The pathologic features of the primary tumors in 285 patients with breast cancer at the time of initial presentation, and with no clinical evidence of distant metastases, have been analyzed. The results have been compared with the detection of tumor cells in the bone marrow by use of an immunocytochemical method using antisera raised against the epithelial membrane antigen (EMA). The authors found EMA-positive cells (i.e., tumor cells) in the bone marrow of 77 (27%) patients and a significant association between the presence of such EMA-positive cells in the bone marrow and tumor size (P = 0.006) and peritumoral vascular invasion (P = less than 0.001). A possible relationship with estrogen receptor negativity (P = 0.06) also was noted.
SUMMARY
Quantitative aspects of corticosteroidogenesis were examined in monolayer cultures of cells from the zona fasciculata and zona reticularis of the adult rat adrenal cortex, maintained for up to 4 months. Corticosterone secretion continued at a steady rate in cultures maintained with corticotrophin (ACTH), the output of maximally stimulated cultures being approximately 12 μg/106 adrenocortical cells/day. In the absence of ACTH, a small amount of 20α-hydroxypregn-4-en-3-one, but no detectable corticosterone, was secreted, resulting in a fluorogenic steroid output 1/125 th of that of maximally stimulated cultures. Restimulation with ACTH of cultures maintained for up to 2 months in its absence resulted in maximum levels of corticosterone secretion after 4–5 days of continuous ACTH treatment. The levels of corticosterone secretion attained on restimulation were similar to those observed in cultures maintained with ACTH from the out set. Withdrawal of ACTH resulted in a fall in steroid output which took 10 days to reach final unstimulated levels. Trophic stimulation of corticosteroidogenesis with a similar time-course was obtained with both cyclic AMP and dibutyryl cyclic AMP, the latter being the more effective.
Confluent monolayer cultures of cells from the zona fasciculata andzona reticularis of the normal adult rat adrenal cortex were maintained with or without corticotrophin (ACTH) for up to 4 months, without proliferation of adrenal cells. Proliferating fibroblast-like cells, however, eventually overgrew the adrenal monolayer in cultures both with and without ACTH. Adrenocortical cells in culture, maintained without ACTH, spread rapidly to form a confluent monolayer, whereas cell spreading was markedly inhibited in the presence of ACTH. Exposure of previously unstimulated cells to ACTH or cyclic AMP caused the adrenal cells to retract with loss of confluence, the process being reversed when ACTH or cyclic AMP was withdrawn. Ultrastructural features of cells cultured with ACTH were typical of normal adrenocortical cells; in cultures without ACTH they were similar to those of adrenocortical cells found in the hypophysectomized rat.
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