CA 125 (Cancer Antigen 125) is an antigen identified by means of a monoclonal antibody on the surface of epithelial ovarian carcinoma cells. The serum concentration levels of CA 125 were measured in 41 women with benign and 95 patients with malignant tumours of the ovary. Immunoradiometric determination was effected by means of a kit supplied by Centocor. 35 U/ml was assumed as limit values of the standard range. Enhanced serum concentrations of CA 125 were seen in 5 per cent of the healthy volunteers of a standard group of persons, in 17 per cent of women with benign and in 78 per cent of women with malignant ovarian tumours. Patients without recurrence of tumour after successful primary treatment showed values above 35 U/ml in only 3 per cent of the cases. The incidence of pathological CA 125 serum concentration levels depended upon the histological type of the ovarian tumour and was highest in women with epithelial carcinomas, especially those with serous cystadenocarcinomas (87 per cent). In follow-up examinations of 30 patients with ovarian carcinoma over a period of one to 60 months, CA 125 concentrations correlated with the disease pattern in 90 per cent of the cases. The increases in CA 125 values preceded clinical diagnosis of the relapse by 1-8 months in seven out of twelve women. Routine determination of CA 125 appears advisable in the control of patients with ovarian carcinoma on account of the high sensitivity and specificity during follow-up.

Summary Aim of this study was to evaluate the results of o standardized protocol for sentinel node (SN) detection in breast cancer using Tc-99m labeled nanocolloidal albumin and a combined intra- and subdermal injection technique. Methods: One hundred and fifty-five women with proven breast cancer (disease stages Tis-T2) were included. Four injections of 10 to 15 MBq of Tc-99m nanocolloid in 0.1 ml physiologic saline were administered intra- and subdermally at the 3,6,9 and 12 o’clock positions in the skin overlying the tumor. Planar scintigraphic images in lateral and anterior projections were obtained once between 2.5 and 18 hours after tracer administration. Guided by a gamma probe, all radioactive lymph nodes in the axilla were resected, then complete dissection followed. Results: In 151 of the 155 women (97.4%), nodal tracer uptake (range 1-7 foci, average 2.2) was scinligraphically revealed. In one of these cases, drainage was only to the internal mammary lymphatic chain. Three of the 4 women with detection failure presented with histologically proven tumor infiltration of the lymphatics and axillary involvement. In 49 of the patients with visualized axillary lymph nodes (32.7%), at least one SN was metastatic. In 21 cases, this SN was the only positive node. The remaining 101 patients with negative SN included 4 cases with axillary involvement. The sensitivity of the SN with respect to the histological status of the entire axilla was thus 92.5%, the negative predictive value was 96.0%. The overall accuracy of the method was 97.3%. There was a significant difference between the number of totally detected radioactive nodes in the groups with and without nodal metastases (3.49 vs. 2.57, p <0.01). Conclusion: The described protocol represents an easy reproducible and reliable method for SN detection in breast cancer that additionally allows flexible timing of surgery. Further, we found evidence that the number of scinligraphically visualized nodes also reflects the histological status of the axilla.

We employed the agar gel electrophoresis method to determine in 63 samples of vulva tissue the cytoplasmatic receptors for oestradiol, dihydrotestosterone and dexamethasone. Tissues with a binding capacity of more than 5 femtomol/mg (fmol = 10(-15) mol) cell proteins were considered receptor positive. The study comprised 17 normal tissues of the vulva, 13 vulva biopsies at the end of the pregnancy period, 7 dystrophically changed tissues, 11 premalignant changes of the vulva and 15 squamous cell carcinomas. In normal as well as in benign or malignantly changed vulva, specific receptors were found for all the four steroids (ER, PR, DHTR, DExaR). Receptors were most frequent in normal vulva tissue (ER = 94%, PR = 54%, DHTR = 38%, DexaR = 83%) with binding-capacities of 8-650 fmol/mg cell proteins. ER levels were higher during the postmenopausal period than during the premenopausal period. In dystrophia the receptor pattern was almost the same as in healthy tissue. Biopsies conducted at the end of the pregnancy period showed in all cases despite the high endogenous oestrogen levels positive ER values up to 875 fmol/mg cell proteins, whereas PR and DTHR were present in only 20% or 25% with low binding capacities. Loss of receptors, particularly of PR, was seen in premalignant changes (dysplasia of vulva, carcinoma in situ) and in case of squamous cell carcinomas. On comparing the receptor distribution of clinically changed vulva tissue with healthy tissue we found only differences by degree but no fundamental differences in principle.(ABSTRACT TRUNCATED AT 250 WORDS)

In order to define cancer of the breast limited to the breast parenchyma 114 infiltrating carcinomas with a maximum size of 1 cm and 88 non-infiltrating carcinomas (without size limitation) were investigated histologically for axillary lymph node metastases. All carcinomas with a size of up to 0.5 cm (25 cases) were free of lymph node metastases. Infiltrating carcinomas with a size of more than 0.5 cm up to 1 cm (108 cases) showed metastases in 25%. Non-infiltrating carcinomas of more than 0.5 cm (69 cases) had lymph node metastases in 1.4%. Considering the excellent prognosis, by histologically criteria infiltrating carcinomas of up to 0.5 cm and all non-infiltrating carcinomas can be considered as cases of "early breast cancer". For detection of these carcinomas mammography is of considerable importance, particularly when micro-calcifications are demonstrated. Among non-invasive carcinomas 74% were thus discovered by this method.