[Fractal geometry in the objective grading of prostate carcinoma]. / Fraktale Geometrie zur Objektivierung des Gradings beim Prostatakarzinom.

BACKGROUND: A possible approach to objectively classify complex patterns in tumor tissue is a mathematical and statistical investigation of the distribution of cell nuclei as a geometric representation of cancer cells by fractal dimensions. Both the existence and changes in the fractal structure of tumor tissue have important consequences for the objective system of tumor grading. In addition, the complexity of growth in different carcinomas or their intercellular interactions can be compared to each other. RESULTS: We present a theoretical introduction into fractal geometry as well as in the computer algorithms based upon the Rényi family of fractal dimensions. Finally, a geometric model of prostate cancer is introduced and the relationship between geometric patterns of prostate tumor and the fractal dimensions of the Rényi family are explained.

[Objective grading of prostate carcinoma based on fractal dimensions: Gleason 3 + 4= 7a ≠ Gleason 4 + 3 =7b]. / Objektivierung des Tumorgradings bei Prostatakarzinomen anhand der fraktalen Dimensionen : Gleason 3 + 4 = 7a ≠ Gleason 4 + 3 = 7b.

BACKGROUND: Significant intra- and interobserver variability ranging between 40 and 80% is observed in tumor grading of prostate carcinoma. By combining geometric and statistical methods, an objective system of grading can be designed. MATERIAL AND METHODS: The distributions of cell nuclei in two-dimensional patterns of prostate cancer classified subjectively as Gleason score 3+3, 3+4, 4+3, 4+4, 4+5, 5+4, and 5+5 were analyzed with algorithms measuring the global fractal dimensions of the Rényi family and with the algorithm for the local connected fractal dimension (LCFD). RESULTS: The dimensions for global fractal capacity, information, and correlation (standard deviation) were 1.470 (045), 1.528 (046), and 1.582 (099) for homogenous Gleason grade 3 (n = 16), 1.642 (034), 1.678 (041), and 1.673 (084) for homogenous Gleason grade 4 (n=18), and 1.797 (042), 1.791 (026), and 1.854 (031) for homogenous Gleason grade 5 (n=12), respectively. The LCFD algorithm can be used to distinguish both qualitatively and quantitatively between mixed and heterogeneous patterns, such as Gleason score 3+4=7a (intermediate risk cancer) and Gleason score 4+3=7b (high-risk cancer). Sensitivity of the method is 89.3%, and specificity 84.3%. CONCLUSION: The method of fractal geometry enables both an objective and quantitative grading of prostate cancer.

Protamine mRNA ratio in stallion spermatozoa correlates with mare fecundity.

Highly compacted sperm DNA in protamine toroids and a minor fraction of nucleohistones are prerequisites for the efficient transmission of the paternal genome into the oocyte at fertilization. The objective of this study was to evaluate whether protamines might serve as a prognostic factor for stallion fertility. In situ hybridization detected specific expression of P1 mRNA in the cytoplasm of stage I to VII spermatids, whereas comparable immunohistochemical stainings showed that protein expression was delayed till elongating spermatids in differentiation stages III to VIII. No staining was detectable in cryptorchid testis because of the lack of spermatids in the seminiferous tubules. Using quantitative real-time polymerase chain reaction, we identified mRNA transcripts of P1 and 2 variants of protamine- 2 (P2, P3) in ejaculated spermatozoa from 45 thoroughbred stallions. According to the mare fertility descriptor (i.e. the 'none-return-rate 28 percentage' or NRR28%), stallions were divided into three groups (i.e. high, reduced and low fertility). The P2/P1 mRNA ratio was found to be significantly reduced in the group with lower fertility (p = 0.016) and was slightly correlated with sperm concentration (correlation coefficient r = 0.263). Furthermore, morphologically abnormal sperm count negatively correlated with P2/P1 mRNA ratio, indicating that spermatozoa carrying head defects display a diminished protamine ratio (r = -0.348). Conversely, the P2/P1 ratio was positively correlated with mare fertility or NRR28% (r = 0.274). Interestingly, P3/P1 mRNA ratio remained unaltered in the investigated groups indicating that this variant plays a minor role in equine sperm chromatin compaction. Aberrant protamine transcripts content in equine spermatozoa was not associated with DNA defragmentation rate as measured by flow cytometric acridine orange test. On the basis of these results, we suggest that, similar to human, equine protamine expression constitutes a checkpoint of spermatogenesis and as a corollary the level of protamine mRNA may reflect the quality of spermatogenesis and spermatozoa's fertilizing capacity.

[Infection and sepsis prevention in prostate biopsy]. / Infektions- und Sepsisprävention bei Prostatabiopsie.

Prostate biopsy is currently the gold standard in the diagnosis of carcinoma of the prostate. An estimated one million prostate biopsies are performed every year in Europe. Worldwide the most frequent form is the transrectal prostate biopsy using preoperative fluoroquinolone prophylaxis. In recent years an increasing rate of infectious complications after prostate biopsy has been observed. The main causative factor is fecal fluoroquinolone-resistant bacteria. This review aims to present the current evidence regarding infectious complications after prostate biopsy and strategies to reduce symptomatic infections and urosepsis.

On the relationship between fractal geometry of space and time in which a system of interacting cells exists and dynamics of gene expression.

We report that both space and time, in which a system of interacting cells exists, possess fractal structure. Each single cell of the system can restore the hierarchical organization and dynamic features of the entire tumor. There is a relationship between dynamics of gene expression and connectivity (i.e., interconnectedness which denotes the existence of complex, dynamic relationships in a population of cells leading to the emergence of global features in the system that would never appear in a single cell existing out of the system). Fractal structure emerges owing to non-bijectivity of dynamic cellular network of genes and their regulatory elements. It disappears during tumor progression. This latter state is characterized by damped dynamics of gene expression, loss of connectivity, loss of collectivity (i.e., capability of the interconnected cells to interact in a common mode), and metastatic phenotype. Fractal structure of both space and time is necessary for a cellular system to self-organize. Our findings indicate that results of molecular studies on gene expression should be interpreted in terms of space-time geometry of the cellular system. In particular, the dynamics of gene expression in cancer cells existing in a malignant tumor is not identical with the dynamics of gene expression in the same cells cultured in the monolayer system.

Tissue as a self-organizing system with fractal dynamics.

Cell is a supramolecular dynamic network. Screening of tissue-specific cDNA library and results of Relative RT-PCR indicate that the relationship between genotype, (i.e., dynamic network of genes and their protein regulatory elements) and phenotype is non-bijective, and mendelian inheritance is a special case only. This implies non-linearity, complexity, and quasi-determinism, (i.e., co-existence of deterministic and non-deterministic events) of dynamic cellular network; prerequisite conditions for the existence of fractal structure. Indeed, the box counting method reveals that morphological patterns of the higher order, such as gland-like structures or populations of differentiating cancer cells possess fractal dimension and self-similarity. Since fractal space is not filled out randomly, a variety of morphological patterns of functional states arises. The expansion coefficient characterizes evolution of fractal dynamics. The coefficient indicates what kind of interactions occurs between cells, and how far from the limiting integer dimension of the Euclidean space the expanding population of cells is. We conclude that cellular phenomena occur in the fractal space; aggregation of cells is a supracollective phenomenon (expansion coefficient > 0), and differentiation is a collective one (expansion coefficient < 0). Fractal dimension or self-similarity are lost during tumor progression. The existence of fractal structure in a complex tissue system denotes that dynamic cellular phenomena generate an attractor with the appropriate organization of space-time. And vice versa, this attractor sets up physical limits for cellular phenomena during their interactions with various fields. This relationship can help to understand the emergence of extraterrestial forms of life. Although those forms can be composed of non-carbon molecules, fractal structure appears to be the common feature of all interactive biosystems.

Complexity, retinoid-responsive gene networks, and bladder carcinogenesis.

Carcinogenesis involves inactivation or subversion of the normal controls of proliferation, differentiation, and apoptosis. However, these controls are robust, redundant, and interlinked at the gene expression levels, regulation of mRNA lifetimes, transcription, and recycling of proteins. One of the central systems of control of proliferation, differentiation and apoptosis is retinoid signaling. The hRAR alpha nuclear receptor occupies a central position with respect to induction of gene transcription in that when bound to appropriate retinoid ligands, its homodimers and heterodimers with hRXR alpha regulate the transcription of a number of retinoid-responsive genes. These include genes in other signaling pathways, so that the whole forms a complex network. In this study we showed that simple, cause-effect interpretations in terms of hRAR alpha gene transcription being the central regulatory event would not describe the retinoid-responsive gene network. A set of cultured bladder-derived cells representing different stages of bladder tumorigenesis formed a model system. It consisted of 2 immortalized bladder cell lines (HUC-BC and HUC-PC), one squamous cell carcinoma cell line (SCaBER), one papilloma line (RT4), and 4 transitional cell carcinomas (TCC-Sup, 5637, T24, J82) of varying stages and grades. This set of cells were used to model the range of behaviors of bladder cancers. Relative gene expression before (constitutive) and after treatment with 10 microM all-trans-retinoic acid (aTRA) was measured for androgen and estrogen receptor; a set of genes involved with retinoid metabolism and action, hRAR alpha nd beta, hRXR alpha and beta CRBP, CRABP I and II; and for signaling genes that are known to be sensitive to retinoic acid, EGFR, cytokine MK, ICAM I and transglutaminase. The phenotype for inhibition of proliferation and for apoptotic response to both aTRA and the synthetic retinoid 4-HPR was determined. Transfection with a CAT-containing plasmid containing an aTRA-sensitive promoter was used to determine if the common retinoic acid responsive element (RARE)-dependent pathway for retinoid regulation of gene expression was active. Each of the genes selected is known from previous studies to react to aTRA in a certain way, either by up- or down-regulation of the message and protein. A complex data set not readily interpretable by simple cause and effect was observed. While all cell lines expressed high levels of the mRNAs for hRXR alpha and beta that were not altered by treatment with exogenous aTRA, constitutive and stimulated responses of the other genes varied widely among the cell lines. For example, CRABP I was not expressed by J82, T24, 5637 and RT4, but was expressed at low levels that did not change in SCaBER and at moderate levels that decreased, increased, or decreased sharply in HUC-BC, TCC-Sup and HUC-PC, respectively. The expression of hRAR alpha, which governs the expression of many retinoid-sensitive genes, was expressed at moderate to high levels in all cell lines, but in some it was sharply upregulated (TCC-Sup, HUC-PC and J82), remained constant (5637 and HUC-BC), or was down-regulated (SCaBER, T24 and RT4). The phenotypes for inhibition of proliferation showed no obvious relationship to the expression of any single gene, but cell lines that were inhibited by aTRA (HUC-BC and TCC-Sup) were not sensitive to 4-HPR, and vice versa. One line (RT4) was insensitive to either retinoid. Transfection showed very little retinoid-stimulated transfection of the CAT reporter gene with RT4 or HUC-PC. About 2-fold enhancement transactivation was observed with SCaBER, HUC-BC, J82 and T24 cells and 3-8 fold with 5637, TCC-Sup cells. In HUC-BC, a G to T point mutation was found at position 606 of the hRAR alpha gene. This mutation would substitute tyrosine for asparagine in a highly conserved domain. These data indicate that retinoid signaling is probably a frequent target of inactivation in bladder carcinogenesis. (ABSTRAC

Distribution of gland-like structures in human gallbladder adenocarcinomas possesses fractal dimension.

BACKGROUND AND OBJECTIVES: Epithelial cells form tissue patterns of higher order such as gland-like structures. A question arises whether distribution of those patterns in adenocarcinomas is subject to certain regularity. METHODS: Due to the pilot nature of this study, gallbladder adenocarcinomas were preselected by histopathological, immunohistochemical, and morphometric analysis to ensure relative homogeneity of the patterns analyzed. A box-counting method was applied to investigate a relationship between a number of gland-like structures and a radius of the expanding family of the concentric circles. RESULTS: The coefficient of linear regression characterizing that relationship possesses noninteger value. It is 1. 585 (well-differentiated adenocarcinomas, standard deviation (SD) = 0.038, n = 100 sections), and 1.340 (moderately differentiated adenocarcinomas, SD = 0.044, n = 100 sections). While both nuclear area and nucleo-cytoplasmic ratio in those tissues remain within a similar range (Analysis of Variance (ANOVA), F(0) = 0.791 < F(alpha) = 3.84, P = 3 x 10(-3) and F(0) = 0.077 < F(alpha) = 3.84, P = 10(-6), respectively, for k = 20,000 cells, in which F(0) is a value of the test function, F(alpha) is a critical, limit value of the F-test at the constant confidence value alpha = 0.05), a difference of fractal dimension is significant (F(0) = 3.94 > F(alpha) = 0.693, n = 100 sections, P = 2 x 10(-3)). Also, variablity of fractal dimension between tumor sections is significant (moderately differentiated adenocarcinomas, F(0) = 1.9856 > F(alpha) = 1.4262, n = 100 sections, P = 0.189). CONCLUSIONS: There is fractal regularity in distribution of gland-like structures in human gallbladder adenocarcinomas. Fractal dimension is a holistic parameter which can be applied to evaluate tumor grading in a quantitative manner.

Retinoid signaling in immortalized and carcinoma-derived human uroepithelial cells.

This paper investigates the presence and functionality of retinoid signaling pathways in human urinary bladder carcinoma and SV40-immortalized uroepithelial cell lines. Only two of eight cell lines were proliferation-inhibited by 10 microM of either all-trans or 13-cis-retinoic acid. Transactivation of the CAT gene under control of a retinoid-responsive element demonstrated functionality of the signaling pathway in both sensitive cell lines and four of six resistant cell lines. Relative RT-PCR analysis of a panel of retinoid-responsive and inducible genes demonstrated changes in expression levels of all the genes in response to-retinoic acid treatment together with numerous aberrations dysregulations. We conclude that retinoid signaling may be a target for inactivation during tumorigenesis by uncoupling gene expression, proliferation and differentiation. Therefore retinoids are more likely to be effective for chemoprevention than for treatment of bladder carcinomas.

On the mitochondrial aspect of reactive oxygen species action in external magnetic fields.

Some retinoids or porphyrins can form radical pairs, alter transfer of electrons, and increase synthesis of reactive oxygen species in the mitochondrial respiratory chain. This leads to cell damage and apoptosis. We propose that co-application of an external static magnetic field of several to several hundreds miliTesla (mT) can enhance those effects by further alteration of electron flow in the mitochondrial respiratory chain, facilitation of forbidden transitions from the triplet to the singlet state of retinoid or porphyrin radicals, and modification of radical pair amount. Since electron flow in the mitochondrial respiratory chain seems to possess fractal dynamics, the magnetic field can initiate self- organization of the flow into more regular patterns, and create optimal conditions for damage of cancer cells without any detriment for the normal counterparts. External low magnetic field should improve effectiveness and selectivity of retinoid chemoprevention or porphyrin photodynamic therapy.

On the holistic approach in cellular and cancer biology: nonlinearity, complexity, and quasi-determinism of the dynamic cellular network.

A keystone of the molecular reductionist approach to cellular biology is a specific deductive strategy relating genotype to phenotype-two distinct categories. This relationship is based on the assumption that the intermediary cellular network of actively transcribed genes and their regulatory elements is deterministic (i.e., a link between expression of a gene and a phenotypic trait can always be identified, and evolution of the network in time is predetermined). However, experimental data suggest that the relationship between genotype and phenotype is nonbijective (i.e., a gene can contribute to the emergence of more than just one phenotypic trait or a phenotypic trait can be determined by expression of several genes). This implies nonlinearity (i.e., lack of the proportional relationship between input and the outcome), complexity (i.e. emergence of the hierarchical network of multiple cross-interacting elements that is sensitive to initial conditions, possesses multiple equilibria, organizes spontaneously into different morphological patterns, and is controlled in dispersed rather than centralized manner), and quasi-determinism (i.e., coexistence of deterministic and nondeterministic events) of the network. Nonlinearity within the space of the cellular molecular events underlies the existence of a fractal structure within a number of metabolic processes, and patterns of tissue growth, which is measured experimentally as a fractal dimension. Because of its complexity, the same phenotype can be associated with a number of alternative sequences of cellular events. Moreover, the primary cause initiating phenotypic evolution of cells such as malignant transformation can be favored probabilistically, but not identified unequivocally. Thermodynamic fluctuations of energy rather than gene mutations, the material traits of the fluctuations alter both the molecular and informational structure of the network. Then, the interplay between deterministic chaos, complexity, self-organization, and natural selection drives formation of malignant phenotype. This concept offers a novel perspective for investigation of tumorigenesis without invalidating current molecular findings. The essay integrates the ideas of the sciences of complexity in a biological context.

Expression of retinoid-responsive genes occurs in colorectal carcinoma-derived cells irrespective of the presence of resistance to all-trans retinoic acid.

BACKGROUND AND OBJECTIVES: Retinoids are metabolized in human intestinal epithelial cells to all-trans retinoic acid; however, it is unknown whether these cells express retinoid receptors, and whether sensitivity or resistance to the hormone is associated with a particular pattern of expression of retinoid-responsive genes. METHODS: Northern blot analysis and reverse transcriptase polymerase chain reaction (RT-PCR) were used to identify mRNAs for retinoid receptors. Both Relative RT-PCR and transfection of retinoid-inducible plasmid were applied to test functionality of the pathway in a model system for colorectal carcinoma progression (primary SW480, all-trans retinoic acid-sensitive cells vs. metastatic SW620, -insensitive cells). RESULTS: Three colorectal carcinoma-derived cell lines were inhibited by the hormone. Retinoic acid receptor type alpha (hRAR alpha) and retinoid X receptor type alpha (hRXR alpha) mRNAs were detected in normal enterocytes, colonocytes, and in all colorectal carcinoma-derived cells studied. Primary carcinomas and metastatic lesions expressed high amounts of hRAR alpha receptor protein, showing no simple correlation between the amounts of mRNA and receptor protein. No pattern of expression of the retinoid-responsive genes was associated with sensitivity or resistance to the retinoid. Expression of the genes occurred irrespective of resistance to the hormone or inactivity of the pathway. CONCLUSIONS: Colonocytes possess a molecular system for transduction of the retinoid signal. All-trans retinoic acid modifies gene expression and inhibits proliferation of these cells. Therefore, retinoids are likely to be effective in chemoprevention of colorectal carcinoma.

Retinoids and secosteroids induce gene expression in human colorectal carcinoma-derived cells but the macroscopic-scale effects remain unpredictable.

Expression of a number of retinoid-responsive genes (hRAR alpha, CRABP I, CRABP II, MK cytokine) and secosteroid-responsive genes (hVD3R, Calbindin) was studied in in vitro model of human colorectal carcinoma by Relative RT-PCR. MK cytokine mRNA has been identified in human colonocytes for the first time. Proliferation of SW480 cells was inhibited by 5 microM all-trans retinoic acid and 5 microM 1 alpha, 25-dihydroxycholecalciferol; however, SW620 cells were not inhibited by all-trans retinoic acid. Unexpectedly, SW620 cells were stimulated by nanomolar concentrations of 1 alpha, 25-dihydroxycholecalciferol. In the latter case, no induction of gene expression was seen. Gene expression was induced in both cell types, whether there was a responsive element in the promotor region or not, suggesting that signal transduction to cellular nucleus did occur. Also, the Scatchard analysis for hVD3R receptor protein confirmed that the amount of the protein was modified under the treatment with both hormones; however, non-linear relationship between the amount of the mRNA and the protein was observed. In general, the genes responded differently to the treatment than it had been predicted. While this variability could be ascribed to the genetic instability, we hypothesize that instability in the cellular network of genes, mRNAs, and proteins is responsible for the observed effects. Due to the complexity, a microscopic-scale phenomenon such as gene expression cannot determine a macroscopic-scale process such as proliferation. This study provides a molecular background for retinoid/secosteroid chemoprevention of colorectal carcinoma; however, these hormones should be applied early to control premalignant lesions rather than advanced carcinomas.

Molecular study of sex steroid receptor gene expression in human colon and in colorectal carcinomas.

BACKGROUND: Sex steroid hormones influence function of the human gastrointestinal tract. Although the specific receptor proteins have been identified in surgical specimens of both intestinal mucosa and colorectal carcinomas, it is still unknown whether they are expressed in intestinal epithelial cells. METHODS: Expression of androgen receptor (AR) protein and estrogen receptor (ER) protein was studied by Scatchard analysis and ELISA (for ER only) in surgical specimens of normal-appearing mucosa, colorectal carcinomas, isolated colonocytes, and human colorectal carcinoma cell lines. Northern analysis was applied to identify the appropriate mRNAs, followed by the sensitive technique of reverse transcription-polymerase-chain-reaction (RT-PCR). RESULTS: AR protein was identified in all surgical specimens analyzed and ER protein in 10 out of 13 normal-appearing mucosa specimens and 4 out of 7 colorectal carcinomas. The receptor proteins were not found in isolated colonocytes or in the transformed cell lines. RT-PCR confirmed that none of the isolated normal colonocytes or transformed colorectal carcinoma-derived cells expressed these mRNAs. Intestinal smooth muscle cells and fibroblasts were found to express sex steroid receptor mRNAs. CONCLUSIONS: Both receptors are present in human large intestine but are expressed in stromal cells and not in intestinal epithelial cells. We hypothesize that sex steroids may influence the function of colonocytes indirectly through stromal-epithelial interactions.

Complexity, dynamic cellular network, and tumorigenesis.

A holistic approach to tumorigenesis is proposed. The main element of the model is the existence of dynamic cellular network. This network comprises a molecular and an energetistic structure of a cell connected through the multidirectional flow of information. The interactions within dynamic cellular network are complex, stochastic, nonlinear, and also involve quantum effects. From this non-reductionist perspective, neither tumorigenesis can be limited to the genetic aspect, nor the initial event must be of molecular nature, nor mutations and epigenetic factors are mutually exclusive, nor a link between cause and effect can be established. Due to complexity, an unstable stationary state of dynamic cellular network rather than a group of unrelated genes determines the phenotype of normal and transformed cells. This implies relativity of tumor suppressor genes and oncogenes. A bifurcation point is defined as an unstable state of dynamic cellular network leading to the other phenotype-stationary state. In particular, the bifurcation point may be determined by a change of expression of a single gene. Then, the gene is called bifurcation point gene. The unstable stationary state facilitates the chaotic dynamics. This may result in a fractal dimension of both normal and tumor tissues. The co-existence of chaotic dynamics and complexity is the essence of cellular processes and shapes differentiation, morphogenesis, and tumorigenesis. In consequence, tumorigenesis is a complex, unpredictable process driven by the interplay between self-organisation and selection.

Expression of sex steroid receptor genes and comodulation with retinoid signaling in normal human uroepithelial cells and bladder cancer cell lines.

The expression of sex steroid receptor genes in human uroepithelial cells (UEC) and their role in bladder carcinogenesis is unknown. Expression of androgen receptor (hAR), estrogen receptor (hER), and vitamin d3 receptor (hVDR3) genes in normal human stromal cells (SC) and UEC, six bladder cancer cell lines, and two SV-40-immortalized cell lines (SVC) was determined by reverse transcriptase polymerase chain reaction (RT-PCR). Functionality was assessed indirectly by relative RT-PCR, which identified comodulation of mRNA expression between retinoic acid and sex steroid receptor genes. UEC and SC expressed hAR and hER mRNA constitutively at low levels, but only positive controls expressed hVDR3. Every cancer cell line and the SVC showed aberrant expression. Treatment of cells with all-trans-retinoic acid up-regulated hAR and hER expression, whereas treatment with sex steroids up-regulated retinoic acid receptor expression. Cell proliferation was not affected by sex steroids or by their inhibitors. Sex steroid signaling pathways are functional in UEC and appear to be altered during bladder tumorigenesis. The sex steroid receptors may play a role in normal differentiation.

G-actin as a risk factor and modulatable endpoint for cancer chemoprevention trials.

Because tumorigenesis is an ongoing process, biomarkers can be used to identify individuals at risk for bladder cancer, and treatment of those at risk to prevent or slow further progression could be an effective means of cancer control given accurate individual risk assessment. Tumorigenesis proceeds through a series of defined phenotypic changes, including those in genetically altered cells destined to become cancer as well as in surrounding normal cells responding to the altered cytokine environment. A panel of biomarkers for the changes can provide a useful system for individual risk assessment in cancer patients and in individuals exposed to carcinogens. The use of such markers can increase the specificity of chemoprevention trials by targeting therapy to patients likely to respond, and thereby markedly reduce the costs of the trials. Previous studies in our laboratories showed the cytoskeletal proteins G- and F-actin reflect differentiation-related changes in cells undergoing tumorigenesis and in adjacent "field" cells, and a pattern of low F-actin and high G-actin is indicative of increased risk. Actin changes may be a common feature in genetic and epigenetic carcinogenic mechanisms. In a group of over 1600 workers exposed to benzidine, G-actin correlated with exposure, establishing it as an early marker of effect. In another study, a profile of biomarkers was monitored in patients who underwent transurethral resection of bladder tumor (TURBT) and received Bacillus Calmette Guerin (BCG) and/or DMSO. The primary objective was to determine how the defined biomarkers expressed in the tumor and the field correlate with clinical response and recurrence. DMSO, known to modulate G-actin in vitro, was used as an agent. Results strongly support the hypothesis that cytosolic G-actin levels measured by quantitative fluorescence image analysis (QFIA) can be an important intermediate endpoint marker for chemoprevention and that the p300 (M344) and DNA ploidy markers identify a high-risk group that requires more aggressive therapy and recurrence monitoring. Further research with other markers has shown that DD23 and nuclear actin, both of which identify late, specific changes, may increase the battery of useful markers. Taken together these studies show how biomarkers are employed to study individuals at risk, aid in the selection of chemopreventive compounds and assist in the understanding of the pathogenesis of malignancy.

Controversies about the genetic model of colorectal tumorigenesis.

According to the genetic model, intestinal tumorigenesis is a result of the ordered in time inactivation of tumor suppressor genes and the activation of oncogenes. A tacit assumption is that both genes involved in the regulation of proliferation and growth factor-inducible genes, although inactivated, would not be changed during that process. The model requires that cancer cell population is homogenous, exists in a deterministic environment, and develops in a teleological manner. Meanwhile, tumorigenesis is rather a combination of both deterministic and stochastic molecular phenomena. Therefore, a novel notion of bifurcating point genes is defined as a generalization of the idea of tumor suppressor genes and oncogenes. Alternative stochastic mechanisms of tumorigenesis are discussed such as a decreased expression of intestinal-specific genes in cancer cells, most likely reflecting adaptation to survival within a heterogeneous, and non-equilibrated cellular population.

Advances in cancer research: report from the eighty-sixth annual meeting of the American Association for Cancer Research.

A meeting of the American Association for Cancer Research was held in Toronto, Canada on March 18-22, 1995 to discuss advances in cancer research. Growing interest was shown in the molecular mechanisms of prostate cancer. Both breast cancer and colorectal cancer continued to be major scientific topics of interest. Research into the genetics of cancer was dominated by the issue of genomic instability due to failures in the mismatch DNA repair gene system of cells. Instability appeared to represent the key mechanism for the generation of mutations. Another common theme was the identification of putative tumor suppressor and metastasis loci using loss of heterozygosity and cell chromosome fusion approaches. A few novel sequences with a potential suppressive function were reported. Also, relationships between growth factor receptors, tumor suppressor genes, oncogenes, and proteins controlling cell cycle were analyzed. Progress in gene therapy and chemoprevention of malignant tumors was frequently discussed.

Colorectal carcinoma as a genetic phenomenon.

Carcinogenesis in human large intestine is a result of multiple, heterogeneous and random genetic changes. Deletion of tumor suppressor genes and activation of oncogenes appear to be important molecular events. These compromise the loss of chromosomes 5, 17, 18 or functional inactivation of FAP, p53 and DCC genes. Activation of Ki-ras and c-myc oncogenes seems to be crucial for both cell immortalization and morphology modification. Identification of genes involved in this process enables both a screening and a new classification. Also it is an important step towards a gene therapy.