CHAPTER 24 INDEXING PRINCIPLES FOR CATEGORY C4 (NEOPLASMS) 24.1 Category C4 contains the MeSH headings for neoplasms and cysts. The neoplasm terms are arranged in two ways: by histologic type (CARCINOMA, LYMPHOMA, LEIOMYOSARCOMA, etc.) and by anatomic site (BRAIN NEOPLASMS, BREAST NEOPLASMS, etc.). 24.1.1 The concept "neoplasm" in MeSH includes "neoplastic disease", "cancer" and "tumor", as well as polyps. While cysts are assigned to the same category as neoplasms, some cysts are neoplastic and others are not. See the ANNOTATED MeSH for specific cysts as to whether they are neoplastic or non- neoplastic. 24.1.2 There is no distinction in MeSH between malignant and benign tumors; both are neoplastic. Often the degree of malignancy is inherent in the specific histologic type of the tumor. If the malignancy of a cancer or tumor is important in an article, use the subheading /pathol on the neoplasm to cover that concept. However, frequently the main concern in a study of "malignancy" is whether or not the neoplasm is capable of metastasis. In such a case, the subheading /second is probably sufficient; see section 24.3.1. 24.1.3 Most terms referring to the histologic type of a neoplasm end with the suffix "-oma" (see the examples in 24.1 above). However, MeSH contains terms for disease concepts which also end in "-oma" but which are not neoplastic. For example, granulomas are not assigned to Category C4 since they are never neoplastic. If a MeSH term ends in "-oma" but refers to a non- neoplastic disease, its annotation states that the correct indexing coordination is a pre-coordinated organ-diseases term rather than an organ-neoplasms term. 24.2 In general, every neoplasm must be indexed with two terms: a histologic type term and a term for the anatomic site. 24.2.1 No histologic heading for a neoplasm may be used unless it is first verified by the indexer in the TECHNICAL NOTES, MEDLARS INDEXING INSTRUCTIONS SUPPLEMENT, Tumor Key (hereafter called just "Tumor Key"). This is based on the World Health Organization's International Classification of Diseases for Oncology. Every histologic type must be verified because the term used by the author may not be histologically correct, even if the term is a valid MeSH heading. For example, although FIBROMA is available in MeSH, a "uterine fibroma" is not a fibroma but a LEIOMYOMA and can be found in the Tumor Key at "fibroma, uterine = LEIOMYOMA." 24.2.1.1 Occasionally, an author acknowledges that the accepted classification of a certain histologic type is the one given in the Tumor Key, but discusses why that term really is not correct; in such a case, index both the histologic type term found in the Tumor Key and the one which the author proposes instead. 24.2.1.2 In addition, there are times in which an author uses a histologic term which does not appear in the Tumor Key at all. These can be very difficult to index. The indexer should check Dorland's Illustrated Medical Dictionary, but since the term probably is fairly new, it may not appear in the dictionary either. In such cases, the indexer should read the introduction and discussion of the article, and check the references at the end. These sections may give other histologic terms used for the type in the past; the indexer can use those terms for the concept after verifying them in the Tumor Key. Or the author may state that this new histologic type is similar to others which do exist in MeSH; in such a case, the indexer can tree those other terms and use the histologic type which is above them all. Intraabdominal desmoplastic small round cell tumor. ABDOMINAL NEOPLASMS / * pathol NEOPLASMS, CONNECTIVE TISSUE / * pathol (The histologic type term was applied after reviewing the histology as discussed by the author in the introduction and discussion, and checking the article references for terms used by other authors. Although a variety of terms was used, all were indented under NEOPLASMS, CONNECTIVE TISSUE.) 24.2.1.3 The word "carcinoma" is often used loosely by authors to mean "cancer". Do not use the MeSH heading CARCINOMA (since this is a specific histologic type of tumor) unless the article states that the tumor is a histologically proven carcinoma. Index only the pre-coordinated organ-neoplasm term as if the author had said "cancer" rather than "carcinoma." Occurrence of breast carcinoma in developing countries. (No discussion of histology) BREAST NEOPLASMS / * epidemiol * DEVELOPING COUNTRIES 24.2.1.4 Frequently we see articles on "-omatosis." This usually means the existence of multiple tumors of the specified histologic type. Always check the Tumor Key first (e.g., "lymphomatosis, malignant - HODGKIN'S DISEASE"), but if the specific "-omatosis" term desired is not there, index the histologic type for the corresponding "-oma" term, and add NEOPLASMS, MULTIPLE PRIMARY (see 24.4.1.6). Juvenile hyaline fibromatosis. * FIBROMA 24.2.1.5 After finding the correct histologic type in the Tumor Key, always check its annotation because many histologic types are specific for a certain organ and that pre-coordinated organ-neoplasm term should be added even if the author never states the site. Radionuclide imaging of hepatoblastomas. HEPATOBLASTOMA / * radionuclide LIVER NEOPLASMS / * radionuclide 24.2.1.5.1 Occasionally, however, such an organ-specific histologic type will occur in an unusual site and the author will stress that fact; despite the annotation saying to use the routine coordination, do not add it when it obviously does not apply. Diagnosis of a non-adrenal pheochromocytoma. (The tumor turns out to be in the bladder.) PHEOCHROMOCYTOMA/ * diag BLADDER NEOPLASMS / * diag Not: ADRENAL GLAND NEOPLASMS / * diag 24.2.1.6 Leukemias and lymphomas are usually systemic; leukemias are neoplasms of the blood, and lymphomas are neoplasms of the lymph. Therefore, in most cases it will not be necessary to add an organ-neoplasm coordinate when indexing leukemia or lymphoma. 24.2.1.6.1 There are, however, articles on lymphomas in specific organs. In such cases, the indexer should of course add the appropriate organ-neoplasms term. Primary non-Hodgkin's lymphoma of the stomach: histologic diagnosis. LYMPHOMA, NON-HODGKIN'S / * pathol STOMACH NEOPLASMS / * pathol 24.2.1.6.2 When indexing lymphomas, there are times in which two terms are needed to cover the histology as discussed by the author. The indexer should check the Trees, and if neither of the terms is indented under the other, both should be indexed. Immunologic studies in a patient with a large-cell diffuse B-cell lymphoma. LYMPHOMA, LARGE-CELL, DIFFUSE / * immunol LYMPHOMA, B-CELL / * immunol 24.2.1.7 Do not interpret the word "lesion" as "cancer"; check the text for a more definitive word. If it is not more precisely defined by the author, index a "lesion" as if it were a "disease", not a "neoplasm"; in many foreign languages "lesion" means "injury." Likewise, do not interpret "mass" as synonymous with "neoplasm"; if there is no proof that a mass is neoplastic, index it as a disease. 24.2.1.8 As mentioned in 24.1.1, cysts are assigned to Category C4 because many cysts are neoplastic. However, although many cysts are in the Tumor Key ("cyst, bone - BONE CYSTS"), not all appear there (BAKER'S CYST see POPLITEAL CYST is in MeSH but not in the Tumor Key), so always check the Annotated MeSH and Permuted MeSH as well as the Tumor Key for cyst terms. After finding the cyst term desired, check its annotation as to whether or not it is neoplastic and whether a coordinate term must be added to cover its anatomic site. 24.2.1.9 If the title of an article specifies only the anatomic site of a tumor, and its histologic type is merely mentioned in passing in the text, it may be that the histology is irrelevant. Similarly, an article may report a study in which the author stresses the anatomic site of the tumor while listing many histologic types which are not treed together in MeSH, without discussing the histologic types or indicating that they are important. Articles such as these, in which the histology of the neoplasm is irrelevant, are most frequent in the fields of psychology, epidemiology, etc. In such cases, index only the pre-coordinated organ-neoplasms term to cover the concept which is important to the author (BRAIN NEOPLASMS, etc.). It is not necessary to index six irrelevant histologic types for completeness. 24.2.2 The second aspect of almost every neoplasm which must be indexed is its anatomic site, in the form of a pre-coordinated organ-neoplasms term. 24.2.2.1 Since the volume of literature on tumors and cancers is so great, there are anatomic site terms in MeSH in the form of pre-coordinated organ- neoplasms headings for most of the organs in the body: STOMACH NEOPLASMS, GALLBLADDER NEOPLASMS, etc. 24.2.2.2 As is our policy with all topics, the indexer must always index the most specific pre-coordinated organ-neoplasms heading available in MeSH. Incidence of melanoma of the eye. MELANOMA / * epidemiol EYE NEOPLASMS / * epidemiol INCIDENCE Incidence of choroidal melanoma. MELANOMA / * epidemiol CHOROID NEOPLASMS / * epidemiol INCIDENCE 24.2.2.3 If a pre-coordinated neoplasm term does not exist in MeSH for a specific part of an organ, index the Category A term for the organ part (IM), add the closest pre-coordinated organ-neoplasms heading available (also IM), and also add the histologic type term (IM). If the subheading needed for the neoplasm can logically be added to the organ part and if it is an AQ, use the subheading on the anatomical term; do not, however, force the use of a subheading when it does not apply. Surgery of the pons in pontine cavernomas. PONS / * surg BRAIN NEOPLASMS / * surg HEMANGIOMA, CAVERNOUS / * surg Prevalence of pontine cavernoma. * PONS BRAIN NEOPLASMS / * epidemiol HEMANGIOMA, CAVERNOUS / * epidemiol PREVALENCE In these examples, since no term exists in MeSH for "pontine neoplasms", PONS was indexed IM. Then the Trees were consulted and PONS was discovered to be indented under BRAIN; since BRAIN NEOPLASMS exists in MeSH, that term was added IM. The subheading /surg could logically be used on PONS and it was an AQ, but /epidemiol is not an AQ for PONS (nor would it have been logical). 24.2.2.3.1 There are a few anatomic site terms in MeSH which are annotated to be indexed NIM in coordination with the more general organ-neoplasms term, indexed IM. In these cases, the specialists in the MeSH Section have determined that the specific site is not as important medically as the more general organ. In such cases, the indexer should of course follow the instructions given in the annotation. Resection for adenocarcinoma of the cardia. CARDIA / surg STOMACH NEOPLASMS / * surg ADENOCARCINOMA / * surg 24.2.2.4 If a pre-coordinated organ-neoplasms heading does not exist for a specific organ, index the pre-coordinated organ-diseases heading (IM), and add the specific histologic type term (IM), or use NEOPLASMS (NIM) if no histologic type is given. Radiography of intra-articular osteoid osteoma. JOINT DISEASES / * radiogr OSTEOMA, OSTEOID / * radiogr Ultrasonography of joint neoplasms. JOINT DISEASES / * ultrasonogr NEOPLASMS / ultrasonogr 24.2.2.4.1 If no pre-coordinated organ-neoplasms or organ-diseases term exists for the anatomic part, and no organ-neoplasms term exists for a more general term as in 24.2.2.3, index the Category A term for the part (IM), add the histologic type (IM), and add the closest pre-coordinated organ-diseases term available, but make it NIM. Use a subheading on the Category A term if it is logical and an AQ. Surgery for synovioma of the hip joint. HIP JOINT / * surg SARCOMA, SYNOVIAL / * surg JOINT DISEASES / surg 24.2.2.5 Under NEOPLASMS BY HISTOLOGIC TYPE (NON MESH), MeSH has treed many terms which sound locational (examples include: NEOPLASMS, MUSCLE TISSUE; NEOPLASMS, VASCULAR TISSUE; NEOPLASMS, ADIPOSE TISSUE and NEOPLASMS, GONADAL TISSUE) . However, each of these terms is annotated that it is to be used only for a histologic type of tumor, not for a tumor located in the particular tissue. Some equivalent locational terms are available (MUSCLE NEOPLASMS, VASCULAR NEOPLASMS, etc.), but for some there is no locational equivalent (adipose, etc.). To index a neoplasm located in one of these tissues, the rules given in 24.2.2.4.+ should be followed. SOFT TISSUE NEOPLASMS (a locational term) should also be added. Pathology of a lipoma in the adipose tissue of the leg. LIPOMA / * pathol ADIPOSE TISSUE / * pathol LEG / * pathol SOFT TISSUE NEOPLASMS / * pathol 24.2.2.6 Occasionally an entry in the Tumor Key implies that the histologic heading listed covers the anatomic site as well. For example, "fibroma, uterine - LEIOMYOMA" might lead the indexer to believe that LEIOMYOMA is sufficient indexing for "uterine fibroma". However, LEIOMYOMA is treed only under NEOPLASMS BY HISTOLOGIC TYPE (NON MESH) and therefore the term UTERINE NEOPLASMS must be added to completely cover the concept. Many site-specific histologic type terms have been annotated to warn that an organ-neoplasms term is still needed as a coordinate, but it is the indexer's responsibility to add the site term when relevant even if there is no annotation. 24.2.3 As stated previously, each neoplasm must be indexed in two places: under the anatomic site as an organ-neoplasms pre-coordinate (IM) and under the histologic type from the Tumor Key (IM). Use the same subheading on both terms, except for the subheading /second (see 24.3.1). Surgery of theca cell tumors of the ovary. THECA CELL TUMOR / * surg OVARIAN NEOPLASMS / * surg 24.3 The subheadings allowed with terms in Category C4 are the same as those available for use with all other diseases, with some additions. Since a tumor can be viewed as a special type of tissue, several subheadings used with the tissue terms of Category A are also available for use with solid tumors (but not with leukemias or lymphomas, which are neoplasms of the blood and lymph). The list below shows all the subheadings allowed with terms in C4. /blood /econ /mortal /second /blood supply /embryol /nurs /secret /chem /enzymol /parasitol /surg /chem ind /epidemiol /pathol /ther /class /ethnol /physiopathol /us /compl /etiol /prev /ul /congen /genet /psychol /urine /csf /hist /radiogr /vet /diag /immunol /radionuclide /virol /diet ther /metab /radiother drug ther /microbiol /rehabil The following are allowed only with the solid tumors in Category C4: /blood supply, /chem, /second, /secret, /ultrastruct 24.3.1 The subheading /second is allowed only with the solid tumors in Category C4, to be used for articles on their metastasis ("the transfer of disease from one organ or part to another not directly connected with it"-- Dorland's Illustrated Medical Dictionary, 27th Edition). The subheading is used on the site to which the tumor metastasized (the secondary site), not the primary site. The subheading /second is also used on the histologic type, which must be the same at both sites. Use /pathol, not /compl, on the primary site (if that site needs to be indexed); there is no need to add /pathol to the histologic type as a coordinate for the primary neoplasm unless the pathology at that site is particularly discussed. See section 19.8.65 for more discussion of the subheading /second, and 24.4.1.3 for a discussion of the infrequently used term NEOPLASM METASTASIS. Liver metastases of breast adenocarcinoma. LIVER NEOPLASMS / * second BREAST NEOPLASMS / * pathol ADENOCARCINOMA / * second Not: ADENOCARCINOMA / (*) pathol unless the pathology of the breast tumor is discussed 24.3.2 Another subheading allowed with solid tumors is /ultrastruct. Since this subheading is usually related to the study of /pathol, assume that ultrastructural studies of neoplasms will be from a pathologic standpoint and do not use both /pathol and /ultrastruct on the same term unless macroscopic pathology is discussed as well as ultrastructural pathology. Ultrastructural pathology of renal cell carcinomas. CARCINOMA, RENAL CELL / * ultrastruct KIDNEY NEOPLASMS / * ultrastruct Not: /pathol on the terms. Histology and ultrastructure of small cell lung carcinoma. LUNG NEOPLASMS / * ultrastruct / * pathol CARCINOMA, SMALL CELL / * ultrastruct / * pathol 24.3.3 Another subheading allowed with solid tumors is /chem. Since the subheading /metab is also allowed with terms from Category C4, and these subheadings are quite similar, use the following guidelines when deciding which of the two to index. In general, if an article is about a one-time determination of compounds in tumor tissue, the subheading /chem will be applicable; it should be coordinated with /anal on the compound(s) analyzed. If, however, the author discusses how the tumor leads to changed levels of the compounds throughout the body, /metab will probably be better. See also sections 19.10.2 and 19.10.4. Myeloma proteins in myeloma tissue. MYELOMA PROTEINS / * anal MULTIPLE MYELOMA / * chem Elevated AFP levels in patients with embryonal carcinoma. AFP / * metab CARCINOMA, EMBRYONAL / * metab 24.4 Oncology literature can be very complex, requiring many indexing coordinations. The list below shows terms which should be considered when indexing articles on neoplasms. If a section number is present, it indicates where discussion of the term can be found in this chapter. TERMS TO CONSIDER WHEN INDEXING NEOPLASMS Term Section ANTIBODIES, NEOPLASM and ANTIGENS, NEOPLASM and indentions 24.4.4.1+ ANTINEOPLASTIC AGENTS and indentions 24.4.2.1+ ANTINEOPLASTIC AGENTS, COMBINED 24.4.2.1.1 BONE MARROW PURGING 24.4.2.4 CANCER CARE FACILITIES CARCINOGENS and CARCINOGENICITY TESTS 24.5.6.2+ CELL TRANSFORMATION, NEOPLASTIC 24.4.1.10+ CHEMOTHERAPY, ADJUVANT 24.4.2.2.1 COCARCINOGENESIS 24.4.1.14 COMBINED MODALITY THERAPY and indentions 24.4.2.2+ DNA, NEOPLASM and RNA, NEOPLASM 24.4.4.2 DRUG RESISTANCE, NEOPLASM DRUG SCREENING ASSAYS, ANTITUMOR and indentions 24.4.2.1.2 GENES, SUPPRESSOR, TUMOR and indentions 24.4.4.3 LEUKEMIC INFILTRATION 24.4.1.2 LYMPHATIC METASTASIS 24.4.1.4 LYMPHOCYTES, TUMOR-INFILTRATING MEDICAL ONCOLOGY NEOPLASM INVASIVENESS 24.4.1.1+ NEOPLASM METASTASIS 24.4.1.3+ NEOPLASM PROTEINS and indentions 24.4.4.4 NEOPLASM RECURRENCE, LOCAL 24.4.1.5 NEOPLASM REGRESSION, SPONTANEOUS 24.4.1.9 NEOPLASM, RESIDUAL 24.4.1.5.1 NEOPLASM SEEDING 24.4.1.11 NEOPLASM STAGING 24.4.1.12 NEOPLASM TRANSPLANTATION 24.5.4 NEOPLASMS, EXPERIMENTAL and indentions 24.5+ NEOPLASMS, HORMONE-DEPENDENT NEOPLASMS, MULTIPLE PRIMARY and indentions 24.4.1.6 NEOPLASMS, POST-TRAUMATIC 24.4.3.3 NEOPLASMS, RADIATION-INDUCED and LEUKEMIA, RADIATION-INDUCED 24.4.3.2+ NEOPLASMS, SECOND PRIMARY 24.4.1.7 NEOPLASMS, UNKNOWN PRIMARY 24.4.1.8 NEOPLASTIC SYNDROMES, HEREDITARY and indentions ONCOGENES and indentions 24.4.4.3 ONCOGENE PROTEINS and indentions ONCOGENIC VIRUSES ONCOLOGIC NURSING ONCOLOGY SERVICE, HOSPITAL PALLIATIVE TREATMENT 24.4.2.3 PARANEOPLASTIC SYNDROMES and indentions PERFUSION, REGIONAL 24.4.2.5+ PRECANCEROUS CONDITIONS and indentions 24.4.1.13 PREGNANCY COMPLICATIONS, NEOPLASTIC PROTO-ONCOGENE PROTEINS and indentions RADIOTHERAPY and indentions REMISSION INDUCTION 24.4.1.9 SALVAGE THERAPY 24.4.2.2.2 TUMOR CELLS, CULTURED and indentions 24.4.5+ TUMOR MARKERS, BIOLOGICAL and indentions 24.4.4.5 TUMOR NECROSIS FACTOR 24.4.1 Many of the terms used in the indexing of neoplasms relate to pathology. 24.4.1.1 NEOPLASM INVASIVENESS. The MeSH definition of this term is "the ability of neoplasms to infiltrate and actively destroy surrounding tissue." NEOPLASM INVASIVENESS is normally indexed NIM, in coordination with /*pathol on the specific neoplasm studied. Use /*pathol as well (not /*second) on any organ-neoplasms term indexed to cover the site of the invasion; since metastasis by definition must be "...to another (organ or part) not directly connected with it" (Dorland's Illustrated Medical Dictionary, 27th Edition), /second cannot apply when an organ is invaded by a neoplasm from an adjacent organ. Invasion of the bladder by an adenocarcinoma of the sigmoid. ADENOCARCINOMA / * pathol SIGMOID NEOPLASMS / * pathol BLADDER NEOPLASMS / * pathol NEOPLASM INVASIVENESS 24.4.1.1.1 NEOPLASM INVASIVENESS should be made IM only for general articles on neoplasm invasiveness, irrespective of any specific neoplasm. Macrophage colony-stimulating factor enhances neoplasm invasiveness. MACROPHAGE COLONY-STIMULATING FACTOR / * physiol NEOPLASM INVASIVENESS / * physiopathol 24.4.1.1.2 When the invasive nature of the neoplasm is inherent in the histologic type, it is not necessary to add NEOPLASM INVASIVENESS. For example, since the Tumor Key has an entry "fibroma, invasive - FIBROMATOSIS, AGGRESSIVE", index only FIBROMATOSIS, AGGRESSIVE and not also NEOPLASM INVASIVENESS for an article on "invasive fibroma." 24.4.1.1.3 The "growth" of a tumor may or may not be related to invasiveness. Tumor growth should also, however, be indexed as the /*pathol of the neoplasm (not /*physiopathol). Pathologists consider the size and extensiveness of a tumor to be part of its pathologic nature. Growth of hepatocellular carcinoma. CARCINOMA, HEPATOCELLULAR / * pathol LIVER NEOPLASMS / * pathol 24.4.1.2 LEUKEMIC INFILTRATION. The MeSH definition of this term is "a pathologic change in leukemia in which leukemic cells permeate various organs at any stage of the disease." LEUKEMIC INFILTRATION is annotated to be an IM coordinate for /*pathol on a specific type of leukemia. The organ infiltrated should also be indexed with the subheading /*pathol (do not use an organ- neoplasms term). Laryngeal infiltration in chronic myelomonocytic leukemia. LARYNX / * pathol LEUKEMIA, MYELOMONOCYTIC, CHRONIC / * pathol * LEUKEMIC INFILTRATION Not: LARYNGEAL NEOPLASMS / * pathol 24.4.1.3 NEOPLASM METASTASIS is rarely used, because the subheading /second is available (see 19.8.65 and 24.3.1). However, there are occasionally articles on metastasis where neither the site of the metastasis nor the histologic type is given. In such cases, NEOPLASM METASTASIS may be used (IM if the article is on metastasis in general, NIM as a coordinate with /*pathol on a specific primary site). Do not add NEOPLASM METASTASIS to any article when /second can be used on either an organ-neoplasms term or a histologic type. Relation between metastatic ability and H-ras oncogene expression. * GENES, RAS NEOPLASM METASTASIS / * genet GENE EXPRESSION GENE SYMBOL: H-ras Metastasis of breast neoplasms. (None of the sites listed is especially important in the article, and too many are given to be indexed.) BREAST NEOPLASMS / * pathol NEOPLASM METASTASIS But: Metastasis of ductal carcinomas of the breast. (Many sites, as in article above) BREAST NEOPLASMS / * pathol CARCINOMA, DUCTAL / * second Not: NEOPLASM METASTASIS 24.4.1.3.1 When an article states that a tumor is "metastatic", check whether it is metastatic from or to the site discussed, as the indexing differs. Metastatic brain tumors. (The article is about brain gliomas which metastasize to various sites.) BRAIN NEOPLASMS / * pathol GLIOMA / * second Metastatic brain tumors. (The article is about various tumors which metastasize to the brain.) BRAIN NEOPLASMS / * second 24.4.1.4 LYMPHATIC METASTASIS is used instead of a specific organ-neoplasms term with the subheading /second for the concept of lymphatic or nodal metastasis. However, it is annotated to be NIM. Use the subheading /second on the specific histologic type term. Prediction of response to chemotherapy in lymph node positive breast papillary adenocarcinoma. BREAST NEOPLASMS / * drug ther / pathol ADENOCARCINOMA, PAPILLARY / * drug ther / second LYMPHATIC METASTASIS 24.4.1.5 NEOPLASM RECURRENCE, LOCAL is used to index the return of a neoplasm of the same histologic type to approximately the same site after some supposedly curative treatment. (If a different histologic type, use the term NEOPLASMS, SECOND PRIMARY; see 24.4.1.7.) The operative word in this term is LOCAL. Not all articles on neoplastic "recurrence" should be indexed as NEOPLASM RECURRENCE, LOCAL; authors often speak of metastasis as a "recurrence", so the text must be checked carefully. Reappearance of basal cell carcinoma on the face three years after Mohs surgery for basal cell carcinoma of the nose. NOSE NEOPLASMS / * surg * MOHS SURGERY CARCINOMA, BASAL CELL / * surg * FACIAL NEOPLASMS * NEOPLASM RECURRENCE, LOCAL 24.4.1.5.1 NEOPLASM RECURRENCE, LOCAL (the return of a tumor) is different from NEOPLASM, RESIDUAL (tumor remaining after therapy). NEOPLASM, RESIDUAL is indexed as an NIM coordinate with no subheading. 24.4.1.6 NEOPLASMS, MULTIPLE PRIMARY is used to index the simultaneous occurrence of two or more neoplasms. Do not add /compl to each of the neoplasms, since the "multiple" term shows that they coexist. A case of papillary carcinoma of the thyroid associated with parathyroid adenoma. * NEOPLASMS, MULTIPLE PRIMARY * THYROID NEOPLASMS * PARATHYROID NEOPLASMS * CARCINOMA, PAPILLARY * ADENOMA Although multiple primary neoplasms are usually different histologically, occasionally authors state that two or more histologically identical tumors are multiple primary neoplasms, rather than being metastases. In such cases, it is correct to index the term NEOPLASMS, MULTIPLE PRIMARY. 24.4.1.7 NEOPLASMS, SECOND PRIMARY is used to index a neoplasm which arises after another and is not a metastasis or recurrence of it. Although the concept is not restricted to treatment-induced neoplasms, many are related to the treatment of the initial neoplasm, so the terms NEOPLASMS, THERAPY-RELATED and NEOPLASMS, TREATMENT-RELATED are available as X-references. If the second neoplasm is caused by prior radiation therapy, add NEOPLASMS, RADIATION-INDUCED or LEUKEMIA, RADIATION-INDUCED; see 24.4.3.2. Angiosarcoma after radiation therapy for carcinoma of the breast. NEOPLASMS, SECOND PRIMARY / * etiol NEOPLASMS, RADIATION-INDUCED / * etiol ANGIOSARCOMA / * etiol BREAST NEOPLASMS / * radiother RADIOTHERAPY / adv eff 24.4.1.8 NEOPLASMS, UNKNOWN PRIMARY is used to index articles on neoplasms which, by their histology, can be determined to be metastases, but whose primary site is unknown. Index this term IM, coordinating it with /*second on both the organ-neoplasms and histologic type terms. Unknown primary squamous cell carcinoma of the head and neck; is irradiation necessary? HEAD AND NECK NEOPLASMS / * radiother / * second NEOPLASMS, UNKNOWN PRIMARY / * radiother CARCINOMA, SQUAMOUS CELL / * radiother / * second 24.4.1.9 NEOPLASM REGRESSION, SPONTANEOUS. The key word in this term is SPONTANEOUS; it is not to be used for neoplasm regression induced by treatment, which should probably be indexed as REMISSION INDUCTION. If the process of spontaneous regression is discussed, the subheading on the neoplasm will probably be /physiopathol. However, articles sometimes merely discuss the disappearance of the neoplasm on x-rays, etc., and in those cases the appropriate diagnostic imaging subheading may be all that is necessary. 24.4.1.10 CELL TRANSFORMATION, NEOPLASTIC is used to index the transformation of a normal cell into a neoplastic cell, or the transformation of a neoplastic but benign cell into one of more malignancy. If the latter, the subheading on the two histologic types will be /pathol; do not use /compl or /etiol. The subheadings allowed on CELL TRANSFORMATION, NEOPLASTIC are restricted: only /chem, /chem ind, /class, /drug eff, /genet, /immunol, /metab, /pathol, /rad eff, /secret, and /ultrastruct. Since both /chem ind and /drug eff are allowed with CELL TRANSFORMATION, NEOPLASTIC, use the following guidelines when deciding which of the two to index. 24.4.1.10.1 CELL TRANSFORMATION, NEOPLASTIC/chem ind is used to index an article about a drug inducing neoplastic transformation. Rat studies on neoplastic transformation caused by 2-acetylaminofluorene. CELL TRANSFORMATION, NEOPLASTIC / * chem ind 2-ACETYLAMINOFLUORENE / * tox CARCINOGENS / * tox RATS (check tag) ANIMAL (check tag) 24.4.1.10.2 CELL TRANSFORMATION, NEOPLASTIC/drug eff is used to index an article about the effects of a drug on neoplastic cells after the transformation has already been effected. Change of transformed cells back to normal morphology by antineoplastic antibiotics. CELL TRANSFORMATION, NEOPLASTIC / * drug eff ANTIBIOTICS, ANTINEOPLASTIC / * pharmacol 24.4.1.11 NEOPLASM SEEDING is used to index the spread of a neoplasm by a procedure performed on the patient (such as surgical treatment, palpation or biopsy) in which neoplastic cells escape and implant themselves elsewhere. The subheading /second may be used on the histologic type and on the resulting organ-neoplasm precoordinate. A case of hepatocellular carcinoma implanted at the chest wall by needle biopsy. HEPATOMA / * second THORACIC NEOPLASMS / * second * NEOPLASM SEEDING BIOPSY, NEEDLE / * adv eff LIVER NEOPLASMS / * pathol 24.4.1.12 NEOPLASM STAGING is used to index a determination of the extensiveness of a neoplasm. NEOPLASM STAGING should be indexed NIM in coordination with /*pathol on the specific neoplasm. Survival of breast cancer patients; stage at diagnosis an important determinant. BREAST NEOPLASMS / * mortal / * pathol NEOPLASM STAGING SURVIVAL RATE Do not index staging as the /*class of the neoplasm. It is possible to classify tumors many ways (by cell type, by tissue of origin, by site, by nomenclature, etc.); staging, however, refers to the degree of spread of the tumor, which is considered a pathologic concept. Do not use NEOPLASM STAGING for the "grading" of a neoplasm, which refers to its degree of malignancy rather than its extensiveness. There is no MeSH term for "grading", but it is usually indexed adequately by applying /*pathol to the neoplasm term. 24.4.1.12.1 NEOPLASM STAGING should be made IM only for general articles on the concept of staging, irrespective of any specific neoplasm. The role of computer tomography in neoplasm staging. * CT XRAY NEOPLASM STAGING / * methods 24.4.1.13 PRECANCEROUS CONDITIONS are diseases such as CERVIX DYSPLASIA and LEUKOPLAKIA which, although not cancerous themselves, are likely to develop into neoplasms. If a disease is discussed as being "precancerous", "likely to become neoplastic", etc., index the disease and, if it is not treed under PRECANCEROUS CONDITIONS, add that term. Do not use /compl for the change into cancer; the most likely subheading will be /pathol. Does Barrett esophagus lead to cancer? BARRETT ESOPHAGUS / * pathol PRECANCEROUS CONDITIONS / * pathol ESOPHAGEAL NEOPLASMS / * pathol 24.4.1.14 COCARCINOGENESIS. The MeSH definition of this term is "The combination of two or more different factors in the production of cancer." COCARCINOGENESIS should be added as an IM concept (with no subheading) whenever an article discusses the fact that a neoplasm was caused by a combination of factors. Does alcohol drinking enhance the initiation of hepatocellular carcinomas caused by occupational exposure to solvents? ALCOHOL DRINKING / * adv eff SOLVENTS / * adv eff * COCARCINOGENESIS CARCINOMA, HEPATOCELLULAR / * etiol LIVER NEOPLASMS / * etiol OCCUPATIONAL EXPOSURE / * adv eff 24.4.2 This section addresses MeSH terms related to the treatment of neoplasms. 24.4.2.1 ANTINEOPLASTIC AGENTS and indentions. The extensive listing of antineoplastic drugs is subdivided into several classes in MeSH. Before indexing the general term ANTINEOPLASTIC AGENTS for a review article or as a PA, consider whether any of the following specific groupings would be more applicable to the article: ANTIBIOTICS, ANTINEOPLASTIC ANTICARCINOGENIC AGENTS (for prevention rather than treatment) ANTIMETABOLITES, ANTINEOPLASTIC ANTINEOPLASTIC AGENTS, ALKYLATING ANTINEOPLASTIC AGENTS, HORMONAL ANTINEOPLASTIC AGENTS, PHYTOGENIC (from plants) 24.4.2.1.1 ANTINEOPLASTIC AGENTS, COMBINED. These "chemotherapy protocols" are discussed further in section 25.5.6.8. If a chemotherapy protocol is not given a name or acronym in the article, index ANTINEOPLASTIC AGENTS, COMBINED with the subheading /*ther use (assuming it is the main point of the article) and add the specific drugs NIM, each with the subheading /admin. If a chemotherapy protocol is given a name or acronym in the article, index ANTINEOPLASTIC AGENTS, COMBINED / * ther use. Then check the Chemical Tool for the protocol and index it if it is there, NIM with /admin. (Be sure to verify that the term in the Chemical Tool refers to the correct protocol, because different protocols are given the same name by different researchers.) If the protocol to be indexed is not in the Chemical Tool, or if the one in the Chemical Tool has the same acronym but is comprised of different drugs, flag the new protocol discussed in the article, indicating its subheading to be /admin (NIM); index ANTINEOPLASTIC AGENTS, COMBINED / * ther use as well, and write that term in the PA field on the flag. 24.4.2.1.2 DRUG SCREENING ASSAYS, ANTITUMOR and its indentions are indexed for articles in which the antineoplastic effects of drugs are studied in vitro or in animals. Screening for antineoplastic effects of ajmalicine in mice. ajmalicine / * pharmacol ANTINEOPLASTIC AGENTS / * pharmacol DRUG SCREENING ASSAYS, ANTITUMOR MICE (check tag) ANIMAL (check tag) Cross-resistance of cultured brain glioma cells to methotrexate and fluorouracil. BRAIN NEOPLASMS / * drug ther GLIOMA / * drug ther FLUOROURACIL / * pharmacol ANTIMETABOLITES, ANTINEOPLASTIC / * pharmacol METHOTREXATE / * pharmacol DRUG RESISTANCE, NEOPLASM * DRUG RESISTANCE, MULTIPLE DRUG SCREENING ASSAYS, ANTITUMOR TUMOR CELLS, CULTURED / drug eff 24.4.2.2 COMBINED MODALITY THERAPY and its indentions. More than one type of treatment is frequently used in oncology. In such cases, index this term NIM. COMBINED MODALITY THERAPY should never be an IM concept in reference to a specific disease with which some therapeutic subheading is used IM. Whether or not to index the subheadings for the specific types of therapy, and which subheading to make IM, will depend on the emphasis of the article. Can radiotherapy improve the effects of surgery in lung cancer? LUNG NEOPLASMS / * radiother / surg COMBINED MODALITY THERAPY Radiotherapy and surgery of lung cancer. LUNG NEOPLASMS / * ther / radiother / surg COMBINED MODALITY THERAPY Surgery of lung cancer. (Radiotherapy and chemotherapy are also given to various patients, but are mentioned only in passing.) LUNG NEOPLASMS / * surg COMBINED MODALITY THERAPY 24.4.2.2.1 CHEMOTHERAPY, ADJUVANT and RADIOTHERAPY, ADJUVANT are specific type of COMBINED MODALITY THERAPY and are indexed NIM in the same manner. Use these terms only if the author uses the term "adjuvant", indicating enhanced activity (see next page); if radiotherapy or a chemotherapeutic agent is used in conjunction with another therapy but the author does not say it is "adjuvant", use COMBINED MODALITY THERAPY. Adjuvant chemotherapy of lung cancer. LUNG NEOPLASMS / * drug ther CHEMOTHERAPY, ADJUVANT Adjuvant radiotherapy after surgery for lung cancer. LUNG NEOPLASMS / * radiother / surg RADIOTHERAPY, ADJUVANT Surgery of lung cancer. (Article has a long section on the benefits of adjuvant radiotherapy.) LUNG NEOPLASMS / * surg / radiother RADIOTHERAPY, ADJUVANT Do not confuse CHEMOTHERAPY, ADJUVANT with either ADJUVANTS, IMMUNOLOGIC or ADJUVANTS, PHARMACEUTIC. The word "adjuvant" means "serving to help or assist..." (Random House Dictionary of the English Language, Second Edition). Adjuvant chemotherapy is drug therapy that enhances other treatments. Immunologic adjuvants are substances that potentiate an immune response. Pharmaceutic adjuvants are compounds added to the formulation of a drug that enhance its bioavailability (for instance, by increasing the dissolution of a tablet, allowing the drug to be absorbed more quickly). 24.4.2.2.2 SALVAGE THERAPY is undertaken in an attempt to save the patient after conventional treatments have failed. SALVAGE THERAPY is usually an IM concept. It is treed under COMBINED MODALITY THERAPY, but SALVAGE THERAPY does not have to involve more than one type of treatment; if the author discusses a single treatment as "salvage therapy", the term should be indexed. Primary childhood osteosarcoma; the role of salvage surgery. OSTEOSARCOMA / * surg * SALVAGE THERAPY CHILD (check tag) 24.4.2.3 PALLIATIVE TREATMENT is used to index articles on relief of pain without cure of its underlying cause. PALLIATIVE TREATMENT is usually an IM concept, and should be coordinated with the specific therapeutic subheading for the type of treatment used, even though the therapy is not intended to cure the disease. Palliative treatment of rectal cancer using the Nd-YAG laser. PALLIATIVE TREATMENT / * methods LASER SURGERY / * methods RECTAL NEOPLASMS / * surg 24.4.2.4 BONE MARROW PURGING. The MeSH definition of this term is "Techniques for the removal of subpopulations of cells (usually tumor cells) from bone marrow ex vivo before it is infused." BONE MARROW PURGING is usually an IM concept, and if the purging agent or method is especially discussed, it should also be indexed IM (with no subheading). Since BONE MARROW PURGING is defined as a method used to prepare bone marrow for transplantation, it is not always necessary to index BONE MARROW TRANSPLANTATION as well if the transplantation procedure itself is not especially discussed. 24.4.2.5 PERFUSION, REGIONAL. The MeSH definition of this term is "Neoplasm drug therapy involving an extracorporeal circuit with temporary exclusion of the tumor-bearing area from the general circulation during which high concentrations of the drug are perfused to the isolated part." Since most antineoplastic agents are extremely toxic, it can be dangerous to administer them in high concentrations, but sometimes a high dose is needed to treat a resistant tumor. If the blood supply to such a tumor can be isolated from the general circulation, the anticancer drug can be administered directly to the tumor without circulating throughout the body; thus, higher doses of the drug can be given without endangering the patient. Although most drug administration routes are indexed NIM when the specific drug is made IM, regional perfusion is so invasive that it will probably be an IM concept even when the specific drug is also made IM. Isolated lung perfusion with FUDR is an effective treatment for colorectal adenocarcinoma lung metastases. FUDR / * admin / ther use ANTIMETABOLITES, ANTINEOPLASTIC / * admin / ther use * PERFUSION, REGIONAL LUNG NEOPLASMS / *drug ther / second ADENOCARCINOMA / * drug ther / second COLORECTAL NEOPLASMS / * pathol 24.4.2.5.1 Sometimes isolation perfusion is used in conjunction with hyperthermia; in such cases, index both PERFUSION, REGIONAL and HYPERTHERMIA, INDUCED. If the hyperthermia is discussed as being a form of treatment, both HYPERTHERMIA, INDUCED and PERFUSION, REGIONAL should be made IM, the subheading on the neoplasm should be /*ther, and the term COMBINED MODALITY THERAPY should be added (NIM). If, however, it is stated that the hyperthermia is being used merely to improve the effectiveness of the drug, then the subheading on the neoplasm should be /*drug ther. PERFUSION, REGIONAL / * methods should be indexed and the term HYPERTHERMIA, INDUCED should be made NIM. The term COMBINED MODALITY THERAPY should not be indexed. 24.4.3 This section addresses MeSH terms and indexing policies related to the etiology of neoplasms. 24.4.3.1 Neoplasms resulting from accidental or environmental exposure to a chemical, or from the adverse effects of a drug used therapeutically, are indexed using the type of neoplasm with the subheading /chem ind, and the drug or chemical with the subheading /adv eff (unless it was from a massive dose, in which case the subheading /pois is more appropriate). Do not use /tox, because this is not experimental induction (see 24.5.6.2). Incidence of skin cancer in vinyl chloride workers. VINYL CHLORIDE / * adv eff SKIN NEOPLASMS / * chem ind / epidemiol OCCUPATIONAL DISEASES / * chem ind / epidemiol INCIDENCE HUMAN (check tag) 24.4.3.2 NEOPLASMS, RADIATION-INDUCED is used for all radiation-induced tumors whether caused by radiodiagnosis, radiotherapy, experimental induction, or accidental exposure (e.g., fallout from the atomic bomb, or occupational exposure in nuclear power plants). NEOPLASMS, RADIATION-INDUCED can be used for animal or human studies. Index NEOPLASMS, RADIATION-INDUCED (IM) as well as the specific organ-neoplasm and histologic type terms, also IM. If the type of radiation is important, index it with the subheading /adv eff; make it IM or NIM by the rules given in section 19.8.60. Incidence of radon-associated lung cancer in uranium miners. RADON / * adv eff LUNG NEOPLASMS / * etiol / epidemiol NEOPLASMS, RADIATION-INDUCED / * epidemiol OCCUPATIONAL DISEASES / * etiol / epidemiol * URANIUM * MINING INCIDENCE Index radiation-induced leukemia using LEUKEMIA, RADIATION-INDUCED, the specific type of leukemia, and the type of radiation as above. See section 24.4.1.7 for a discussion of NEOPLASMS, SECOND PRIMARY resulting from radiation treatment of cancer. 24.4.3.2.1 If radiation is used experimentally in the deliberate induction of a tumor for study, index NEOPLASMS, RADIATION-INDUCED as an NIM concept and do not use the subheading /adv eff on the type of radiation. As with studies on chemically-induced tumors, the technique may not be important in the article and the radiation aspect may not have to be indexed at all (see 24.5.6.1.) 24.4.3.3 NEOPLASMS, POST-TRAUMATIC is indexed for articles on neoplasms resulting from physical wounds and other non-radiation injuries. NEOPLASMS, POST-TRAUMATIC should be indexed IM for articles on post-traumatic neoplasms in humans, but should be made NIM for articles on studies in experimental animals unless discussed as a model of trauma-induced tumors in humans. (As with experimental chemically- or radiation-induced tumors, the technique may not be important in the article and may not have to be indexed at all.) 24.4.4 This section addresses terms related to the chemistry, immunology, and genetics of neoplasms. 24.4.4.1 ANTIBODIES, NEOPLASM and ANTIGENS, NEOPLASM. Neoplasm antigens are compounds on the surface of tumor cells which lead to the formation of antibodies. Articles on such antigens and/or antibodies should be indexed as the /immunol of the neoplasm, coordinated with the compound and the appropriate antigen or antibody term (unless the term for the compound is an indention). CA-125 antigen levels in the sera of patients with gastrointestinal malignancies. CA-125 ANTIGEN / * blood GASTROINTESTINAL NEOPLASMS / * immunol Not: ANTIGENS, NEOPLASM / * blood because CA-125 ANTIGEN is indented under it. Blood levels of myelomonocytic antigen L1 in patients with various types of acute leukemia. myelomonocytic antigen L1 / * blood ANTIGENS, NEOPLASM / * blood LEUKEMIA / * immunol ACUTE DISEASE 24.4.4.1.1 Sometimes the title of an article states that an "antigen" is being assayed, but the introduction gives no indication that the author cares about the immunology of the neoplasm. Immunochemical and immunohistochemical assays involve the use of an antibody to the compound being measured, which means that the compound assayed can be called an "antigen"; however, the immune reactions of the chemical studied may not really be relevant to the article. In such a case, it is more appropriate to index the article as the /chem of the neoplasm than as its /immunol; also, the term ANTIGENS, NEOPLASM should not be added. Immunofluorescence demonstration of melanoma-associated antigen in melanoma tissue. (No discussion of antigenic activity or other immunology) melanoma-associated antigen / * anal MELANOMA / * chem IMMUNOFLUORESCENCE TECHNIQUE 24.4.4.2 DNA, NEOPLASM and RNA, NEOPLASM are genetic concepts, so the correct coordinate on the neoplasm is probably /genet (although if the article is primarily concerned with the expression of a gene, /metab may be more important). If any specific type of DNA or RNA is important, it should be added as a coordinate. Blood levels of DNA and poly(A) mRNA in small lymphocytic lymphoma. DNA, NEOPLASM / * blood RNA, NEOPLASM / * blood POLY(A)-MRNA / * blood LYMPHOMA, SMALL LYMPHOCYTIC / * genet 24.4.4.3 GENES, SUPPRESSOR, TUMOR and ONCOGENES (and indentions of both). These terms are also related to the /genet of neoplasms. In MeSH, there are many specific indentions under both terms. Remember to add the Gene Symbol even if a MeSH term exists for the gene. Studies on the RB gene in patients with familial retinoblastoma. * GENES, RB RETINOBLASTOMA / * genet EYE NEOPLASMS / * genet HUMAN (check tag) GENE SYMBOL: RB 24.4.4.4 NEOPLASM PROTEINS and indentions. Add the term NEOPLASM PROTEINS as a coordinate when indexing any specific tumor protein not indented under it in MeSH, or when indexing a tumor protein from the Chemical Tool for which the (HM) is not NEOPLASM PROTEINS. (Consider also the many ONCOGENE PROTEINS and PROTO- ONCOGENE PROTEINS available in MeSH and the Chemical Tool.) The subheading to use on the neoplasm term varies with the article; /metab, /chem, and /genet are the most likely possibilities. Increased levels of mucins resulting from oversynthesis in colorectal adenocarcinoma. MUCINS / * biosyn NEOPLASM PROTEINS / * biosyn COLORECTAL NEOPLASMS / * metab ADENOCARCINOMA / * metab Many specific neoplasm proteins exist in the Chemical Tool, but remember that a new one should not be flagged unless the indexer has proof that its molecular weight has been determined; see section 25.5.6.1. Expression of the genes for oncoprotein 18 and oncoprotein 19 as shown by immunoperoxidase demonstration of their levels in adenocarcinomas of the stomach. oncoprotein 18 / * anal / genet NEOPLASM PROTEINS / * anal / genet ADENOCARCINOMA / * chem / genet STOMACH NEOPLASMS / * chem / genet IMMUNOPEROXIDASE TECHNIQUES GENE EXPRESSION Do not flag oncoprotein 19 unless the article states that its molecular weight has been determined; NEOPLASM PROTEINS covers it if not. 24.4.4.5 TUMOR MARKERS, BIOLOGICAL and indentions. These are endogenous compounds which are defined in MeSH as "metabolized and secreted by neoplastic tissue and characterized biochemically in cells or body fluids. They are indicators of tumor stage and grade as well as useful for monitoring responses to treatment and predicting recurrence..." Tumor markers are also used for screening purposes. Add the term TUMOR MARKERS, BIOLOGICAL as a coordinate for the specific compound being determined (if it is not an indention). Circulating cell adhesion molecules as a prognostic marker in cutaneous melanoma. CELL ADHESION MOLECULES / * blood TUMOR MARKERS, BIOLOGICAL / * blood SKIN NEOPLASMS / * blood MELANOMA / * blood PROGNOSIS Serum prostate-specific antigen measurements during radiotherapy of prostatic cancer. PROSTATE-SPECIFIC ANTIGEN / * blood PROSTATIC NEOPLASMS / * blood / * radiother Not: TUMOR MARKERS, BIOLOGICAL / * blood because PROSTATE-SPECIFIC ANTIGEN is indented under it. The subheading on the neoplasm may be /diag or /prev rather than /blood, /urine, etc. Do not, however, use /diag use on TUMOR MARKERS, BIOLOGICAL or on the compound being determined, because /diag use is restricted to exogenous compounds; see section 19.8.23. Diagnostic value of colon-specific antigen levels in the neoplastic tissue in colonic adenocarcinoma. colon-specific antigen / * anal COLONIC NEOPLASMS / * diag ADENOCARCINOMA / * diag TUMOR MARKERS, BIOLOGICAL / * anal Not: /diag use on the antigen or marker terms 24.4.5 Many preclinical articles involve the use of TUMOR CELLS, CULTURED or one of its indentions. There are two types of studies which use TUMOR CELLS, CULTURED: those in which the cells are viewed as neoplastic cells, and those in which the cells are viewed as models of non-neoplastic cells. The indexing varies for the various uses, each of which is discussed below. 24.4.5.1 If the specific neoplasm is important, but the cultured cells are merely used as a research technique, the term TUMOR CELLS, CULTURED should be indexed NIM with no qualifier, while the appropriate subheading(s) should be used on the neoplasm term. Complete amino acid sequence of collagen in a mouse fibrosarcoma cell line. NEOPLASM PROTEINS / * chem COLLAGEN / * chem FIBROSARCOMA / * chem AMINO ACID SEQUENCE MOLECULAR SEQUENCE DATA CELL LINE, TUMOR MICE (check tag) ANIMAL (check tag) 24.4.5.2 There are times when, as above, the specific neoplasm is important and the cultured cells are used merely as a research technique, but the appropriate subheading is not an AQ for the neoplasm term while it is an AQ for TUMOR CELLS, CULTURED. In such cases, the subheading desired may be used on TUMOR CELLS, CULTURED but the term should still be NIM. The subheading to use on the IM neoplasm term will depend on the article. Radiation effects on cultured gastric leiomyoma cells. (The author discusses how there has been disagreement on the effectiveness of radiotherapy in leiomyomas.) LEIOMYOMA / * radiother STOMACH NEOPLASMS / * radiother TUMOR CELLS, CULTURED / rad eff 24.4.5.3 When the tumor cells are used as a model of a non-neoplastic cell or a physiologic process in a cell, TUMOR CELLS, CULTURED should be indexed NIM with no subheading, as should the specific neoplasm. (The neoplasm term may not be needed at all; it should be indexed only if in the title or especially discussed). The IM term should be the specific cell type or physiologic process of which the tumor cells are models. Calcium channels in mouse neuroblastoma cells. (In the introduction, the author states that these cells are model neurons.) NEURONS / * physiol CALCIUM CHANNELS / * physiol TUMOR CELLS, CULTURED NEUROBLASTOMA MICE (check tag) ANIMAL (check tag) Cell differentiation in Friend erythroleukemia cells. (The author states that these are good cells for studying cell differentiation, but does not discuss their neoplastic nature.) CELL DIFFERENTIATION / * physiol TUMOR CELLS, CULTURED FRIEND VIRUS LEUKEMIA, ERYTHROBLASTIC, ACUTE 24.4.5.3.1 When the cell name is in the title, but the name does not convey the nature of the parent tumor and the article discusses the cells only as models, do not add the type of tumor even if it can be discerned from the article. The alpha/beta receptor on Jurkat cells. (The author states that this is a human T-cell leukemia cell line being used as a model T-cell.) T-LYMPHOCYTES / * immunol RECEPTORS, ANTIGEN, T-CELL, ALPHA-BETA / * anal TUMOR CELLS, CULTURED HUMAN (check tag) Not: LEUKEMIA, T-CELL 24.4.5.4 Occasionally, the tumor cells themselves are the main point of the article, usually when a new cell line is presented or culture techniques are discussed. In such cases, TUMOR CELLS, CULTURED should be made IM. The neoplasm will probably also be an IM concept; since the cells are the main point, the correct subheading on the neoplasm will probably be /*pathol. Development of a new line of hemangioendothelioma cells exhibiting altered cell division. CELL LINE, TUMOR / * cytol HEMANGIOENDOTHELIOMA / * pathol CELL DIVISION 24.5 Index unspecified experimental neoplasms or general articles on experimental neoplasms using the term NEOPLASMS, EXPERIMENTAL (IM). Check the tag ANIMAL and add the specific animal if given. Use any applicable subheading. Effect of protamines on protein biosynthesis in experimental tumors in mice. PROTAMINES / * pharmacol NEOPLASM PROTEINS / * drug eff / biosyn NEOPLASMS, EXPERIMENTAL / * metab MICE (check tag) ANIMAL (check tag) 24.5.1 There are many specific types of experimental tumors indented under NEOPLASMS, EXPERIMENTAL in MeSH; always prefer a specific indention if available. Formation of antibodies in rats with experimental Yoshida sarcoma. SARCOMA, YOSHIDA / * immunol ANTIBODIES, NEOPLASM / * biosyn RATS (check tag) ANIMAL (check tag) 24.5.2 Index an experimental neoplasm of an organ using the pre- coordinated organ-neoplasms term only; do not add NEOPLASMS, EXPERIMENTAL (IM or NIM). The animal check tags plus the lack of the subheading /vet will identify the article as being about an experimental neoplasm. 24.5.3 Similarly, index an experimental neoplasm of a particular histologic type using the term for that histologic type only; do not add NEOPLASMS, EXPERIMENTAL (IM or NIM). Many articles on experimental neoplasms are primarily about the histologic type. The article may state that the tumor was transplanted onto the back, thigh, or leg of the experimental animal, but that does not mean that the site is of particular importance; the site is often chosen for convenience. It is not necessary to index a term for the site unless the site or organ is discussed as relevant in the article. Immunology of Walker carcinoma 256 implanted into the thigh of rats. CARCINOMA 256, WALKER / * immunol RATS (check tag) ANIMAL (check tag) NEOPLASM TRANSPLANTATION Not: SOFT TISSUE NEOPLASMS / * immunol Not: THIGH or HINDLIMB But: Effect of nephrectomy in experimental nephroblastoma. * NEPHRECTOMY NEPHROBLASTOMA / * surg KIDNEY NEOPLASMS / * surg ANIMAL (check tag) 24.5.4 Index transplanted tumors using the heading NEOPLASM TRANSPLANTATION. In most articles the transplantation is incidental to the study and just a convenient research method, so NEOPLASM TRANSPLANTATION is usually NIM and may not need to be indexed at all. Do not routinely add the specific type of transplantation (even TRANSPLANTATION, HETEROLOGOUS, which is usually an IM concept); index the type only when it is especially discussed. Growth of transplanted mesotheliomas in mice. (The tumors were from humans.) MESOTHELIOMA / * pathol NEOPLASM TRANSPLANTATION MICE (check tag) ANIMAL (check tag) HUMAN (check tag) Not: TRANSPLANTATION, HETEROLOGOUS 24.5.5 Often animals are bred for the "spontaneous" development of tumors. Distinguish carefully between an experimental tumor in such strains and truly spontaneous neoplasms. If the article shows that the "spontaneous" tumors occurred in animals bred to develop them and were used for research purposes, index the tumors like other experimental neoplasms, not like veterinary tumors. If, however, the tumors were truly spontaneous, index them as veterinary neoplasms (see 24.6+). 24.5.6 Studies on the chemical induction of neoplasms may be divided into two groups: Induction of a neoplasm by the adverse effects of a drug or chemical used therapeutically, or from accidental or occupational exposure, is discussed in section 24.4.3.1. Deliberate induction of a neoplasm by a drug or chemical is discussed in this section; index the chemical, and add the type of neoplasm with the subheading /chem ind. 24.5.6.1 If a chemical is used because it is known to cause a particular type of neoplasm and the researcher wants to study some aspect of that tumor (the most frequent occurrence), index the aspect studied as the IM subheading on the neoplasm. In these cases, /chem ind on the tumor will be NIM and no subheading should be used on the chemical. It is possible that the chemical induction is merely mentioned as a research technique and should not be indexed at all. See also 25.11.2. Immunological cytotoxicity in methylnitrosourea-induced mammary tumors in animals. MAMMARY NEOPLASMS, EXPERIMENTAL / * immunol / chem ind METHYLNITROSOUREA CARCINOGENS * CYTOTOXICITY, IMMUNOLOGIC ANIMAL (check tag) Secretion of gonadotropins in experimental pituitary tumors. (In the Materials and Methods section, it mentions that the tumors were induced by diethylstilbestrol.) PITUITARY NEOPLASMS / * secret GONADOTROPINS, PITUITARY / * secret Not: PITUITARY NEOPLASMS / chem ind Not: DIETHYLSTILBESTROL 24.5.6.2 If a chemical is studied to determine whether it has the ability to induce neoplasms, it should be indexed with the subheading /*tox. 24.5.6.2.1 For a study of the general ability of the compound to cause tumors (i.e., to determine whether the chemical is carcinogenic), CARCINOGENS / * tox should also be indexed. The method of study, if discussed, is indexed as CARCINOGENICITY TESTS. Rat studies on tumor initiation by triethanolamine triethanolamine / * tox CARCINOGENS / * tox CARCINOGENICITY TESTS RATS (check tag) ANIMAL (check tag) 24.5.6.2.2 If, however, the study is on the ability of the chemical to cause a specific neoplasm, then only that aspect needs to be indexed. Again, the method, if discussed, is indexed as CARCINOGENICITY TESTS. Studies on brain tumor induction by nitrosourea compounds in guinea pigs. BRAIN NEOPLASMS / * chem ind NITROSOUREA COMPOUNDS / * tox CARCINOGENICITY TESTS GUINEA PIGS (check tag) ANIMAL (check tag) Not: CARCINOGENS / * tox 24.5.6.2.3 The term CARCINOGENS is used primarily in the indexing of animal toxicology studies such as the one in 24.5.6.2.1 above, where researchers try to determine whether a compound is carcinogenic. For studies of neoplasms in humans resulting from drug or chemical exposure, it is far more likely that the correct indexing will be the specific neoplasm with the subheading /chem ind, paired with /adv eff on the chemical, rather than the term CARCINOGENS; see 24.4.3.1. 24.6 The indexing for neoplasms in veterinary animals (as opposed to laboratory animals) is like the indexing for all other veterinary diseases; see sections 19.8.81 and 23.33+. Since most neoplasms in mammals have their histologic counterparts in humans, the correct histologic headings for veterinary tumors can be found in the Tumor Key used for indexing human neoplasms. 24.6.1 Index a neoplasm in a veterinary animal using: the histologic type of neoplasm with the subheading /*vet, the organ-neoplasms term with the subheading /*vet, and the animal-diseases term (*CAT DISEASES, *CATTLE DISEASES, etc.). In addition, the MeSH term for the animal must be added (either as a check tag or as a main heading indexed NIM) and the check tag ANIMAL must be checked. If a subheading is used on the animal-diseases term, it should be added NIM to the organ-neoplasms and histologic type terms. Castration for a Leydig cell tumor of the testis in a pet poodle. LEYDIG CELL TUMOR / * vet / surg TESTICULAR NEOPLASMS / * vet / surg DOG DISEASES / * surg CASTRATION, MALE / * vet DOGS (check tag) ANIMAL (check tag) MALE (check tag) CASE REPT (check tag) 24.6.2 If there is no pre-coordinated organ-neoplasms term in MeSH for the animal organ, index the animal organ IM. Add the histologic type term with the subheading /*vet, or use NEOPLASMS / vet (NIM) if no histologic type is given. Add the animal-diseases term (IM), the MeSH term for the animal (either as a check tag or as a main heading indexed NIM), and check the tag ANIMAL. Malignant melanoma of the beak in a penguin; pathology as shown at autopsy. BEAK / * pathol MELANOMA / * vet / pathol BIRD DISEASES / * pathol AUTOPSY / vet BIRDS ANIMAL (check tag) CASE REPT (check tag) 24.6.3 If there is no pre-coordinated animal-diseases term in MeSH for a specific animal, index the MeSH term for the animal, making it IM. Intestinal neoplasms in lions. INTESTINAL NEOPLASMS / * vet * LIONS ANIMAL (check tag) 24.6.4 There are anatomic terms in MeSH which are restricted to animals, with corresponding human terms also available: MAMMAE or UDDER versus the human BREAST, the animal ABOMASUM versus STOMACH, etc. 24.6.4.1 When an animal organ has an identical or near-identical counterpart in humans, index a neoplasm of the animal organ with the term for the organ, plus the organ-neoplasms term for the corresponding human organ (unless a term exists for the neoplasm in the animal organ). Epidemiology of abomasal tumors in cattle. * ABOMASUM STOMACH NEOPLASMS / * vet / epidemiol CATTLE DISEASES / * epidemiol CATTLE (check tag) ANIMAL (check tag) Mammary neoplasms in cats. * MAMMARY NEOPLASMS * CAT DISEASES CATS (check tag) ANIMAL (check tag) Not: BREAST NEOPLASMS / * vet 24.6.4.2 When the organ of the animal is not anatomically the same as that in humans, do not use the corresponding human organ-neoplasm term. Index instead a more general term treed above it. Pathology of oviduct tumors in ducks. OVIDUCTS / * pathol GENITAL NEOPLASMS, FEMALE / * vet / pathol POULTRY DISEASES / * pathol * DUCKS ANIMAL (check tag) FEMALE (check tag) Not: FALLOPIAN TUBE NEOPLASMS / * vet /pathol