Surgical Application of DNA Ploidy to Non-small-cell Lung Carcinoma

Clinical application of DNA analysis and a method of rapid DNA measurement were studied. DNA contents of 110 stage I lung carcinomas were measured, using paraffin embedded tissues, by means of flow cytometry. Aneuploidy was fond in 73.6% of the tumors, and diploidy was found in 26.4%. In patients with DNA aneuploidy in T_2N_0, those treated with lobectomy had significantly longer survival time than those treated with limited operations (segmentectomy or partial resection of the lung). These results indicate that patients with DNA aneuploidy among patients with the disease Stage of T_2N_0 should not be treated with limited operations. The DNA content of 44 cases of benign lung diseases were also measured, and none of them were DNA aneuploid cases. It was concluded that DNA aneuploidy was a useful marker of malignant cells. Furthermore, as a surgical application of these results, interoperative DNA analysis is necessary ; so that a method of rapid DNA analysis was invented. It was possible to achieve DNA measurement within 15 minutes by using Triton X-100, RNase and PI, and the best DNA histogram was acquired by using 5% Triton X-100, 20 Kunitz/ml RNase and 50 μg/ml PI. These results indicate that it is possible to make interoperative DNA analysis and also it is useful to detect malignant cells and to determine the operative procedure

Resection of Segments 4, 5 and 8 for a Cystic Liver Tumor Using the Double Liver Hanging Maneuver

To achieve complete anatomic central hepatectomy for a large tumor compressing surrounding vessels, transection by an anterior approach is preferred but a skillful technique is necessary. We propose the modified technique of Belghiti's liver hanging maneuver (LHM). The case was a 77-year-old female with a 6-cm liver cystic tumor in the central liver compressing hilar vessels and the right hepatic vein. At the hepatic hilum, the spaces between Glisson's pedicle and hepatic parenchyma were dissected, which were (1) the space between the right anterior and posterior Glisson pedicles and (2) the space adjacent to the umbilical Glisson pedicle. Two tubes were repositioned in each space and ‘double LHM’ was possible at the two resected planes of segments 4, 5 and 8. Cut planes were easily and adequately obtained and the compressed vessels were secured. Double LHM is a useful surgical technique for hepatectomy for a large tumor located in the central liver

Changes of Concentrations of Free Amino Acids in HeLa Cells Induced by Antitumor Agent

In this report we have investigated that the amino acid is most actively metabolized in the tumor cells damaged by antitumor agents, and discussed imbalanced amino acid procedure to be combined with cancer chemotherapy. The concentrations of 24 free amino acids in medium and in cells were determined in HeLa cells treated with Adriamycin. The free amino acids that decreased in the medium but increased in cells were glutamine and arginine. From this result, we treated HeLa cells with Adriamycin in medium of glutamine-deficiency and obtained a marked cytocidal effect. It would be difficult to make tumor tissues of glutamine-depletion in the whole body. For clinical application, local administration such as intraarterial infusion of L-glutamine antagonists combined with antitumor agents is expected as a practical administration method

Clinical Application of Lung Cancer Cell DNA Analysis

Nuclear DNA patterns were evaluated for 115 lung cancers which were surgically resected. Seventeen percent showed diploidy pattern and 83% were aneuploidy. The 3-year survival was 90% in those who showed diploid and 58% in those who revealed aneuploid in analysis of nuclear DNA patterns. In conclusion determination of nuclear DNA pattern for lung cancer cells is of clinical value to assess the surgical outcome besides the histochemical evaluation

Nuclear DNA Analysis in Hepatocelular Carcinoma in Comparison with Clinicopathologic Factors

Nuclear DNA patterns were analyzed in the 33 patients with primary hepatocellular carcinoma on the basis of clinicopathologic standpoint. It is concluded that biologic behavior of hepatocellular cancer cells in patients with DNA aneuploidy pattern displayed highly malignant potential, indicating severe atypism, rapid growth of rupturing, the presence of cancer invasion into the wall of portal vein and distant metastasis. Furthermore, the survival time in patients with DNA aneuploidy pattern in hepatocellular carcinoma was shorter than that in patients with diploidy one

A Case of Intraductal Papillary Neoplasm of the Bile Duct with Stromal Invasion

Intraductal papillary neoplasm of the bile duct (IPNB) represents biliary papillary tumors mainly growing and is considered to be of relatively low-grade malignancy. Here we report a case of IPNB in whom the poorly differentiated component deeply infiltrated the bile duct wall. A 77-year-old male had an invasive carcinoma of the bile duct 3 cm in size. He underwent right hemihepatectomy with combined resection of the extrahepatic bile duct. Papillary growing tumor was observed in the common bile duct and the right posterior Glisson's pedicle was invaded. Histologic finding showed papillary adenocarcinoma in the surface layer superficially extending to the epithelium of the surrounding bile duct. In the subserosal layer, the tumor represented poorly differentiated adenocarcinoma. The tumor was diagnosed as invasive bile duct carcinoma arising from IPNB

DNA Ploidy Study in Esophageal Cancers

The values of DNA content in 47 patients with esophageal cancers were evaluated in comparison with clinic o-pathological factors and their prognoses. DNA ploidy profiles were analyzed from paraffin-embedded preparates. The diploid tumors accounted for 41.1% in this series. Aggressive cancer extension was not necessarily seen in the aneuploid tumors as compared with the diploid tumors. One must be aware that some of the diploid tumors indicate worse prognosis

Surgery for Perforation Complicating Colon Cancers

Eleven patients with perforation complicating colon cancers were clinically analyzed with respect to perforation sites and surgical outcome. In general, perforations complicating colon cancers are divided into two categor ies, free perforation and penetration with abscess or fistula formation. It is emphasized that surgical outcome for free perforation is unsatisfactory. Therefore, two-stage operation is recommended and the aim of the treatment should be first concentrated on peritonitis. In conclusion, complete resection of carcinoma is necessary in obtaining a satisfactory result

A Study of Long-Term Metabolism of Nucleic Acid in the Repair Process of Cancer Cells with Cis-diamminedichloroplatinum (II)

CDDP is one of the anticancer drugs in which the presence of the repair mechanism has been pointed out. Thus, using established pulmonary cancer cells, we evaluated the metabolism of DNA and RNA in damaged cells treated with CDDP (0.1, 1.0, 10μg/ml) by means of 3 H-TdR . 3 H-UR incorporation assay for 15 days referring to the growth curve and colony forming assay. 3H-TdR uptake inhibition rate in CDDP treatment was higher than 3H-UR uptake inhibition rate and showed good correlation with the inhibition rate of colony formation. In order to evaluate the activity of metabolism of DNA and RNA, the experimental period was divided into two parts : an early stage (2-10 days) and a later stage (7-15 days), and changing phases of uptake of 3H-TdR and 3H-UR was estimated as an increased rate. In the early stage, cells treated CDDP at lower concentrations tended to show more active DNA and RNA metabolism, especially RNA. In the later stage, cells with 0.1μg/ml CDDP which had shown only slight growth inhibition in the early stage revealed lower activity than that in the early stage. Cells with 1.0vg/ml CDDP which showed regrowth after 7 days, and cells with 10μg/ml CDDP which were not recognized with proliferation were observed with more active metabolism of RNA than that in the early stage. Those results indicated that metabolism of RNA is closely associated with the cellular repair process by CDDP

Expressions of Vascular Endothelial Growth Factor (VEGF)-D and VEGF Receptor-3 in Colorectal Cancer: Relationship to Lymph Node Metastasis

Angiogenic factors play a major role in tumor growth and metastasis. Vascular endothelial growth factor (VEGF)- D is a ligand for VEGF receptor-3 (VEGFR-3/Flt-4), which mainly expressed on the lymphatic endothelium. Recent experimental studies have shown that VEGF-D induces tumor lymphangiogenesis and promote metastatic spread of tumor cells via lymphatic vessels. However, the contribution of VEGFD to lymph node metastasis in human colorectal cancer is less understood. We therefore examined VEGF-D and VEGFR-3 expression in patients with colorectal cancer. Sections of formalin-fixed and paraffin-embedded specimens from 76 colorectal cancers were immunohistochemically stained for VEGF-D and VEGFR-3. Staining for VEGF-D was positive in the cytoplasm of tumor cells in 43 of 76 examined tumors (56.6%). Staining for VEGFR-3 was positive in endothelial cells in 38 (50.0%) tumors. Univariate analysis showed that both VEGF-D and VEGFR-3 expressions correlated significantly with lymph node metastasis, histological type and depth of tumor invasion. However, logistic regression analysis indicated that VEGF-D expression, but not that of VEGFR-3, was an independent predictor for lymph node metastasis. Our data suggest that VEGF-D plays an important role in lymph node metastasis in colorectal cancer