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Abstract: Classically, squamous cell carcinoma (SCC) of the head and neck is a disease of older adults, but recently there have been reports of an increasing incidence in young people. This study of patients in the Republic of Ireland compares sex distribution, sites, risk factors, stage and grade of tumour, and nodal status of 130 patients with SCC of the head and neck, 30 of whom were less than 40 years old. There was a highly significant association between age, smoking status, and site of tumour. For the first time to our knowledge in a study such as this, the preoperative haematological status of the patients was assessed, and although 15% were anaemic there was no significant difference in the occurrence of anaemia between the younger and the older patients. We think that it is possible that the biology of SCC of the head and neck in young people differs from that in older people. [Copyright &y& Elsevier]

Summary: Cervical cancer, a potentially preventable disease, remains the second most common malignancy in women worldwide. Current screening protocols rely on the Pap smear test, which has a reported false-negative rate of 15–50%. Advances in automation of cervical cytology have resulted in improved cell preservation techniques and overall high-quality cellular material that is suitable for molecular analysis. The current focus is primarily on the use of molecular biomarkers as adjuncts to existing screening procedures. These biomarkers include human papillomavirus (HPV) and the host cell regulatory molecules, minichromosome maintenance proteins, Cdc6 (a cell division cycle protein) and p16(INK4A) tumour suppressor protein. Developments in micro-array technology and its application to the study of cervical cancer have greatly expanded the list of differentially regulated genes known to be involved in cervical cancer. This will help to unravel the pathogenesis of HPV infection and dysplastic progression, and ultimately improve treatment of cervical intra-epithelial neoplasia and cervical cancer. [Copyright &y& Elsevier]

Introduction The close relationship between coagulation, thrombosis and cancer has long been established. Gynaecological cancers, in particular ovarian cancers, carry a high risk of thrombosis but coagulation activation is also thought to play a role in tumorigenesis and metastasis. In experimental animal models of metastasis, mice with a genetic procoagulant phenotype are prone to develop metastasis and anticoagulant therapy dramatically reduces pulmonary metastasis in these models. The aPC pathway is a key natural anticoagulant pathway, in addition to its role in venous thrombosis, dysregulation of this pathway is also thought to play a role in the pathogenesis of some cancers. No data exists in ovarian and endometrial cancers. Aim The aim of this study is to determine the expression of key proteins of the activated protein C pathway in endometrial and ovarian malignant tumours compared to benign tumours and to assess their role in patient survival. Materials and Methods RNA was extracted from 78 (54 malignant and 24 benign) fresh frozen ovarian and endometrial tumours samples. Tumour biopsies were mRNA expression of endothelial protein C receptor (EPCR), protein S (PS), protein C (PC), thrombomodulin (TM), Factor V (FV) and VIII (FVIII) and PAR-1 and PAR-2 was measured using TaqMan Low Density Arrays. mRNA fold change relative to benign expression was determined using the 2 -delta delta Ct method with 18s as internal standard. All patients gave full and informed consent and the study had the approval of the hospital ethics committee. Total cell protein was extracted from ovarian tumour tissue. Enzyme-linked immunosorbent assay (ELISA) was used to measure protein plasma expression Results EPCR (P < 0.001), protein S (P < 0.0001) and Factor VIII (P < 0.003) mRNA expression was significantly downregulated in malignant tumours compared with benign. Factor V and PAR-2 were significantly upregulated (P < 0.001; P < 0.004). Protein C was not consistently expressed. Reduced EPCR and TM protein expression was also observed in malignant tumours with increased plasma levels of Factor V. Reduced protein S and increased FV were associated with decreased survival. Plasma levels of Factor V were related to grade in the endometrial cancer group. PAR-2 mRNA expression was increased in ovarian tumours (P < 0.001) however PAR-1 expression remained unchanged. Conclusions Our results show reduced expression of key proteins associated with activation of protein C combined with increased expression in FV in gynaecological malignancies. These changes may contribute to local thrombin production and tumour progression and metastasis. Further work is required to determine the precise mechanisms involved. [ABSTRACT FROM AUTHOR]