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Background. Carcinoma arising in the gastric remnant many years after partial gastrectomy for benign disease, referred to as gastric remnant cancer (GRC) is well known, and many causal explanations have been proposed. Elsewhere, Epstein-Barr virus (EBV) involvement has been demonstrated in a small but significant fraction of gastric cancers, and evidence has been presented suggesting that, in positive cases, EBV may have played a causal role. The present report is concerned with EBV involvement in GRC in particular. Methods. Paraffin sections from 48 cases of GRC were studied by EBER-1 in situ hybridization. Results. Thirteen cases (27.1%) showed uniform hybridized signals restricted to the carcinoma cells in contrast to no hybridization in the normal mucosa, intestinal metaplasia, or hyperplastic epithelium. The prevalence of EBV involvement in GRC was significantly higher (P < 0.0001) than in gastric carcinomas from 1825 nonremnant cases; the difference remained highly significant even when the comparison was restricted to nonremnant cancers arising in the cardia and middle stomach. for which EBV-positive rates were highest. Conclusion. The EBV may play an important role in the carcinogenesis of GRC. Cancer 1994; 74:805-9. Key words: Epstein-Barr virus, gastric cancer, gastric remnant cancer, EBER-1 in situ hybridization.

Background. The risk of female breast cancer in association with radiation dose is well established, on the basis of follow-up studies of the atomic bomb survivors and other exposed populations. This association is especially strong for women exposed before 20 years of age and appears to be much weaker among women exposed after 40 years of age. Methods. Breast tissue samples from 88 high-dose and 225 low-dose autopsy cases from the Radiation Effects Research Foundation Life Span Study sample were examined in detail to determine whether nonproliferative and proliferative breast lesions are associated with radiation dose. Results. Prevalence of proliferative disease in general and atypical hyperplasia in particular were positively associated with radiation dose. The associations were strongest for subjects who were between 40 and 49 years of age at the time of the bombing. Conclusions. It is hypothesized that the strongest association in women 40 to 49 years of age may be related to the age dependence of radiation-induced breast cancer, in that potential cancers induced in this age group by radiation exposure may receive too little hormonal promotion to progress to frank cancers.

Generally, risk factors for the development of cancer are determined retrospectively. After patients have developed cancer their histories are compared with the general population to glean any differences that might be of medical interest. The authors of the present study have access to a unique resource which permits special tests to be performed on blood samples taken before the patients actually developed symptoms of cancer. A large number of samples of blood serum were collected from 1970 to 1972 and again from 1977 to 1979 from citizens of Hiroshima and Nagasaki who had been exposed to unusually high levels of radioactivity some years previously. These subjects are known to be at an especially high risk for the development of cancer. Two factors of interest in the ongoing study of cancer development are the roles of nutritional iron and copper. Since high levels of serum ferritin, and low levels of serum transferrin are indicators of large body stores of iron, these proteins were measured in the stored serum samples of 233 patients who later developed stomach cancer and 84 patients who later developed lung cancer. Researchers also measured ceruloplasmin, a copper-containing protein, which reflects the body stores of copper. Low levels of ferritin were found to be more common among the patients with stomach cancer. When the levels were grouped into five classes, the patients in the lowest, or fifth, class had three times the risk of stomach cancer as those in the highest quintile of ferritin. Many of the patients in the group had been previously diagnosed with achlorhydria, an absence of stomach acid which indicates atrophy of the stomach lining. Patients with both low ferritin levels and achlorhydria had a 10-fold greater risk of stomach cancer. The risk of stomach cancer was not influenced by the levels of ceruloplasmin, and none of the factors investigated were related to the risk of lung cancer in these subjects. In some cases, the low levels of ferritin were evident five years prior to the onset of cancer, indicating that it is possible to detect some risk factors for stomach cancer years before the actual onset of disease. (Consumer Summary produced by Reliance Medical Information, Inc.)