Annals of Oncology 2006 17(8):1179; doi:10.1093/annonc/mdl293
© 2006 European Society for Medical Oncology
in this issue
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Extranuclear hormone receptors in primary breast cancer
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Proliferation of breast cancer cells is divided into hormone-dependent
and -independent tumor growth; the former is regulated by the
expression of hormone receptors (HRs) such as estrogen (ER)
and progesterone receptors (PR). Estrogens such as estradiol
are a crucial growth factor for HR-positive breast cancer cells,
with growth stimulation being mediated by the genomic action
of nuclear ERs. In contrast, extranuclear ER expressed in the
cell membrane and cytoplasm modulates the proliferation of breast
cancer cells nongenomically via crosstalk with components of
growth factor-signaling pathways such as PI3K/Akt and MAPK.
In this issue,
Kim et al. report the results of a study that
aimed to explore this cross-talk between extranuclear expression
of ER and PR and growth factor signaling pathways in primary
breast cancer. These authors report that PR is expressed extranuclearly
more frequently than ER in primary breast cancer, and extranuclear
HRs cross-talk with the Akt/HER-2-signaling pathways and activation
of aromatase.
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Survival differences for bronchioloalveolar carcinoma patients
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Bronchioloalveolar carcinoma (BAC) is a subset of lung adenocarcinoma
with characteristic clinical, epidemiologic, and histopathologic
features. However, the existing staging system for advanced
stage BAC is problematic, as it may not accurately reflect survival
outcomes for advanced BAC patients. In this issue,
Zell et al.
report the results of a case-only analysis of US Surveillance,
Epidemiology, and End Results (SEER) data (1998-2002) that aimed
to compare the survival rates for patients within the subsets
of stage IIIB and stage IV BAC. Analyzing 2345 incident cases
of BAC, including 707 patients with stage IIIB or IV BAC, these
authors report that among stage IIIB and IV BAC patients, those
presenting with ipsilateral intrapulmonary metastasis have improved
survival outcomes, and they conclude that reclassification of
the BAC staging system would better stratify patients with advanced
disease into clinically relevant prognostic groups.
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Mast cells in Waldenstrom's macroglobulinemia support lymphoplasmacytic cell growth
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Waldenstrom's macroglobulinemia (WM) is a B-cell disorder characterized
by bone marrow infiltration by lymphoplasmacytic cells (LPC).
Bone marrow mast cells have increasingly been reported in association
with LPC in WM such that this has become characteristic of WM
and is now used widely as a supportive basis for diagnosis.
A role for mast cells in supporting tumor growth has long been
suggested, and more recent evidence has implicated mast cells
in supporting angiogenesis in promoting solid tumor growth.
In this issue,
Tournilhac et al. report the results of a study
that aimed to investigate the role of mast cells in the pathogenesis
of WM, and sought to delineate the role of putative tumor necrosis
factor (TNF) family members in supporting WM cell expansion.
These authors suggest that in WM, mast cells may support tumor
cell expansion through constitutive CD154-CD40 signaling, and
they conclude that this could provide a framework for therapeutic
targeting of mast cells in WM.
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Colorectal cancer screening using sigmoidoscopy
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Colorectal cancer diagnosed at an early stage, either as a result
of alerted symptoms or by screening, has more chance of being
surgically cured and is associated with an improved prognosis.
Therefore, screening procedures, such as endoscopy or fecal
occult blood testing (FOBT), have a key role in the diagnosis
of premalignant or of early malignant lesions. Colonoscopy examines
the entire colon and can remove adenomas and early cancers,
but compared with sigmoidoscopy, colonoscopy has a higher rate
of perforation, a higher rate of sedative-associated complications,
and higher cost. In this issue,
Bleiberg et al. report the results
of a study that aimed to evaluate, by compliance, numbers of
cancer and advanced neoplasia detected at surgery and the number
of interval cancers at 5 years, the feasibility and efficacy
of using sigmoidoscopy followed, if advanced neoplasms were
found, by colonoscopy for screening colorectal cancer. These
authors conclude that screening sigmoidoscopy is feasible and
that advanced and non-advanced distal neoplasia appear to be
relevant markers for advanced neoplasia in the rest of the colon.
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Quote
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"‘You oughtn't to talk about Miss Harrington's bosom,’ he says to me like he was mad. ‘The poor girl's not well. She's got the anemia.’
‘Is that bad, Pop?’ I asked.
‘Well,’ he says, ‘I can't see that it's done her much harm so far, but I reckon it's pretty serious if you got to eat vegetables for it.’"
The influence of diet on hematologic disease considered in The Diamond Bikini by Charles Williams.
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