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The relationship between DNA distribution pattern and estrogen receptor (ER) content was investigated in primary mammary carcinomas from 56 female patients. The data showed that mammary carcinomas in which the DNA amounts of the tumor cells do not deviate conspicuously from diploid or tetraploid DNA values of normal mammary epithelium are characterized by high levels of ER. On the other hand, mammary carcinomas containing a sizable number of cells with DNA amounts in the normal DNA synthesis region or with high degrees of aneuploidy are distinguished by low or even unmeasurable ER levels. These results strongly indicate a correlation between nuclear DNA distribution patterns and ER levels in primary breast carcinomas.

Measurements of cytophotometric Feulgen DNA content and incorporation of 3H-thymidine were made in individual tumor cells from 58 patients with squamous cell carcinomas of the head-neck region. These measurements were correlated with a point ranking system for pathological grading for these types of tumors. Two of the parameters of the grading system, mode of invasion and nuclear polymorphism which had been found to be important factors in prognosis in clinical studies were correlated to the objective cellular DNA measurements. In 40 carcinomas, 10 were found to have a predominantly diploid distribution of DNA values, while the remaining 30 tumor values were either multiples of diploid or were aneuploid. Generally, tumors with low point rankings for individual morphological parameters tended to have diploid DNA values. Those tumors with higher DNA values usually had larger point rankings and more advanced clinical stage. When tumor cells from biopsies of 39 patients were studied by 3H-thymidine incorporation, no relevant connections between the labeling index and cellular DNA amounts, malignancy grading, or clinical stage were found.

The authors present a case of choriocarcinoma of the fallopian tube. The patient was enrolled in an IVF program and to our knowledge this is the first report of a choriocarcinoma following treatment with clomiphene citrate and hMG. The possible role of superovulation in inducing the tumour is discussed. The patient was treated by conservative surgery only and is in remission 1.5 years after the event.

The cancer incidence was studied in 18,030 patients (33% males, 67% females) with skin hemangioma who were admitted to Radiumhemmet, Karolinska Hospital, Stockholm, Sweden, 1920-1959. Radium-226 sources were used in 12,821 patients, x-ray therapy was used in 2,515 patients, and no radiotherapy was given to 2,694 patients. Cancer incidence in the cohort was searched by record linkage with the Swedish Cancer Register for the period 1958-1982. The median age was 6 months for the treated patients and 8 months for the patients not receiving radiotherapy. In the group treated with radium-226 or orthovoltage x rays (greater than or equal to 100-kV peak), 224 cancers were observed [relative risk (RR) = 1.18; 95% confidence interval (CI) = 1.03-1.35]. In patients given contact x rays, 10 cancers were observed (RR = 0.71; 95% CI = 0.34-1.30). In patients not treated with ionizing radiation, 34 cancers were observed (RR = 0.93; 95% CI = 0.64-1.29). In patients treated with radium-226 or orthovoltage x rays, an RR of 1.65 was observed for breast cancer (95% CI = 1.26-2.13) and an RR of 2.73 was found for soft tissue tumors (95% CI = 1.18-5.38). Patients with brain tumors, thyroid cancers, and bone tumors had received radiotherapy close to the tumor site more often than expected. For patients with breast cancer, no such difference was found. For cancers of the breast and thyroid, the RR was higher in patients given more than one treatment.

During the period 1923 to 1972, 62 women with theca-cell tumors were treated at Radiumhemmet. The mean age at diagnosis was 59.5 years. Concomitant endometrial carcinoma was found in 13 patients. At 1978, after a mean observation time of 15.5 years, 30 patients were alive. No patient died from thecoma. Malignant disease caused death in 7 women. No difference in survival was found between 20 patients and 40 controls matched by age and place of residence.

During 1958, 91 cases of breast carcinoma in women below 30 years of age were reported to the Swedish Cancer Registry. A histologic reexamination showed that 16 of these women had only benign proliferative conditions. Among the remaining 75 patients, two had noninvasive carcinoma, eight advanced carcinoma, and 65 operable invasive carcinoma. The carcinomas were characterized by little fibrous stroma and little or no elastosis. The survival rate of the patients with invasive breast carcinomas was similar to that in a total geographic material of all ages with breast carcinoma. The carcinoma was treated during pregnancy or within 1 year after delivery in 15 patients, with the same survival rate as for those whose carcinoma was not complicated by pregnancy.

To study the origin of the choanal polyp, the maxillary sinus was surgically explored using a preservative technique. An antral cyst or a cystic rudiment, usually attached to the inferolateral aspect of the sinus wall, was disclosed in 15 patients with this condition. As a part of the choanal polyp, the antral cyst exhibited a macroarchitecture and microarchitecture identical to the structure of the common intramural cyst of the maxillary sinus as studied in nine patients. It is concluded that the choanal polyp develops from the expanding intramural cyst protruding through the maxillary ostium and into the nasal cavity.

The nuclear DNA content in tumor cells from invasive ductal breast carcinomas was analyzed in 26 patients who survived more than 10 years and in 23 patients who died within 2 years after operation. The DNA content of individual tumor cells was measured in sections from the originally paraffin-embedded specimens. In short-term survivors, a large proportion of cells with very high DNA values was found in all tumors except one. Only two patients of the long-term survivors had tumors that exhibited such high DNA values. Prognostic information obtained by DNA analysis compared with histologic malignancy grading showed that the specificity using DNA analysis was distinctly higher. The data thus suggest that analysis of DNA content of tumor cells in breast adenocarcinomas can be a useful supplement to histologic malignancy grading to obtain prognostic guidance in individual patients.

In a retrospective study of 83 osteosarcoma patients treated by surgery and adjuvant interferon from 1971 to 1986, the clinical course was related to different clinicopathologic features and tumor DNA content. DNA analysis was feasible in 60 cases. Four tumors were diploid and 56 hyperploid. The 7-year survival rate, estimated by life-table analysis, was 0.44 for the whole series. Multivariate analysis disclosed that male sex, proximal tumor location, and histologic Grade IV were independent risk factors--all approximately of equal strength. DNA analysis did not provide prognostic information, except for tumors with extreme abnormality of the DNA content, which was associated with a very poor prognosis. A prognostication model was created, based on the number of risk factors present. The 7-year survival rate for patients with none, one, two, or three risk factors was 0.80, 0.59, 0.42, and 0.13, respectively. The estimated 7-year rate of local recurrence was 0.29: 0.07 after ablative surgery and 0.54 after local surgery. Among patients who were free of metastasis 1 year after diagnosis, local recurrence reduced the 7-year survival rate from 0.86 to 0.48. In high-grade osteosarcoma, conventional clinicopathologic features and local tumor control remain the most important prognostic factors.

Immediately after mastectomy, estrogen receptor concentration was measured in fine needle aspirates and in histologic tissue specimens from 13 human breast carcinomas. Fine needle aspirates were shown to contain enough material for receptor analysis when the sensitive method of isoelectric focusing in slabs of polyacrylamide gel was used for receptor determination. Aspirations with two different needles (outer diameter 0.7 and 1.4 mm) from each tumor yielded highly correlated receptor values (r = 0.97, p less than 0.0001). There was also a highly significant correlation (r = 0.91, p less than 0.0001) between the receptor content in needle aspirates and in tissue specimens from the same tumor.

Eighteen patients with advanced and inoperable colorectal adenocarcinomas were treated with high doses of alpha 2 Interferon (Schering-Plough Corporation). The patients were randomized to receive either subcutaneous injections of 20 X 10(6) I.U./m2 three times weekly for 3 months, or pulsed treatments of 50 X 10(6) I.U./m2 daily, given intravenously, for 5 consecutive days every 4 weeks. No objective tumour regression was seen in any patient. The side effects were considerable.

An analysis of 936 women with granulosa- and theca-cell tumors reported to the Swedish Cancer Registry between 1958 and 1972 showed crude annual incidence rates for these lesions of 0.72 and 0.74, respectively, pre 100 000 of the female population, unchanged during the period. The age-specific incidence rates, both groups taken together, increased almost linearly from 35 to 69 years. The women displayed an increased risk of developing endometrial carcinoma and malignant lymphoma, possibly also breast, colon and thyroid carcinoma.

The risk of second primary malignancy arising after therapeutic irradiation was evaluated in the Radiumhemmet series of carcinoma of the uterine cervix treated in 1914-1965. Only tumours appearing more than 10 years after irradiation were taken into account. Comparisons of observed with expected incidence showed excess of malignancies in urinary bladder, endometrium, ovaries and rectum, but not of colon carcinoma. Comparisons were made with cohorts from the Swedish Cancer Registry.

Histological specimens from 80 invasive breast carcinomas comprising typical cases of 16 ductal, nine papillary, 14 comedo, 13 colloid (mucous), 15 lobular, and 13 medullary carcinomas were examined with respect to nuclear DNA and estrogen receptor content. In agreement with previous studies, ductal carcinomas were found to exhibit different types of nuclear DNA distribution patterns, i.e., tumors with DNA values in the normal diploid or tetraploid regions indicative of good prognosis (euploid tumors) or those with values exceeding the normal tetraploid region indicative of poor prognosis (aneuploid tumors). The majority of the papillary and colloid tumors were euploid, while comedocarcinomas in general had aneuploid profiles. These findings are in agreement with expected survival within these patient groups. In lobular breast carcinomas, the correlation between the DNA distribution patterns and expected patient survival was less obvious; and in medullary carcinomas where the vast majority of the tumors showed aneuploid DNA profiles, the correlation to expected patient survival was low. Thus, lobular carcinoma in general seems to have a worse prognosis than is expected from nuclear DNA analysis, whereas medullary carcinomas in general seem to carry a better prognosis than indicated from DNA measurements. In agreement with earlier reports there was a good correlation between nuclear DNA content of the tumor cells and cytosol estrogen receptor values, i.e., euploid tumors in general exhibited relatively high receptor levels, whereas aneuploid tumors had low or unmeasurable estrogen receptor levels.

Screening programmes identify a large number of women suspected of having a precancerous lesion of the uterine cervix, necessitating an efficient organization of diagnosis, treatment and follow-up. The ultimate criterion for the evaluation of a programme should be the long-term impact on incidence and mortality. A major problem is lack of uniformity in nomenclature, both with regard to cytology and pathology, as well as observer variation in reading and different standards. The fairly large group of women with mild and moderate atypia in cervical smears creates problems for diagnosis and management that have not been satisfactorily solved. The treatment of precancerous lesions, severe dysplasia and carcinoma in situ has been improved by the introduction of many new methods. A change is occurring from the use of hysterectomy, radiation and big cones towards more conservative methods such as colposcopy-guided biopsies, smaller cones, cryosurgery and laser treatment. This change in treatment techniques does not appear to impair the short-term results of treatment. However, a strong warning is given against using tissue-destructive methods before performing a thorough evaluation of the extent and histopathological nature of the disease. The increasingly large group of women treated for in-situ carcinoma deserves special attention and long-term follow-up, as even after treatment they still represent a high-risk group for invasive carcinoma of the uterine cervix.

Isoelectric focusing in polyacrylamide gel combined with limited proteolysis is a simple and specific method for quantitation of estradiol receptors in breast cancer tissue. At least eight different samples can be analyzed simultaneously on one gel, and the whole procedure, including sample preparation, takes less than 7 hr. In comparison with sucrose gradient centrifugation, isoelectric focusing is more sensitive, possibly due to the short time (1.5 to 2 hr) needed for the analysis. Furthermore, only one incubation with tritium-labeled estradiol is needed for an analysis, which means that a smaller amount of tumor tissue is needed than for most other methods. This fact allows analysis of the estrogen receptor content in tumor material obtained from fine-needle biopsy.

In a cytometric DNA study of high-grade osteosarcoma, the relationship between DNA content and morphology was analyzed. The investigation, based on microspectrophotometry of tissue sections and flow cytometry (FCM), included both primary lesions and recurrences. FCM analysis, applied to a consecutive series of 47 primary osteosarcomas, disclosed that 2 were diploid and 45 were nondiploid, 8 of which were tetraploid. Multiple aneuploid peaks were detected in 13 tumors. Among the nondiploid tumors, there was no clear relationship between the peak DNA value(s) and the histologic subtype (osteoblastic, chondroblastic, fibroblastic) or grade (III-IV). The proliferative activity, as reflected by the percentage of S-phase cells, could be determined in 38 of the 47 tumors analyzed by FCM. The percentage was higher for aneuploid than for tetraploid lesions; however, the distribution of S-phase cells was not related to the histologic subtype or the grade of the tumors. To assess the reliability of a single sample for FCM, the DNA content of biopsy and surgical specimens was compared in 20 tumors; there was complete agreement in all cases with respect to the classification of the lesion as diploid, tetraploid or aneuploid. Analysis by FCM or microspectrophotometry of 12 local recurrences and 16 metastases and the corresponding 19 primary tumors showed that an aneuploid characteristic of the primary lesion was retained during progression of the disease. In 12 tumors analyzed by microspectrophotometry in tissue sections, comparison of chondroblastic and osteoblastic/fibroblastic areas within the same lesion consistently disclosed hyperploidy in both areas.(ABSTRACT TRUNCATED AT 250 WORDS)