Many genes participate in the regulation of cell cycle progression from G1 to S phase. Functional loss of one or more of these genes has been reported to be associated with carcinogenesis and/or tumor progression and poor prognosis in many cancers. In a series of 126 patients with hepatocellular carcinoma (HCC), we immunohistochemically evaluated tumor expression of the cell cycle-related gene protein products of Rb, p21 (WAF1), and p53. Positive immunostaining for Rb, p21, and mutant p53 protein was detected in 58%, 33%, and 37% of the tumors, respectively. The proportion of HCCs exhibiting aberrant p53 protein expression increased significantly with advancing stage of disease (p < 0.001), poorer histological classification of differentiation (p < 0.01), and increasing tumor size (p < 0.01). A decrease in the proportion of HCCs expressing p21 protein was also associated with advancing clinical stage of disease (p < 0.01), and larger tumor size (p < 0.05). The only clinicopathological feature found to be associated with Rb status, was intrahepatic metastasis, which occurred with a higher frequency in HCCs exhibiting positive immunoreactivity for Rb protein expression (p < 0.05). Multivariate survival analysis revealed that, amongst the protein products of the different genes evaluated, only positive immunostaining for aberrant p53 protein expression served as an independent prognostic indicator, being significantly associated with worse survival in patients with HCC (p = 0.023). Analysis for relationships between gene products showed an inverse correlation between expression of aberrant p53 protein and p21 protein (p < 0.01), and also an inverse correlation between p21 protein and Rb protein expression (p < 0.05) in these cases of HCC. These findings demonstrate that positive immunostaining for mutant p53 protein expression is a significant indicator of tumor progression and poor prognosis, confirm that p21 protein expression is induced in a p53-dependent manner, and suggest that Rb protein expression may be regulated to some extent by p21 in HCC.

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Long-term postoperative analysis of nutritional status after limited gastrectomy for early gastric cancer.

BACKGROUND/AIMS: An examination was made of the postoperative long-term effects of limited gastrectomy (LG) on nutritional status, as one of the factors that influence quality of life. METHODOLOGY: Nutritional status in 33 patients who underwent LG for early gastric cancer, was compared with that of 36 patients who underwent standard gastrectomy (SG). Nutritional conditions were assessed preoperatively, and then 1 and 2 weeks, 1 and 6 months, and 1, 2 and 3 years after surgery. RESULTS: Postoperative recovery of both body weight and body fat mass was greater in LG than SG, and there were significant differences between the two groups of patients from six months after surgery until three years had elapsed. CONCLUSION: LG minimized the extent of nutritional impairment during long-term recovery from surgery, as compared with SG. LG would seem to be a suitable operative procedure for some patients with mucosal gastric cancer, without reducing radicality for cancer.

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