Long-term outcomes after treatment for pedunculated-type T1 colorectal carcinoma: a multicenter retrospective cohort study.

BACKGROUND: The risk for lymph node metastasis and the prognostic significance of pedunculated-type T1 colorectal carcinomas (CRCs) require further study. We aimed to assess the validity of the 2014 Japanese Society for Cancer of the Colon and Rectum (JSCCR) guidelines based on long-term outcomes of pedunculated-type T1 CRCs. METHODS: In this multicenter retrospective cohort study, we examined 176 patients who underwent resection endoscopically or surgically at 14 institutions between January 1990 and December 2010. Patients meeting the JSCCR curative criteria were defined as "endoscopically curable (e-curable)" and those who did not were "non-e-curable". We evaluated the prognosis of 116 patients (58 e-curable, 58 non-e-curable) who were observed for >5 years after treatment. RESULTS: Overall incidence of lymph node metastasis was 5 % (4/81; 95 % confidence interval 1.4-12 %: three cases of submucosal invasion depth ≥1000 µm [stalk invasion] and lymphatic invasion, one case of head invasion and budding grade 2/3). There was no local or metastatic recurrence in the e-curable patients, but six of them died of another cause (observation period, 80 months). There was no local recurrence in the non-e-curable patients; however, distant metastasis was observed in one patient. Death due to the primary disease was not observed in non-e-curable patients, but six of them died of another cause (observation period, 72 months). CONCLUSIONS: Our data support the validity of the JSCCR curative criteria for pedunculated-type T1 CRCs. Endoscopic resection cannot be considered curative for pedunculated-type T1 CRC with head invasion alone.

Paradoxical effects by preoperative oral low-dose tegafur administration in human gastric carcinomas: enhanced apoptosis and increased intratumoral microvessel density.

This study examined the effect of preoperative low-dose tegafur treatment in human gastric carcinomas. Among 55 patients with gastric carcinoma, 33 received an oral administration of tegafur 600 mg/body/day for 7 days before. Formalin-fixed, paraffin-embedded specimens were immunostained for Ki-67, P53, P21, CD34, Bax, VEGF, and dThdPase and also examined by the terminal deoxynucleotidyl transferase-mediated dUTP-digoxigenin nick end labeling procedure. The apoptotic index (AI), Ki-67 labeling index (KI) and intratumoral microvessel density (IMVD) were counted. Mean AI and IMVD were 3.4+/-1.60 and 126.1+/-36.56 in the treated carcinomas, and 2.3+/-0.88 and 98.0+/-44.40 in the non-treated carcinomas, both values being significantly higher in the former (P<0.05). The treatment resulted in a significant increase of mean AI in the intestinal type, in the early, and in the P53-positive carcinomas (P<0.05), while the treatment brought a significant increase of IMVD in the diffuse type, in the early and in the P53-negative carcinomas (P<0.05, respectively). No significant difference was noted on the frequency of P53, P21, BAX, VEGF and dThdPase expressions between the two groups. Ki-67 expression did not correlate with any factors. Preoperative low-dose tegafur treatment resulted in a paradoxical effect; enhanced apoptosis and increased IMVD in human gastric carcinomas.

Mast cells in human allografted kidney: correlation with interstitial fibrosis.

INTRODUCTION: Chronic allograft nephropathy is the major cause of long-term graft failure in human allografted kidney transplantation. In addition to macrophages and T lymphocytes, mast cells have been shown to increase in chronic allograft nephropathy. The present study examined tryptase-positive mast cells and microvessels in the allografted kidney. MATERIALS AND METHODS: We selected 131 biopsy specimens obtained from 100 allografted, 14 non-grafted renal biopsy specimens and nine nephrectomy specimens due to renal cell carcinomas. Formalin-fixed, paraffin- embedded specimens were immunostained using primary antibodies for mast cell tryptase, mast cell chymase and CD34. The number of the mast cells and microvessels was counted in at least 20 high-power fields (10 x 40). RESULTS: Tryptase-positive mast cells outnumbered chymase, toluidine blue or naphthol-AS-D choloacetate-positive mast cells. The mean number of the tryptase-positive mast cells was significantly higher in the 36 specimens with chronic allograft nephropathy (5.1 +/- 3.5) among the grafted kidneys with other disease categories (P < 0.001). In the chronic allograft nephropathy, the mean numbers of mast cells was significantly higher in Ci 2 + Ci 3 (n = 20; 6.4 +/- 3.89) than in Ci 1 (n = 16; 3.6 +/- 2.65) (P < 0.01). In the non-grafted kidney, the number of mast cells was highest in the four specimens with diabetic nephropathy. Mast cells and microvessels were analysed in the two representative cases, which subsequently developed chronic allograft nephropathy. Both of the cases showed the highest number of mast cells in chronic allograft nephropathy. In contrast, the mean number of microvessels tended to decrease along with interstitial fibrosis. CONCLUSIONS: This study demonstrated clearly a close association between renal interstitial fibrosis and mast cells, which might play an important role in the development of chronic allograft nephropathy.

Minichromosome maintenance 2 expression is correlated with mode of invasion and prognosis in oral squamous cell carcinomas.

BACKGROUND: This study examined the immunohistochemical expression of cell-cycle related molecules as well as cell proliferation and pathologic findings in oral squamous cell carcinoma (SCC) in order to clarify their pathobiologic and prognostic significance. METHODS: A total of 46 oral SCC specimens were analyzed using Ki-67, minichromosome maintenance 2 (MCM2), p53, p27, p21, and TUNEL. Aspects including tumor differentiation, mode of carcinoma invasion, tumor metastasis, and patient prognosis were compared among the specimens. RESULTS: A significantly higher MCM2 labeling index (LI) was observed in the moderately differentiated SCCs when compared to the well-differentiated SCCs (P<0.05). The higher MCM2 LI was correlated with mode of invasion Grade 4 (infiltrative growth) and patient prognosis. In contrast, the LIs of Ki-67, TUNEL-signal, p53, p27, and p21 were not correlated with patient prognosis. CONCLUSION: Higher MCM2 LI provides useful information for patient prognosis in oral SCCs.

Cardiac chondrosarcoma producing parathyroid hormone-related protein.

Chondrosarcoma is a malignant tumor characterized by the formation of cartilage. A case of primary cardiac chondrosarcoma of the left atrium developed in a middle-aged male. The preoperative serum concentrations of C-parathyroid hormone-related protein (PTHrP) and calcium were high (413.2 pmol/L and 12.2 mg/dl, respectively), but normalized after resection of the tumor, which measured 7 x 5 x 3.5 cm. The tumor was histopathologically diagnosed as chondrosarcoma, composed of outer atypical chondroid cells and inner pleomorphic and spindle mesenchymal cells mimicking malignant fibrous histiocytoma. Half of the cartilaginous tumor cells and a few pleomorphic cells showed cytoplasmic immunoreactivity for PTHrP. The tumor is a possible example of the functional pleiotropy of chondrosarcoma.