Summary and conclusionsSections of breast carcinomas removed from 69 patients six to 13 years previously were examined using an immunoperoxidase technique to determine whether carcinoembryonic antigen (CEA) was present. Patients who had CEA-negative tumours had significantly higher five-and 10-year survival rates. The difference was not related to the stage of the disease, postoperative treatment, or histological type of tumour.These results suggest that immunohistological assessment of CEA in breast-cancer tissue may provide more precise prognostic information.Introduction Recently' we found a positive correlation between the presence of carcinoembryonic antigen (CEA) in sections of breast carcinomas and the presence of lymph-node metastases. This

An immunoperoxidase technique for the histological demonstration of Carcinoembryonic Antigen (CEA) was applied to paraffin sections from 74 breast carcinomas and 43 benign breast lesions. Sixty-six per cent of the carcinomas and the only case of granular cell myoblastoma examined were CEA positive. Two examples of mammary dysplasia (7%) showed foci of CEA positive acini. All tumour tissue found in lymphatics and in metastases in lymph nodes was CEA positive, including two cases where the primary tumour was CEA negative, and all the metastases examined from CEA positive tumours. A significant relationship was found between CEA positivity of the primary tumour and the presence of lymph node metastases.

SUMMARY An immunoperoxidase technique for the detection of carcinoembryonic antigen was applied to 10 cases of granular cell myoblastoma. Consistent, strong, intracytoplasmic granular staining, which can be easily interpreted, was obtained in all cases. Schwannomas, neurofibromas, dermatofibromas, and leiomyomas were negative. The test is helpful in confirming doubtful cases. The results tend to support the suggestion that granular cell myoblastoma is derived from perineural rather than endoneural cells.In a recent study of carcinoembryonic antigen (CEA) in benign and malignant breast lesions using the immunoperoxidase technique, a case of granular cell myoblastoma included in the series stained very strongly for CEA (Shousha and Lyssiotis, 1978). This prompted us to review and stain other granular cell myoblastomas from various sites in an attempt to investigate the consistency of the results and the possibility of using the test in the diagnosis, and explaining the histogenesis, of these lesions. Cases and methodsTen cases diagnosed as granular cell myoblastoma were found in the files of the Histopathology Departments of the Charing Cross and Royal Free Hospitals during the period 1965 to 1976. The diagnosis was confirmed by the examination of sections stained with haematoxylin and eosin, periodic acidSchiff, reticulin and phosphotungstic acid. Sections 5 microns thick were cut from stored paraffinembedded blocks of tissue. The sections were then deparaffinised in xylene and stained for CEA using the peroxidase-labelled antibody sandwich technique, as described in detail elsewhere (Shousha and Lyssiotis, 1978). Briefly, endogenous peroxidase was blocked with 30 % hydrogen peroxide in methanol, and nonspecific background staining was reduced by 1:5 normal swine serum. The sections were then treated consecutively with 1:50 rabbit anti-CEA serum, normal swine serum, and peroxidase-labelled swine anti-rabbit IgG. Thorough

SUMMARY Twenty-six untreated patients with chronic persistent hepatitis were followed prospectively for one to 17 years (mean 5 6 years). The patients developed no clinical features of chronic liver disease. Raised serum transaminase levels were usually, but not consistently, the only biochemical abnormality; gamma globulin values were normal. Serum markers of past or present hepatitis B infection were found initially in 14 patients: another two developed markers during their follow-up. Nine patients progressed to a mild or moderate chronic active hepatitis as shown by serial needle liver biopsies but there was no evidence of cirrhosis. This progression was not associated with any clinical or biochemical deterioration. Seven of these patients had presented with insidious symptoms, seven had serum markers of hepatitis B infection, and the four who were HBsAg positive had relatively lower serum HBsAg concentrations than did those patients who continued with chronic persistent hepatitis.