A step-wise logistic regression analysis of papillary carcinoma of the thyroid

Fourteen cytologic features seen in fine needle aspirates of papillary carcinoma of the thyroid were subjected to a step-wise logistic regression analysis to determine which are predictive of papillary carcinoma. The study cases included 38 histologically proven papillary carcinomas and 54 other palpable thyroid nodules. The three most important variables in making the prediction of papillary carcinoma were intranuclear inclusions, papillary structures without vessels and cells with metaplastic cytoplasm.

Histiocytes and the detection of endometrial adenocarcinoma

Histiocytes have long been recognized as part of the milieu of endometrial carcinoma in gynecologic smears. In an effort to determine whether a quantitative assessment of histiocytes, especially in the absence of endometrial cells, could increase the effectiveness of the cervicovaginal smear for diagnosis of endometrial carcinoma, smears obtained prior to a tissue diagnosis of endometrial adenocarcinoma were evaluated from 44 postmenopausal women. Smears from 97 age-matched patients in the same clinic were also evaluated and used as a control group for the endometrial carcinoma patients. All smears were evaluated for the presence of histiocytes and for the presence of benign or malignant endometrial cells, with the histiocytes quantitated as minimal (less than 5 per high-power field [HPF]), moderate (5 to 10/HPF) or heavy (greater than 10/HPF). Sensitivity and specificity were calculated to assess the role of histiocytes in the presence and in the absence of endometrial cells using cytologic findings. Our data indicate that the presence of moderate or heavy numbers of histiocytes on cervicovaginal smears of postmenopausal women increased the cytologic sensitivity from 61% to 82% when considered a marker of disease along with endometrial cells. These results suggest that attention to the presence of histiocytes on cervicovaginal smears may increase the utility of cytology for the diagnosis of endometrial lesions and may be a useful guideline for the cancer-related gynecologic examination.

Cytologic evidence of extensive keratotic reaction in women exposed to diethylstilbestrol in utero

Squamous mucous membranes and squamous metaplastic epithelium sometimes undergo hypermaturation with the production of a keratin layer. Anucleated keratotic squamous plaques in smears are generally recognized as cytologic evidence of this altered maturation. This keratotic reaction was quantified in cytologic smears from 191 women exposed in utero to diethylstilbestrol (DES). Keratotic reaction was observed in the vaginal smear in 40% of the cases, in the cervical smear in 26% and in the endocervical smear in 19%; overall, a keratotic reaction was observed in at least one specimen from 48% of the women. These frequencies are higher than those reported in other studies. The observed frequency was age related. The significance of the hyperkeratosis, including its possible relationship to a lower dysplasia rate among DES-exposed women, is unclear. No conclusions can be drawn until more is known about behavioral factors in DES-exposed women.

Cutaneous melanoma in relation to exogenous hormones and reproductive factors

Eighty-seven women of ages 37-74, who resided in King County, Wash., and who had been diagnosed between July 1976 and November 1979 as having cutaneous malignant melanoma, were interviewed regarding prior use of estrogen-containing preparations and reproductive history. The responses were compared with those of a random sample of 863 women from the same county. Among the 61 women with superficial spreading melanoma (SSM), use of oral contraceptives for 5 years or more was more common than among controls. The estimated relative risks for users of 5-9 and 10 years or more were 2.4 and 3.6, respectively. No differences between cases and controls were noted for oral contraceptive use of 4 years or less. Giving birth to a first child after age 30 was also associated with an increased relative risk of SSM. Although the positive findings regarding oral contraceptive use and age at birth of first child must be interpreted cautiously pending results of other studies, they suggest that hormonal factors can play a role in the etiology of SSM.

Major histologic types of cancers of the gum and mouth, esophagus, larynx, and lung by sex and by income level

Incidence rates by income level were computed for squamous cell carcinomas of the gum and mouth, larynx, and esophagus and for squamous cell carcinoma, small cell carcinoma, and adenocarcinoma of the lung in white males and females aged 35--64 years, with the use of data for the nine geographic areas of the Third National Cancer Survey and the 1970 U.S. census. Within sex, age, and geographic area groups, patterns of cancer incidence by income level were analyzed by use of a nonparametric statistical method. Higher rates for males than for females were found for every histologic type studied, and the ratio of male-to-female rates increased with age (especially for squamous cell carcinomas of the larynx and lung). A strong inverse relation to income level was found for all of the histologic types studied in males and for squamous cell carcinomas of the gum and mouth and esophagus and small cell carcinoma of the lung in females. These findings are discussed with reference to patterns of smoking and alcohol use by sex and social class.