubecka, Lucinda Kurzava, Kirsty Flower, Hannah Buvala, Samer Gawrieh, Suthat Liangpunsakul, Naga Chalasani, James M. Flanagan, Barbara Stefanska. Differences in gene-specific DNA methylation in blood DNA as a biomarker for early detection of hepatocellular carcinoma in populations at risk. [abstract]. In: Proceedings of the 107th Annual Meeting of the American Association for Cancer Research; 2016 Apr 16-20; New Orleans, LA. Philadelphia (PA): AACR; Cancer Res 2016;76(14 Suppl):Abstract nr 2786.

Persistent Nausea and Vomiting in Pregnancy

Question: A 23-year-old pregnant woman at 27 weeks gestation presented with 10 weeks of persistent nausea, emesis, and a 20-pound weight loss. On examination, she appeared ill and had epigastric tenderness. Laboratory assessment was notable for anemia (hemoglobin level, 7 g/dL). Hyperemesis gravidarum was entertained, but upper endoscopy revealed circumferential, edematous narrowing of the gastric antrum with ulceration (Figure A, arrow). Gastric biopsies were obtained (Figure B). Computed tomography showed intrauterine pregnancy (Figure C, thin arrow) and a thickened gastric wall (Figure C, thick arrow). What is the diagnosis? Look on page 323 for the answer and see the Gastroenterology web site (www.gastrojournal.org) for more information on submitting your favorite image to Clinical Challenges and Images in GI. Gastric biopsy (Figure B) demonstrates adenocarcinoma with signet ring cells (arrows). The thick arrow in Figure C shows circumferential gastric thickening consistent with linitis plastica. The patient subsequently acknowledged her father perished with gastric cancer at age 45 years. Hereditary diffuse gastric cancer (HDGC) was confirmed by CDH-1 gene mutation testing. Vaginal delivery was expedited and chemotherapy initiated. Unfortunately, the patient succumbed to metastatic disease. Gastric cancer during pregnancy is rare, but should be considered in women with hyperemesis late in pregnancy. HDGC is an autosomal-dominant, inherited gastric cancer syndrome characterized by germline mutation of CDH-1 gene, which encodes for the cell-to-cell adhesion protein E-cadherin. It is a relatively rare cancer syndrome but may account for approximately 1% of all cases of gastric carcinoma in populations with a low incidence of gastric cancer such as the United States, Canada, and the United Kingdom.1Blair V. Martin I. Shaw D. et al.Hereditary diffuse gastric cancer: diagnosis and management.Clin Gastroenterol Hepatol. 2006; 4: 262-275Abstract Full Text Full Text PDF PubMed Scopus (142) Google Scholar Diffuse-type gastric adenocarcinoma with signet-ring cells is the most common cancer in carriers of germline CDH-1 mutations. Genetic testing for mutations in the CDH-1 gene is widely available. However, only 30%–50% of families meeting diagnostic criteria carry a predisposing CDH-1 mutation.1Blair V. Martin I. Shaw D. et al.Hereditary diffuse gastric cancer: diagnosis and management.Clin Gastroenterol Hepatol. 2006; 4: 262-275Abstract Full Text Full Text PDF PubMed Scopus (142) Google Scholar The revised International Gastric Cancer Linkage Consortium diagnostic criteria for CDH-1 mutation testing in HDGC include (1) 2 gastric cancer cases in family, 1 confirmed diffuse gastric cancer under age 50, (2) 3 confirmed diffuse gastric cancer cases in first- or second-degree relatives independent of age, (3) diffuse gastric cancer in an individual under age of 40, and (4) personal or family history of diffuse gastric cancer and lobular breast cancer, 1 diagnosed under the age of 50.2Fitzgerald R.C. Hardwick R. Huntsman D. et al.Hereditary diffuse gastric cancer: updated consensus guidelines for clinical management and directions for future research.J Med Genet. 2010; 47: 436-444Crossref PubMed Scopus (412) Google Scholar The other malignancy that occurs at increased frequency in HDGC families is lobular breast carcinoma. It is unclear why germline CDH-1 mutation predisposes predominantly to gastric cancer. There is a high lifetime risk for advanced gastric cancer in HDGC of approximately 70% in men and 80% in women by 80 years of age.3Pharoah P. Guilford P. Caldas C. Consortium TIGCLIncidence of gastric cancer and breast cancer in CDH1 (E-cadherin) mutation carriers from hereditary diffuse gastric cancer families.Gastroenterology. 2001; 121: 1348-1353Abstract Full Text Full Text PDF PubMed Scopus (479) Google Scholar The risk for advanced gastric cancer is age-related and estimated to be <1% at 20 years and increasing to 4% at 30 years.3Pharoah P. Guilford P. Caldas C. Consortium TIGCLIncidence of gastric cancer and breast cancer in CDH1 (E-cadherin) mutation carriers from hereditary diffuse gastric cancer families.Gastroenterology. 2001; 121: 1348-1353Abstract Full Text Full Text PDF PubMed Scopus (479) Google Scholar Because most patients have advanced stage gastric carcinoma at diagnosis, prophylactic gastrectomy is recommended in asymptomatic CDH-1 mutation carriers over the age of 20 years to prevent the development of this lethal cancer. If prophylactic gastrectomy is declined, intensive gastroscopic surveillance should be performed with the patient informed of the limitations for endoscopic detection of early lesions in HDGC.

Serum Pepsinogens and Helicobacter Pylori are not Associated with Esophageal Squamous Cell Carcinoma in a High-Risk Area in China

The role of serum pepsinogen level and Helicobacter pylori infection in esophageal carcinoma remains controversial. It may be a risk or protective factor, or without association with esophageal carcinoma. We prospectively examined associations between serum pepsinogen status, H pylori infection and the risk of esophageal squamous cell carcinoma in the Chinese population. In the present study, 1501 subjects from a community-based general population of Northern China were included. The incidence of esophageal carcinoma among the subjects was registered during a 15-year follow-up period by annual home visit, and the risks of low serum pepsinogen level and H pylori infection in the development of ESCC were evaluated using logistic regression. The total accumulated incidence of ESCC in the cohort was 666/100,000 during the 15-year follow-up. Notably, all the cases were verified to be ESCC. Logistic regression analysis showed that age ≥60 (OR = 9.67; 95% CI, 2.797-33.423) was the only risk factor for esophageal squamous cell carcinoma in the population. There was no significant association between sex, H pylori infection, pepsinogen level (PG I ≤70 ng/ml alone, PG I/II ratio ≤3 alone, or PG I ≤70 ng/ml and PG I/II ratio ≤3) and esophageal squamous cell carcinoma. In this prospective study, neither H pylori infection nor abnormal pepsinogen status had a predictive role for the development of esophageal squamous cell carcinoma in the rural population of China.

The Freqence of Renal Cell Carcinoma in Population of Patients with Kidney Tumors

A kidney tumor is an abnormal growth within the kidney that usually occurs over a period of a time. Each tumor has its own characteristics and it is important to know what tumor the patient has so that the proper treatment can be administered. Kidney tumors can be benign or malignant. Symptoms of all types of kidney tumors are very similar and unspecific. The aims of study: a) To determine how many patients, who were clinically and radiologically diagnosed with kidney tumor, after surgical intervention, have histopathologicaly confirmed renal cell carcinoma; b) To compare number of female and male patients have histopathologicaly confirmed renal cell carcinoma; c) To compare numbers of patients with renal cell carcinoma who are older than 50 years with the ones who are younger than 50 years; d) To determine the most common risk factors for renal cell carcinoma; e) To determine the most common symptoms of renal cell carcinoma; f) To determine what was the most common stage of kidney cancer in the time when it was histopathologicaly confirmed. This study was observational, descriptive, retrospective study of renal cell carcinoma. The study consisted of 28 patients who were clinically and radiologically diagnosed with kidney tumor, which was surgically removed and histopathologicaly tested. All patients were surgically treated at the Urological Clinic of Clinical Centre University of Sarajevo from 1/1/2012 to 06/30/.2012. from 28 patients with a kidney tumor 26 had RCC, the most of patients with RCC were older than 50 years (22 patients), there was 7 female and 19 male patients, the most common symptom was pain (10 patients), the most common risk factor, excluding age, was hypertension (11 patients), patients with RCC was usually diagnosed stage 4 Fuhrman (11 patients). Doctors should give their intention to discover early symptoms of renal cell carcinoma and to do preventive exams and tests in the population of patients who have one or more risk factors for developing this disease. Early diagnose and appropriate therapy could reduce mortality and morbidity of the patients with renal cell carcinoma, and could also reduce costs of treatment.

Can the Gail model be useful in American Indian and Alaska Native populations?

Very little is known about breast carcinoma risk factors for American Indian/Alaska Native (AI/AN) women undergoing screening. The Gail model has been a useful tool for predicting the risk of breast carcinoma in several populations. It has not been applied systematically to AI/AN women. The current study was a retrospective review of 1458 screening mammograms performed for AI/AN women. The authors applied the Gail model to estimate both absolute risk and relative risk for breast carcinoma for AI/AN women screened in South Dakota, Arizona, and Alaska. The mean age of the women was 52.4 years. The onset of menses was not significantly different than expected. The average age at first birth was 20 years, very few women were nulliparous, and few women were age > 30 years at first live birth. The proportion of women reporting a first- or second-degree relative with breast carcinoma was similar to the proportion in the general population. The results of the model indicated an overall average relative risk that ranged from 1.42 to 2.69 compared with white American women, depending on the model assumptions used. Using a modified Gail model and calculating an imputed absolute risk, the expected incidence of breast carcinoma in this population increased to rates of 170-180 per 100,000 in the next 10 years, a significant increase over the Surveillance, Epidemiology and End Results-derived incidence rates from 1988 to 1992 of 31.6 per 100,000 for AI women in New Mexico and 78.9 per 100,000 for AN women. The model indicated a likelihood of increasing rates of breast carcinoma in the study population. The data obtained were useful in generating preliminary estimates of breast carcinoma risk in the study population, for which no prospective population survey has been completed. The inherent weaknesses in the current retrospective study indicated the need for a large-scale prospective data collection to confirm these exploratory findings.

Epoxide hydrolase Tyr113His polymorphism is not associated with susceptibility to esophageal squamous cell carcinoma in population of North China.

To investigate the possible association of microsomal epoxide hydrolase (mEH) Tyr113His polymorphism with susceptibility to esophageal squamous cell carcinoma (ESCC) in a population of North China. The mEH Tyr113His genotypes were determined by polymerase-chain reaction (PCR)-restriction fragment length polymorphism (RFLP) analysis in 257 patients with esophageal squamous cell carcinoma (ESCC) and 252 healthy subjects as a control group. The frequencies for Tyr and His alleles were 44.2%, 55.8% in ESCC patients, and 44.0% and 56.0% in healthy subjects, respectively. No statistic difference in allele distribution was observed between ESCC patients and controls (chi2=0.008, P=0.929). The overall genotype distribution difference was not observed between cancer cases and controls (chi2=2.116, P=0.347). Compared with Tyr/Tyr genotype, neither His/His genotype nor in combination with Tyr/His genotype significantly modified the risk of the development of ESCC, the adjusted odds ratio was 1.076 (95% CI=0.850-1.361) and 0.756 (95% CI=0.493-1.157), respectively. When stratified for sex, age, smoking status and family history of upper gastrointestinal cancer, His/His genotype alone or in combination with Tyr/His genotype also did not show any significant influence on the risk of developing ESCC. MEH Tyr113His polymorphism may not be used as a stratification marker in screening individuals at a high risk of ESCC.

Bronchogenic carcinoma in lung transplant recipients

Although lung transplant recipients have a higher prevalence of non-melanoma skin cancers and lymphoma than the general population, the same has not been noted for bronchogenic carcinoma. If an increased prevalence of bronchogenic carcinoma exists, contributing factors may include the high rate of previous tobacco use in this population and/or the chronic immunosuppression used to prevent allograft rejection. With time, the incidence of bronchogenic carcinoma in the lung transplant population is likely to parallel the increasing longevity and number of transplanted individuals. We describe 2 cases of bronchogenic carcinoma in lung transplant recipients that demonstrate the morbidity associated with the discovery or development of bronchogenic carcinoma in this population.

Differences in diagnostic criteria for gastric carcinoma between Japanese and Western pathologists

There have been many studies on gastric carcinoma in populations with contrasting cancer risks. We aimed to find out whether the criteria for the histological diagnosis of early gastric carcinoma were comparable in Western countries and Japan. Eight pathologists from Japan, North America, and Europe individually reviewed 35 microscope slides: 17 gastric biopsy samples and 18 endoscopic mucosal resections taken from 17 Japanese patients with lesions ranging from early gastric cancer to adenoma, dysplasia, and reactive atypia. The pathologists were given a list of pathological criteria and a form on which they were asked to indicate the criteria on which they based each diagnosis. For seven slides most Western pathologists diagnosed low-grade adenoma/dysplasia, whereas the Japanese diagnosed definite carcinoma in four slides, suspected carcinoma in one, and adenoma in only two. Of 12 slides with high-grade adenoma/dysplasia according to most Western pathologists the Japanese gave the diagnosis of definite carcinoma in 11 and suspected in one. Of six slides showing high-grade adenoma/dysplasia with suspected carcinoma according to most Western pathologists the Japanese diagnosed definite carcinoma in all. There were no major differences in the diagnoses of three slides showing reactive epithelium and seven slides with clearly invasive carcinoma. When the opinion of the majority of the pathologists was taken as the final diagnosis there was agreement between Western and japanese in 11 of the 35 slides (kappa coefficient 0.15 [95% CI 0.01-0.29]). Presence of invasion was the most important diagnostic criterion for most Western pathologists whereas for the Japanese nuclear features and glandular structures were more important. In Japan, gastric carcinoma is diagnosed on nuclear and structural criteria even when invasion is absent according to the Western viewpoint. This diagnostic practice results in almost no discrepancy between the diagnosis of a superficial biopsy sample and that of the final resection specimen. This may also contribute to the relatively high incidence and good prognosis of gastric carcinoma in Japan when compared with Western countries.

Urinary cholesterol in cancer screening

Cholesterol determinations in morning urine samples were taken in 235 selected patients with a positive test for microscopic hematuria. Values ranged from 0.2 to 76.0 mg (median 5.5) in 23 patients with urologic malignancies and from 0.1 to 33.4 mg (median 1.1) in 38 patients with various benign diseases of the kidney or urogenital tract. In the 28 patients with urinary tract infections and 146 subjects without evidence of disorders of the kidney and the urogenital system, urinary cholesterol excretion was usually normal (0.1 to 1.9 mg; median 0.35). Using 1.0 mg urinary cholesterol per morning urine as a cutoff point, sensitivity for urologic carcinomas is about 80 per cent with a comparable high specificity of 90 per cent. Therefore, subsequent measurements of urinary cholesterol in populations with microscopic hematuria could define two groups, one with high prevalence and one with low prevalence of urologic malignancies. The less complicated colorimetric instead of gas-liquid chromatographic determination of urinary cholesterol can be recommended as a screening test for urologic carcinomas in populations with microscopic hematuria.