Secretion of human chorionic gonadotropin and alpha-fetoprotein by an ovarian germ cell tumor of apparent yolk sac origin

alpha-Fetoprotein (alpha FP) and four placental proteins, human chorionic gonadotropin (hCG), human placental lactogen (hpL), pregnancy specific beta 1-glycoprotein (SP1), and placental protein 5 (PP5), were measured in a 17-year-old patient with endodermal sinus tumor of the ovary. The circulating levels of alpha FP were consistently high (more than 14 mg/ml), and alpha FP was localized in tissue sections using immunohistochemical techniques. None of the four placental proteins was detectable in serum samples, but hCG was detected in urinary concentrates in an episodic manner. This ectopic hCG resembled placental hCG in its physicochemical and immunological characteristics. Unlike alpha FP, hCG was not detected in the tumor by immunohistochemical methods. This study indicates that the neoplasm elaborated both hCG and alpha FP. Whether pure endodermal sinus tumor of the ovary is capable of secreting hCG cannot be answered by this study because of limited histologic sampling. The likelihood that this represents a mixed germ cell tumor in which only the endodermal sinus tumor element was sampled remains a possibility. This study also indicates that the 24-hr urinary concentrate is far more sensitive than serum samples for hCG detection.

Cyclic alternating combination chemotherapy for small cell lung cancer

Sixty-two patients with small cell carcinoma of lung received cyclic alternating non-cross-resistant combination chemotherapy. Radiation to the chest was given to all the patients. Patients were given a course of VP16, adriamycin and vincristine (VAV) followed by radiation (3,000 rads) to the chest and then a second course of VAV. Three weeks later, a course of cytoxan, CCNU, and methotrexate (CCM) was given (6 weeks). Subsequently, the treatment was cycled between two courses of VAV (6 weeks) and one course of CCM (6 weeks). Overall objective response rate of 73%, with 45% complete response, was noted. Overall median survival was 50 weeks, with 83 weeks for complete responders. Median survival for patients with regional disease was 58 weeks compared to 40 weeks for extensive disease. All the patients headed for complete response did so prior to receiving CCM. These results were not superior to conventional combination chemotherapy regimens.

Nasopharyngeal carcinoma: results of treatment over a 27 year period, 1950 through 1977

In a retrospective study, 107 patients with squamous cell carcinoma of the nasopharynx were reviewed. One hundred six patients were treated primarily by radiation therapy and only one by surgery. The overall 5 year survival rate free of disease was 29 percent. Possible prognostic factors of age, sex, cancer stage, histopathology, and treatment were studied. The younger patients did significantly better. Patient's sex and clinical stage were not significant factors in this study. The patients with lymphoepitheliomas, anaplastic carcinomas, and those with poorly differentiated cell types did significantly better than those with more differentiated lesions. Fifty-five patients received irradiation therapy of 6,000 rads by external ports alone, and 51 patients received radiation therapy of 6,000 rads by external ports supplemented by 1,500 rads using an intracavitary radium applicator. The higher survival rate with the use of the supplementary dosage was only suggestively significant.

Comparison of chemotherapy alone versus chemotherapy and radiation therapy of extensive small cell carcinoma of the lung

In a randomized study 145 patients with extensive small cell carcinoma of the lung were treated with chemotherapy alone (Cytoxan, CCNU, methotrexate) or with the same drug regimen and with radiation therapy to the brain, chest, and abdomen. One hundred eighteen of these patients were evaluable. Those patients receiving radiation had a better response rate (55% vs 31%, P = .016) but significantly greater toxicity. There was no significant difference in rates of complete response (7% vs 8%) or in survival (median 18.4 vs 15.3 weeks) between the two groups overall. The median survival of those patients with a partial response to therapy was 18 weeks; for those achieving a complete response it was 46 weeks. However, a clear difference in survival comparing responders with non-responders was evident only for patients who were assigned to chemotherapy alone. Partial regressions have little, if any, correlation with improvement in survival. Therapy in this disease must be oriented toward inducing complete response.

Induction of plasma protein secretion in a newly established human hepatoma cell line

To study the expression and the regulation of hepatocyte markers, we have undertaken to establish human hepatoma cell lines of various phenotypes. We now report the establishment of a new human hepatoma cell line, HA22T/VGH. This cell line has many of the properties of human hepatocellular carcinoma. Only 5 of 15 plasma proteins investigated were detected in the medium of a 10-day-old HA22T/VGH culture. However, when the HA22T/VGH cells and a clonal derivative, C5, were cultured in an aggregated form, all 15 plasma proteins were found in the culture medium. These results indicate that hepatoma cell lines with different phenotypes can be established, and they provide a good experimental framework to investigate differentiation of human hepatocytes.

[A new human hepatoma cell line: establishment and characterization]

We have grown a human hepatoma cell line, designated as HA22T/VGH, from a 52-yr-old male hepatoma patient since July 1, 1980. This cell line has been subcultured more than 100 passages. The chromosome analysis of HA22T/VGH indicated that the chromosome numbers varied from 70 to 146, with the mode of 73. Methylcellulose soft agar assay showed that approximately 40% of the HA22T/VGH cells formed colonies. The HA22T/VGH produced tumors in nude mice. Histopathological studies of the tumor revealed the arrangement of hepatoma. Detected by the complement fixation method HA22T/VGH cells secreted ceruloplasmin, Factor B, C3, C4, Gc-globulin and alpha 1-acid-glycoprotein. These cells contained the liver associated enzymes: alanine amino transferase, tyrosine amino transferase and gamma-glutamyl transferase. HBsAg and alpha-fetoprotein were not detectable in the HA22T/VGH culture media or cell lysates by the radioimmunoassay.

Progress in the chemotherapy of small cell carcinoma of the lung

A comparison was made between six different approaches to the chemotherapy of small cell carcinoma of the lung. The value of single-agent chemotherapy was compared to combination chemotherapy and radiation therapy, and with cyclic alternating combination chemotherapy in 161 patients. Cyclic alternating chemotherapy with modest radiation therapy to the primary site provided significant advantages over single-agent or combination chemotherapy. A combination of VP-16 + Adriamycin + vincristine seemed particularly effective in inducing an initial objective tumor response rate of 83%, with a projected median survival of 13.2 months. Of patients treated with cyclic alternating therapy, 51% were alive at one year. It thus appears that where complete response is achieved, prolonged disease-free survival can be expected.

A case of malignant lymphoma, undifferentiated, Burkitt's type with high antibodies to Epstein-Barr virus

A 5-year-4-month-old girl was admitted to Taipei Municipal Jen-Ai Hospital because of a rapidly enlarging right submandibular tumor. The diagnosis of malignant lymphoma, undifferentiated, Burkitt's type was made by distinctive histopathological features. Positive serological findings related to Epstein-Barr virus infection were disclosed. Complete remission has been achieved since the treatment with high-dose cyclophosphamide was given, and no signs of relapse have been found yet.

The effect of maternal cardiac disease and digotoxin administration on labour, fetal weight and maturity at birth

One hundred and twenty-two patients with cardiac disease were compared with 250 controls with respect to the duration of pregnancy and labour, birth weight percentile and Apgar score. The babies of the patients with cardiac disease were light-for-dates (18% below the 10th percentile); the mothers, if multiparous, delivered at an earlier gestational age. The patients with cardiac disease did not have shorter labours than the control group. Digoxin administration and the severity of heart disease had no significant effect on these variables.

Treatment of inoperable lung carcinoma: a combined modality approach

Twenty-four patients with inoperable lung carcinoma other than of the small cell type who received cis diamminedichloro platinum (II)-based combination chemotherapy were further treated with all available treatment modalities: radiation therapy, lung resection, chemotherapy, and immunotherapy. There were 2 operative deaths, and 2 patients died 6 and 8 months postoperatively of cardiac causes. Postmortem examination on these 4 patients revealed no evidence of residual tumor. The remaining 20 patients are alive 7 to 33 months from the onset of chemotherapy and 4 to 27 months following lung resection. These results, although preliminary, are encouraging, and further study is in progress.

Antibodies to Epstein-Barr virus capsid antigen and early antigen in nasopharyngeal carcinoma and comparison groups

Antibodies to Epstein-Barr virus capsid antigen (anti-VCA) and early antigen (anti-EA) were measured in 263 patients with nasopharyngeal carcinoma (NPC), 624 age- and sex-matched neighborhood controls, 570 family members of NPC patients and 830 family members of neighborhood controls in Taiwan. The distribution of antibody titers was significantly different between NPC patients and the other three groups. More than 55% and 45% of NPC patients had titers of greater than or equal to 1:640 and greater than or equal to 1:80 for anti-VCA and anti-EA, respectively, while less than 6.7% and 2.5% of the other three groups had such high titers. The geometric means of anti-VCA and anti-EA titers were 1:352 and 1:45, respectively, in NPC patients compared to less than 1:77 and 1:12, respectively, in the comparison groups. Anti-VCA and anti-EA titers were significantly correlated. The association of EBV with NPC is discussed.