Biomedical subjects

A Myoui

Publications and source records attributed to A Myoui.

33 records · Page 2Linked to original sources

PubMed1997

P-glycoprotein expression in soft-tissue sarcomas.

Multidrug resistance (MDR) is an important problem in chemotherapy for neoplastic disease. In humans. MDR is mainly mediated by P-glycoprotein (P-gp) a product of the MDRI gene, which acts as a transmembrane protein pump and eliminates chemotherapeutic agents from the cells. Expression of P-gp was immunohistochemically studied by using two monoclonal antibodies, JSB-1 and C-219, on paraffin-embedded sections from 55 patients with soft-tissue sarcoma. The histological diagnosis of tumors was malignant fibrous histiocytoma in 24 cases, liposarcoma in 9, synovial sarcoma in 7, malignant neurogenic tumors in 6, leiomyosarcoma in 5, others in 4. The histological grade was determined on the basis of criteria previously proposed by us. Out of 55 cases, 34 (62%) were positive for P-gp expression. There was a significant difference in P-gp expression between high-grade (90%) and intermediate and low-grade tumors (46%) (P < 0.005). Tumors expressing P-gp had a less favorable prognosis than P-gp-negative tumors in the high- and intermediate-grade tumors. The current study demonstrated that the estimation of P-gp expression could be used to select appropriate therapeutic modalities.

ATP Binding Cassette Transporter, Subfamily B, Mem↗

PubMed1997

Influence of local recurrence on the prognosis of soft-tissue sarcomas.

We have investigated the significance of local recurrence on survival in 173 patients with localised soft-tissue sarcomas of the limbs and of the trunk. The overall survival rates at five and ten years were 75.2% and 68.0%, respectively. After definitive surgery at our hospitals, there was local recurrence in 25 patients (14.5%). After inadequate operations elsewhere, there was a higher incidence of late local recurrence (28.3%), in comparison with those with primary tumours treated by us (9.0%), or patients referred to us immediately after inadequate surgery elsewhere (10.2%). Because of small numbers these differences in the survival rates were not statistically significantly different. Univariate survival analysis showed that local recurrence after definitive surgery (p = 0.006) together with the histological grade (p = 0.0002), the size of the tumour (p = 0.002), its depth in relation to deep fascia (p = 0.003), and the surgical margin (p = 0.0001) were the significant prognostic factors. Local recurrence at the initial presentation did not affect survival. Multivariate analysis showed that local recurrence after definitive surgery also lost its apparent prognostic significance.

Adolescent↗

PubMed1996

Prognostic factors in angiosarcoma: a multivariate analysis of 55 cases.

Data for prognostic factors in angiosarcoma (AS) are limited, prompting a large-scale study of AS with multivariate analysis. To analyze prognostic factors in angiosarcoma (AS), clinical and histologic findings in 55 patients collected from hospitals in Japan were reviewed. Prognostic factors were evaluated by univariate and multivariate Cox's proportional hazards models. The study involved 32 males and 23 females, ages 18-93 (median, 69) years. The primary sites of tumors included head and neck (32 cases), trunk (10), extremities (3), spleen (3), breast (3), and other (4). The overall 2-year survival rate was 21%. Univariate analysis of clinical factors including age, sex, size and depth of tumor, tumor-related symptoms, interval between onset of symptoms and admission, surgical procedures, adjuvant chemotherapy, and adjuvant radiotherapy showed that age, tumor size, and mode of treatment were significant for survival. Histologic factors analyzed were mitotic counts, cellularity, cellular pleomorphism, extent of necrosis, vascular differentiation, and nonspecific diagnosis. Only mitotic counts were significant for prognosis. Multivariate analysis on these four factors revealed that tumor size, mode of treatment, and mitotic counts were independent prognostic factors.

Adolescent↗

PubMed1996

Dedifferentiated liposarcoma of the subcutis.

This report describes an 82-year-old woman with dedifferentiated liposarcoma, an extremely rare neoplasm of the subcutis. The patient had first recognized a very soft mass in the anterolateral part of the right thigh more than 20 years earlier, but because the tumor showed little change over this period, she did not seek treatment. She recently noticed a hard, rapidly growing mass within the former tumor. Both magnetic resonance imaging and axial computed tomography revealed a subcutaneous fatty lesion measuring 12 x 7 x 4 cm and a well-delineated mass-like area (4 x 3 x 3 cm) of nonfatty tissue within the lesion. Histologically, the former was a mature lipomatous tumor with broad fibrous septa containing some atypical stromal cells, and the latter was a much more cellular, spindle cell tumor with a malignant fibrous histiocytoma-like pattern. The authors propose that dedifferentiated liposarcoma is not restricted to the deep soft tissues and may develop in the subcutis and further suggest appropriate surgical management for well-differentiated fatty tumors of subcutaneous origin.

Aged↗

PubMed1996

Prosthetic reconstruction for periacetabular malignant tumors.

This article reports the reconstruction method and functional results of a newly designed tumor hip prosthesis with a constrained joint mechanism which was used after treatment for 13 primary and 5 metastatic periacetabular malignant bone tumors. The overall 5-year survival rate for patients with primary tumors (n=13) was 50%. The local recurrence rate was 30%. More than 90% of the patients whose hips were reconstructed with the constrained tumor hip prosthesis experienced pain relief and were able to walk with a cane. No patients had greater than 3 cm shortening of the involved limb. Infection was the most serious complication. This prosthesis restored iliofemoral stability after surgical resection of periacetabular malignant tumors.

Acetabulum↗

PubMed1995

Prognostic significance of posterior subtalar joint arthrography following fractures of the calcaneus.

Nineteen patients with 22 intra-articular fractures of the calcaneus were investigated by posterior subtalar joint arthrography after 6 (2-15) months following injury, and their clinical symptoms were compared with the arthrographic findings. The arthrograms were classified into four types based on the findings of the joint space of the posterior subtalar joint in Anthonsen's view. The classification correlated significantly (P = 0.03) with the clinical results which were assessed after 23 (9-41) months following injury. We conclude that posterior subtalar joint arthrography has prognostic value in assessing patients with fractures of the calcaneus.

Adolescent↗

PubMed1993

Histologic grading in soft-tissue sarcomas. An analysis of 194 cases including AgNOR count and mast-cell count.

In order to establish a new histologic grading system for STS, we evaluated histologic prognostic factors. For this purpose, we selected 194 patients with STS: 31 in the upper extremities, 63 in the trunk, and 100 in lower extremities. All the patients were treated by surgery, followed by chemotherapy in 74 cases, radiotherapy in 11, chemotherapy and radiotherapy in 30, or no adjuvant treatment in 79. Histologic factors evaluated were mitotic count, extent of necrosis, cellularity, cellular pleomorphism, extent of myxoid change, sclerosis, non-specific histologic diagnosis, counting of reaction product in silver stain for nucleolar organizer regions (AgNOR) and mast-cell counts. Univariate analysis revealed mitotic count, necrosis, cellularity, cellular pleomorphism, non-specific histologic classification, AgNOR count and mast-cell count to be significantly related to prognosis. Multivariate analysis revealed that AgNOR count, cellularity and necrosis were independent prognostic factors. A new grading system was introduced: low-grade, intermediate-grade and high-grade. The survival between each group were significantly different; the 5-year-survival rate in patients of the low-, intermediate- and high-grade groups was 87%, 74% and 35% respectively. Our findings suggest that this histologic grading system may be useful for making therapeutic decisions.

Adolescent↗

PubMed1993

Usefulness of argyrophilic nucleolar organizer staining for histologic grading of soft-tissue sarcomas.

Accurate histologic grading is essential for making a proper therapy decision in soft-tissue sarcomas (STS). The usefulness of the argyrophilic stain for nucleolar organizer region (AgNOR) in assessing the histologic grade of STS has been examined. One hundred and forty-two patients with STS confined to the extremity and trunk were selected. Tumors were classified based on the criteria of Enzinger and Weiss ["Soft-Tissue Tumors." St. Louis: C. V. Mosby, 1983]. In addition, non-specific classification was made based on the shape of proliferating cells occupying more than 50% of the field in the sections such as pleomorphic cell, small round cell, spindle cell, epithelioid cell, myxoid, and unclassified tumors. The mean number of AgNOR dots per nucleus of tumor cells was calculated in 200 cells (AgNOR count). Each category of non-specific classification was divided into a high-count group (< 8 AgNOR count) and a low-count group (> 8 NOR). The low-count group showed a significantly better prognosis than the high-count group in small round cell and spindle cell tumors (P < 0.007 and P < 0.0005, respectively). Similar results were obtained in pleomorphic cell tumors, though they were statistically not significant because of the relatively small number of examined cases. Most patients with epithelioid cell and myxoid tumors were in the low-count group. These findings suggest that the assessment of histologic grading of STS could be made effectively by the non-specific classification and the aid of AgNOR staining.

Actuarial Analysis↗

PubMed1992

High endothelial venules in extranodal lymphomas with emphasis on their prognostic significance.

In the present study, the frequency of occurrence of high endothelial venules (HEVs) in extranodal lymphomas at various sites was examined, and its prognostic implication subsequently estimated. The presence of HEVs was tested for by an immunohistochemical method using the monoclonal antibody, HECA-452, known to be specific for HEVs. The number of cases at each extranodal site were 13 in the thyroid, three in the salivary gland, 15 in the gastrointestinal(GI) tract, 20 in the brain, six in the lung, 12 in the pleura, nine in the testis, 10 in the bone, 19 in the skin and seven in the breast. Histologically, 26 of the 114 cases (23%) were of high grade malignancy according to the Working Formulation. Immunohistochemistry revealed 89 cases (78%) to be of B-cell type, eight (7%) T-cell type and 17 (15%) others. HEVs were observed frequently among the cases of lymphoma of the salivary gland (100%), thyroid (77%), GI tract (53%), lung (50%) and breast (43%). Evident were a preponderance of female patients (P less than 0.02) and those with histologically favorable lymphoma types (P less than 0.001), and a more favorable prognosis (P less than 0.001) for cases with HEVs over those without. There were no significant differences in age and immunologic type distributions between cases with and without HEVs. The findings suggest that the presence of HEVs could be used as an indicator for a favorable prognosis in cases of extranodal lymphoma.

Adolescent↗

PubMed1991

Soft tissue sarcoma of the pleural cavity.

Seventeen cases of soft tissue sarcoma (STS) developing in the pleural cavity were collected from Japanese hospitals, and their clinical and pathologic findings summarized. Eight of the 17 patients had a 15-year to 50-year (mean, 28.8) history of chronic pleural inflammatory disease (pleuritis, pyothorax, and pulmonary tuberculosis) before the onset of the pleural sarcoma. Histologically, malignant fibrous histiocytoma was the most common tumor type (11 cases), followed by angiosarcoma (four). The age at diagnosis of the sarcoma ranged from 15 to 74 years (mean, 58); the male-to-female ratio was 3.3:1. In the eight cases of sarcoma associated with chronic pleural inflammatory disease, male preponderance was more marked (7:1). The commonest presenting symptom was chest pain. A mass could be detected by chest roentgenograms in 13 patients and computed tomographic scans in 15 patients. No patient had distant metastases at first admission. Thirteen patients were treated by surgery, chemotherapy, and/or radiation therapy. Thirteen of the 17 patients died 1 to 87 months (mean, 14.2) after therapy for STS. The actuarial 1-year survival rate was 38.5%. These findings suggest that long-standing pleural inflammation might be an etiologic factor for development of pleural STS.

Adolescent↗

PubMed1991

Prognostic significance of argyrophilic nucleolar organizer staining in soft-tissue sarcomas.

The utility of argyrophilic stain for nucleolar organizer region (AgNOR) for estimating proliferative activity and prognosis of soft-tissue sarcomas (STS) was examined. Formalin-fixed and paraffin-embedded sections of 38 cases with STS were used; the reaction product of AgNOR stain was observed as dots mainly in the nucleoli. The mean number of AgNOR dots per nucleus of tumor cells was calculated in 200 cells (AgNOR count). The AgNOR count, ranging from 1.4 to 16.1 (mean, 7.5), showed a good correlation with cellularity (r = 0.483, p less than 0.003) and histologic grade (r = 0.626, p less than 0.00005), but less shown with mitotic counts (r = 0.350, p less than 0.04). The prognosis of cases with AgNOR low-count group (5-year survival rate was 74.6%) was much better than those in high count group (33.3%) (p less than 0.0005). The AgNOR count correlated well with reactivity of tumor cells for Ki-67 staining, which was available only in freshly prepared sections. These findings suggested that the AgNOR staining is a simple and useful method for estimating tumor-cell proliferation and prognosis of patients with STS.

Adolescent↗

PubMed1991

Intermediate lymphocytic lymphoma: its frequency and characteristics in Japan.

The nature of intermediate lymphocytic lymphoma (ILL) in Japan was investigated. For this purpose, we have reviewed 1,766 cases of malignant lymphoma and related diseases, and 38 cases were selected as ILL. In two cases, small lymphoid cells proliferated as a wide mantle of atrophic secondary follicles. The frequency of ILL in nodal and extranodal non-Hodgkin's lymphoma was 3.4% and 3.9%, respectively. The frequency was high in orbit and salivary gland lymphomas; two out of three cases and one out of six cases, respectively. Age range (median) and sex ratio (M:F) in nodal and extranodal cases were 34-65 (52) years and 2.1:1 and 22-82 (61) years and 1.1:1, respectively. The majority of nodal ILL presented as systemic disease, but extranodal ILL usually presented as localized disease. ILL when treated with chemotherapy and/or radiotherapy had a favorable prognosis, the 5-year survival rate was 82%.

Adult↗

PubMed1991

Histological factors contributing to favorable prognoses of soft tissue sarcomas in premenopausal patients.

The correlations of sex with various histologic factors in soft tissue sarcomas (STS) were studied in 142 adult patients over the age of 20 years. They included 63 with malignant fibrous histiocytomas, 20 with liposarcomas, 20 with synovial sarcomas, 11 with malignant Schwannomas and 28 with other forms of STS. These were divided into four groups, according to age (20-49 years and greater than or equal to 50 years) and sex. Survival rates in female patients were better than those in male patients, and the difference was significant between the 20-49 year groups (p less than 0.01). The relative frequencies in distribution of each histologic type were similar among male and female patients in both age groups. Among histological factors, mitotic counts showed a significant correlation (P less than 0.04) with sex, followed by cellularity. STS in female patients aged 20-49 years had lower mitotic counts than in patients in other groups, where it occurred with a higher frequency of low and intermediate grade tumors. The findings suggested estrogen, either directly to indirectly, to have a favorable effect on STS prognosis in premenopausal female patients.

Adult↗

PubMedDate not supplied

Usefulness of argyrophilic nucleolar organizer staining for predicting prognosis of patients with recurrent soft tissue sarcoma.

Local recurrence of tumor is a common phenomenon in soft tissue sarcoma (STS) and may be accompanied by an increase in malignant potential. In the present study, an increase of proliferative activity in recurrent tumors compared to primary tumors was observed using a silver stain for nucleolar organizer regions (AgNOR), and its implication for predicting prognosis is assessed. 44 patients with STS showing local tumor recurrence were selected. Local recurrence was defined as new tumor growth more than 2 months after the initial surgery in the same region where the primary tumor occurred. All patients received surgery, followed in 11 patients by adjuvant radiotherapy and/or chemotherapy. The histologic subtype was malignant fibrous histiocytoma in 22 cases, synovial sarcoma in 5, leiomyosarcoma in 4, liposarcoma in 3, malignant schwannoma in 3, and others in 7. The interval between initial surgery and local recurrence ranged from 2 to 72 months. No patients changed from one histological subtype to another. Histological changes included an increase in mitosis, cellularity, and sclerosis in 43.2, 31.8, and 27.3%, respectively. The AgNOR count (mean +/- SD) in recurrent tumors (7.22 +/- 2.59) was significantly higher than that in primary tumors (5.58 +/- 2.28; p < 0.0057), clearly showing a tendency for an increase in proliferative activity during recurrence. The 5-year survival rate of patients with a marked increase (> 4) in AgNOR count (16.7%) was worse than with minor to moderate increases (60.0%; p < 0.02). Marked AgNOR increase was more frequently observed in the tumors located in the head and neck and retroperitoneum (40%) than in other sites (9%). Irrespective of the primary site of tumors, a marked AgNOR increase resulted in an unfavorable prognosis. Multivariate analysis of change in histologic factors including AgNOR, cellularity, mitotic counts, pleomorphism, myxoid change, necrosis, sclerosis, and tumor size showed that increase of AgNOR counts was significant (p < 0.05). The present findings suggest that AgNOR counts can be used as a prognostic factor in recurrent STS.

Adult↗

PubMedDate not supplied

DNA ploidy pattern and cell cycle stage of tumor cells in soft-tissue sarcomas: clinical implications.

Staining and counting of argyrophilic nucleolar organizer region (AgNOR), segments of DNA with ribosomal genes, is useful for estimation of the proliferative activity in soft tissue sarcoma (STS). The precise role of AgNOR in STS, however, is still uncertain. In the present study, ploidy pattern and stage of cell cycle were analyzed in 151 cases of STS in the extremities and trunk, and their correlation with AgNOR and utility as independent prognostic factors were estimated. For this, microspectrophotometric and flow-cytometric analyses were done on paraffin-embedded material from 84 and 111 cases, respectively. Fifty-five percent cases showed an aneuploid pattern with a less favorable prognosis. The range of the DNA index and percentage of cells in S + G2M phase were 0.89-2.04 (mean +/- SD, 1.23 +/- 0.32) and 5.4-83.7% (mean +/- SD, 32.95 +/- 17.92), respectively. Tumors having less than 40% cells in the S + G2M phase showed a favorable prognosis compared to those over 40%. Both the ploidy pattern and stage of the cell cycle showed a good correlation with the AgNOR count: a high frequency of cases having aneuploidy and S + G2M phase in the AgNOR high count group. These findings provide a theoretical base for explaining the utility of AgNOR for the estimation of proliferative activity. In multivariate analysis, only AgNOR counts were a prognostic factor among histologic factors reflecting proliferative activity of tumors. The DNA ploidy pattern and the stage of the cell cycle was proved not to be an independent factor for prognosis.

Adolescent↗