The relationship between tumour stage, T-lymphocyte subset infiltration and survival was examined in patients with prostate cancer (n ¼ 80). On multivariate analysis PSA (HR 2.47, 95% CI 1.27 -4.83, P ¼ 0.008) and CD4 þ T-lymphocyte count (HR 2.29, 95% CI 1.25 -4.22, P ¼ 0.008) had independent significance. Increased CD4 þ T-lymphocyte infiltration within the tumour was stage independent and associated with poor outcome in patients with prostate cancer.

The relationship between the systemic inflammatory response, tumour proliferative activity, T-lymphocytic infiltration, and COX-2 expression and survival was examined in patients with transitional cell carcinoma of the urinary bladder (n ¼ 103). Sixty-one patients had superficial disease and 42 patients had invasive disease. Cancer-specific survival was shorter in those patients with invasive compared with superficial bladder cancer (Po0.001). On univariate analysis, stratified by stage, increased Ki-67 labelling index (Po0.05), increased COX-2 expression (Po0.05), C-reactive protein (Po0.05) and adjuvant therapy (Po0.01) were associated with poorer cancer-specific survival. On multivariate analysis of these significant factors, stratified by stage, only C-reactive protein (HR 2.89, 95% CI 1.42 -5.91, P ¼ 0.004) and adjuvant therapy (HR 0.29, 95% CI 0.14 -0.62, P ¼ 0.001) were independently associated with poorer cancer-specific survival. These results would suggest that tumour-based factors such as grade, COX-2 expression or T-lymphocytic infiltration are subordinate to systemic factors such as C-reactive protein in determining survival in patients with transitional cell carcinoma of the urinary bladder.

The Kalow allele for cholinesterase is a quantitative variant of the usual gene and has been shown to result from a single base pair change in the DNA. A new method based on the polymerase chain reaction to distinguish Kalow alleles of the cholinesterase gene was developed. Using the amplification refractory mutagenesis system, two different reactions distinguished the presence of a guanine (normal Elu allele) from that of an adenine (Kalow Elk allele) at nucleotide 1615 within the coding sequences of the gene. The frequency of the Kalow allele in our sample of 51 persons was determined to be 20%. The mean total cholinesterase activity in heterozygotes was 90% of that in persons who typed as E,uE,u homozygotes. Two E kE k homozygotes were identified and their cholinesterase activities were the two lowest measured.

Plasma concentrations of vitamins A and E, serum and erythrocyte folic acid, serum B12 and erythrocyte enzyme activations (to assess vitamins B1, B2 and B6 status) were measured at the start and finish of 39 courses of total parenteral nutrition (TPN). The daily regimen was standard. Plasma vitamin A, E, and folate concentrations and vitamin B6 status improved significantly during TPN. Three patients developed low levels of vitamin A and two patients developed high transketolase activations (B1 depletion) during therapy. The adequacy of vitamin replacement and the monitoring of vitamin status during TPN is discussed.

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