Comparative study of hepatocellular carcinoma in Shikoku, Japan: a study of 198 autopsy cases in Tokushima and Ehime Prefectures.

A total of 198 cases with hepatocellular carcinoma (HCC) autopsied in two different areas in Shikoku, Tokushima and Ehime, was examined clinicopathologically. The incidence of HBsAg-positives in overall HCC cases was 49.0%, being higher in Tokushima (52.4%) than in Ehime (43.1%). The difference seemed to be caused by the high incidence in female cases in Tokushima (46.7% in Tokushima vs. 23.1% in Ehime). The mean age of HCC cases with HBsAg (53.9 years) is younger than that of cases without HBsAg (58.8 years). The incidence of HBsAg-positive HCC cases in Shikoku decreased step by step toward older age groups from 63.4% in 41-50, 59.5% in 51-60, 34.6% in 61-70, to 15.8% in over-71 age groups, and has been decreasing gradually with the passage of time from 57.1% in 1960-1971, 50.0% in 1972-1976, to 40.8% in 1977-1981. The incidences of HBsAg-negatives in all autopsy cases increased from 2.0% in 1960-1971 to 3.3% in 1977-1981 (P less than 0.05) although the incidences of HBsAg-positives showed almost the same level. Both in Tokushima and Ehime, the incidences of HCC associated with cirrhosis and HCC with HBsAg were smaller in grade IV cases, and the incidence of HBsAg-positive HCC was high in cases with macronodular type of cirrhosis.

[Clinicopathological observation on renal cell carcinoma. "The relationship between the histological and clinical findings"].

The relationship between the histological and clinical findings of 128 cases of renal cell carcinoma operated on during the past 17 years were analyzed. With elevation of tumor grading, the elevated ESR and CRP-positive cases were increased with a significant difference. The serum alpha 2-globulin was elevated in the grade 3 group significantly, but not in the grade 1 or 2 group. Seven of the eight spindle cell type cases showed an elevation of ESR, CRP-positive and an elevation of alpha 2-globulin. There was no difference in clinical findings between well circumscribed border and poorly demarcated margin. A high percentage of quick type cases of renal cell carcinoma were found in high grade cases with a significant difference.

Liver cell dysplasia and hepatitis B surface antigen in liver cirrhosis and hepatocellular carcinoma.

Liver tissues of 223 autopsy cases of cirrhosis and hepatocellular carcinoma were examined for liver cell dysplasia in relation to hepatitis B surface antigen (HBsAg) detected with orcein stain. Liver cell dysplasia was found in 94 cases (42.2%): 37 were from cases of cirrhosis only, and 53 were from cases of cirrhosis with hepatocellular carcinoma. There was a significant difference in the overall incidence of HBsAg in cases with and without dysplasia (70.2%:32.6%). A similar difference was found in all groups, i.e., those with cirrhosis, cirrhosis with hepatocellular carcinoma, and hepatocellular carcinoma only, in which none of 11 cases of HBsAg negative had dysplasia. A good correlation was seen between the semiquantitative grade of dysplasia and the incidence of HBsAg. These findings suggest a close relationship of HBsAg with liver cell dysplasia.

Distribution of histaminase in human tumor tissues. An immunohistochemical study.

Tissue samples from 125 cases of a variety of human malignancies and benign conditions were examined for the presence of histaminase by the immunoperoxidase method on conventional pathological specimens. Histaminase was found diffusely in the cytoplasm of cancer cells of primary and metastatic tumors of lung, thyroid gland, pancreas, stomach, esophagus, ovary and pharynx. Histaminase-positive cases were also found in carcinoids, dysgerminomas and in melanoma. The incidence of positive histaminase staining in epithelial malignancies overall was 28/84, and those in sarcoma as well as in benign conditions were 1/22 and 0/19, respectively, excluding placental decidual cells and eosinophils intermingled in the tissues. No significant difference in the incidence of histaminase was found by histological type or by degree of cellular differentiation. The present results thus provided another direct evidence for the production of histaminase by many kinds of tumor cells.

Hepatitis B antigen in the liver in hepatocellular carcinoma in Shikoku, Japan.

An analysis of 105 autopsy cases (77 male, 28 female) of hepatocellular carcinoma (HCC) showed that 90 cases (85.7%) were associated with liver cirrhosis, of which 75 cases (83.3%) were of the macronodular type. Hepatitis B surface antigen (HBsAg) was detected with orcein stain in the hepatic tissue in 58 cases (55.2%). The incidence of HBsAg in cases of HCC patients with cirrhosis (58.9%) was higher, but not significantly, than that in those without cirrhosis (33.3%). The mean age of HBsAg-positive cases was five years less than that of HBsAg-negative cases, the age distributions therefore being significantly different.

Ultrastructural observations on preneoplastic epidermoid metaplasia in the lungs of rats.

Epidermoid metaplasia, of a type that consistently progresses to epidermoid carcinoma, was induced in rats at the interface of pulmonary tissue and intrapulmonary deposits of beeswax that contained either benzo(alpha)pyrene or the heptane-soluble fraction of cigarette smoke condensate. The preneoplastic epithelium was searched for morphological harbingers of neoplasia and compared with the type of reactive bronchial metaplasia, rarely associated with cancer, that results from chronic murine pneumonitis. The carcinogen-laden beeswax caused both proliferation and migration of epithelial cells from bronchi adjacent to the wax deposits. These initial proliferating cells were characterized by a lack of differentiation and were similar to the basal cells of bronchial epithelium. The migrating epithelium rapidly established itself at the interface of wax and viable lung tissue as a highly differentiated, stratified squamous epithelium. This epithelium was not qualitatively different from normal squamous epithelium. However, quantitative differences were evident from both normal epithelium and the metaplastic epithelium resulting from nonspecific injury. In the preneoplastic epithelium, the first indications of aggressive behavior occurred in foci of dysplastic basal cells that sent cytoplasmic intrusions through defects in the basement membrane. Characteristically, these dyplastic basal cells had numerous infoldings of the nuclear membrane and prominent nucleolar alterations. All strata of preneoplastic cells contained excessively complex interdigitations of the plasma membrane and unusually large numbers of desmosomes and tonofilaments. In contrast, the nonspecific metaplastic epithelium consisted almost entirely of multilayered uniform cells that closely resembled immature but otherwise normal basal cells of respiratory epithelium.