Differential expression of anti-apoptotic protein Bcl-2 in keratinizing versus non-keratinizing squamous cell carcinoma of the anus

Background: Histologically, tumors of the anal region are either keratinizing (K) or non-keratinizing (NK) squamous cell carcinomas (SCCA). We hypothesized that these two variants might represent, not only morphologically, but also biologically, dissimilar malignancies. The present study was undertaken to compare the expression of apoptosis-regulating proteins Bcl-2 and p53 in K versus NK SCCA. Methods: We performed an immunohistochemical analysis on 98 pre-treatment biopsies of patients with anal canal cancers. Tissue sections were examined immunohistochemically for expression of proteins Bcl-2 (clone 124, DAKO, 1:100) and p53 (clone DO7, DAKO, 1:200). Expression of p53 and Bcl-2 was considered positive when >5% of tumor cells were stained. Tumor histology was correlated with protein expression as well as with other clinical variables. Results: There were 64 NK and 34 K SCC. The proportion of Bcl-2 positive tumors was statistically higher in NK carcinomas (51.5 vs. 23.5%, p=0.009). In addition, women were more likely than men to present with NK carcinomas (71 vs. 45%, p=0.03) as well as with Bcl-2 positive tumors (47 vs. 29%, p=0.05). The more distal the tumor is (anal margin), the more frequently the keratinizing subtype is observed (87 vs. 23%, p=0.0002). By contrast, there was no correlation between p53 and tumor histology (p=0.83). Conclusions: Our data demonstrate that non-keratinizing and keratinizing SCCA differ in their Bcl-2 expression. In addition, significant differences were observed in the distribution of these two histological subtypes according to gender and tumor sublocation. These findings may indicate possible differences in the carcinogenesis process of these two histological subtype

Lymph node retrieval in abdominoperineal surgical specimen is radiation time-dependent

BACKGROUND: A low yield of lymph nodes (LN) in abdominoperineal resection (APR) specimen has been associated with preoperative radiation therapy (XRT) in population-based studies, which may preclude adequate staging of anorectal carcinomas. We hypothesized that the number of LN retrieved in APR specimen was correlated with the dose and the timing of pelvic irradiation. PATIENTS AND METHODS: We performed a retrospective study of 102 patients who underwent APR in a single institution between 1980 and 2004. Pathological reports were reviewed and the number of lymph nodes retrieved in APR specimens was correlated with: 1) Preoperative radiation; 2) Dose of pelvic irradiation; and 3) Time interval between the end of XRT and surgery. RESULTS: There were 61 men and 41 women, with a median age of 66 (range 25–89) years. There were 12 patients operated for squamous cell carcinoma of the anal canal (SCCA) and 90 for rectal cancer. 83% and 46% of patients with anal and rectal cancer respectively underwent radical/neoadjuvant radiotherapy. The mean ± SD number of LN in APR specimen was 9.2 ± 5.9. The mean number of LN in APR specimen was significantly lower in patients who underwent preoperative XRT (8 ± 5.5 vs. 10.5 ± 6.1, Mann-Whitney U test, p = 0.02). The mean number of LN was not significantly different after XRT in patients with SCCA than in patients with rectal cancer (6.2 ± 5.3 vs. 7.8 ± 5.3, p = 0.33). Finally, there was an inverse correlation between the yield of LN and the time elapsed between XRT and surgery (linear regression coefficient r = -0.32, p = 0.03). CONCLUSION: Our data indicate that: 1) radiation therapy affects the yield of LN retrieval in APR specimen; 2) this impact is time-dependent. These findings have important implications with regard to anatomic-pathological staging of anal and rectal cancers and subsequent decision-making regarding adjuvant chemotherapy

Improved Long-Term Outcome of Surgery for Advanced Colorectal Liver Metastases: Reasons and Implications for Management on the Basis of a Severity Score

Background: The outcome of liver resection for colorectal liver metastases (CRLM) appears to be improving despite the fact that surgery is offered to patients with more-severe disease. To quantify this assumption and to understand its causes we analyzed a series of patients on the basis of a standardized severity score and changes in management occurring over the years. Methods: Patients' characteristics, operative data, chemotherapies and follow-up were recorded. CRLM severity was quantified according to Fong's clinical risk score (CRS), modified to take into account the presence of bilateral liver metastases. Three periods were analyzed, in which different indications, surgical strategies and uses of chemotherapy were applied: 1984-1992, 1993-1998, and 1999-2005. Results: Between January 1984 and December 2005, 210 liver resections were performed in 180 patients (1984-1992, 43 patients; 1993-1998, 42 patients; 1999-2005, 95 patients). CRLM severity increased throughout the time periods, as did the use of neoadjuvant chemotherapies, repeat resections, and multistep procedures. While the disease-free survival did not improve over time, the 1-, 3- and 5-year overall survival rate increased from 85%, 30%, and 23% in the first period, to 88%, 60%, and 34% in the second period, and to 94%, 69%, and 46% in the third period. Conclusions: Analysis according to the CRS showed that despite the fact that patients had more severe disease, the overall survival improved over the years, mainly thanks to more aggressive treatment of recurrent disease. Management of advanced CRLM should, from the start, take into account the likelihood of secondary procedure

Effect of phospho-compost and phosphate laundered sludge combined or not with endomycorrhizal inoculum on the growth and yield of tomato plants under greenhouse conditions

The study aims to evaluate the eff ect of endomycorrhizal inoculum (arbuscular mycorrhizal fungi), phospho-compost and phosphate sludge in single (M, PC, PS) or dual combinations (PC+M, PS+M, PS+PC) compared to agricultural and Mamora soils (A and S) on the growth, fl owering, and yield of tomato plants. Among the studied treatments, the substrates containing 5% of phospho-compost combined with endomycorrhizal inoculum (PC+M) gave the most positive eff ect followed by phospho-compost (PC) and endomycorrhizal inoculum (M). In response to PC+M substrate, tomato plant height, the number of leaves and fl owers attained 90 cm, 30, and 25, respectively. In substrates PC and M, tomato plants showed a height of 85 and 75 cm, leaves number of 30 and 19 leave/plant and number of fl owers of 21, and 19 fl ower/plant. An optimal yield with (12 fruits/plant) was recorded in tomato plants grown on the substrate amended with bio-inoculant (AMF) and phospho-compost at a rate of 5%. In terms of qualitative parameters, the highest fresh and dry weight of aerial plant parts and root system were recorded in tomato plants grown in culture substrate incorporating 10 g of endomycorrhizal inoculum and 5% of phospho-compost reaching respectively103.4 g, 34 g 90.1 g, 28.9 g as compared to 87, 51, 23 and 24.1 g noted by tomato plants on the substrate with phospho-compost (5%) (PC). The highest mycorrhization parameters (frequency (F), intensity of mycorrhization (M), average arbuscular content (A), average vesicular content (V), average intraradicular spore content (S)) were found in the roots of tomato plants growing on substrates amended with 5% phospho-compost plus 10 g of endomycorrhizal inoculum, with percentages of 100% F, 61% M, 40.67% A, 18.36% V, and 56.9% S

Effects of a Composite Endomycorrhizal Inoculum on Olive Cuttings under the Greenhouse Conditions

This study was carried out in a nursery to evaluate the impact of mycorrhizal fungi on the cutting's root growth, and root colonization of a Moroccan olive variety ‘Picholine Marocaine' under greenhouse conditions during 2 years of cultivation. The results revealed that the inoculation with a composite inoculum of arbuscular mycorrhizal fungi (AMF) stimulated an early root formation and high development of vegetative shoots in inoculated cuttings respectively, 35 days (50 days in the control plots) and 40 days (60 days in the control plots) after their culture. The progressive establishment of mycorrhizal symbiosis in the roots of the inoculated plants showed that the root and vegetative masses were respectively 24 g and 19.5 g two years after inoculation. The average height and the leave's number of the inoculated plants relative to the control were respectively s 42/ 12 cm and 145/12. The newly formed roots were mycorrhizal and present different structures characteristic of AMF: arbuscules, vesicles, hyphae and spores, whose frequency and intensity reached 90% and 75% two years after cuttings cultivation. The arbuscular and vesicular contents and the number of spores were 67%, 96% and 212 spores/ 100 g of soil respectively. The fourteen species of mycorrhizal fungi isolated from the rhizosphere belong to 4 genera (Glomus, Acaulospora, Gigaspora, and Scutellospora) and three families (Glomaceae, Acaulosporaceae and Gigasporacea).The Glomus genus was the most dominant (65%) followed by the Gigaspora genus (22%). Glomus intraradices, Gigaspora sp.2, Glomus versiformes are the most abundant species, their frequency of occurrence are respectively 30%, 21% and 16%

Adjuvant Radio-chemotherapy for extrahepatic biliary tract cancers

<p>Abstract</p> <p>Background</p> <p>Extrahepatic biliary duct cancers (EBDC) are uncommon malignancies characterized by a poor prognosis with high rate of loco-regional recurrence. The purpose of the present study is to assess the feasibility and the potential impact of adjuvant radiotherapy (RT) in a series of patients treated in one institution.</p> <p>Methods</p> <p>Twenty three patients with non-metastatic bile duct cancer treated surgically with curative intent (4 gallbladder, 7 ampullary and 12 cholangiocarcinoma) received 3D conformal external beam RT to a median total dose of 50.4Gy. Concurrent chemotherapy based on 5-FU was delivered to 21 patients (91%). Surgical margins were negative in 11 patients (48%), narrow in 2 (9%), and microscopically involved in 8 (35%). Eleven patients (55%) had metastatic nodal involvement. The average follow-up time for all patients was 30 months (ranging from 3-98).</p> <p>Results</p> <p>Acute gastrointestinal grade 2 toxicity (RTOG scale) was recorded in 2 patients (9%). Nausea or vomiting grade 1 and 2 was observed in 8 (35%) and 2 patients (9%) respectively. Only one patient developed a major late radiation-induced toxicity. The main pattern of recurrence was both loco-regional and distant (liver, peritoneum and/or lung). No difference was observed in loco-regional control according to the tumor location. The 5-year actuarial loco-regional control rate was 48.3% (67% and 30% for patients operated on with negative and positive/narrow/unknown margins respectively, p = 0.04). The 5-year actuarial overall survival was of 35.9% for the entire group (61.4% in case of negative margins and 16.7% in case of positive/narrow/unknown margins, p = 0.07).</p> <p>Conclusions</p> <p>Postoperative RT with 50-60 Gy is feasible with acceptable acute and late toxicities. The potential benefit observed in our series may support the use of adjuvant RT in patients with locally advanced disease. Prospective randomized trials are warranted to confirm definitively the role of RT in this tumor location.</p