Human chromosome 7 ORF 24 (C7orf24) has been identified as a tumor-related protein, and shown to be ac-glutamyl cyclotransferase. In the cur-rent study, we characterized the promoter region of the human C7orf24
gene to explore the transcriptional regulation of the gene.
For decades we have been learning about the interplay between tumors and the
immune system. Our knowledge seemed somewhat incomplete and indirect, like
listening to the ocean waves through a shell. Only recently, cancer immunotherapy has
started to become a reality, with Provenge (Dendreon Corporation, WA), an
autologous antigen-presenting cell preparation, earning the approval of United States
Food and Drug Administration (FDA) for the treatment of advanced prostate cancer in
TRUS is the imaging technique most frequently used to assess the primary tumor, but its chief use is directing prostate biopsies, not staging. No TRUS finding consistently indicates cancer with certainty. CT lacks sensitivity and specificity to detect extraprostatic extension and is inferior to MRI in visualization of lymph nodes. In general, MRI performed with an endorectal coil is superior to CT to detect cancer in the prostate and to assess local disease extent.
The noninvasive proliferation of epithelial cells within ducts is termed prostatic intraepithelial neoplasia. PIN is a precursor of cancer, but not all PIN lesions develop into invasive cancers. Of the cancers identified, 95% are adenocarcinomas; the remainder are squamous or transitional cell tumors or, rarely, carcinosarcomas. Metastases to the prostate are rare, but in some cases colon cancers or transitional cell tumors of the bladder invade the gland by direct extension.
Metastatic Disease: Castrate
Castration-resistant disease can manifest in many ways. For some it is a rise in PSA with no change in radiographs and no new symptoms. In others it is a rising PSA and progression in bone with or without symptoms of disease. Still others will show soft tissue disease with or without osseous metastases, and others have visceral spread. The prognosis, which is highly variable, can be predicted using nomograms designed for the castration-resistant disease state.
Brachytherapy is the direct implantation of radioactive sources into the prostate. It is based on the principle that the deposition of radiation energy in tissues decreases as a function of the square of the distance from the source (Chap. 81). The goal is to deliver intensive irradiation to the prostate, minimizing the exposure of the surrounding tissues. The current standard technique achieves a more homogeneous dose distribution by placing seeds according to a customized template based on CT and ultrasonographic assessment of the tumor and computer-optimized dosimetry.
Patients with stage I disease, no residual tumor, and well or moderately differentiated tumors need no adjuvant therapy after definitive surgery, and 5-year survival exceeds 95%. For all other patients with early disease and those stage I patients with poor prognosis histologic grade, adjuvant platinum-based therapy is warranted. Large prospective randomized trials have demonstrated that adjuvant therapy improves disease-free and overall survival by 8% (82% vs. 74%, p = .008).
Malignant germ cell tumors are usually large (median—16 cm). Bilateral disease is rare except in dysgerminoma (10–15% bilaterality). Abdominal or pelvic pain in young women is the usual presenting symptom. Serum human chorionic gonadotropin (β-hCG) and α fetoprotein levels are useful in the diagnosis and management of these patients. Before the advent of chemotherapy, extensive surgery was routine, but it has now been replaced by careful evaluation of extent of spread, followed by resection of bulky disease and preservation of one ovary, the uterus, and the cervix, if feasible.
Incidence and Epidemiology
Carcinoma of the endometrium is the most common female pelvic malignancy. Approximately 39,080 new cases are diagnosed yearly, although in most (75%), tumor is confined to the uterine corpus at diagnosis, and therefore most can be cured. The 7400 deaths yearly make uterine cancer only the eighth leading cause of cancer death in females.
Patients with stage IV disease (outside the abdomen or invading the bladder or rectum) are treated palliatively with irradiation, surgery, and platinum-based chemotherapy. Progestational agents produce responses in ~10–20% of patients. Well-differentiated tumors respond most frequently, and response can be correlated with the level of progesterone receptor expression in the tumor.
Harrison's Internal Medicine Chapter 105. Malignancies of Lymphoid Cells
Malignancies of Lymphoid Cells: Introduction
Malignancies of lymphoid cells range from the most indolent to the most aggressive human malignancies. These cancers arise from cells of the immune system at different stages of differentiation, resulting in a wide range of morphologic, immunologic, and clinical findings. Insights on the normal immune
system have allowed a better understanding of these sometimes confusing disorders.
Some malignancies of lymphoid cells almost always present as leukemia (i.e.
Table 105-6 presents the best documented translocations and associated oncogenes for various subtypes of lymphoid malignancies. In some cases, such as the association of the t(14;18) in follicular lymphoma, the t(2;5) in anaplastic large T/null cell lymphoma, the t(8;14) in Burkitt's lymphoma, and the t(11;14) in mantle cell lymphoma, the great majority of tumors in patients with these diagnoses display these abnormalities. In other types of lymphoma where a minority of the patients have tumors expressing specific genetic abnormalities, the defects may have prognostic significance.
Evaluation of an adequate biopsy by an expert hematopathologist is sufficient to make a diagnosis of follicular lymphoma. The tumor is composed of small cleaved and large cells in varying proportions organized in a follicular pattern of growth (Fig. 105-7). Confirmation of B cell immunophenotype and the existence of the t(14;18) and abnormal expression of BCL-2 protein are confirmatory. The major differential diagnosis is between lymphoma and reactive follicular hyperplasia. The coexistence of diffuse large B cell lymphoma must be considered.
The expression of proteoglycans (PGs), essential macromolecules of the
tumor microenvironment, is markedly altered during malignant transforma-tion and tumor progression. Synthesis of stromal PGs is affected by factors
secreted by cancer cells and the unique tumor-modified extracellular matrix
may either facilitate or counteract the growth of solid tumors.
This book brings together the knowledge of eminent experts in the field of malignant mesothelioma, a highly invasive tumor of mesothelium that is the protective lining covering several body cavities. Malignant mesothelioma shows extremely poor progression and is refractory to almost any kind of therapy putting considerable challenges in its treatment. This book covers many important aspects of malignant mesothelioma like epidemiology, immunology, molecular mechanisms and clinical options and will be useful to anybody interested in its history, pathology, and treatment....
Cancer may constitute the most extensively studied
disease entity of our time. Nevertheless, our comprehension
of the cellular and molecular pathology
of malignant transformation is incomplete. In view
of the diverse clinical presentations of various
malignancies, doubts may be raised as to whether it
is appropriate to refer to cancer as one group of disease
states. The notion of malignant tumors as a
pathologic and pathophysiologic class of conditions
begs the question for defining criteria that characterize
all malignant growths, regardless of their tissue
(BQ) Part 1 book "Pediatric malignancies pathology and imaging" presentation of content: Laboratory techniques used in the diagnosis of pediatric tumors, imaging techniques used in the diagnosis of pediatric tumors, soft tissue sarcomas, malignant bone tumors, tumors of lymphoid and hematopoietic tissues, tumors of the central nervous system.
(BQ) Part 2 book "Pediatric malignancies pathology and imaging" presentation of content: Pediatric cancer in the head and neck, malignancies of the pediatric lower respiratory tract, gastrointestinal, pancreatic and hepatic malignancies in children, malignant renal tumors, germ cell and gonadal tumours,...