Differential expression of VASP in normal lung tissue and lung adenocarcinomas.

BACKGROUND: Vasodilator stimulated phosphoprotein (VASP) is associated with focal adhesions and is thought to have an important role in actin filament assembly and cell motility. We hypothesise that an increase in the expression of VASP is involved in the progression and invasion of lung adenocarcinomas in parallel to tumour progression. A study was undertaken to analyse VASP expression in normal lung tissue and lung adenocarcinomas. METHODS: Human lung tissues with adenocarcinomas (n = 26) were used. Normal lung tissue specimens (n = 14) were taken from areas a standard distance (3 cm) from resected adenocarcinomas of patients who underwent surgical lung resection. Adenocarcinomas were classified according to pathological staging and histopathological grades. Tissues were stained for VASP using immunohistochemistry. RESULTS: Normal lung pneumocytes showed no VASP expression while alveolar macrophages had the strongest immunoreactivity for VASP. Bronchial epithelium (surface epithelium, goblet cells) and bronchial gland cells had a very weak immunoreactivity for VASP. Adenocarcinomas had significantly greater VASP expression than normal epithelium (p < 0.001). Moreover, VASP expression in adenocarcinomas increased significantly with more advanced tumour stage (p < 0.001). CONCLUSIONS: The spatial and differential expression of VASP in normal lung tissue and lung adenocarcinomas suggests that it is likely to be involved in the differentiation of normal lung cells to adenocarcinomas. The significant increase in the expression of VASP in adenocarcinomas in parallel to pathological staging suggests that it may regulate the invasive behaviour of lung adenocarcinomas as adenocarcinoma invasion is increased in more advanced tumours.

The prognostic relevance of angiogenesis and mast cells in squamous cell carcinoma of the oesophagus.

AIMS: Angiogenesis, an important prognostic factor in several tumours, is a complex event mediated by angiogenic factors released from cancer cells and host immune cells. Among the host immune cells, a role has been implicated for mast cells in tumour progression via promoting angiogenesis. Data have been recorded that indicate a correlation between intratumoral neovascularisation, as assessed by microvessel density (MVD), and prognosis in squamous cell carcinoma (SCC) of the oesophagus. However, a correlation between mast cell density (MCD) and either prognosis or angiogenesis has not been delineated yet in this disease. The aim of this study was to investigate the prognostic value of MVD and MCD in SCC of the oesophagus. The correlation between MVD and MCD was also evaluated. METHODS: MVD and MCD were investigated in tumour specimens from 53 patients diagnosed with SCC of the oesophagus. Intratumoral microvessels were stained with anti-CD34 antibody and mast cells with toluidine blue before being measured by light microscopy. RESULTS: Both MVD and MCD were associated with the depth of wall invasion, lymph node metastasis, and tumour progression (stage). A significant correlation was noted between MVD and MCD values (r = 0.72). The prognosis was significantly worse in patients with high MVD (> or = 92) and high MCD (> or = 18) values. Multivariate analysis indicated that MVD and stage were independent predictors of survival. CONCLUSIONS: These findings support the suggestion that MVD is a reliable prognostic marker in SCC of the oesophagus. Moreover, MCD may have a role in the angiogenesis of these tumours and might be responsible for their aggressive behaviour.

Operative management of substernal goiter: analysis of 52 patients.

Thyroid surgery for substernal goiter is an uncommon operation. This study was carried out to evaluate the clinical presentation, workup, surgical complications, and risk of malignancy for substernal goiter. From January 1995 to June 2001, 52 patients [27 men and 25 women (ratio, 1.1:1); average age of 52 years (range, 26-71 years)] underwent thyroid surgery for substernal goiter at Akdeniz University Hospital. All patients were symptomatic at presentation. A chest radiograph was used for most patients with a computed tomography scan being by far the most helpful in the study. A cervical approach was adequate for resection of the lesions in 50 (96%) patients. Two (4%) patients required medial sternotomy for removal of thyroid tissue. There was no perioperative mortality. Transient recurrent laryngeal nerve (RLN) palsy occurred in 2 (4%) patients, and permanent RLN occurred in 2 (4%) patients. The incidence of transient and permanent hypoparathyroidism was 8% and 6%, respectively. Other complications included wound infection in 2 (4%) patients and postoperative bleeding in 1 patient (2%). Histopathologically, 46 (88%) lesions were benign and 6 (12%) were malignant. Because the history of substernal goiter is progressive enlargement, surgical removal of thyroid tissue is always indicated and should be performed as soon as possible, unless there are contraindications for surgery. Cervical collar incision is nearly always adequate, with few exceptions.

Primary vascular echinococcosis: an uncommon cause of chronic iliofemoral arterial occlusion.

We report the case of a 33-year-old woman who was admitted to our clinic with the diagnosis of chronic arterial occlusion of the right lower extremity. Preoperative angiography suggested an iliofemoral atherosclerotic occlusion. During surgery multiple hydatid cysts causing iliofemoral occlusion were found and excised. Arterial reconstruction was performed using an iliofemoral bypass technique with a polytetrafluoroethylene vascular graft. This case emphasizes that, in sheep-raising countries or in patients from such countries, primary vascular echinococcosis should be considered in the differential diagnosis of chronic arterial occlusion.