European Journal of Cancer: Highlights of Issue 39:04

Only 97% are predicted to arrive safely on this 2 hour hypothetical flight - would you get on board?

Focus on quality assurance in radiotherapy

“It is time for everyone to take this area seriously”. That is the statement of Dixon and Sullivan. In this issue, they compare radiotherapy treatment and delivery to high risk industries, where attention to detail, alertness, precision as well as adequate resources (both personnel and materials) are required to minimise risks. Referring to a previous publication by Berwick and Leape, they use an analogous example of a flight to emphasise that the safety statistics for the airline industry are relatively good when compared with health care statistics (see above). Their current perspective also highlights 2 papers by Kouloulias and colleagues published in this issue that examine the needs and process for quality assurance in radiotherapy. Dixon and Sullivan provide an outline of key components for a comprehensive quality assurance programme.

Smoking in adolescents

A cohort from Lyon in France was followed over time from the age of 11 to 17 years. Cross-sectional questionnaires were used to try to identify factors associated with regular smoking. Adolescents who played sports, used computers and read were less likely to be regular smokers whereas those caring less about the importance of health and who associated with friends and family who smoked were more likely to be regular smokers. Those living with one or no parent and with increased alcohol and drug use, as well as those that were sexually active were also more likely to smoke. The authors suggest that those with a sense of well-being are less likely to smoke. Their results also indicated that the percentage of never smokers that expected to remain non-smokers increased with age. Thus, this emphasises the need to begin prevention efforts in early adolescence or even earlier. The similarity of their results to data obtained in other countries “underlines a universal need for age-specific prevention”, they said.
On a related theme, we are publishing in the EJC later this year a Special Issue on “Adolescents and Cancer”.

E-cadherin expression in NPCs is associated with the methylation status of the gene

This is the conclusion of the study by Tsao and colleagues in this issue who looked at the expression level of E-cadherin and the methylation of the E-cadherin 5’ CpG promoter region. They examined 6 cell lines and found that those that were heavily methylated showed little or no E-cadherin expression- either at the protein or mRNA level. These results were confirmed in clinical tissue samples where 15/29 were methylated and all of these had weak expression. In contrast, in 10 non-malignant nasopharyngeal samples (NPCs), there was only one sample that showed weak expression and this sample was also found to be heavily methylated. This study confirms similar observations in other cancers, but is the first to show such a link for NPC cells. Interestingly, 2 cell lines that showed comparable methylation and mRNA expression differed in their level of protein expression leading the authors to suggest that there may be other post-transcriptional mechanisms also operating in these cells. Moreover, some of the samples with a weak E-cadherin expression did not show evidence of methylation indicating that E-cadherin is likely to be downregulated by several mechanisms. E-cadherin has often been associated with an advanced stage of disease and a poor survival and is frequently lost or reduced in NPCs. Thus, the authors propose that their findings “suggest that the restoration of E-cadherin to prevent or reduce the metastatic phenotype of NPC cells may be a potential therapeutic strategy”. On a related theme, Chen and colleagues studying methylation status and E-cadherin expression in cervical cancer tissues-a study also published in this issue- concluded that E-cadherin expression was (in part) correlated with DNA methylation in cervical cancer. These two studies are discussed in an accompanying editorial by Drs. Di Croce and Pelicci.

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