SummaryWe have developed sensitive assays for cytokeratin (K) 8, 16, 19, stromelysin 3 (ST3), MUC1 and maspin mRNAs using reverse transcription polymerase chain reaction (RT-PCR) and used these to assess lymph node status in patients undergoing surgery for breast cancer. In addition the RT-PCR assays were tested against lymph nodes from non-cancer patients to determine their specificity. Despite high sensitivity RT-PCR assays for K8, K16, K19, ST3 and maspin were not found to be useful as markers of submicroscopic disease as transcripts of these genes were detected in the great majority of control lymph nodes tested. Expression of MUC1 was also not found to be useful as it was both insensitive and non-specific. The importance of assessing potential markers against an adequately sized control population is demonstrated, as failure to do so can lead to erroneous conclusions.

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Keratin 19 mRNA is detectable by RT-PCR in lymph nodes of patients without breast cancer Sir We were interested to read the paper on the use of cytokeratin 19 (K19) mRNA by reverse transcription polymerse chain reaction (RT-PCR) combined with Southern blotting for the detection of lymph node micrometastasis in breast cancer patients by Schoenfeld et al (1996). The authors have reported that, among 75 histologically node-negative breast cancer patients, 23 (30.6%) demonstrate K19 mRNA in their lymph nodes whereas none of 28 control lymph nodes without epithelial malignancy show K19 expression. This report and another by Traweek et al (1993) are in sharp contrast with our data in that K19 mRNA is readily detected by RT-PCR in 31 of 40 (77.5%) lymph nodes from five of eight patients with benign bowel diseases, none of whom had any signs of an epithelial malignancy. We also found that two of these same eight had K19-positive bone marrow aspirates. Our methods involve extremely careful dissection of lymph nodes before cutting any epithelial tissue to avoid epithelial cell contamination from surgical gloves or dissection equipment. RNA extractions were performed, including blank samples, so that reagent contamination could not account for positive results. Our PCR strategy allows discrimination of K19 cDNA-derived PCR products from K19 genomic DNA-or K19 pseudogene-derived PCR products, methodologies of which have recently been published by Gunn et al (1996). Furthermore, we showed that the 31 lymph nodes that expressed K19 mRNA did not express keratin 20, a gene expressed highly by the epithelial cells of the gastrointestinal tract only) ruling out epithelial cell contamination as the source of K19 mRNA in these lymph nodes. Among 35 breast cancer patients so far studied, 17 were histologically node negative whereas 18 were histologically node positive. Ninety-five of 143 lymph nodes (66.4%) from the former group and 128 of 166 lymph nodes (77.1%) from the latter group were found to be K19 positive by RT-PCR. From these findings we have concluded that a low level of K19 mRNA is expressed in most lymph nodes, and that these data concur with previous reports by Krisman et al (1995), Adams et al (1995) and Burchill et al (1995).

BackgroundHepatocellular carcinoma (HCC) is a leading cause of cancer‐related death worldwide. The incidence of HCC is affected by genetic and non‐genetic factors. Genetically, mutations in the genes, tumor protein P53 (TP53), catenin beta 1 (CTNNB1), AT‐rich interaction domain 1A (ARIC1A), cyclin dependent kinase inhibitor 2A (CDKN2A), mannose 6‐phosphate (M6P), smooth muscle action against decapentaplegic (SMAD2), retinoblastoma gene (RB1), cyclin D, antigen presenting cells (APC), AXIN1, and E‐cadherin, have been shown to contribute to the occurrence of HCC. Non‐genetic factors, including alcohol consumption, exposure to aflatoxin, age, gender, presence of hepatitis B (HBV), hepatitis C (HCV), and non‐alcoholic fatty liver disease (NAFLD), increase the risk of HCC.Recent FindingsThe severity of the disease and its occurrence vary based on geographical location. Furthermore, men and minorities have been shown to be disproportionately affected by HCC, compared with women and non‐minorities. Ethnicity has been reported to significantly affect tumorigenesis and clinical outcomes in patients diagnosed with HCC. Generally, differences in gene expression and/or the presence of comorbid medical diseases affect or influence the progression of HCC. Non‐Caucasian HCC patients are significantly more likely to have poorer survival outcomes, compared to their Caucasian counterparts. Finally, there are a number of factors that contribute to the success rate of treatments for HCC.ConclusionAssessment and treatment of HCC must be consistent using evidence‐based guidelines and standardized outcomes, as well as international clinical practice guidelines for global consensus. Standardizing the assessment approach and method will enable comparison and improvement of liver cancer research through collaboration between researchers, healthcare providers, and advocacy groups. In this review, we will focus on discussing epidemiological factors that result in deviations and changes in treatment approaches for HCC.

E-commerce site product taxonomy developers and maintainers will make a 10 minute presentation that responds to the following questions:What methods were used to develop the categorization scheme on the commerce website in the first place? Is the site activity monitored to see how the category schemes perform? How are product taxonomies and other category schemes modified in response to user activitry or merchandising campaigns? Classification researchers and teachers will each provide up to a 10 minute response to the e-commerce site developers. In these responses, they will be asked to respond to the following questions: