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K Shiromizu

Publications and source records attributed to K Shiromizu.

At least 19 recordsLinked to original sources
PubMed2001

Analysis of E6 variants of human papillomavirus type 33, 52 and 58 in Japanese women with cervical intraepithelial neoplasia/cervical cancer in relation to their oncogenic potential.

The variation of the E6 region of human papillomavirus type 16 (HPV16) is associated with a high risk for cervical carcinogenesis. To see whether the same is the case with HPV33, 52 and 58, known to have high homology with HPV16, we analyzed the E6 sequence variation of these HPVs in 107 Japanese women with cervical intraepithelial neoplasia (CIN) or invasive cervical cancer (ICC): 20 HPV33-positive, 46 HPV52-positive and 41 HPV58-positive cases. HPV33 variants were more frequently observed in CINs I/II than in CIN III/ICCs (71% (5/7) versus 15% (2/13), P=0.02). In HPV52-positive cases, a single E6 variant was detected in 98% of the cases, whereas the prototype accounted for 98% of HPV58-positive cases. In summary, the distribution of E6 variants is different among HPV types tested, suggesting a link between E6 variation and oncogenic potential being type-specific.

Female↗
PubMed2001

Prognostic factors of stage IV epithelial ovarian cancer: a multicenter retrospective study.

OBJECTIVE: In the present study, we conducted a multicenter retrospective analysis to elucidate the prognostic factors of stage IV epithelial ovarian cancer. METHODS: In November 1999, 24 Japanese institutions received questionnaires regarding stage IV epithelial ovarian cancer patients. Eligibility criteria included all patients with stage IV epithelial ovarian cancer who were surgically confirmed and initially treated in each institution between January 1990 and December 1997. Data were collected regarding age, performance status, tumor histologic subtype, site of metastasis, preoperative CA125, cytoreductive surgery, residual disease after cytoreductive surgery, and response to primary chemotherapy. Survival analysis and comparisons were performed by univariate and multivariate methods. RESULTS: Two hundred twenty-five patients with stage IV ovarian cancer were identified. The median age of the patients was 54 years. The most common site of extraperitoneal disease was malignant pleural effusion (39.6%). Of the 225 patients who underwent an attempt at surgical debulking, 70 (31.1%) were optimally cytoreduced. Most patients received platinum-based combination chemotherapy for primary chemotherapy. In multivariate analysis, performance status, histology, and residual disease after cytoreductive surgery were independent prognostic predictors of outcome. The overall median survival for optimally debulked patients was 32 months compared to 16 months for suboptimally debulked patients (P < 0.0001, hazard ratio: 0.415). CONCLUSION: Optimal surgical debulking, performance status, and histology appear to be important prognostic factors of survival in patients with stage IV epithelial ovarian cancer.

Adult↗
PubMed2000

A clinicopathological study of postoperatively upgraded early squamous-cell carcinoma of the uterine cervix.

OBJECTIVE: To investigate the clinicopathological backgrounds and diagnostic problems of postoperatively upgraded early squamous-cell carcinomas of the uterine cervix. PATIENTS AND METHODS: A total of 23 patients with postoperatively upgraded early squamous-cell carcinomas who were treated at the Saitama Cancer Center during the period of January 1, 1976, through December 31, 1991, were analyzed clinicopathologically. We reexamined the Pap smears (ectocervix, endocervix), colposcopic findings, punch biopsies, and histological findings of the operative specimens. All patients were divided into one of 3 groups based on each patient's main location of the carcinoma of the cervix: Type A: ectocervical type; Type B: endocervical type; or Type C: combined (ectocervical and endocervical) type. Clinical staging of the uterine cervical carcinomas was done in accordance with the 1994 FIGO rules. RESULTS: The numbers of patients were: Type A, 2; Type B, 10; Type C, 11. Of the 23 patients, 21 (91.3%) had lesions in the endocervical portion at least. Fifteen patients (65.2%) complained of atypical vaginal bleeding. Colposcopic findings suggesting an invasive carcinoma appeared for only 6 patients (26.1%). A cytological reevaluation revealed that the endocervical findings were much stronger than the ectocervical ones in 10 (66.7%) of 15 patients whose smears of both sites could be rechecked. CONCLUSIONS: Even if the preoperative diagnosis was early cervical carcinoma, CIS or Stage Ia1, the signs of atypical vaginal bleeding suggested that the final clinical stage would be upgraded after an operation. Furthermore, when the endocervical cytological findings were much more exaggerated than the ectocervical ones, the possibility of deeply invaded endocervical lesions should be considered.

Adult↗
PubMed1999

Balance of IgG subclasses toward human papillomavirus type 16 (HPV16) L1-capsids is a possible predictor for the regression of HPV16-positive cervical intraepithelial neoplasia.

Human papillomavirus type 16 (HPV16) is known to be a major causative agent of cervical cancer. To test the hypothesis that an enhanced Th1 response favors the natural course of cervical intraepithelial neoplasia (CIN), we measured IgG subclasses toward HPV16 L1-capsids because IgG1/IgG2 balance reflects Th2 and Th1 responses, respectively. We examined IgG2/IgG1 ratios in sera from 67 anti-HPV16 L1-positive women; 18 were cytologically normal women, 29 were CIN patients, and 20 were cervical cancer patients. The IgG2 dominance (IgG2/IgG1 ratio >1) was observed in 94, 48, and 5%, respectively (p < 0.001). The regression rate of CIN lesions was significantly different between patients with and without IgG2 dominance: 83.3% (5/6) versus 16.7% (1/6), respectively (p < 0.05). These findings raise the possibility that IgG2 dominance toward HPV16 L1-capsids, i.e., Th1 dominance, may be a useful marker to predict viral clearance or the regression of HPV16-positive CIN.

Capsid↗
PubMed1999

A clinicopathological study of postoperative pulmonary metastasis of uterine cervical carcinomas.

OBJECTIVE: To investigate the clinicopathological backgrounds and prognostic factors of uterine cervical carcinomas metastatic to the lung. METHODS: A total of 519 patients with invasive cervical carcinoma (Stage pTIb-IIb) treated by abdominal radical hysterectomy at the Saitama Cancer Center from January 1, 1976 to December 31, 1989 were analyzed clinicopathologically. RESULTS: The frequencies of pulmonary metastasis were 6.4% (24/377) and 11.3% (16/142) in patients with negative and positive pelvic lymph nodes, respectively. Among 24 negative lymph node patients, 15 had pulmonary metastasis only. The overall 5-year survival rate of these 15 patients was 36% after relapse. Of the 15, the prognosis of 12 patients with 1-3 pulmonary metastases only was better, that is, 46% after surgical resection (mean size of resectable tumor = 2.8 cm) and/or chemotherapy. But the other patients died within 3.3 years after relapse. CONCLUSIONS: The occurrence of pulmonary metastasis only, its number (1-3) and size (mean size = 2.8 cm), and no lymph node metastasis are important prognostic factors. For these patients, active surgical resection of the pulmonary lesion(s) and further chemotherapy are recommended in order to improve their prognosis.

Adenocarcinoma↗
PubMed1999

Clinicopathological study of recurrent uterine cervical squamous-cell carcinoma.

OBJECTIVE: To improve prognoses of patients with recurrent uterine cervical squamous-cell carcinoma. PATIENTS AND METHODS: We clinicopathologically analyzed 464 patients with uterine cervical squamous-cell carcinoma (126 positive, 338 negative pelvic lymph-node metastasis) who were treated at the Saitama Cancer Center from January 1, 1976 to December 31, 1991. RESULTS: The recurrence rates of negative pelvic lymph-node metastasis patients were 14. 2% (39/274) in pT1b and 32.8% (21/64) in pT2b. But for positive lymph-node metastasis patients the rates were 39.0% (23/59) in pT1b and 58.2% (39/67) in pT2b. The interval to recurrence was shorter in positive pelvic lymph-node patients than in negative patients. The 5-year survival rates after relapse of negative lymph-node patients with intrapelvic, extrapelvic, and both-sites recurrence were 53, 12, and 40%, respectively. But among distant recurrent sites, lung metastasis in negative lymph-node patients and lymphatic tract metastasis brought relatively fair prognoses. CONCLUSIONS: Regular long-term checks are necessary and active retreatments are recommended for patients with local recurrences, lung metastasis, or lymphatic vessel metastatic lesions.

Bone Neoplasms↗
PubMed1999

Endometrial adenocarcinoma with diffused/scattered "intramural" spreads: report of a case and review of the literature.

A case is reported of endometrial adenocarcinoma of the uterus in an 85-year-old patient with an unusual spreading pattern. On macroscopic examination, only a tiny exophytic tumor was found in the uterine cavity, while microscopic examination demonstrated a scattered (scirrhous) spread of the carcinoma cells throughout the myometrium. The tumor occupied about half of the upper uterine corpus. The intramural spread of the tumor could not be seen at the time of macroscopic examination of the uterine cut surface. The tumor cells were attached closely to the serosal membrane, and metastasis to the left ovary was found. Intraoperative cytology detected malignant cells in the ascites. We present here this unusual type of endometrial carcinoma and review our previous report which dealt with pure "intramural carcinomas of the uterine corpus".

Adenocarcinoma↗
PubMed1998

Leiomyosarcoma of the uterine cervix.

The clinicopathologic features of a patient with uterine leiomyosarcoma arising in the cervix are presented. A 47-year-old Japanese woman was admitted with complaints of hypermenorrhea and abdominal distention. A hysterectomy with bilateral salpingo-oophorectomy revealed a tumor weighing 10.5 kg, which was the largest cervical leiomyosarcoma reported in the literature. She was given eight courses of combination chemotherapy (VADIC and Hydroxyurea, DTIC, Etoposide) and is alive without evidence of recurrence 35 months after the initial therapy.

Female↗
PubMed1998

Random nuclear p53 overexpression pattern in tamoxifen-mediated endometrial carcinoma.

In a previous paper, we suggested that tamoxifen (TAM)-mediated endometrial carcinogenesis may not involve estrogenic pathways because of random estrogen receptor positivity among endometrial carcinomas with and without TAM treatment for breast cancer. DNA adduct formation (reported in rat liver and human endometrium) was considered to be a more plausible mechanism for TAM-mediated carcinogenesis. To examine the reported correlation between DNA adduct formation and p53, the present study examined p53 expression in the endometrial carcinomas reported in the previous study. Seven endometrial adenocarcinomas associated with long-term TAM treatment for breast carcinoma and 4 carcinomas without TAM treatment but with history of breast carcinoma were immunohistochemically investigated for nuclear p53 expression. The bcl-2 product was also examined. Diffuse and intense nuclear reactivity for p53 protein was present in only one TAM-related case. Essentially, no differences were observed in the bcl-2 staining patterns of TAM-treated and -untreated patients with cancer. Thus, p53 overexpression in endometrial carcinomas occurring in patients with breast cancer seems to be not specific for TAM-treated patients, and, if DNA adduct formation has any role in this type of endometrial carcinogenesis, it may not be related preferentially to p53 gene alteration. Further studies are needed to understand the precise mechanism(s) of the endometrial carcinogenesis.

Adult↗
PubMed1996

Intracervical US with a high-frequency miniature probe: a method for diagnosing early invasive cervical cancer.

PURPOSE: To determine whether intracervical ultrasound (US) with a high-frequency miniature probe can depict cervical neoplasms, especially in early invasive stages. MATERIALS AND METHODS: Forty-eight women with cervical cancer underwent preoperative transvaginal and intracervical US. US scans were compared with findings from histologic examination or surgery. RESULTS: Intracervical US was completed in 45 of the 48 patients. Both intracervical and transvaginal US were unable to depict preinvasive cancer. Intracervical US depicted the lesion in eight of 16 patients (50%) in whom the depth of cancer invasion was less than or equal to 5 mm, whereas transvaginal US failed to depict the lesion in all 16 patients. Intracervical US depicted the lesions in all 19 patients in whom the depth of cancer invasion was more than 5 mm, whereas transvaginal US was successful only in 14 (74%). CONCLUSION: Intracervical US is useful for evaluating invasive cervical cancer and is especially suitable for detecting early invasion in the endocervix.

Adult↗
PubMed1996

Cytologic assessment of metastatic ovarian carcinoma.

Significance of routine cytologic examination in the diagnosis of metastatic ovarian carcinoma was assessed. Twenty-one cases of metastatic carcinoma of the ovary were examined both pathologically and cytologically. Primary sites of the carcinoma were the stomach, breast, large bowel and uterine corpus. Cytology specimens were taken from the portio, endocervix and endometrium of the uterus, ascites and vaginal surgical stump. Malignant cells were detected in the samples from the portio, endocervix and endometrium in two, three and eight cases, respectively. One of the portio and endocervix and two of the endometrial specimens indicated the cases to be from endometrial primary sites. Primary sites of the remaining cases were the stomach and breast. Preoperative and intraoperative cytology of ascites were done in 16 cases and positive results were obtained in 11 cases. Postoperative recurrence was found cytologically in the surgical stump and ascites in two cases. Preoperative routine cytology of the uterus is considered to have diagnostic potential and ascite cytology to be an accurate index of intra-peritoneal spread in the case of metastatic ovarian carcinoma.

Adult↗
PubMed1996

Pathological aspects of normal-sized ovarian carcinoma.

Twenty cases of ovarian carcinoma with normal-sized ovaries were examined histologically. Fifteen of them had metastatic disease of the peritoneal cavity and three of the remaining showed uterine involvement. Only in one case was the tumor confined to the ovary, but this patient had experienced systemic chemotherapy before surgery. The remaining case had metastasis of the stomach. Thus, "normal-sized" ovarian carcinoma has a great tendency to spread externally. Histology of the carcinoma was that of common epithelial carcinoma of the ovary with variable degrees of differentiation except for three cases of apparent ovarian metastasis. No cases of definite mesothelioma with ovarian involvement were encountered. A search for determinants of the peritoneal spread was performed using immunohistochemistry for p53 and bcl-2 proteins. However, no differences were found in the antigen expression between the group with and without peritoneal metastasis.

Adult↗
PubMed1996

Cytological distinction between clear cell carcinoma and yolk sac tumor of the ovary.

Cytological characteristics of clear cell carcinoma (CCC) and yolk sac tumor (YST) of the ovary were examined and compared. Indices for differential diagnosis of these two histologically similar but biologically different tumors were analyzed based on cytological features of the tumor cells. The main results obtained were from three cases of CCC and one case of YST who underwent imprint smear or similar examinations. Seventeen cases of CCC and two of YST with positive cytology results, mainly obtained from ascites samples, were also examined. Cytological characteristics of CCC compared to those of YST were: more marked cohesiveness of tumor cells with less-marked pleomorphism, well-preserved cell borders, fine vesicular cytoplasm, evenly thickened nuclear membrane, and fewer nucleoli and multinucleated giant cells in number. Cells with large cytoplasmic vacuolation were infrequent, and hobnail-shaped tumor cells were rather few in number in CCC cases examined. On the other hand, in the case of YST, cells were more dyscohesive, with marked cellular pleomorphism, usually faint cell borders, no thickening of nuclear membrane and occasional presence of nuclear grooves. The "naked" cells were commonly observed. Further, nucleoli were frequently numerous in number, and multinucleated giant cells were frequently found which showed marked cellular and nuclear atypism. These characteristics found mainly in imprint smears were also relatively well preserved in specimens obtained from ascites or other metastatic sites. These findings indicate that detailed cytological examination can provide a means for differential diagnosis of CCC and YST, supplementing other clinical information.

Adenocarcinoma, Clear Cell↗
PubMed1995

Cytopathological features of undifferentiated carcinoma of the ovary.

Cytopathological characteristics of undifferentiated carcinoma of the ovary were examined and reviewed. Seven cases of undifferentiated carcinoma were encountered among 202 malignant ovarian neoplasms in the Saitama Cancer Center. Histologically, two cases contained a minor component of usual Müllerian carcinoma and five others were purely of solid architecture without differentiation. Nevertheless, six cases, four of which were totally undifferentiated histologically, showed cytological features characteristic of adenocarcinoma. The results indicate that even carcinomas histologically diagnosed as undifferentiated may have cytological features of glandular differentiation, which may be Müllerian in origin.

Aged↗
PubMed1995

Proliferative and apoptotic status in endometrial adenocarcinoma.

The contribution of cell proliferation and apoptosis to growth patterns in endometrial adenocarcinoma were investigated. Immunohistochemical staining was carried out by an antibody for Ki-67 proliferative antigen, Ley apoptotic antigen, and oncogene products bcl-2 and p53. Forty cases of endometrial adenocarcinoma were classified as exophytic, endophytic, and mixed exo- and endophytic in light of their vertical growth pattern, and, in each case, the carcinomatous area was divided into three layers by its vertical axis. In all but one case, no zonal distribution of the antigen expression was observed. In one case, an exophytic tumor, Ki-67 expression was intense in the surface layer and Ley expression in the deep layer was also intense, suggesting a correlation between macroscopic growth pattern and cellular growth and apoptotic potential. However, in general, zonal distribution of cell proliferation and apoptosis could not explain the growth morphology of endometrial adenocarcinoma of the uterus and it was suggested that factor(s) other than cell proliferation and apoptosis determine macroscopic growth patterns.

Adenocarcinoma↗