Chemical Compounds As Carcinogenic Agents Second Supplementary Report: Literature of 1938 and 1939 Biological Considerations
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CHEMICAL COMPOUNDS AS CARCINOGENIC AGENTS SECONDSUPPLEMENTARY REPORT: LITERATURE OF 1938 AND 1939 J. W. COOK AND E. L. KENNAWAY (From the Royal Cancer Hospital (Free), London, and the University of Glasgow) BIOLOGICALCONSIDERATIONS (Continued from page 428, Jitly 1940) II. Action of Carcinogenic Compounds in Difierent Species and Tissues A number of reports of the action of carcinogenic compounds on human tis- sues have appeared. Klar (601) developed a nodule on the forearm after completion of a series of experiments with 3:4-benzpyrene. He applied a solution of the hydrocarbon (0.25 per cent in benzol) to the skin of mice with a paint brush and for at least part of the period wore rubber gloves. He also conducted experiments, of which no description is given, with the powdered hydrocarbon contained in a glass vessel. Three months after the completion of the experiments a small nodule appeared on the dorsum of the left forearm, This was excised in May 1938 and described by Professor Huckel as a “ so- called benign calcifying epithelioma.” The growth extended into the subcu- taneous fatty tissue; the connection with the superficial epithelium is not described nor is it evident in the two photomicrographs which illustrate the report. The author does not state his age. Gordonoff and Walthard (562) record the occurrence of a tumor in a labo- ratory assistant, aged forty-two, engaged in applying methylcholanthrene (0.3 per cent in benzol) to the skin of mice. The site was in the nasolabial fold, at a spot often touched by the patient when smoking. The microscopic ap- pearance was that of a “ still well delimited stage of an incipient squamous- cell sarcoma.” Cottini and Mazzone (479) deliberately applied 3 :4-benzpyrene ( 1 per cent in benzene) to the skin, generally of the arm or thigh, of 26 patients with various cutaneous diseases, usually daily for periods up to 120 days. The changes observed were ( 1) pigmentation (“ an increase in melanin in the basal layer of the epidermis ”), which was more distinct in older people and in parts exposed to light, and (2) verrucae. The latter are described as “ an accentua- tion of the relief pattern of the skin secondary to a deepening of the sulci,” but no dimensions are given. The changes retrogressed completely within two months after cessation of the applications. In a child aged four, suffering from xeroderma pigmentosum with multiple squamous-cell cancers of the face, the skin reacted to the hydrocarbon in the ordinary way, though the reaction to ultraviolet radiation was intense. This latter effect was less in areas treated with the hydrocarbon. Application of an ointment containing 1 per cent 3:4- benzpyrene to one of the ulcerated cancers in this patient had at first a favour- 521 522 J, W. COOK AND E. L. KENNAWAY able effect, but after 30 applications no definite retardation was observed. A similar result was obtained in a man of sixty with an x-ray cancer. Oberling, SanniC, GuCrin and GuCrin (726) have published data upon carci- nogenesis by 3 :4-benzpyrene in several species. (1) The hydrocarbon (1 per cent benzene) was applied twice weekly to the skin of 5 rabbits. Towards the third month 2 animals developed nodules which on biopsy showed squamous epithelioma, but in spite of continuation of the painting these tumours disappeared. At the end of one year the 3 sur- viving rabbits began to show malignant growths; 2 died, in the 18th and 19th months, with infiltrating epithelioma, while the third showed, in the 2 1st month, far-advanced ulcerating and vegetating epithelioma. (2) Application of the same solution to the skin of rats produced, in 3 animals which died between the nineteenth and the twenty-eighth month, epi- theliomas partly of basal-cell and partly of squamous type. The production of such tumours in the skin of the rat by methylcholanthrene was previously described and illustrated by Bachmann et d. (208). (3) In guinea-pigs the same solution applied to the skin produced only traces of papilloma even when the experiment lasted more than two years. (4) Of 5 fowls similarly treated one developed an erythroblastic blood re- action, another an erythroblastic leukaemia and a tumor of the ovary, and a third, after two years, an atypical spinocellular epithelioma. (5) 3:4-Benzpyrene dissolved in lard was given with the food to 20 mice. Of 3 which lived more than six months, 2 showed epithelioma of the squamous portion of the stomach (cf. Waterman, 359, 360). Rats similarly treated de- veloped no tumours of the alimentary tract. (6) Negative results were also obtained in rats by intrahepatic and intra- renal injections of a colloidal solution 1 in 10,000 and by injection into the kidney of a “ solution huileuse.” Of 4 rats in which a crystal of 3:4- benzpyrene was inserted into the kidney, one developed a keratinizing renal carcinoma with peritoneal metastasis, which was transmitted by grafting. (7) In an attempt to ascertain the minimum effective dose the authors found that 0.05 mg. produced sarcoma subcutaneously in one of 5 rats in a year and a half (cf. Dobrovolskaia-Zavadskaia, 501). The importance of concentration is shown by an experiment in which the same quantity of hydro- carbon was carcinogenic when injected in 0.5 C.C. of oil, but was inactive in 5.0 C.C. of the same medium. Strong and Smith (807) injected methylcholanthrene subcutaneously ( 1.O mg. in sesame oil) into male and female mice, two months old, of strains NH, HE, CBA, C57, JK, CBAN, and N. These mice had received an injection of India ink within twenty-four hours after birth. Tumours appeared in 42 of them as follows: in 16 males and 18 females, sarcoma; in 6 females of strain NH, between the 82nd and the 199th days, and in 2 females of strain JK on the 203rd and 217th days, adenocarcinoma of the mammary gland at the in- jection site. Females of the two closely related strains NH and JK have an extremely low incidence of spontaneous tumours, none having been met with in the former strain since its origin three years ago. The experiment was repeated without the use of India ink, and at the time of the report 2 NH mice (T CHEMICAL COMPOUNDS AS CARCINOGENIC AGENTS 523 females) had developed mammary cancer. A female of this strain painted with a 1 per cent methylcholanthrene solution ( ? solvent) had also developed a mammary cancer near the site of painting. These tumours showed many areas of squamous metaplasia and were thought to have arisen from ducts. Mider and Morton (685) applied methylcholanthrene twice weekly to nine areas of the skin in turn in 65 breeding females of sub-line 212 of the dilute brown strain of mice. This sub-line has a lower incidence of mammary cancer than other members of the strain. Cancers were obtained in 13 mice between the 106th and 268th days of life (average 181st day), while 14 of 42 control breeding females developed mammary cancer between the 250th and 475th days (average 371st day). “ The number of observations does not permit any comparison of the breast tumor incidence in the two groups. The con- stant marked reduction in the latent period, however, is unquestionably sig- nificant.” Mammary tumours were not obtained in 75 virgin females, nor in males, treated similarly. [On the production of mammary cancers by applications to the skin, cf. Widmark, 842 (see p. 405 in the previous installment of this paper) and Maisin and Coolen, 17 1.1 Larionow (633) added 3 :4-benzpyrene or 1: 2 :5 :6-dibenzanthracene in ((oil” to the food of mice at intervals of from one to three days for from five to seven months, the whole amount given being from 9 to 19 mg. Of 60 mice, 41 survived a whole course of feeding and the first tumours appeared six months after the dosage had ceased, ie., a year from the beginning of the ex- periment, when 22 animals still remained alive. These mice showed: (1) papilloma of the pre-stomach in 6 instances, some multiple and one showing a transitional stage to cancer; (2) a squamous carcinoma of the pre-stomach; (3) one example each of adenoma of the sebaceous gland, mammary adenoma, and mammary adenocarcinoma; (4) adenoma of the lung in 5 instances; a single adenocarcinoma of the lung with metastases. No data are given in the French or English summaries of this paper on the incidence of tumours in control mice. Bonser and Orr (438) have described the histology of 160 tumours induced in the subcutaneous tissue of mice by methylcholanthrene (in lard or paraffin) or by 3 :4-benzpyrene or 1: 2 :5 :6-dibenzanthracene (in paraffin), which were distributed between the two sexes as follows: Male Female Sarcoma 65 60 Sarcoma and carcinoma of breast - 13 Sarcoma and squamous carcinoma 2 4 Carcinoma of breast - 9 Squamous carcinoma 1 5 Sarcoma, breast carcinoma and squamous carcinoma - 1 __ 68 92 “ The occurrence of a considerable series of mammary adenocarcinomas in female mice at the site of injection of a carcinogenic hydrocarbon and, from the histological appearances, directly attributable to the action of the hydro- carbon is a phenomenon which has not been described before. As the tumours occurred close to the injected material and were as frequent in IF TABLEXIII: Obserrwltions on Eighl Highly Inbrcd Strains of Mice, Showing SyscCPribilitr lo SpMJancous Mammary and Pulmonary Tumours and Induced Sub- cvtanu~wand Pdlrrmrcrry Tumoovs. and Naiurot~mulo TranrplrmbMc Tu~rs(Andrro6nt) CaH 95 to 100 per cent ? Medium High LOW Develop spontaneous and induced hepatomas C Less than 5 per cent 20 to 30 per cent High LOW LOW An incidence of 50 per cent of spontaneous