Læknablaðið - 15.05.2000, Blaðsíða 30

FRÆÐIGREINAR / KRABBAMEINSRANNSÓKNIR
Niðurstöður: Alls greindist 71 einstaklingur með hepatocellular
carcinoma á tímabilinu, 51 karl (71,8%) og 20 konur (28,2%).
Meðalaldur karla við greiningu var 69,3 ár (18-95) og meðalaldur
kvenna 72,9 ár (52-89). Nýgengi á tímabilinu var 1,83/100.000 (0,84-
3,34), nýgengi karla var 2,61 en nýgengi kvenna 1,04 (karlankonur
2,5). í 54 tilvikum töldust fullnægjandi upplýsingar vera fyrir hendi
til að meta ástand lifrar utan æxlis. í 27 tilvikum (50%) var um
lifrarsjúkdóm að ræða, þar af voru 23 (42,6%) með skorpulifur. Al-
gengustu orsakir skorpulifrar hjá þessum sjúklingum voru áfengis-
misnotkun (30,4%) og hemochromatosis (26,1%).
Ályktanir: 1) Nýgengi hepatocellular carcinoma er lægra á íslandi
en í flestum nágrannalöndum. 2) Skorpulifur er mun sjaldgæfari
meðal íslenskra sjúklinga með HCC. 3) Áfengismisnotkun og
hemochromatosis eru algengustu orsakir skorpulifrar hjá þessum
sjúklingum.
E 07 Lymphomas of the Gastrointestinal Tract Diagnosed in
lceland 1983-1998
Torfi Höskuldsson1'2, Jón Gunnlaugur Jónasson2, Bjarni A. Agnarsson2
Frá 'læknadeild HÍ. 2Rannsóknastofu HÍ í meinafræði
Primary lymphomas of the intestinal tract are relatively rare malig-
nancies, but a number of studies indicate an increasing incidence of
these tumors. One form of gastrointestinal lymphoma is the extra-
nodal marginal zone B-cell lymphoma also known as MALToma
(Mucosal Associated Lymphoid Tissue lymphoma) which is most
often found in the stomach. Until the late eighties these tumors
were usually diagnosed as inflammatory lesions or so-called pseu-
dolymphoma. Recently however, much has been learned about
MALTomas, including the possible causal role of Helicobacter
pylori. The goal of this study is to analyze the incidence, location,
and histopathological classification of gastrointestinal lymphomas
in Iceland. The time period of this study is from 1983 to 1998. The
names of all patients with primary lymphomas in the gastrointes-
tinal tract between 1983 and 1998 were obtained from the Depart-
ment of Pathology at the University of Iceland. Additional patients
were found in the Icelandic Cancer Registry. Tlie cases were
grouped according to the recent REAL classification of lymp-
homa. The total number of patients diagnosed with gastrointestinal
lymphoma in the 16 year study period were 53 (35 males and 18
females). Age at diagnosis ranged from 3 to 90, the mean being
54.8. From 1983 to 1990 there were 15 cases, whereas from 1991 to
1998 there were 38 of which the majority (23) were MALTomas.
The three most common lymphomas were MALToma (23), diffuse
large B-cell lymphoma (16), and Burkitt's lymphoma (6). Eleven
of the MALTomas were associated with Helicobacter pylori. Most
of the lymphomas were located in the stomach (39) while the rest
was in the small intestine (14). The incidence for males during the
study period was 1.70 per 100,000 and for females 0.88 per 100,000.
The incidence from 1983 to 1990 for both sexes was 0.76 per
100,000 and increased to 1.78 per 100,000 from 1991 to 1998 which
is statistically significant.
Our study indicates a higher incidence of GI lymphoma in
Iceland as compared to other similar population-based studies.
E 08 Comparison of a rare cervical carcinoma and two
cutaneous tumors
Birgir Andri Briem,A3, Christopher P. Crum23
Frá 'læknadeild HÍ, 2Divison of Women's and Perinatal Pathology, Brigham and
Women's Hospital, Boston MA, 3Pathology Services, Inc, Cambridge, MA
Introduction: Adenoid basal carcinoma (ABC) of the uterine
cervix is a rare subset of tumors found to have an extremely benign
prognosis compared to other invasive cervical neoplasias. The
purpose of this study was to try to shed some light on this unique-
ness by examining the cellular phenotype, proliferative index and
HPV presence in these tumors. For comparison we analysed two
types of cutaneous tumors with similar morphology, adenoid basal
cell carcinoma (ABCC) and basaloid squamous cell carcinoma
(BSCC). Material and methods: Five cases of ABC from the files of
Brigham and Women's Hospital, 20 cases of ABCC and 16 cases of
BSCC from Pathology Services Inc. were chosen and the tissue
samples stained using immunohistochemical markers p63 (for
basal/stem cell phenotype) and Ki-67 (for proliferation). These
cases were also submitted to HPV nucleic acid detection using the
polymerase chain reaction tecnique (PCR) and restriction frag-
ment length analysis. Furthermore, hemotoxyllin and eosin stained
shdes were examined for the overall morphology.
Results: The ABCs were characterised by cervical intraepithelial
neoplasia (CIN), type II-III, of the overlying mucosa with nume-
rous nests invading the cervical stroma. As the nests got deeper
into the stroma they appeared to become more benign-looking
(less cellular pleiomorphism) and developed glandular differentia-
tion. The p63 was positive for all ABC tumors with almost all of the
tumor cells staining but focally loosing their stain in areas of glan-
dular differentiation (maturation). Ki-67 staining was prominent in
the superficial nests but gradually diminished and disappered in
the deeper nests. Four out of five cases were HPV 16 positive. The
ABCCs and BSCCs showed intense staining with p63 and variable
Ki-67 staining with BSCCs being more heavily stained. All cases
were HPV negative.
Discussion: All tumors stained intensely with p63 which implies an
immature basaFstem cell phenotype. However the loss of p63
staining in areas of glandular differentiation and the gradual dimi-
nution of the Ki-67 stain deep in the stroma separates the ABCs
from the cutaneous tumors. The ABCs seem to be characterised by
a progressive selection for a cell population with low malignant
potential (low proliferative index) and capacity to undergo matu-
ration (glandular differentiation) which likely explane its excellent
prognosis. ABCs are associated with HPV 16 infection as pre-
viously described. Factors which influence the development of this
tumor remain to be elucidated.
E 09 Ávaxtaflugugenið Kek1 skráir fyrir himnuprótíni sem er
neikvæður stjórnandi EGF-viðtaka boðleiðarinnar
Laufey Þóra Ámundadóttir1'3, Margrét Andrésdóttir’, Christian Ghiglione',
Philip Leder’, Norbert Perrimon', Kermit Carraway lllrd2
Frá 'Dpt. of Genetics, Howard Hughes Medical Institute, Harvard Medical School,
Division of Signal Transduction, ’Beth Israel Deaconess Medical Center, Boston,
MA 02215, ’íslenskri erfðagreiningu/DeCODE Genetics
352 Læknablaðið 2000/86
Kekl genið var einangrað í Drosophila Melanogaster við leit af
genaafurðum sem eru tjáð á ákveðnum stigum í fósturþroskun