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Biomedical subjects

G U Auer

Publications and source records attributed to G U Auer.

At least 19 recordsLinked to original sources
PubMed2000

Genome instability in human tumorigenesis: microphotometry of interphase nuclei and pathologic mitoses reveals dysplasia.

Tumorigenesis goes with genome instability comprising point mutations and gross chromosome aberrations due to defective DNA repair mechanisms and multiple overrun of cell cycle checkpoints. Pathologic mitoses (CDFs) occur in human precancers and cancers and were detected by nuclear DNAs deviating more or less than 0.5 c from 4.0 c values. Abundant CDFs were recorded above 4.5 c threshold in lesions of the uterine cervix and the stomach. Low-grade dysplasias and well differentiated carcinomas showed 3%-10% CDFs, high-grade dysplasias 30%-44% CDFs in total divisions. Poorly differentiated cancers comprised some 50% CDFs. Most telophase CDFs showed asymmetric morphology and unbalanced DNA content in their corresponding "halves". CDFs precede DNA aneuploidy of interphase nuclei not only in precancers, but also in cancer. Chromatin bridges and lagging chromosomes suggest that unbalanced telophases are caused by somatic nondisjunction. Tumour progression from low-grade to high-grade dysplasia and cancer is characterised by recurrent shifts from 2 c to 4 c interphase nuclei and a remarkable increase in the 5 c exceeding rate. Clonal selection is the gateway in tumorigenesis for aberrant karyotypes.

Breast Neoplasms↗
PubMed1999

Reliability and significance of DNA measurements in interphase nuclei and division figures in histological sections.

DNA contents from single cells at interphase and division were analysed in histological sections and in imprints from 73 breast cancer specimens. Fetal livers from 18 terminations of normal pregnancies provided the standard for truly mitotic prophases, metaphases and telophases. The reliability of DNA quantities from image microphotometry was improved using paraffin-embedded tissue samples from which 4, 8 and 15 microns slices were Feulgen stained. Imprinted replicas from the mirror surface of each freshly cut specimen provided matching domains and represent the crucial approach in this project. A close positive relationship was observed between interphase nuclei in 8 microns sections and their imprinted counterparts (r = 0.992; n = 73). Interphase nuclei in 4 microns sections yielded insufficient DNA contents when compared with the imprints (r = 0.815; n = 21) and with endogenous lymphocyte nuclei. This 2 cDNA standard also calibrated 232 mitotic figures to 3.91 +/- 0.01 c in 15 microns sections from fetal liver. Prophases, metaphases and telophases were slightly scattered (coefficient of variation = 0.04 each). The 0.09 c deficiency to plain 4.0 c was read as an artifact from sectioning. However, the methodical bias did not challenge the most irregular DNA distribution profiles recorded from chromosome division figures (CDFs) in 15 microns sections of breast cancers. Poorly differentiated and aggressive breast cancer (Auer type IV, Zetterberg type A) exhibited a 4.5 c exceeding rate of 82.24% from a total of 752 CDFs in 10 randomly selected cases. Well differentiated, slowly growing cancer with diploid interphase nuclei (Auer I, Zetterberg D) surprisingly showed a 4.5 c exceeding rate of 29.26% from a total of 173 mitoses and CDFs in 10 randomly selected cases. The bulk of data beyond the mitotic 4.0 c level discriminates biological bias from methodical impairment. We concluded that 8 microns sections are sufficient for human interphase nuclei, whereas a depth of 15 microns preserves intact mitoses and CDFs.

Breast Neoplasms↗
PubMed1999

Adenocarcinoma of the uterine cervix in Ireland and Sweden: human papillomavirus infection and biologic alterations.

Paraffin-embedded samples from cervical adenocarcinomas, 19 cases from Irish patients and 19 cases from Swedish patients, were analyzed by polymerase chain reaction for the presence of infection with human papillomavirus (HPV). The results were compared with DNA ploidy, proliferation activity, and p53 and p21/WAF1 expression. The studies were performed to discover whether high-risk HPV infection in adenocarcinomas of the uterine cervix is associated with an increased proliferative activity and genomic instability. The results show that the majority (84.6%) of patients 59 years of age or younger showed HPV infection. The overall prevalence of HPV DNA was 60.5%, with the high-risk types, 16 and 18, the most frequent. HPV-16 had a prevalence of 23.7% (9 of 38), and HPV-18 had a prevalence of 26.3% (10 of 38). The HPV-positive tumors predominantly showed a tetraploid DNA distribution pattern, whereas HPV-negative tumors more frequently showed highly scattered aneuploid DNA profiles. Both HPV-positive and HPV-negative cases displayed high proliferative activity, as indicated by high Ki-67 and cyclin A immunoreactivity. Tumor suppressor gene analysis detected low p53 expression and high p21/WAF1 expression in HPV-positive patients and high p53 expression without simultaneously increased p21/WAF1 (indicative of mutated p53) in HPV-negative cases in the groups of women older than 59 years of age.

Adenocarcinoma↗
PubMed1997

The impact of tumour angiogenesis, p53 overexpression and proliferative activity (MIB-1) on survival in squamous cervical carcinoma.

Tumour angiogenesis (antifactor VIII-related antigen antibody), p53 overexpression (DO-1) and proliferative activity (MIB-1) were immunohistochemically analysed for the prediction of long-term survival in 113 patients with squamous cervical carcinoma. The median follow-up time was 82 months (range 72-99). In early stages (IB-IIA), neovascularisation was significantly related to tumour size. Significantly more patients in stage IIA had high tumour vascularity compared to stage IB (P < 0.01) but no significant difference was found between early and advanced stages (IIB-IVB) of cervical carcinoma. p53 overexpression was correlated to the stage of disease (P < 0.01). No relationship was found between tumour angiogenesis, p53 overexpression or MIB-1 and pelvic lymph node metastases, histological subtype or differentiation. Tumours with more than 50% p53 overexpression was significantly correlated with survival in the univariate analysis, but no independent predictive value was found. It is concluded that immunohistochemically detectable p53 overexpression as measured by DO-1 and proliferative activity as measured by MIB-1 seems of no clinical value for the prediction of long-term survival in squamous cervical carcinoma. The predictive value of tumour angiogenesis for survival outcome has still to be determined in squamous cervical carcinoma.

Adult↗
PubMed1996

Diagnostic impact of nuclear DNA content and proliferative activity in benign and malignant melanocytic lesions.

Nuclear DNA content was assessed, using image cytometry, in adult melanocytes in normal skin and in 20 intradermal naevi, 60 junction naevi, 107 compound naevi, 61 dysplastic naevi, 17 melanomas in situ and 101 primary malignant melanomas. Proliferation was estimated using mitotic counting and immunohistochemical staining by anti-Ki-67 (clone MIB1) monoclonal antibodies. All normal adult melanocytes; and intradermal naevi (97% junction naevi, 98% compound naevi, 66% dysplastic naevi) were diploid. Thirty-four percent of the dysplastic naevi, 88% of the melanomas in situ and 96% of the malignant melanomas were clearly aneuploid. Proliferation, as assessed by mitotic counting and MI81 index, was significantly higher in aneuploid invasive malignant melanomas than in aneuploid dysplastic naevi (P<0.0001). The results indicate that histomorphologically defined entities of melanocytic lesions are characterized by typical DNA distribution patterns. Distinct aneuploidy combined with high proliferation rates generally seem to be well correlated to an increased malignancy potential of the lesion. In dysplastic naevi, the clonic expansion of aneuploid naevus cells may be limited by host defence mechanisms. Thus, DNA aneuploidy seems to indicate increased risk of malignant transformation, but has to be combined with other data, such as proliferation, in order to differentiate more precisely between different melanocytic lesions.

Adult↗
PubMed1995

The relationship between proliferating cell nuclear antigen (PCNA), nuclear DNA content and mutant p53 during genesis of cervical carcinoma.

Proliferating cell nuclear antigen (PCNA), nuclear DNA content and mutant p53 overexpression were studied by means of image cytometry and immunohistochemistry respectively in normal mucosa (n = 10), in mild (n = 16), moderate (n = 9) and severe (n = 17) atypical lesions, as well as in squamous cell carcinomas (n = 36) of the cervix uteri. The results show that increasing histopathological atypia in the cervical mucosa was correlated to an initial increase of PCNA followed by distinct aneuploidy and p53 overexpression. The data are suggested to contribute to a better understanding of the genesis of cervical carcinoma, and to indicate that the coexistence of both distinct aneuploidy and p53 immunoreactivity can be used to decide if a cell population is neoplastic, whereas the absence of p53 overexpression does not necessarily exclude neoplasia. This diagnostic procedure can be suggested to improve early detection of intraepithelial squamous neoplasia.

Aneuploidy↗
PubMed1994

The relationship between aneuploidy and p53 overexpression during genesis of colorectal adenocarcinoma.

This paper describes the investigation of nuclear DNA content and p53 immunoreactivity in normal mucosa (n = 25), mildly (n = 15), moderately (n = 28) and severely atypical (n = 22) colorectal adenomas and in colorectal adenocarcinomas (n = 116). Twenty-seven per cent of the mildly atypical, 43% of the moderately, 77% of the severely atypical adenomas and 91% of the colorectal carcinomas were distinctly aneuploid. In the aneuploid lesions p53 immunoreactivity was not observed in mildly atypical adenomas, whereas 17% of the moderately atypical, 24% of the severely atypical adenomas and 66% of the adenocarcinomas were p53 positive. None of the diploid lesions were p53 immunoreactive. These data are interpreted to indicate that genomic instability as reflected by crude aneuploidy occurs early during genesis of colorectal carcinoma and represents a high risk factor for p53-gene mutation.

Adenocarcinoma↗
PubMed1994

Immunohistochemical expression of the mutant p53 protein and nuclear DNA content during the transition from benign to malignant breast disease.

Immunohistochemical expression of the cellular phosphoprotein p53 was investigated in archival, formalin-fixed, and paraffin-embedded surgical breast tissue specimens from 543 patients using the polyclonal antibody CM-1. Cytometric DNA assessments were performed on histopathologically or cytopathologically identified cell nuclei using image analysis. The series included five samples of normal resting breast parenchyma, 35 benign lesions including benign tumors, 54 hyperplastic lesions with and without atypia, 109 carcinomas in situ, and 340 invasive adenocarcinomas. In 56 of the latter cases specimens from corresponding lymph node metastases also were investigated. Mutant p53 protein expression was absent in normal resting parenchyma and in benign lesions, including benign tumors and epithelial hyperplasias. However, 14 of the 54 hyperplasias (26%) were found to be of DNA aneuploid type. Thirteen of 109 (12%) carcinomas in situ and 79 of 340 (23%) invasive neoplasms expressed the mutant p53 protein. Eight of nine (89%) p53 immunoreactive carcinomas in situ and 62 of 78 (80%) invasive carcinomas with p53 expression were DNA aneuploid. In invasive carcinomas p53 expression was absent in well differentiate neoplasms. In contrast, 58 of 158 (37%) poorly differentiated invasive carcinomas immuoreacted. Intraductal carcinomas of comedo type and poorly differentiated invasive carcinomas of comedo type expressed the mutant p53 protein in seven of 18 cases (39%) and in 14 of 22 cases (64%), respectively. The staining behavior of lymph node metastases was the same as that of the corresponding primary tumors. The present findings suggest that chromosomal alterations as indicated by DNA aneuploidy occur in precancerous lesions.(ABSTRACT TRUNCATED AT 250 WORDS)

Breast↗
PubMed1994

DNA ploidy in human colorectal adenomas.

The DNA content of 101 colorectal adenomas of various histologic types resected from 83 patients was determined by image cytometric measurements in order to investigate if a correlation between DNA ploidy and particular histomorphologic features exists and if DNA measurements can be of additional diagnostic value. Overall, 67 of 101 (66%) adenomas showed an aneuploid DNA distribution pattern, including 8 of 19 (42.1%) mildly atypical, 32 of 48 (66.7%) moderately atypical and 27 of 34 (79.4%) severely atypical adenomas. Correlating DNA content with the histologic type, 17 of 42 (40.5%) tubular, 28 of 37 (75.7%) tubulovillous and all 22 villous adenomas exhibited aneuploid DNA histograms. Aneuploidy was also observed more frequently in larger adenomas. The results show a good correlation between tumor size, histomorphologic features and DNA content. The most remarkable observation is that as many as 42% of the adenomas histomorphologically considered mildly atypical exhibited aneuploidy. Since aneuploidy has been demonstrated to indicate premalignant or malignant cellular alterations, DNA image cytometry is suggested for providing valuable additional information on the diagnosis of colorectal adenomas.

Adenoma↗
PubMed1993

Prognostic value of the combined assessment of proliferating cell nuclear antigen immunostaining and nuclear DNA content in invasive human mammary carcinomas.

The expression of the S-phase associated, nuclear protein proliferating cell nuclear antigen (PCNA) was investigated in routinely paraffin-embedded surgical specimens from 209 breast cancer patients. Cytometric DNA assessments were performed on fine-needle aspirates, upon which the primary diagnosis of breast cancer had been based. The mean clinical follow-up was 16 years (range 13-20 years). The percentage of PCNA immunoreactive tumour cells ranged between less than 5 to 60% (mean value 13.34%). There was a direct association between PCNA expression, high histological tumour grade (p < 0.01), and DNA aneuploidy (p = 0.009). In a subgroup of 22 patients with near-diploid DNA distribution patterns the PCNA expression yielded additional prognostic information. Patients with tumours of near-diploid DNA histograms and more than 20% of PCNA immunoreactive neoplastic cells had a significantly worse clinical course, than patients with near-diploid tumours containing less than 20% PCNA immunoreactive cells (p = 0.0001). In contrast, the PCNA immunoreactivity did not yield additional prognostic information for patients with distinctly diploid or highly aneuploid tumour variants. In a multivariate analysis comprising all 209 patients, nodal status (p < 0.01), tumour size (p < 0.01), and DNA ploidy (p < 0.01) were found to have significant prognostic effect. The findings indicate that carcinomas characterised by high proliferative activity and near-diploid DNA distribution patterns can show rapid tumour progression. The combined assessment of the PCNA immunoreactivity and of the nuclear DNA content in routinely processed surgical specimens of breast cancer patients appears to be of prognostic value.

Breast Neoplasms↗
PubMed1993

DNA content and PCNA immunoreactivity in oral precancerous and cancerous lesions.

Thirty-three dysplastic lesions showing varying degrees of atypia located in the oral cavity and 83 squamous cell carcinomas located in the oral cavity and tongue (n = 56) or in the lips (n = 27) were analysed by means of proliferating cell nuclear antigen (PCNA) immunoreactivity and image cytometric DNA measurements. The results show that in dysplastic lesions increasing cellular atypia correlated to elevated proliferative activity and aneuploidy occurring in the basal cell layers. In highly differentiated squamous carcinomas increased PCNA immunoreactivity and aneuploidy was preferentially observed focally (grade 1 tumours) or in the invasive zones (grade 2 tumours). In contrast, more poorly differentiated carcinomas (grade 3 and 4 tumours) showed strongly elevated proliferative activity and aneuploidy throughout the entire tumour mass.

Aged↗
PubMed1993

Immunohistochemical expression of the mucin-type glycoprotein A-80 and prognosis in human breast cancer.

Immunohistochemical expression of the tumour associated mucin-type glycoprotein A-80 was investigated in a series of 173 breast cancer patients with a clinical follow-up between 13 and 19 years. A routine immunoperoxidase technique was used in formalin-fixed, paraffin-embedded surgical tumour specimens. One hundred and fifty of 173 tumours (87%) immunostained with MAb A-80. The degree of A-80 immunoreactivity was related to the tumour grade but not to lymph node status, tumour size, or nuclear DNA distribution pattern. In univariate analysis the degree of A-80 expression was found to be of significant prognostic value both in node negative and in node positive breast cancer patients (P = 0.03). Patients with non-A-80 immunoreactive tumours had significant longer distant metastases-free survival times and fewer relapses than women with carcinomas composed of A-80 immunoreactive tumour cells. This prognostic value was reduced in a multivariate analysis, including lymph node status, tumour size, and nuclear DNA distribution pattern, but retained borderline significance (P = 0.08). In conclusion, the findings of this study indicate that expression of the mucin-type glycoprotein A-80 as determined by immunohistochemistry seems to be related to clinical outcome in breast cancer patients.

Adult↗
PubMed1993

DNA ploidy in human colorectal adenocarcinomas.

Image cytometric determination of DNA content was performed on 207 colorectal adenocarcinomas surgically resected from 205 patients. Of these 207 tumors, 193 (93.2%) showed an aneuploid DNA distribution pattern, whereas the remaining 14 (6.8%) exhibited a DNA pattern corresponding to that found in proliferating diploid populations. The DNA content of 20 of these colorectal carcinomas was also studied by flow cytometric measurements on deparaffinized, disintegrated material. Flow cytometric measurement detected aneuploidy in only 9 of these 20 (45%) tumors, whereas 17 of the same 20 (85%) carcinomas showed aneuploidy when using image cytometric measurement on imprints. These results suggest that colorectal carcinomas are either aneuploid (vast majority) or proliferating diploid and that image cytometric DNA measurement on histologically controlled material is superior to flow cytometric measurement.

Adenocarcinoma↗
PubMed1992

Expression of the c-erbB-2 proto-oncogene product and nuclear DNA content in benign and malignant human breast parenchyma.

The expression of the c-erbB-2 proto-oncogene product was investigated immunohistochemically in 474 formalin-fixed and paraffin-embedded human breast tissue samples. The series included 32 benign and 26 hyperplastic lesions, 32 carcinomas in situ and 384 invasive breast carcinomas, 107 of which were less than 1 cm in diameter. Cytometric DNA assessments were performed on histopathologically or cytodiagnostically identified cell nuclei, using image analysis. C-erbB-2 immunoreactivity was not seen in normal parenchyma or in benign and hyperplastic lesions. Mammary carcinomas in situ were more frequently immunoreactive (59%) than invasive neoplasms (23%). Invasive tumours more than 1 cm in diameter immunoreacted more often (26%) than small invasive carcinomas (16%). C-erbB-2 expression in regional lymph node metastases was the same as in the corresponding primary tumours. Significant differences were observed between the c-erbB-2 expression in DNA diploid and aneuploid lesions; for carcinomas in situ the figures were 40% and 72%, respectively. Invasive carcinomas of DNA diploid type rarely showed c-erb-B-2 expression, irrespective of tumour size and nodal status (7-11%). DNA aneuploid tumours were more frequently immunoreactive with increasing levels during progression (32-41%). Our data indicate that genetically stable invasive mammary tumours seem rarely to express the c-erbB-2 protein, even during progression, whereas genetically unstable invasive neoplasms frequently show c-erbB-2 immunoreactivity which increases during tumour progression.

Breast↗
PubMed1992

Prognostic significance of immunohistochemical c-erbB-2 proto-oncogene expression and nuclear DNA content in human breast cancer.

Immunoreactivity of the c-erbB-2 proto-oncogene product and nuclear DNA content were assessed in specimens from 211 breast cancer patients with a mean follow-up of 16 years (range 13-19 years). A routine immunoperoxidase technique was used and cytometrical DNA assessments were performed on cytodiagnostically identified tumour nuclei, using image analysis. C-erbB-2 cell membrane staining was observed in 29% of the cases and was found to be related to tumour size (P = 0.02), histopathological grade (P = 0.02) and nuclear DNA content (P < 0.01). In univariate analysis immunohistochemical c-erbB-2 expression was of prognostic significance among node-positive patients (P = 0.02), but not among women with node-negative disease. This prognostic ability was reduced by multivariate analysis and was no longer significant. In contrast, nuclear DNA content was significantly related to distant recurrence-free survival even in multivariate analysis after adjustment for nodal status and tumour size (P < 0.01). In conclusion, the findings of the present study indicate that c-erbB-2 expression is of limited prognostic value in a subgroup of patients, whereas nuclear DNA content seems to provide significant prognostic information even in node-negative patients.

Adult↗
PubMed1992

Immunohistochemical c-erbB-2 protooncogene expression and nuclear DNA content in human mammary carcinoma in situ.

Immunohistochemical c-erbB-2 proto-oncogene expression and nuclear DNA distribution patterns were assessed in 119 formalin-fixed paraffin-embedded surgical specimens of human mammary carcinomas in situ (CIS). The series consisted of 107 ductal carcinomas in situ (DCIS), 9 lobular carcinomas in situ, and 3 cases of Paget's disease of the nipple. Nuclear DNA distribution patterns were assessed by image cytometric analysis of histopathologically identified cell nuclei. Fifty-one of 107 (48%) DCIS were immunoreactive for c-erbB-2, whereas specific cell membrane staining was absent in lobular carcinomas in situ. The neoplastic cell nuclei of 46 CIS (39%) were of DNA diploid type, and 73 CIS (61%) contained aneuploid nuclear DNA. Among various histopathologic subtypes of DCIS, significant differences in c-erbB-2 immunoreactivity and nuclear ploidy were observed. DCIS of the comedo type most often were c-erbB-2 positive and exhibited aneuploid nuclear DNA histograms. DCIS of micropapillary type was the second most frequently reactive c-erbB-2 expression, and aneuploidy were less common in solid, cribriform, and papillary DCIS. The results of the current study indicate that immunohistochemical expression of the c-erbB-2 proto-oncogene product is closely related to the histopathologic subtype and the nuclear DNA content of mammary CIS. Examples of CIS that are c-erbB-2 immunoreactive and DNA aneuploid seem to have a significantly higher risk for the subsequent development of infiltrating mammary carcinoma.

Biomarkers, Tumor↗
PubMed1991

Quantitative nuclear DNA content in fine needle aspirates of pancreatic cancer.

The quantitative nuclear DNA content of nuclei from fine needle aspirations from 70 patients with pancreatic cancer was measured using an image analyser system. Retrospective analysis of patients indicated that cases with tumour stemlines in the diploid region had the best chance for radical surgery (p less than 0.006) and the best probability of survival (p less than 0.0004). The prognosis for patients with tetraploid stemlines was intermediate and was poorest for patients with no stemlines in the diploid-tetraploid region. From those parameters assessed postoperatively, only the tumour stage added appreciable information on prognosis to the preoperative quantitative DNA content obtainable. Therefore, in patients with pancreatic cancer the quantitative DNA content should be taken into account in planning treatment and assessing prognosis. Furthermore, the quantitative DNA content may have a major role in stratification for further treatment trials.

Adult↗