Bone scan as a stratification variable in advanced prostate cancer

Article Abstract:

In about 40 percent of all cases of prostate cancer, metastatic cancer spread has already begun at the time of diagnosis. Prostate cancer cells spread through the blood stream and preferentially take up residence in bone. An imaging technique known as radioactive scintigraphy may be used to demonstrate the presence of metastatic cancer in bone. In this technique, a radioactive isotope is administered to the patient, which is absorbed by the metastatic tumors; scanning the body then reveals the location of these tumors by measuring the radioactivity. For prostate cancer, the patient is given methylene diphosphate radioactively labelled with the synthetic isotope technetium 99m. Attempts to use such bone scans for the objective staging of prostate cancer have not proved particularly successful, however, which may be due to wide variations in equipment and technique between different institutions. In addition, the quantitative analysis of a bone scan for the whole body may be more laborious than warranted by its clinical importance. For this reason, an attempt was made to determine if easily obtained bone scan data might prove to be a useful tool for evaluating the prognosis of prostate cancer. Bone scans were obtained from 76 patients with Stage D-2 (advanced) prostate cancer. Rather than conduct a laborious analysis, the bone scans were classified simply on the basis of whether one or two skeletal areas were involved or whether three or more skeletal regions contained cancerous tissue. It was found that the patients with only one or two metastatic cancer deposits seen on bone scan had a significantly longer survival than the patients with three or more involved skeletal areas. The study also confirmed that the spine and the ribs were the most common sites of involvement of prostate cancer cells. The pelvis was the next most common site of involvement, followed by the long bones of the arms and legs. Of the major bones imaged using the bone scan, the skull was least likely to have prostate cancer deposits. (Consumer Summary produced by Reliance Medical Information, Inc.)

Cases, Reports, Diagnosis, Prostate cancer, Cancer invasiveness, Radioisotopes in medical diagnosis, Radioisotopic diagnosis

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The prognostic significance of glial fibrillary acidic protein staining in medulloblastoma

Article Abstract:

Medulloblastoma is a childhood brain tumor involving cells within the cerebellum (an area of the brain). It is known that a medulloblastoma develops from primitive cells, but the exact characteristics of these cells remain a point of contention among pathologists. Some investigators feel that the cells of medulloblastoma are capable of differentiation (expressing the characteristics of a mature cell type), while other investigators doubt this. A study was conducted to determine if medulloblastoma cells expressed the glial fibrillary acidic protein (GFAP), a specific protein that is expressed in the adult forms of certain glial cells in the nervous system. Medulloblastoma specimens from 48 patients with medulloblastoma were stained using immunocytochemical methods to detect GFAP. The protein was clearly identified in 15 cases and was absent in 23 cases. In some cases, the presence or absence of GFAP could not be conclusively determined. When the features of the tumor specimens were correlated with the survival of the patients, no relation could be found between the histologic appearance of the tumor, the number of dividing cells, or several other features, and the length of survival. However, the presence or absence of GFAP correlated significantly with survival. Of the patients expressing GFAP in their tumors, 82 percent were alive at the end of five years. In contrast, only 30 percent of the patients whose tumors did not express GFAP survived five years. (Consumer Summary produced by Reliance Medical Information, Inc.)

Measurement, Physiological aspects, Prognosis, Proteins, Neuroglia, Glia, Medulloblastoma, Brain tumors

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