Expression patterns of emmprin and monocarboxylate transporter-1 in ovarian epithelial tumors.

Emmprin is a transmembrane glycoprotein known as a matrix metalloproteinase inducer and is highly up-regulated in malignant cancer cells. The monocarboxylate transporters (MCTs) are responsible for H(+)-linked transport of monocarboxylates across the cell membrane. It was recently demonstrated that proper plasma membrane localization and activity of MCTs require the presence of emmprin as a chaperone and that MCT-1 also acts as chaperone for emmprin. The objectives of this study were to clarify emmprin and MCT-1 expression patterns in ovarian epithelial tumors and to elucidate the clinicopathological significance of co-localization of the two molecules. Immunohistochemical analysis of 205 epithelial tumors indicated that emmprin is always localized in cell membranes but its distribution differs according to tumor type: in lateral membranes in 89 % of adenomas, in lateral and basal membranes in 76 % of borderline tumors, and in membranes surrounding the entire cell in 98 % of carcinomas. Most carcinomas in situ also showed a lateral and basal expression pattern. In only 21 % of the carcinomas, the cells expressing membranous MCT-1 showed co-localized emmprin expression. Poor co-localization of the two molecules was more frequently found in serous carcinomas. However, the overall survival was not significantly different for the good and poor co-localization carcinoma groups. These findings indicate that the emmprin expression pattern might discriminate between invasive carcinomas and borderline tumors including carcinoma in situ. Moreover, there may be an as yet unidentified regulatory mechanism(s), for localization of MCT-1 and emmprin in cell membranes in vivo.

Multi-institutional retrospective analysis of the inhomogeneity correction for radiation therapy of lung cancer.

The purpose of this work is to retrospectively analyze the effect of the inhomogeneity correction using clinically treated plan of stage III non-small-cell lung cancer within multiple institutions in Japan. Twenty-five patients among five facilities of radiation therapy were registered for this study. The isocenter dose or D(95) of PTV or other important values were compared with and without an inhomogeneity correction using model-based algorithm. The differences in isocenter dose were 4% average and 10% maximum for the first Anterior-Posterior opposed field plan to 40 Gy and 6% average and 11% maximum for the off-cord boost oblique field plan of 20 Gy. The differences in D(95) dose were 1% average and 9% maximum for the first plan and 1% average and 6% maximum for the boost plan. D(95) prescription seemed to be a superior method; however, its reliability depends on each clinical case. Additionally, maximum dose, minimum dose and mean dose for both the primary tumor and the metastatic lymph node were analyzed, and the minimum dose had the most impressive results. In some cases, the target volume had unintended underdose of more than 10%. Finally, an analysis of the organ at risk was added, and this showed no meaningful differences for the V(20) of the lung and the maximum dose of the spinal cord. These results provide a standard for the effects of the inhomogeneity correction.

Primary leiomyosarcoma of the fallopian tube.

Primary sarcoma of the fallopian tube is a very rare neoplasm. We report the case of a 69-year-old woman affected with leiomyosarcoma of the left fallopian tube. Her chief complaint was lower abdominal pain. The preoperative diagnosis was a left adnexal malignant tumor based on pelvic examination, abdominal computed tomography, and magnetic resonance imaging. Following a laparotomy, she was ultimately diagnosed with a FIGO IIc fallopian tube leiomyosarcoma. She was treated with total abdominal hysterectomy, bilateral salpingo-oophorectomy, pelvic lymph node dissection, partial omentectomy, and low anterior resection for rectal invasion. The patient subsequently received adjuvant chemotherapy with pirarubicin and ifosfamide. Thirty months after the first therapy, a computed tomography scan revealed metastasis of the liver, lung, and supraclavicular lymph node. The patient died of the disease 39 months after the initial treatment.

Monitoring of endometrial K-ras mutation in tamoxifen-treated patients with breast cancer.

INTRODUCTION: A high incidence of endometrial K-ras mutations has been reported in tamoxifen (TAM)-treated patients with breast cancer. We examined the changes in the frequency of the endometrial K-ras mutations after the cessation of TAM treatment. METHODS: DNA was extracted from fresh cytological or polypectomy samples of the endometrium in 28 patients who had undergone TAM treatment of breast cancer. Mutations were detected by an enriched polymerase chain reaction-enzyme-linked minisequence assay (Sumitomo Metal Industry, Inc, Tokyo, Japan). K-ras codon 12 mutations were monitored in these 28 patients. RESULTS: An initial examination detected endometrial K-ras mutations in 13 of the 28 patients. However, repeated examinations performed after cessation of TAM treatment did not detect endometrial K-ras mutations in any of these 13 patients. No endometrial K-ras mutation has been detected in the repeated examinations performed for these patients for more than 2 years since the cessation of TAM treatment. In addition, the 15 patients who did not have endometrial K-ras mutations in the initial examination did not demonstrate them in repeat examinations. CONCLUSIONS: The cessation of TAM treatment may reduce the risk of developing endometrial cancers through K-ras mutations.

Monte Carlo calculations of correction factors for plastic phantoms in clinical photon and electron beam dosimetry.

The purpose of this study is to calculate correction factors for plastic water (PW) and plastic water diagnostic-therapy (PWDT) phantoms in clinical photon and electron beam dosimetry using the EGSnrc Monte Carlo code system. A water-to-plastic ionization conversion factor k(pl) for PW and PWDT was computed for several commonly used Farmer-type ionization chambers with different wall materials in the range of 4-18 MV photon beams. For electron beams, a depth-scaling factor c(pl) and a chamber-dependent fluence correction factor h(pl) for both phantoms were also calculated in combination with NACP-02 and Roos plane-parallel ionization chambers in the range of 4-18 MeV. The h(pl) values for the plane-parallel chambers were evaluated from the electron fluence correction factor phi(pl)w and wall correction factors P(wall,w) and P(wall,pl) for a combination of water or plastic materials. The calculated k(pl) and h(pl) values were verified by comparison with the measured values. A set of k(pl) values computed for the Farmer-type chambers was equal to unity within 0.5% for PW and PWDT in photon beams. The k(pl) values also agreed within their combined uncertainty with the measured data. For electron beams, the c(pl) values computed for PW and PWDT were from 0.998 to 1.000 and from 0.992 to 0.997, respectively, in the range of 4-18 MeV. The phi(pl)w values for PW and PWDT were from 0.998 to 1.001 and from 1.004 to 1.001, respectively, at a reference depth in the range of 4-18 MeV. The difference in P(wall) between water and plastic materials for the plane-parallel chambers was 0.8% at a maximum. Finally, h(pl) values evaluated for plastic materials were equal to unity within 0.6% for NACP-02 and Roos chambers. The h(pl) values also agreed within their combined uncertainty with the measured data. The absorbed dose to water from ionization chamber measurements in PW and PWDT plastic materials corresponds to that in water within 1%. Both phantoms can thus be used as a substitute for water for photon and electron dosimetry.

A normal uterus communicating with a double cervix and the vagina: a müllerian anomaly without any present classification.

OBJECTIVE: To report a rare uterine anomaly consisting of a normal uterus, a double cervix, and a double vagina. DESIGN: Case report. SETTING: University hospital. PATIENT(S): A 28-year-old nulligravida patient referred for evaluation of primary infertility and a suspected müllerian anomaly. INTERVENTION(S): Clinical and surgical evaluation of the anomaly. MAIN OUTCOME MEASURE(S): Description and treatment for a rare uterine anomaly and a subsequent literature search. RESULT(S): Successful resection of vaginal septum and subsequent pregnancy. CONCLUSION(S): This extremely rare anomaly is not explained by classic embryologic teachings, and it does not fit into the classification system currently used to describe müllerian anomalies.