An interferometric study of the anhydrous nuclear mass of exfoliated cells from experimental cervical cancer

Lucy Wortham James Award. Cytologic detection and diagnosis of cancer. Its contributions and limitations

The use of cytology for the detection and diagnosis of cancer has been a rapidly developing area of pathology. Cytology has been used for mass screening of asymptomatic people, for selective screening of individuals at high risk, and for diagnosis in patients suspected of having cancer. The only area in which mass screening has proved to be cost effective in reducing morbidity and mortality rates is cancer of the uterine cervix. Selective high risk screening has been proposed for endometrium, lung, urinary tract, gastrointestinal tract and oral cavity. Field trials have been performed for each site and some are still operational. While a degree of success has been achieved in identifying patients with early and asymptomatic cancer, cost effectiveness has not as yet been demonstrated and it seems unlikely that it will be. The cytologic diagnosis of cancer of these sites in symptomatic patients is highly effective for lung and bladder cancer. It has been somewhat less effective for gastrointestinal cancer. It is also of value in identifying cancer cells in effusions and for cancer staging. Fine-needle aspiration biopsy for the diagnosis of cancer has been used for over half a century, but in more recent years it has gained wider usage and is now used to diagnose tumors of almost any organ. It is highly cost effective, does not require hospitalization or anesthetic, and is rapid and accurate. Some of the indications and limitations of cellular diagnosis of cancer are presented.

Interferometric studies of endothelial cells in primary culture

A population of endothelial cells grown from Xenopus laevis tadpole hearts was investigated by microinterferometry. The resulting interferograms were evaluated by an automatic image analyzer. The mean values of dry mass were 778 +/- 340 pg (10(-15) g) for whole cells, 648 +/- 309 pg for cytoplasm, 116 +/- 45 pg for nuclei, and 19 +/- 10 pg for nucleoli. Two subpopulations of cells were identified, an actively growing one and a less active one. The density (dry mass per microm2) of the nuclei and nucleoli of less active cells was greater than that of the nuclei and nucleoli of actively growing cells. In addition, the inactive cells were always large and possessed a considerable amount of cytoplasm. The entrance of cells into S-phase could not be detected by microinterferometry; and no differences were apparent between cells possessing one nucleolus and those containing two nucleoli. The values obtained in these amphibian cells were compared with those derived from mammalian cells.

Dysplasia, carcinoma in situ, and microinvasive carcinoma of the uterine cervix

Carcinoma in situ is defined as the early stage of cancer and must therefore be initiated by an as yet unknown carcinogen(s). Progression of the lesion to invasive carcinoma is reported to occur in a high proportion of nontreated cases. Reserve cell proliferations are frequently associated with both dysplasia and carcinoma in situ, and it is suggested that these are the cells from which both lesions arise. Dysplasia may result from both carcinogenic and noncarcinogenic stimuli. Since dysplasia usually either regresses or remains stabilized over a prolonged period, it is suggested that it is more frequently associated with noncarcinogenic stimuli. Microinvasive carcinoma is limited to lesions with no more than 5 mm. of stromal invasion as measured from the surface. Confluence of growth and lymphatic-like space invasion should not interdict the diagnosis. Microinvasive carcinoma thus defined rarely gives rise to lymph node metastasis or eventuates in death. The diagnosis cannot be made from punch biopsy specimens. Only if pathologists adhere to a standard nomenclature can follow-up studies be used successfully to identify the natural behavior of each type of lesion in this spectrum.