Jonas Valaitis

Increasing incidence of adenocarcinoma of the lung

Review of the histology of 219 lung cancers initially diagnosed at Lutheran General Hospital, Park Ridge, Illinois, in 1963–1967 and 1974–1976, confirms the increasing incidence of adenocarcinoma. This is due to an increase of adenocarcinoma in men. In women, the incidence of adenocarcinoma was higher than squamous carcinoma in the earlier period (44% adeno, 18% squamous). The percentage of women with lung cancer has also significantly increased from 19% to 31%, which increases the overall incidence of adenocarcinoma of the lung. As the number of women with lung carcinoma has increased, there has been no change in the percentage of adenocarcinoma in women. Cancer 47:1046–1046, 1981.

Prognostic significance of cancer cells in the circulating blood: A ten year evaluation

Abstract Seven per cent of 767 patients with cancer studied more than five and as many as ten years ago in our laboratory had positive blood samples. A similar frequency of positive blood samples was obtained when only those patients considered “curable” were tabulated, or those patients studied before, during, and after operation. The survival rate in the entire group of 767 patients was not different with regard to positive or negative blood samples, being 13 and 12 per cent, respectively. The survival rate for “curable” patients with positive blood samples was no different from the survival rate for those with negative blood samples; it was 32 per cent for each category. Although there is no apparent difference in the five to ten year survival rates of all 767 cancer patients, regardless of whether the blood samples are positive or negative, a definite trend is apparent in the decreased survival of patients with a shower of circulating cancer cells during or after operation. Only two of twenty-three patients (8 per cent) with showers of cancer cells demonstrated during operation were alive and well five to ten years postoperatively as compared with a 16 per cent survival (26 of 182) of patients with negative blood samples at all times before, during, and after operation. Also, vascular metastases developed in 39 per cent of those patients with showers of circulating cancer cells during operation as compared with only 18 per cent of those patients with all negative blood samples.

Neuroendocrinoma of the Jejunum: Electron microscopic and biochemical analysis

A 56‐year‐old woman presented with a sudden, severe hemorrhage per rectum. Angiography localized a jejunal tumor, which was excised. Light microscopy suggested a neuroendocrine tumor, but neither a smooth muscle tumor nor a lymphoma could be excluded. Electron microscopy showed dense cored, single membrane bound secretory granules 150–220 nm in diameter; myofilaments were not observed. Biochemical analysis of tumor tissue yielded considerable amounts of catecholamines, VMA, 5‐HIAA, and metanephrines. These combined ultrastructural and biochemical observations establish the diagnosis of neuroendocrine tumor; however, in this case neither type of information is sufficiently specific to define the tumor as either a paraganglioma or a carcinoid. Although paraganglia and mucosal endocrine cells in the GI are currently thought to constitute distinct cell types, they share numerous structural and functional properties, and they are both thought to be part of the APUD cell system. These parallels and similarities are shared by the neoplasms derived from them which often display features of both. In the absence of specific granule types or specific substances isolated from tumor tissue, only the application of specific immunocytochemistry techniques may allow the precise “functional” classification of such tumors.

Cancer Cells in the Blood: Incidence and Importance to Prognosis and Treatment

One of the most devastating events to take place in the natural history (or altered natural history) of many types of malignant tumours is the development of hematogenous metastases. This type of dissemination places cancer cells beyond the confines of primary surgical resection. Although it is true that the vast majority of cancer cells in the circulating blood are probable destroyed within vascular channels, the frequent occurrence of hematogenous metastases following resection of “favorable” lesions is ample proof that some cancer cells in the bloodstream are quite viable and capable of forming distant metastases. Although surgical excision, radiation therapy, and/or chemotherapy have resulted in apparent long-term control of disseminated disease. in some cases, the occurrence of blood-borne metastases is still a factor that is usually lethal. Accordingly, this route of dissemination deserves intensive study.