Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The incidence of metastases from primary adenocarcinoma of the rectum in lymph nodes smaller than 5 mm is not known. Lymph nodes measuring less than or equal to 5 mm usually are not detected by manual techniques of examination of the surgical specimen. This retrospective analysis describes the results when a lymph node clearing technique that identifies lymph nodes as small as 1 mm was used to treat surgical specimens from 27 consecutive patients with rectal adenocarcinoma who underwent abdominoperineal resection with a curative intent and for whom all pathologic data were retrievable. Nine hundred thirty lymph nodes were found, with an average of 34 lymph nodes per specimen (range 0-88). Seventy-two of the 345 lymph nodes found in patients with Dukes C tumors were found to have metastases. Fifty-six (78 percent) of these 72 lymph node metastases occurred in lymph nodes measuring less than or equal to 5 mm. Three lymph node metastases were found in the perianal zone, 53 in the perirectal zone, and 16 in the pericolonic zone. Lymph node metastases from rectal adenocarcinomas often will occur in lymph nodes smaller than 5 mm. We concluded that the use of lymph node clearing techniques discovers these metastases, thereby offering the potential for enhanced staging of primary rectal adenocarcinomas.
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PMID:Incidence of metastases from rectal adenocarcinoma in small lymph nodes detected by a clearing technique. 164 3

Thoracic computed tomography (CT) is an essential component in the preoperative staging of bronchial carcinomas as is mediastinoscopy (MSC) in cases of mediastinal lymphoma. It is known that endoscopic ultrasonography (EUS), as a new diagnostic procedure, can predict lymph-node involvement in cases of tumors in the upper gastrointestinal tract with an 80% probability. In a prospective study, we examined whether EUS could be used to ascertain the presence of mediastinal lymph nodes in cases of bronchial carcinoma. Since 1990, therefore, 32 patients with operable non-small-cell bronchial carcinoma have been examined with an Olympus-Aloka EU-M2 or EU-M3 (frequency 7.5 and 12 MHz) in addition to routine diagnostics. The graded cross-sections of lymph-node dissections obtained during subsequent surgery served as evidence as to the true or false prognosis of the lymph-node status. Endoscopic ultrasonography identifies the presence and estimates the size of subcarinal, tracheobronchial, paraortal and paraesophageal lymph nodes better than computed tomography. Lymph nodes lying behind organs containing air (pretracheal lymph nodes) cannot be identified by ultrasonography. Lymph-node involvement was correctly identified by EUS in 72% of the cases, and the specificity was 86%. The poor sensitivity, at 67%, is explained by the high proportion (37%) of patients with anthracosilicosis, as the latter produces the same echo pattern as malignant infiltration. In 47% of all the cases, CT showed enlarged mediastinal lymph nodes which were not actually infiltrated in 67%. Of these lymph nodes, 33% could be classified as definitely free of metastases on the strength of their echo pattern, the rest were inflamed or really infiltrated by metastases.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Endoscopic ultrasonography of the mediastinum in the diagnosis of bronchial carcinoma. 166 46

Adoptive immunotherapy may be useful for treating or visualising metastatic cancer. Lymphocytes were taken from 6 patients with metastatic colorectal cancer and cultured with cells from the patients primary tumour to produce tumour-activated killer (TAK) lymphocytes. We re-injected each patient with IIIIn-labelled TAK cells in order to visualise metastases. Images were taken with a gamma-camera for up to 48 h after injection. Metastases were revealed as early as 4 h in the lung and as late as 48 h in the abdomen. Liver images produced "cold" spots corresponding to metastatic lesions. Lymph nodes were not visualised. Re-injection of TAK cells raised against autologous colorectal tumours reveals the sites of metastases.
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PMID:Imaging of metastatic colorectal cancer with tumour-activated killer lymphocytes. 167 24

To see if there was an association between the number of lymph node metastases and the macroscopic findings of the tumour (such as size, location, and gross appearance), the nuclear DNA content was cytophotometrically analysed in biopsy specimens taken at preoperative endoscopy from 84 cases of gastric cancer. The DNA ploidy patterns were classified into type D, type A1, and type A2, according to the stem lines and the degree of scatter of the cells. Lymph nodes were positive in 2 of 20 (10%) in type D and 10 of 30 (33%) in type A1; these were both significantly lower than that in type A2 (24 of 34, 71%). Knowing the degree of nodes metastases or the microscopic lymphatic spread before the operation is almost impossible at present; the nuclear DNA content is closely associated with metastatic content of the nodes, so the cytophotometric determination of the DNA ploidy patterns from biopsy specimens may be useful in predicting the nodal state.
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PMID:Preoperative prediction of nodal state in gastric cancer by nuclear DNA content. 167 81

A cell culture technique was developed to investigate submicroscopic lymph node metastases in patients with stage 1 or 2 malignant melanoma. Lymph nodes were isolated from standard dissections and bivalved. Half of the node was evaluated by routine histopathologic examination, while the other half was processed and placed into tissue culture. Three hundred twenty-three lymph nodes were collected from 41 patients. The cell culture technique identified 155 of 323 lymph nodes containing micrometastases, while only 20 of 323 lymph nodes tested positive with routine histochemical processing. Nine patients were upgraded from stage 1 or 2 to stage 3 disease after micrometastases were identified in lymph node cultures. Identification of melanoma was confirmed by cytologic examination, immunohistologic staining, and the presence of GD3 ganglioside and 250-kd glycoprotein melanoma-associated antigens. This study provides evidence that the culture of lymph nodes is a sensitive method for the detection of micrometastases. In addition, this procedure may change prognosis and identify candidates for adjuvant therapies.
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PMID:Detection of submicroscopic lymph node metastases in patients with melanoma. 152 91

Fourteen patients suffering from advanced inoperable cervical cancer were investigated by planar scintigraphy after subcutaneous administration of a radiolabelled (I-123) epidermal growth factor (EGF). The objective of the study was to test whether labelled EGF concentrates in lymph node metastases of squamous cell cancer of the cervix uteri. Scintigraphic results were correlated with the gynecological findings, computed tomography (CT), ultrasound (US) and in two patients with histology. A series of scintigrams were performed up to 24 hours post injection. Slight activity in liver and kidneys was found already 30 min after s.c. injection of EGF. Optimal imaging quality for the lymphatics was obtained at 6-8 hours post injection. Accumulation in the pelvic lymph nodes was documented by the region of interest technique (ROI). Lymph nodes of the inguinal and iliac communis region were marked in all cases. Due to this, accumulation of EGF could not be called selective. In 11/14 patients hot spots were correlated to other pelvic lymph nodes. In 4/11 patients with positive EGF-scanning metastatic disease was confirmed by CT scan and/or US examination. 2/11 patients underwent a Probatoria operation. The respective histological reports confirmed our scintigraphic results. In conclusion, labelled EGF did not fulfil our theoretical expectations of excellent accumulation in lymph node metastases and cannot at present be recommended for routine clinical use.
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PMID:Lymphoscintigraphy using epidermal growth factor as tumour-seeking agent in uterine cervical cancer. 177 99

Lymph nodes draining progressive tumors contain tumor-sensitized but not functional preeffector T lymphocytes. These cells can acquire antitumor reactivity after stimulation with tumor cells and interleukin-2 (IL-2). We demonstrated here that, in the absence of tumor cells, preeffector cells could be stimulated and expanded by sequential culture with anti-CD3 monoclonal antibody and IL-2. The adoptive transfer of such activated cells mediated immunologically specific reductions of established pulmonary metastases. The therapeutic effects could be enhanced by the administration of IL-2. This activation represents a secondary immune response because effector cells could be generated only from tumor-draining but not from normal or adjuvant-stimulated lymph nodes. Furthermore, treatment of advanced metastases with these cells resulted in prolongation of survival and cure of the disease. Thus, anti-CD3 may serve as a universal reagent for activating tumor-sensitized T lymphocytes for cancer therapy.
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PMID:Activation by anti-CD3 of tumor-draining lymph node cells for specific adoptive immunotherapy. 182 49

Lymph nodes (LN) draining progressively growing tumors contain tumor-sensitized but not fully functional preeffector lymphocytes. These cells could acquire therapeutic efficacy and be expanded upon sequential culture with anti-CD3 mAb for 2 days followed by incubation in IL-2 for 3 days. Using the weakly immunogenic MCA 106 and MCA 205 murine sarcomas, we have further defined conditions of this anti-CD3/IL-2 activation with which preeffector cells differentiated into immune effector cells. In vitro activation and expansion of effector cells required sequential but independent stimulation with anti-CD3 and IL-2 because the simultaneous presence of both anti-CD3 and IL-2 at either stage did not enhance the efficacy of activation. Generation of effector cells by this two-stage activation was critically dependent on the optimal concentrations of anti-CD3 (1.0 microgram/ml) and IL-2 (2-10 U/ml). However, these conditions were not optimal for inducing the greatest cellular proliferation. In adoptive immunotherapy experiments, although the transfer of anti-CD3/IL-2-activated cells alone could mediate the regression of established metastases, the concomitant administration of IL-2 enhanced the in vivo activity of these cells. More importantly, tumor regression mediated by the anti-CD3/IL-2-activated cells was found to be immunologically specific. The specificity was determined by the tumor that stimulated the preeffector cell response. In spite of their in vivo antitumor effects, the anti-CD3/IL-2-activated tumor-draining LN cells did not exhibit detectable in vitro cytotoxicity against the tumor target in the 4-h 51Cr-release assay. In mice bearing progressive tumor, draining LN contained most preeffector cells. Some preeffector cells were also detected in the spleen whereas mesenteric LN did not demonstrate any reactivity. In kinetics studies, sensitization of preeffector cells in the draining LN occurred between 4 to 6 days after tumor inoculation. As the tumor progressed, the presence of preeffector cells declined gradually suggesting a tumor-induced suppression. These results define the conditions whereby tumor-draining LN cells could be stimulated, in the absence of tumor Ag, to develop into specific therapeutic effector cells. Our findings also raise the possibility of using similar approaches for isolating immune effector cells from cancer patients for adoptive immunotherapy.
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PMID:Specific adoptive immunotherapy mediated by tumor-draining lymph node cells sequentially activated with anti-CD3 and IL-2. 183 72

Three hundred forty-five patients with stage IB squamous cell carcinoma of the cervix were treated at the University of Michigan Medical Center from 1970 through 1985. The overall cumulative 5-year survival was 89%. The clinical characteristics included mean age 44.6 years, nulliparity 10%, married 93%, obese 38%, hypertension 32%, diabetes mellitus 5%, smoking 54%, symptoms of bleeding 68%, positive cytologic smear 83%. Lymph nodes were diseased in 45 of 261 (17%) with 26 unilateral (10%) and 19 bilateral (7%). Tumor differentiation showed: grade 1, 112 (33%); grade 2, 144 (42%); grade 3, 86 (25%). Factors that did not influence survival included age, presence or absence of positive cervical cytologic smear, the interval from previous papanicolaou smear, hypertension, smoking history, patient's blood type, and transfusion at radical hysterectomy. In all patients survival was significantly influenced by the following features: tumor classified as well differentiated (95%) or poorly differentiated (82%); tumor size less than 3 cm (91%) or greater than 3 cm (76%); negative lymph nodes (93%) or positive lymph nodes (61%). When three or fewer lymph nodes were involved, the survival was 79% compared with 33% when four or more lymph nodes were involved. In 213 patients undergoing radical hysterectomy the cumulative 5-year survival was significantly influenced by the amount of residual cervical disease: no residual disease, 100%; less than 50% penetration, 96%; greater than 50% penetration, 83%. Involvement of the lower uterine segment reduced survival to 73% compared with 95% when the lower segment was uninvolved. One hundred seventeen patients without angiolymphatic invasion had a 97% cumulative 5-year survival whereas 70 patients without disease in the lymph nodes but with angiolymphatic invasion had an 88% cumulative 5-year survival rate. A Cox model, multiple proportional hazard analysis was performed for all patients, and the factors that influenced survival included tumor grade, tumor size, presence of metastatic disease in the lymph nodes, and diabetes mellitus. In patients undergoing radiation therapy, the tumor grade and size were significant factors in survival. In patients undergoing radical hysterectomy, survival was influenced by the depth of cervical penetration and lower uterine segment involvement whereas the tumor grade, tumor size, patient's age, and removal of ovaries were not significant.
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PMID:Stage IB squamous cell cancer of the cervix: clinicopathologic features related to survival. 204 98

Sixteen patients with primary breast cancer were studied with a pancarcinoma monoclonal antibody B72.3, an IgG1 molecule directed against tumor-associated glycoprotein (TAG-72) present in several tumors. Five millicuries of 111In was used to label 0.2 mg (six patients), or 2 mg (six patients), or 20 mg using the site-directed bifunctional DTPA method (at carbohydrate moiety). Digital, planar, and SPECT images were obtained at 2, 48, 72 and 96 hr when possible. HAMA levels were obtained before the Mab infusion and at 1, 3, and 6 wk postinfusion. Fourteen of 14 known primary breast lesions were detected by imaging (100% sensitivity). Two fibrocystic lesions were negative. Seven of 14 patients had lymph node metastases by histologic methods, but all were missed by radioimmunoscintigraphy. Tumor uptake of Mab ranged 0.00054%-0.0038% of the ID/g. The tumor-to-normal breast tissue ratio was 4.3 +/- 0.91 (mean +/- s.e.m.). Lymph nodes localization of 111In-B72.3 by tissue analysis was similar for tumor-bearing and normal nodes (0.0039 +/- 0.0023 versus 0.0025 +/- 0.0019). Pharmacokinetics revealed mean plasma half-life of 33.3-41.2 hr for the different doses. There was no statistical difference between any of the pharmacokinetic parameters of different doses. HAMA was positive only in 17% of the patients. The study suggests that this antibody has 100% sensitivity for primary breast cancers, but very poor detection rate of metastatic lesions in axillary lymph nodes; thus making it of questionable value in the initial staging process of this disease.
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PMID:Indium-111-labeled B72.3 monoclonal antibody in the detection and staging of breast cancer: a phase I study. 206 85


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