The relationship between p53, c-myc product expression and clinicopathological parameters in primary breast carcinomas

Sixty-four primary breast carcinomas were analyzed by flow cytometry for their expression of p53 and c-myc proteins. c-myc protein expression was correlated with pathological infiltration (p = 0.05), but the other parameters (tumor size, lymph node status, menopausal status, steroid receptor status, and histological type) were not statistically correlated. On the other side, p53 protein expression was significantly correlated with large tumor size (p = 0.0001) and lymph node metastasis positive (p = 0.001), and weakly correlated with post menopausal status (p <0.01) and pathological infiltration (p = 0.01). Although there was no correlation between only p53 protein oevr-expression and disease free survival. but when p53 protein over-expression and c-myc protein oevr-expression were simultaneously found in the same tumor-cell population, prognosis of these cases were poor. Namely simultaneous over-expression of p53 protein and c-myc protein was found in 22 cases, 7 of 22 (31.8%) have had a relapse. In other 2 cases relapse was found, but both these cases were medullary carcinoma and the level of expression of p53, and c-myc protein was low. This study indicates that plural gene product expression should be simultaneously analyzed when investigate the prognostic markers in breast carcinomas

Testicular Torsion in Undescended Testis : A Case Report and View of Sixty-two Cases in Japan

A 7-year-old boy with cerebral palsy was presented with a progressively enlarging tender, left inguinal mass. Examination revealed absence of the left testis in the scrotal sac. The left testis was palpable in the left superficial inguinal pouch. The right testis was normaly palpable in the right scrotum. A diagnosis of a torsion in the undescended left testis was confirmed by exploratory surgery. Orchidectomy of the left testis was performed and the remainder of the patient\u27s course was uneventful. We presented this case to describe the clinical features of testicular torsion in the undescended testis with a review of 62 cases in Japan. Specific emphasis was placed on the incidence, relationship of cerebral palsy to torsion, diagnosis, and treatment of testicular torsion in cryptorchidism

COLORECTAL CARCINOMA IN PATIENTS LESS THAN 40 YEARS OF AGE : PATHOLOGY AND PROGNOSIS

Clinicopathologic features in 35 patients below the age of 40 years with colorectal carcinoma were reviewed and compared with those of a control group containing 409 patients ranging from 40 to 74 years of age. All cases in this series were experienced at the First Department of Surgery, Nagasaki University School of Medicine, during the 18 years from 1970 to 1988. 1) Young patients accounted for 6.7% of all cases with colorectal cancer, and this group included more female patients than in the elderly control group. 2) The young patient group presented with advanced lesions (Dukes\u27 stage C) in 54.3% of cases compared with 35.6% of the old patient group with significantly high incidences of lymph node involvement. There were no significant differences in the hepatic metastasis and peritoneal dissemination among two groups. 3) Mucinous carcinoma and vascular invasion were frequently found on histologic examination in the young group, which suggested the highly malignant potentiality, but no significant difference in DNA ploidy pattern was observed between the young and the control group. 4) Curative resection rates were 71.4% in young and 68.1% in elderly patients. Overall 5-year survival was 56.9%. Five-year survival in 25 patients undergoing potentially curative resection increased to 74.4% with the similar rates of the control group. Improved 5-year survival following potentially curative resection stresses the need for early diagnosis and treatment

Surgery for Diverticular Disease of the Colon

Surgery for complications of colonic diverticulum was evaluated on the basis of a result of clinical experience for the 15 patients. 1) Average age was 48.9 years, and right-side oriented lesions were more often seen in younger patients. The men and women ratio was 1.5 to 1.0. 2) The reasons for surgery were disticulitis in 7 (46.7%), perforation in 3 (20.0%) and abscess and fistula formation in 2 (13.3%), respectively. 3) Complications on the left side were much more severe than those on the right side and also seen more often in older patients

Tumor Markers (CEA, CA19-9, TPA) in Portal Blood in Colorectal Cancer Patients

The Carcinoembryonic antigen (CEA), CA19-9 and Tissue Polypeptide Antigen (TPA) levels in portal blood in colorectal cancer patients were studied in correlation with the peripheral blood levels and histopathologic findings in order to know serum levels increased. 1) Portal blood CEA, CA19-9 and TPA increased by operative maneuver. 2) Mean values of these markers in portal blood were higher than those in peripheral blood. 3) Portal blood CEA was correlated with Dukes\u27 staging, and revealed higher positive rates than CEA in peripheral blood in each stage. Portal CA19-9 changed within normal value and strikingly rose in Dukes\u27 D stage. Portal TPA tends to be higher in all stages and correlated with grades, but the value in Dukes\u27 D were lower than that of peripheral blood. 5) Moderately differentiated adenocarcinoma revealed the highest level of portal CEA (P<0.05), but portal CA19-9 and TPA did not indicate any correlation with cell differentiation. 6) The mean values of portal and peripheral CEA, CA19-9 and TPA showed significant elevation in those with infiltration of cancer cells extending through the proper muscle layer. This study suggests that the mechanism of these markers\u27 transfer from tumor into the portal vein is the most important decisive factor of the peripheral levels

Malignant Potential in the Analysis of DNA Ploidy Pattern in Patients with Colorectal Cancer

Recently the measurement of cellular DNA content has been focused on knowing the extent of cancer extension and biological behaviour of the tumor cells as well as on producting occurrence of recurrence and the survival time in patients with carcinomas of various organs. And also it is well known that tumor markers such as CEA, CA19-9 and CA72-2 are of great value in predicting recurrence in the follow-up study. It is common that colorectal cancers show well differentiated carcinoma which demonstrates relatively fair prognosis. However, some revealed aggressive and rapid extension of carcinoma, indicating a poor prognosis. The purpose of this study is to certify the significance of the measurement of cellular DNA content for assessing biologic behavior of colorectal cancer in comparison with clinicopathologic factors which have been used for assessment of their prognosis. Development of flow cytometer enabled us to measure the nuclear DNA content with ease, speed and producibility. Furthermore, prevalence of flow cytometric technique makes it possible to know more accurate outcome. When assessed biologically aggressive behavior of tumor cells, potent chemotherapy and extensive surgery are mandatory for improvement of the outcome. It is necessary to search for the method of the accurate assessment of the outcome for patients with carcinomas. The purpose of this study is to clarify the validity of nuclear DNA measurement for assessment of the prognosis in patients with colorectal cancer in comparison with clinicopathologic factors

Vascular Patterns of Villous Tumors of the Colorectum

In order to more fully understand the morphological characteristics of villous tumors of the colorectum, the vascular patterns of six colorectal resection specimens were microangiographically studied. Grossly, villous adenomas were of two main types: pedunculated polyps and carpet-like lesions. Pedunculated villous adenomas had many large stalk vessels in a broad short pedicle, representing a large blood supply to the tumor. The carpet-like lesions were composed of continuous clusters of polyps with stalk vessels and the flat elevated lesions among polyps and at the periphery showed similar vascular patterns to the mucosa of normal colon. In lesions with cancer invasive to the proper muscle layer, scattered ulcerations due to the destruction of polyps were also observed, corresponding to at least a Dukes B lesion. The above findings could represent very important additional information for endoscopic treatment or local excision for the prevention of hemorrhagic complicatios or incomplete removal of tumor

Surgery for Gastric Cancer in Younger Patients

Twenty-five patients with gastric cancer were clinically evaluated in terms of a clinicopathological pattern in younger patients. 1) Female was more predominant than male. 2) The main tumor location was the cardia and the gross appearance was Borrmann IV of undifferentiated carcinoma in the majority. 3) Less hepatic metastases were seen in younger patients, whereas, the common extension in younger patients was peritoneal dissemination and serosal invasion. 4) The surgical outcome was satisfactory as far as a curative operation be performed. On the contrary, the result of non-curative operation was extremely pessimistic. Recently great strides in the surgical outcome of gastric cancer have been achieved in combination with adjuvant therapy of immunochemotherapy. Improvement of surgical outcome is attributable to the standarized operative procedure with reasonable node dissection. It is common that carcinomas in various organs affect older patients, not usually younger ones. The purpose of this study is to clarify the clinicopathologic features of gastric cancer in younger patients on the basis of our result of clinical experience

En Bloc Resection for Lung Cancer Involving Left Atrium

En bloc resections for patients with left atrium involved by lung cancers were evaluated in the 8 patients in terms of the operative procedure, the indication and the outcome. In one patient, application of extracorporeal circulation was accomplished to perform a complete resection and also to permit patch plasty to compensate volume diminution. En bloc resection on extracorporeal circulation is recommended for patients with limited cancer extension of squamous cell carcinomas without nodal involvement. In addition, emphasis has been placed in the genesis of double cancer in follow-up study according to improvement of surgical result in reflection of susceptibility to carcinomas in other organs

The Outcome of the Treatments of Chest Trauma Patients

Ninety-nine patients with chest trauma were clinically evaluated in terms of their prognoses. In accordance with advances in thoracic surgery, the survival rates were remarkably improved. However, six deaths were encountered in this series. The causes of deaths were attributable to associated injuries extend to two or three regions including the head and the abdomen so that precise detection and proper treatments should be made as quickly as possible. In conclusion, the prognoses of serious chest trauma patients are influenced by the presence and the degree of concomitant injuries as well as proper urgent managements