Prolactin receptor is a negative prognostic factor in patients with squamous cell carcinoma of the head and neck

Background: The influence of human prolactin (hPRL) on the development of breast and other types of cancer is well established. Little information, however, exists on the effects of hPRL on squamous cell carcinomas of the head and neck (SCCHNs). Methods: In this study, we evaluated prolactin receptor (PRLR) expression in SCCHN cell lines and assessed by immunohistochemistry the expression in 89 patients with SCCHNs. The PRLR expression was correlated with clinicopathological characteristics as well as clinical outcome. The effect of hPRL treatment on tumour cell growth was evaluated in vitro. Results: Immunoreactivity for PRLR was observed in 85 out of 89 (95%) tumours. Multivariate COX regression analysis confirmed high levels of PRLR expression (>25% of tumour cells) to be an independent prognostic factor with respect to overall survival (HR=3.70, 95% CI: 1.14–12.01; P=0.029) and disease-free survival (P=0.017). Growth of PRLR-positive cancer cells increased in response to hPRL treatment. Conclusion: Our data indicate that hPRL is an important growth factor for SCCHN. Because of PRLR expression in a vast majority of tumour specimens and its negative impact on overall survival, the receptor represents a novel prognosticator and a promising drug target for patients with SCCHNs

Adrenal venous sampling for catecholamines: a normal value study

<b>Context:</b> Pheochromocytomas are rare, but potentially fatal, neoplasms. The diagnosis and localization of pheochromocytoma can be challenging, and recently there has been some debate regarding the role for adrenal venous sampling (AVS). The utility of AVS in this setting is hampered by a lack of normative value data for adrenal vein catecholamine concentrations and the reliability of lateralization ratios. We sought to address these concerns by analyzing AVS catecholamine concentrations from patients who did not have pheochromocytoma.<p></p> <b>Design/Setting:</b> Eighteen patients underwent successful AVS for evaluation of cortisol-producing adrenal masses. All had normal 24-h urinary excretion of fractionated catecholamines and metanephrines.<p></p> <b>Results:</b> There was a wide range of catecholamine concentrations in both the right (epinephrine 389–118326 pg/ml; norepinephrine 156–11193 pg/ml) and left (epinephrine 113–9327 pg/ml; norepinephrine 229–2216 pg/ml) adrenal veins. The right adrenal vein-to-left adrenal vein epinephrine gradient was as high as 83:1 (median 2.1:1; P < 0.02). Although less striking, similar findings were also seen for norepinephrine.<p></p> <b>Conclusions:</b> This report provides a reference range for adrenal vein catecholamine concentrations in nonpheochromocytoma patients and illustrates the wide variation in epinephrine and norepinephrine concentrations. Epinephrine and norepinephrine concentrations are statistically significantly higher in the right vs. the left adrenal vein; in the case of epinephrine, up to an 83-fold difference was found between the right and left adrenal veins. These data highlight why AVS should not be used in the investigation of adrenal pheochromocytoma.<p></p> Marked gradients between adrenal vein catecholamine concentrations in nonpheochromocytoma patients highlight why adrenal venous sampling should not be used to detect adrenal pheochromocytoma.<p></p&gt