The incidence of a number of cancers is affected by socio‐economic status. We hypothesized that the incidence of head and neck squamous cell carcinoma (HNSCC) would fall with increasing affluence, that this pattern would be similar for all sites, and that more second primary tumours would appear in deprived groups. Data on all HNSCC registered between 1985 and 1991 in the South West of England was collected. Tumours of the lip and skin were excluded. The measure of socio‐economic status chosen was the Carstairs Index.1 Tumours were classified as ‘first alone’, ‘first plus others’, ‘synchronous’ (within 60 days) or ‘subsequent’. Corrected χ2 testing was applied. There were 1570 cases of HNSCC, 72% in men, 28% in women. Carstairs index could be determined for 1467 cases. Overall, socio‐economic status was inversely related to the development of HNSCC. In men, the most deprived group had a significantly higher incidence of oral carcinoma than all other groups (P < 0.01), whereas the incidence of laryngeal carcinoma showed a gradual rise with increasing deprivation. In women, the trend was less clear. Seventy‐two (4.9%) went on to develop a second primary, of which 35% were lung and 12% bladder. Socio‐economic status did not affect the development of a second primary tumour in either sex. Thus, in the South West of England, socio‐economic status affects the incidence of HNSCC, but there are different patterns in different tumour sites. However, socio‐economic status does not affect the incidence of a second primary. The association of HNSCC with carcinoma of the bladder is a new finding.
Background: Counts of apoptosis (programmed cell death) are increasingly performed and have been found to have prognostic value for some tumour sites.1 To date there has been no good data on the best technique for measurement of apoptotic fraction. We therefore decided to determine the best method of identifying apoptotic and mitotic cells in paraffin‐sections for head and neck squamous cell carcinoma (HNSCC). Methods: Sections were cut from at least four separate areas from each of 10 large (T3/T4) squamous cell carcinomas of the head and neck (from histopathology archives). All sections were stained with the three methods. Methyl green/pyronine (G) and haematoxylin/eosin (H) are conventional histological stains which demonstrate both apoptosis and mitosis. In situ end‐labelling/ISEL (I) is an immunohistochemical technique that labels DNA strand breaks, characteristic of apoptosis. Using light microscopy (×100) the percentage of cells undergoing apoptotis (I) and apoptotis and mitotis (H, G) was recorded. Data was transformed as determined by distribution testing, and then measures of agreement (mean difference and 95% confidence intervals) calculated. Within‐patient SDs were used as a measure of repeatability, and κ scores for interobserver error.2 Results: Median apoptotic indices for the three methods were: H, 0.771 (range 0–2.63); G, 0.854 (range 0.10–4.23); I, 0.15 (range 0–39.1). Mean differences for the measures of agreement were: H. versus I, 1.5 ( SD 2.1); H, versus G, 1.0 ( SD 1.5); G, versus I, 1.5 ( SD 2.5). For mitosis, H versus G mean difference 1.2 ( SD 3.3). Within‐patient SDs for apoptosis were: H, 0.38; G, 1.00; I, 3.9. For mitosis, the figures are H, 0.45; G, 0.59. κ (uncorrected) for apoptotic counts with H was 0.28 (‘fair’). Conclusions: The most repeatable results are obtained with haematoxylin and eosin. The ISEL technique demonstrated high variability within tumours despite standardization of methods and agrees poorly with the other methods. This may be due to variable fixation, or cross‐reactivity with processes other than apoptosis. ISEL is not a suitable technique for measuring apoptotic rates in archival material.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.