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Biomedical subjects

T Hachisuga

Publications and source records attributed to T Hachisuga.

At least 37 records · Page 2Linked to original sources

Detection of human papillomavirus types 16 and 18 in primary and in metastatic lesions of cervical carcinomas.

Human papillomavirus (HPV) types 16 and 18 are most prevalent in cervical carcinomas and are also present in metastatic sites. Thirty-six patients with lymph node metastases were examined for the possible presence of HPV 16 and 18 DNA sequences in the primary tumors as well as in metastatic lymph nodes. Polymerase chain reaction (PCR) analysis revealed the presence of the genome of HPV type 16 (HPV 16) in 17 tumors (47%) and that of HPV type 18 (HPV 18) in 2 tumors (6%), while 17 tumors (47%) were negative for both types. Of the 17 HPV 16-positive patients, 15 metastatic lymph nodes were also positive and 2 were negative. In 2 patients positive for HPV 18, the metastatic sites were negative. All the 17 patients negative for HPV in the primary tumors were also negative for HPV 16 and HPV 18 in the metastatic lymph nodes. These data confirmed the positive correlation of HPV DNA status between primary and metastatic tumors. However, the discrepancy in 11% of cases was attributed to presence of heterogeneous clones in the primary tumor.

Adult↗

Assessment of lectin binding for prognosis in endometrial carcinoma.

The binding of Ulex europeus agglutinin-I (UEA-I) and Peanut agglutinin (PNA) was studied in 56 endometrial carcinomas. The positive rates of UEA-I and PNA were 66%. Following neuraminidase treatment, the PNA positive rate increased from 66% to 98% and most tumors stained abundantly. UEA-I staining was unaffected. Using a combined grading system based on architectural and nuclear abnormalities, the PNA positive rates of grade 1, grade 2 and grade 3 tumors were 78%, 70% and 36%, respectively. There was no correlation between UEA-I binding and the grading systems. UEA-I binding correlated significantly with the presence of myometrial invasion and vessel permeation. Metastatic endometrial carcinomas showed a high affinity of tumor cells for UEA-I. Tissues that stained with UEA-I were those from patients with the worst prognosis. PNA and UEA-I reactivities relate to the biologic activity of endometrial carcinomas. UEA-I can serve as a prognostic marker for patients with endometrial carcinoma.

Adenocarcinoma↗

Local immune response in persistent cervical dysplasia.

OBJECTIVE: To investigate the differences in local immune response between persistent and regressive cervical dysplasia. METHODS: We conducted a quantitative study of Langerhans cells, pan-T cells, and helper-inducer T cells in the subepithelial connective tissue using immunohistochemical techniques with S-100 protein antibody, UCHL1, and OPD4, respectively, in 52 paraffin sections. The subjects were patients with persistent cervical dysplasia and a comparable control group of 46 patients with regressive dysplasia. RESULTS: In the subepithelial stroma, the mean (+/- standard deviation) numbers of S-100- and OPD4-positive cells in the persistent group were 8.6 +/- 8.1 and 84.6 +/- 66.3, respectively, compared with 15.1 +/- 9.4 and 147.0 +/- 67.7, respectively, in the regression group. These data demonstrate a significant reduction of Langerhans cells and helper-inducer T cells (P < .0002 and P < .0001, respectively) with persistent dysplasia. CONCLUSION: The decreased numbers of S-100-positive Langerhans cells and helper-inducer T cells in persistent dysplasia compared to those of regressive dysplasia strongly support a decreased local immune response in persistent cervical dysplasia.

Adult↗

Detection of Epstein-Barr virus DNA from a lymphoma-like lesion of the uterine cervix.

The case of a 60-year-old woman in whom a lymphoma-like lesion of the cervix was found during an episode of silent Epstein-Barr virus (EBV) infection is presented. Fractional curettage was performed because of abnormal endometrial smear. The endocervical curettage specimens were diagnosed as highly suggestive of malignant lymphoma, but microscopic examination of a subsequent hysterectomy specimen revealed a benign lymphoid hyperplasia. Those were retrospectively interpreted as a lymphoma-like lesion of the cervix. In the absence of clinical symptoms of infectious mononucleosis, the results of serologic tests for EBV revealed an active EBV infection. EBV DNA was demonstrated in nuclei of large lymphoid cells in endocervical curettage specimens by in situ hybridization. She is alive and well 32 months postoperatively. When female patients with lymphoma-like lesions of the lower genital tract are encountered, examinations for EBV are recommended.

Cervix Uteri↗

Detection of human papillomavirus genome and analysis of expression of c-myc and Ha-ras oncogenes in invasive cervical carcinomas.

Invasive carcinomas of the uterine cervix of 38 patients were examined for the presence of human papillomavirus (HPV) genomes and for the state of the c-myc and Ha-ras oncogenes. A combination of Southern blot hybridization and polymerase chain reaction revealed the presence of the genome of HPV type 16 in 17 tumors (45%), that of HPV type 18 in 3 tumors (8%), and that of unknown types in 16 others (42%), while no viral DNA sequences were detected in 2 tumors. Of the 38 tumors, c-myc amplification was found in only 1 tumor, while there was no Ha-ras amplification. Overexpression of the c-myc gene was observed in 15 (44%) of the 34 tumors analyzed, while there was no overexpression of Ha-ras. Of the 23 squamous cell carcinomas analyzed, relapse-free rates at 24 months were 55% in tumors with c-myc overexpression and 100% in case of tumors with no c-myc overexpression, respectively. The results suggest the possibility that activation of the c-myc oncogene is involved in tumor progression.

Base Sequence↗

Microcarcinoma of the endometrium: a mapping study with special reference to cytologic atypia in the endometrium.

In order to elucidate the basis for the development of an endometrial carcinoma, we looked for microcarcinomas measuring < 5 mm in greatest diameter, and studied their histologic characteristics and those of the neighboring endometrium. Using serial step section methods, two microcarcinomas were detected. A microcarcinoma was found in one of 14 uteri resected for atypical hyperplasia and the other was found in one of 114 uteri resected for endometrial carcinoma. The neighboring endometrium of the former was adenomatous and had atypical hyperplasia and that of the latter was atrophic and contained atypical glands characterized by cytologic atypia and not by architectural changes. The findings may suggest endometrial carcinomas to have two pathogenetic forms: a carcinoma associated with hyperplasia and occurring in premenopausal women, a second carcinoma associated with atrophic endometrium and occurring in postmenopausal women. Atypical glands in atrophic endometria may indicate that endometrial specimens from postmenopausal women should be carefully screened for cytologic atypia.

Adenocarcinoma↗

Expression of ras oncogene product and EGF receptor in cervical squamous cell carcinomas and its relationship to lymph node involvement.

The expression of ras oncogene product p21 and epidermal growth factor (EGF) receptor was studied immunohistochemically in tissues obtained from 52 patients with squamous cell carcinoma of the uterine cervix. We examined the relationship between p21 and EGF receptor expression and lymph node metastasis in cervical cancer. The data demonstrate that the patients with positive staining for ras p21 in cervical carcinomas have a higher incidence of lymph node metastasis than the patients with negative staining for p21 (P = 0.027). Although the levels of p21 expression in the metastatic sites were reduced compared to those in the primary sites, tumor cells in metastatic lymph nodes also expressed p21. No relationship was found between EGF receptor expression and lymph node metastasis. These results suggest that expression of ras oncogene product may be associated with the biological aggressiveness of cervical carcinomas.

Carcinoma, Squamous Cell↗

Antitumor effects of human recombinant interferon-gamma and tumor necrosis factor on five cervical adenocarcinoma cell lines, in vivo and in vitro.

We examined the antitumor effects of recombinant interferon-gamma (IFN-gamma) and tumor necrosis factor (TNF) on cervical adenocarcinoma cell lines, in vitro and in vivo. Four of five cell lines showed a high sensitivity to IFN-gamma, in vitro. One of five cell lines showed a remarkable sensitivity to TNF, in vitro. Only one cell line resistant to both IFN and TNF was derived from a well-differentiated adenocarcinoma of endocervical type. Experiments using nude mice bearing transplanted tumors revealed that these cytokines were also effective against tumors in vivo. All these observations suggest that IFN-gamma or TNF can have positive effects in the treatment of patients with adenocarcinoma of the uterine cervix.

Adenocarcinoma↗

[The clinical significance of serum sialyl SSEA-1 antigen in obstetrical and gynecological patients].

To evaluate the clinical significance of serum SSEA-1 level, the antigen level was measured in sera of obstetric and gynecologic patients. A positive rate was low in patients with endometriosis (9.1%), myoma uteri (0%), benign ovarian tumor (15%), cervical squamous cell carcinoma (14%) and endometrial carcinoma (18%). In this series of study, interest was that positive cases in benign ovarian tumor group were all patients with dermoid cyst. On the other hand, a high positive rate was observed among the patients with cervical adenocarcinoma (50%), primary ovarian malignancies (55%) and secondary ovarian malignancies (50%). Among the patients with ovarian malignancies, serum sialyl SSEA-1 level significantly increased according to clinical stage. In patients with positive serum sialyl SSEA-1, rising or falling of the serum level of this antigen correlated well with progression or regression of the disease. Measurement of serum CA125 was also performed in patients with ovarian malignancies, which showed a significantly higher positive rate (96%) and revealed that this antigen has no correlation with sialyl SSEA-1. A low positive rate of serum sialyl SSEA-1 level (9.1%) was observed in gravidas, while a higher positive rate (43%) in puerperas, especially within three days after parturition. This evidence should be considered when serum sialyl SSEA-1 antigen is measured as tumor marker. All these observations suggest that the measurement of serum sialyl SSEA-1 level is useful not only in the diagnosis of ovarian malignancies but for the judgment of the effect of treatment and the search for their recurrences.

Antigens, Neoplasm↗

Glassy cell carcinoma of the endometrium.

A case of glassy cell carcinoma of the endometrium in a 62-year-old woman is reported. Microscopically, a cytoplasm of ground-glass appearance was observed with a distinct cell wall and large nuclei containing prominent nucleoli. These histologic characteristics are consistent with those of glassy cell carcinoma of the cervix. Treatment consisted of total abdominal hysterectomy and bilateral salpingo-oophorectomy with pelvic lymph node dissection followed by external irradiation to the whole pelvis. The patient was alive without evidence of disease at 5 1/2 years.

Adenocarcinoma↗

Cervical cancers in uterus didelphys.

Two cases of cervical cancer in uterus didelphys are presented. One was extensive adenocarcinoma and one was squamous cell carcinoma in situ. In both cases the cancers appeared to have originated separately in each cervix.

Adenocarcinoma↗

Interferon gamma treatment for cervical intraepithelial neoplasia.

Eight patients with cervical intraepithelial neoplasia (CIN) were administered perilesional injections of human recombinant interferon gamma (IFN-gamma), and the response was evaluated by colposcopy and exfoliative cytology and then by histopathology. In all patients, colposcopic and cytologic findings improved after two to four injections of IFN-gamma and the cytologic findings reverted to normal in five of these eight patients. All five were free of dysplastic lesions. The other three patients with positive cytology and positive colposcopy after completion of IFN-gamma treatment underwent hysterectomy or laser conization, and histopathologic examination revealed residual dysplastic lesions. On the other hand, a control study revealed that only one of eight patients showed spontaneous regression during the 3-month observation period. During the course of these treatments, keratinizing cells were often present in the cervical smears and isolated cell keratinization was often evident in the residual dysplastic lesions of the surgical specimens. These observations suggest that IFN-gamma treatment is an effective therapeutic method for CIN lesions and that IFN-gamma has the potential to differentiate nonkeratinizing squamous cells into keratinizing cells.

Adult↗

[A case of an unusual mixed müllerian tumor in the lower uterine segment].

A unique case of a mixed müllerian tumor in a 33-year-old woman is presented. On gross examination of the hysterectomized specimen, well-circumscribed nodules, the largest measuring 3 cm in diameter, were found in the lower uterine segment. Microscopic examination revealed that the lesion was composed of a malignant glandular epithelium and a spindle cell stroma containing a smooth muscle. The atypical gland had deeply infiltrated into the normal myometrium and showed a squamous differentiation. This tumor should be differentiated from a benign mixed müllerian tumor, including an atypical polypoid adenomyoma, an adenofibroma, and an adenomyoma.

Adult↗

[Clinical evaluation of the treatment of early cervical neoplasia by carbon dioxide laser conization].

One hundred twenty patients with cervical neoplasia were treated by conization, 78 with a carbon dioxide laser and 42 with a cold knife. Bleeding during the conization was 82.5 +/- 91.4 ml with the laser and 117.3 +/- 82.6 ml with the cold knife. The time required for the operation was 55.0 +/- 16.7 min and 37.7 +/- 10.2 min, respectively. With the aid of a local injection of epinephrine, peroperative bleeding was much less pronounced in the laser group (25.4 +/- 39.5 ml) and the time required for the operation was further shortened to 36.4 +/- 15.0 min. Six patients treated with the cold knife (14.3%) suffered postoperative hemorrhage requiring hemostasis, but only one in the laser series (1.3%). Forty-nine patients of 78 treated with the laser and 15 of 42 treated with the cold knife were subjected to conservative therapy. All of them were followed up by cytology, colposcopy and histology, and there was no failure or recurrence at either 8 weeks and 1 year after the operation. Unsatisfactory colposcopic findings developed in 9 patients (18.4%) in the laser group compared with 11 patients (73.3%) in the cold knife group. Specimens obtained after laser conization were satisfactory for use in histopathological evaluation. Conization with a carbon dioxide laser appears to be an acceptable procedure as a diagnostic method and conservative therapy for cervical neoplasia.

Adult↗

Immunocytochemical detection of S-phase cells in normal and neoplastic cervical epithelium by anti-BrdU monoclonal antibody.

The use of a monoclonal antibody (MAb) to bromodeoxyuridine (BrdU) to identify S-phase cells was examined in 30 cervical biopsy specimens and 30 cervical smears from 18 patients with cervical neoplasia. Each patient received a local injection of 300 mg to 500 mg of BrdU into the cervix, at the time of endocervical laser conization, to label S-phase cells in neoplastic tissue. Labeled cells in normal and neoplastic tissues were detected in biopsy specimens or smears by indirect immunoperoxidase staining using the anti-BrdU MAb. The BrdU labeling index (BrdU LI, defined as the percentage of labeled cells in relation to the total number of cells counted) was calculated for all specimens. The level of BrdU-positive cells was 5.1% in normal cervical squamous epithelium, 12.3% in slight-to-moderate dysplasia and 21.2% in severe dysplasia to carcinoma in situ. In tissues without any dysplasia, BrdU-positive cells were mainly confined to the parabasal layer of the epithelium. In tissues showing slight-to-moderate dysplasia, BrdU-positive cells were mainly found in the lower half of the epithelium. BrdU-positive cells in severe dysplasia to carcinoma in situ were distributed throughout the full thickness of the epithelium. In addition, the few samples of squamous metaplasia and reserve cell hyperplasia encountered in this study exhibited a higher BrdU LI than did normal squamous epithelium. In cytologic specimens, BrdU-positive cells were found only in the cases of carcinoma in situ and in two cases containing normal cervical columnar epithelial cells. These results suggest that the immunocytochemical detection of BrdU by MAb staining may be useful for evaluating the proliferative activity in normal and neoplastic cervical epithelium.

Antibodies, Monoclonal↗

[Mass screening for endometrial cancer according to the Law of Health for the Elderly].

Due to the gradual increase of endometrial cancer, mass screening for this type of cancer began from 1987 in Japan in accordance with the Law of Health for the Elderly. However, a screening system for endometrial cancer has many controversial problems when compared with that for cervix cancer. Criteria for screening, methods of screening, management after screening, and executive systems are all controversial points in the performance of mass screening. The actual condition in the detection of endometrial cancer in Fukuoka Prefecture based on a questionnaire is discussed in this paper.

Aged↗

Treatment of advanced cervical cancer by a combination of peplomycin, vincristine, mitomycin-C, and cisplatin.

Eighteen patients with advanced or recurrent carcinoma of the cervix were treated with a combination of peplomycin, vincristine, mitomycin-C, and cisplatin (POMP). Ten of the 16 evaluable patients (63%) responded, including 4 with a complete response. Median duration of the response was 7 months. Two of 6 with intrapelvic recurrent tumors responded to some extent following intraarterial infusion. The subcutaneous infusion of peplomycin was well accepted by the patients. Toxicity was tolerable. This regimen seemed to be one of the regimens which should be considered for the advanced or recurrent cervical cancer.

Antineoplastic Combined Chemotherapy Protocols↗

Immunohistochemical demonstration of histiocytes in normal ectocervical epithelium and epithelial lesions of the uterine cervix.

The numbers of Langerhans cells and lysozyme-positive macrophages were assessed quantitatively in normal ectocervical epithelium, cervical intraepithelial neoplasia (CIN), microinvasive squamous cell carcinoma (MICA), clinical invasive squamous cell carcinoma (CICA), and koilocytotic atypia using the avidin-biotin-peroxidase complex (ABC) method. The distribution of Langerhans cells was different from that of lysozyme-positive macrophages in that the former were intermingled with the cervical lesion, while the latter were present mainly surrounding the cervical lesion and/or on the edge of the cervical lesion. The numbers of Langerhans cells and lysozyme-positive macrophages in CIN were significantly larger than those in normal ectocervical epithelium and significantly smaller than those in invasive squamous cell carcinoma (MICA + CICA). Langerhans cell number significantly increased as the grade of CIN advanced. In contrast, the number of lysozyme-positive macrophages did not differ significantly between progressive grades of CIN. As for koilocytotic atypia, the numbers of Langerhans cells and lysozyme-positive macrophages in koilocytotic atypia were significantly greater than those in normal ectocervical epithelium but did not differ significantly from those in CIN 1 and CIN 2. With respect to stromal lymphoid infiltration, invasive squamous cell carcinoma with moderate or dense stromal lymphoid infiltration showed significantly greater numbers of Langerhans cells and lysozyme-positive macrophages than that with no or scattered stromal lymphoid infiltration, but such a correlation was not found in CIN.

Carcinoma, Squamous Cell↗