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Detection of MET oncogene/hepatocyte growth factor receptor in lymph node metastases from head and neck squamous cell carcinomas.

The c-MET oncogene encodes the receptor for hepatocyte growth factor/scatter factor (HGF/SF), which is known to stimulate the invasive growth of epithelial cells cultured in vitro. The Met/HGF receptor is a heterodimeric transmembrane tyrosine kinase, which is a prototype for a new family of growth factor receptors. The c-MET oncogene is expressed in several types of epithelial tissue including keratinocytes and is over-expressed in a number of human carcinomas. Studies on various carcinoma cell lines have shown that over-expression and structural alteration of the receptor result in its activation and confer tumorigenesis. We have studied Met/HGF receptor expression in tissue specimens from 34 patients with head and neck squamous cell carcinomas (HNSCC) and in 17 regional lymph node metastases. Western blot analysis was employed, using monoclonal antibodies directed against either the intracellular or extracellular domain of the receptor. Each sample was compared to its normal counterpart. The receptor did not show any major structural alterations in HNSCC tissues, but its expression was increased from 2- to 50-fold in about 70% of tumors. Immunohistochemistry then showed that the same antibodies stained only a few cells in the basal layer of normal squamous epithelium but intensely marked tumor cells. In the lymph node metastases of Met-positive tumors, receptor expression was maintained and sometimes increased with respect to primary tumors. Immunohistochemical analysis of the metastatic lymph nodes showed that cells were negative in the normal lymphatic tissue and strongly stained in tumor cells. Over-expression of the Met/HGF receptor was found at all tumor stages but was more significant in those associated with enlarged or multiple (N2-N3) lymph node metastases. These data show that expression of the Met/HGF receptor may be involved in the progression of HNSCC towards a metastatic phenotype and may be a useful marker of head and neck tumor cell spread to regional lymph nodes.

Adult↗

MUC 1 core protein as a marker of gallbladder malignancy.

AIM: The significance of MUC 1 expression in the gallbladder tissues in relation to cancer and non-cancer disease is not well understood. The aim of this study was to clarify the significance of MUC 1 expression. MATERIALS AND METHODS: A monoclonal antibody (CA 15--3; DF 3) was applied to stain MUC 1 core protein in surgical specimens. RESULTS: MUC 1 expression is significantly higher (p<0.0001) in gallbladder cancer (69/88) compare to non-cancerous tissue, while, very trace in normal and inflammatory tissues. The expression rate was significantly lower (p<0.0001) when the cancer did not penetrate the mucosal layer than when cancers did penetrate this layer. The MUC 1 expression rate was (4/14) in T1 tumours, (11/14) in T4, (40/45) in T3, and (14/15) in T2, respectively. Every cell of normal and inflammatory mucosa, and T1 cancers had the polarized pattern. The depolarized pattern was dominant in cancer cells from the advanced tumours of T2, T3 and T4. That is, (45/74) of cancer cells from the mucosal layer and (58/74) of penetrating cancer cells in submucosal layer had the depolarized pattern. There was no significant correlation of MUC 1 expression rate and staining pattern with cancer differentiation and microscopic venous invasion. On the other hand, lymphatic vessel invasion was significantly correlated with the staining pattern but not with expression rate. CONCLUSION: MUC 1 core protein expression rate and pattern are suggesting that MUC 1 core protein would be a marker of malignant transformation of gallbladder epithelium and its depolarized expression would also be a marker of invasion of gallbladder cancer.

Adenocarcinoma↗

[Cytophotometric method of determination of DNA content of neoplastic cells].

The content of DNA was investigated by the method of pulsed cytophotometry in cells of the following neoplasms: pulmonary cancer, benign lesions and cancer of the stomach, melanomas of the skin, malignant lymphomas and metastases of cancer into the lymphatic node. In the normal tissues and benign tumours the number of proliferating cells (DNA value of 3p, 4p) was not significant--from 2.0 to 5.0%. Polyploid cells were absent. In tumours the number of cells varied broadly--proliferating cells from 5.0 to 27,0%, polyploid cells from 9.0 to 40.0%. The use of the method of pulsed cytophotometry in prophylactic examinations is not effective, since in many cases changes could be detected only in single cells not identifiable on DNA-cytograms. Investigation of DNA content by the method of pulsed cytophotometry in a great number of tumour cells makes it possible to determine more accurately the character of the tumoral process, the level of differentiation of the tumoral tissue.

Cell Nucleus↗

PATHOLOGY OF TUMOURS IN CHILDREN.

An analysis of the types of tumour in children in the Manchester hospital region indicates that approximately two-thirds arose in the reticuloendothelial or nervous systems. The high mortality is largely due to the nature or site of the tumours, the majority of which cannot be eradicated by purely local measures. The most likely means of causing any significant improvement would be by greater centralization in the treatment of these children.

Adolescent↗

Diagnostic fine needle aspiration of soft tissue metastases from cancer of the prostate.

Pathologic confirmation of soft tissue metastases is necessary for staging and followup of patients with cancer of the prostate. Fine needle aspiration with cytologic evaluation is recommended over other biopsy procedures because it is safe, accurate and applicable to deep and superficial lesions. Small metastases, such as lymph nodes or skin nodules, remain in situ as useful markers to follow the course of the disease and response to treatment.

Abdominal Neoplasms↗

[Submucosal injection of lipiodol-bleomycin in esophageal cancer].

Submucosal injection of Lipiodol-bleomycin (BLM) for esophageal cancer is complementary to CT scan in preoperative determination of the depth of the cancerous invasion in the esophageal wall. This procedure was performed not only for diagnosis but also as a preoperative therapy in 109 cases with esophageal cancer in Hiroshima University Hospital. The Lipiodol-BLM suspension was prepared by mixing 45 mg BLM and 5 ml Lipiodol on a clean bench. The mixture was usually injected into the submucosal layer of the esophagus using fiberscopy 12 days before the operation. BLM concentration was measured in the primary tumor, normal esophageal tissue around the tumor and regional lymph nodes in the specimen in 14 cases. As a result, a low level of BLM had been maintained in these tissues for a long time. The concentration of the primary tumor was 4 times higher than that of the normal esophageal tissue. In order to predict the side effects of BLM, such as pulmonary fibrosis, the change in serum BLM level was measured in 12 cases. Serum BLM decreased to an unmeasurable level 24 hours after the injection. Thus, the submucosal injection of lipiodol-BLM for esophageal cancer seems to be promising for a targeting cancer chemotherapy.

Bleomycin↗

[Staging of musculoskeletal tumors in diagnostic imaging].

The staging of primary malignant bone and soft tissue tumors requires adherence to a unified staging system. The staging system of the American Joint Commission for Cancer, the Enneking system, and the Hajdu system are described in respect of the radiologic staging criteria. Plain film radiography can estimate the biological aggressiveness of a bone tumor and in many cases narrow the differential diagnosis. Computed tomography is most sensitive in depicting cortical erosions and calcified periosteal reactions as well as in screening for distant metastasis. Angiography is mainly employed for vascular tumors and for the monitoring of interventional procedures such as tumor embolization. For both bone and soft tissue tumors, magnetic resonance tomography is the method of choice for the staging of intra- and extramedullary tumor extension, for the differentiation of neighboring compartments, and in the detection of invasion of the regional neurovascular bundle. After administration of contrast agents, the mode of enhancement gives further information on the nature of the tumor. With consistent application of the staging criteria in preoperative imaging, limb-saving therapy can be employed more often and the prognosis of the disease can be improved.

Bone Neoplasms↗

Attempt to modify Rauscher-virus leukemogenesis by modulation of lymphoreticular and hematopoietic tissue.

Rauscher erythroleukemia virus of the mouse was originally isolated from an animal bearing a lymphocytic neoplasm. In order to control extraneous influences on leukemia development, we modulated thymus-dependent and bursa-dependent lymphatic tissues and the granulopoietic and erythropoietic components of hemoreticular tissues during the latent period of leukemia development. In all experiments the same type of erythroleukemia was found with some variation in the course of the disease.

Animals↗

[Clinical application of the international histological and cytological classification of hematologic and lymphatic neoplasms].

The first part of the International classification of neoplastic diseases of haemopoietic and lymphatic tissues by Mathé et al is discussed. The classification is exhaustive but the Table does not include all varieties of hemoblastoses mentioned in the explanatory text and shown in illustrations. Some of the terms seem disputable or inaccurate. The structure of leukemias (623 cases) based on the data of the Sverdlovsk regional haematological centre for 1975-1979 is presented, as reconsidered according to the above classification. The role of trepanobiopsies in diagnosis of leukemias is emphasized.

Bone Marrow↗

Localized operable soft tissue sarcoma of the upper extremity. Presentation, management, and factors affecting local recurrence in 108 patients.

Radical ablative surgery for upper extremity sarcoma often results in significant loss of function. With the recent emphasis on limb preservation, function-sparing excision has been combined with adjuvant radiation and chemotherapy in an increasing number of patients. To assess the effect of changing management on local recurrence rates and identify factors governing local failure, the records of 108 patients with operable, nonmetastatic soft tissue sarcoma of the upper extremity, treated at the Memorial Sloan-Kettering Cancer Center between 1968 and 1978, were reviewed. Median follow-up care was 8.2 years. One third of the patients presented with locally recurrent tumors after initial treatment elsewhere. Over half of the lesions were above the elbow and 62% were high grade. Seventy-three patients (68%) had limb-sparing surgery (LSS), but margins were considered adequate in less than half. Local recurrence was directly related to the adequacy of the surgical margins and was significantly higher in the LSS patients (p = 0.008). Other factors associated with an increased risk of local failure included: presentation with local recurrence, superficial location, and invasion of vital structures (LSS only). Local failure varied significantly with histologic type and was highest in patients with embryonal rhabdomyosarcoma and angiosarcoma. When the data were subjected to multivariate analysis, the following variables emerged as independent predictors of local failure: presentation with local recurrence, surgery by LSS, inadequate margins, angiosarcoma, and invasion of vital structures. These risk factors should be carefully weighed when selecting local treatment for patients with upper extremity soft tissue sarcomas.

Adolescent↗

Retroperitoneal soft tissue sarcomas: a review of the literature.

The English language literature on retroperitoneal sarcomas published between 1981 and 1988 has been reviewed. The histology, different prognostic factors, value of imaging techniques, and need for multidisciplinary management are discussed. Complete surgical excision with tumor-free margins confirmed by histology is essential if long-term survival and local control are to be achieved. In many cases resection of adjacent organs is required as most patients present with advanced, aggressive local disease. The roles of adjuvant radiotherapy and chemotherapy in the treatment of retroperitoneal sarcomas are uncertain and must await further controlled, randomized, prospective studies.

Diagnosis, Differential↗

[Correlation of lymphangiogenesis to progression of colorectal cancer].

BACKGROUND & OBJECTIVE: Lymphatic metastasis affects the prognosis of colorectal cancer patients. The binding of vascular endothelial growth factor-C (VEGF-C) and vascular endothelial growth factor receptor-3 (VEGFR-3) promotes lymphangiogenesis and lymphatic metastasis. This study was to investigate the interrelation of VEGF-C, VEGFR-3 and lymphangial density (LAD), and to identify their correlations to clinicopathologic factors of colorectal cancer. METHODS: The tissue microarrays containing 105 cases of colorectal cancer and 105 cases of normal colorectal tissue were produced separately. The expression of VEGF-C and VEGFR-3 was detected by immunohistochemistry; LAD was assessed through Podoplanin immunohistochemical staining. RESULTS: The positive rates of VEGF-C and VEGFR-3, and LAD were significantly higher in colorectal cancer than in normal colorectal tissue (61.0% vs. 22.8%, P<0.01; 55.2% vs. 20.0%, P<0.01; 8.91+/-3.75 vs. 6.68+/-1.38, P<0.01). The expression of VEGF-C had no correlation to that of VEGFR-3. LAD was significantly higher in VEGF-C-positive colorectal cancer than in VEGF-C-negative colorectal cancer (10.89+/-3.36 vs. 5.83+/-1.67, P<0.01). VEGF-C was up-regulated in colorectal cancer at Dukes'C stage, or with lymph node metastasis or distant metastasis; VEGFR-3 was up-regulated and LAD was higher in colorectal cancer at Dukes'C stage, or with lymph node metastasis. CONCLUSION: VEGF-C and VEGFR-3 are related with the lymphangiogenesis, lymphatic metastasis, and progression of colorectal cancer.

Aged↗

Brain metastasis of Merkel cell carcinoma. Case report and review of the literature.

Merkel cell carcinoma (MCC) is a rare primary cutaneous neuroendocrine tumor that is locally aggressive and has potential for metastatic spread. However, brain metastases are rare, and therapy for such tumors has never reported. The authors present a 48-year-old woman with MCC of the left elbow and a right cerebellar metastasis. After the right cerebellar mass was totally resected, radiation treatment and chemotherapy were performed. Eight cases of brain metastasis have been reported in the literature, but only 5 have been presented in sufficient detail for analysis. Therapy for brain metastases has always been palliative whole-brain irradiation and chemotherapy except for our patient, who underwent total removal of the tumor and survived for 11 months without neurological deficit. Except in the case of 1 with a particularly radiosensitive MCC, the patients with brain metastases died within 9 months after detection of the brain lesions. If possible, aggressive excision of brain metastases as well as of the primary lesion should be done.

Carcinoma, Merkel Cell↗