Immunohistochemical detection of nm23/NDP kinase and cathepsin D in medullary carcinomas of the thyroid gland

Reduced expression of nm23/NDP kinase and increased expression of cathepsin D seem to be correlated with the high metastatic potential in a variety of malignancies. The expression of nm23/NDP kinase and that of cathepsin D have been evaluated by means of an immunohistochemical technique in paraffin-embedded tissues from 44 primary medullary carcinomas of the thyroid gland (MCT) and from the corresponding lymph node metastases in 32 of these cases. In addition, lymph node metastases from 4 cases were studied. We found that 36 of 44 (82%) primary and 26 of 36 (72%) lymph node metastatic MCT were nm23/NDP kinase positive, whereas 14 of the 44 (32%) primary and 17 of the 36 (47%) lymph node metastatic MCT were cathepsin D positive. We found no indication that the nm23/NDP kinase level has any prognostic significance in MCT. The cathepsin D level is close to being prognostically significant in this study, and we cannot exclude the possibility that it could be of prognostic value. However, it seems to be quite weak, and therefore of little use in a clinical situation.

High incidence of human papillomavirus in 146 cervical carcinomas. A study using three different pairs of consensus primers, and detecting viral genomes with putative deletions

Polymerase chain reaction (PCR) primer sets and probe-cocktails were used for human papillomavirus (HPV) detection and typing of 146 fresh frozen biopsies of cervical carcinoma. We obtained a high detection rate (96%) by using three sets of consensus primer pairs directed at the L1 and E1 regions of HPV and by probing with a cocktail of random-labelled consensus and type-specific PCR products derived from HPV plasmids. In addition, we performed type-specific PCR amplification with E6-E7 primers. The procedure was designed to detect all HPV-positive cases in a rapid, sensitive and specific way. In addition, by using different regions for amplification, we detected cases with putative genomic deletions in HPV. All the negative PCR and DNA isolation controls were negative. The six negative samples were negative with all probe-cocktails and type-specific primers and three of these negative samples were clear cell carcinomas. The detection rate was similar in squamous carcinomas and in adenocarcinomas and type 16 was most common (65%) in both types of carcinoma. There were no double infections of human papillomavirus 16 and 18.

TP53 gene mutations and protein accumulation in primary vaginal carcinomas

Primary carcinomas from 46 patients were screened for TP53 alterations. Immunohistochemistry demonstrated nuclear TP53 protein accumulation in 22 (48%) cases using the polyclonal CM1 antiserum, whereas 15 (33%) cases showed positive nuclear staining with the mononuclear antibody PAb 1801. Constant denaturant gel electrophoresis (CDGE) was used to screen 27 of the vaginal carcinomas for mutations in the conserved regions of the TP53 gene (exons 5-8). Six of these tumours (22%) contained mutations: four were found in exon 5 and two in exon 8. A total of 50% of the primary vaginal carcinomas carried a TP53 alteration. These results indicate that TP53 abnormalities may be involved in the development of these tumours. However, there was no significant association between TP53 abnormalities and survival.

Accumulation of p53 protein in human malignant melanoma. Relationship to clinical outcome

Paraffin-embedded tissue from the primary tumours of 116 patients with malignant melanoma, and in 40 cases also from corresponding metastases, were examined for accumulation of p53 protein. The fraction of tumours with positive p53 immunostaining was 13% in the least invasive and 36% in the most invasive primary lesions and 48% in the metastases. Where comparisons could be made, both the level and pattern of p53 immunoreactivity were the same in the primary and metastatic tumours. Nine (50%) patients with p53-positive and 34 (39%) with p53-negative primaries relapsed during the first 5 years, but no difference in disease-free period was observed between the two groups. However, an overall longer survival time was observed among patients with p53-positive primaries, especially for those with tumours less invasive than 3.0 mm. Notably, all 11 patients in this group were alive 5 years after diagnosis of the disease, whereas 15 out of 70 (21%) patients with p53-negative tumours died in same period. The results show that an increased level of p53 protein does not indicate increased degree of malignancy in melanoma, but rather suggests a more favourable disease progression.

Null cell adenomas and oncocytomas of the pituitary gland

This review highlights the most interesting features of null cell adenomas and oncocytomas of the pituitary gland. Recently, application of sensitive methods have documented a very low amount of active hormone production in these clinically nonfunctioning tumours. However, further studies are needed to clarify the histogenesis of null cell adenomas and oncocytomas.

Proliferative activity of synovial sarcoma: an immunohistochemical evaluation of Ki-67 labeling indices of 52 primary and recurrent tumors

The relationship between cell differentiation and proliferation in biphasic synovial sarcoma (BSS) and the connection between the two components of these tumors and monophasic synovial sarcoma (MSS) are still unknown. In this study we specifically compared the Ki-67 labeling indices (Ki-67-LI) in the solid/glandular and spindle cell components of primary BSS (n = 8) as well as the values thus obtained in primary BSS both outside clear-cut biphasic areas (n = 7) and in primary MSS (n = 23). We also compare the Ki-67-LI of primary tumors (seven BSS, seven MSS) and their respective first recurrences. We observed that the cells of the solid/glandular component of BSS proliferate significantly faster (p = 0.007) than those of spindle cell areas. No significantly different Ki-67-LI were observed in the comparison of the solid/glandular areas of BSS with the spindle/epithelioid component of BSS without clear-cut biphasia and MSS. No significant differences of Ki-67-LI were observed in the comparison of primary tumors of both subtypes with their respective first recurrences. The implications of the low proliferative activity of the spindle cell component of BSS exhibiting clear-cut biphasia, which was also confirmed in a concurrent study using anti-proliferating cell nuclear antigen/Cyclin PC10, remains to be clarified.

[Microwave oven in immunohistochemistry. An important tool for determination of antigens in formalin-fixed and paraffin-embedded tissue]

Immunocytochemical methods are important tools for identifying antigens in tissue sections and cell smears. Some antigens were retrieved in formalin-fixed and paraffin-embedded tissues by means of a microwave technique. This method also increased the sensitivity of the immunohistochemical detection of several other antigens. Altogether, microwave boiling of the tissue sections in citrate buffer clearly improved the immunoreactivity for cytokeratin 18, oestrogen receptor, Ki-67 protein, PCNA, p53 protein, retinoblastoma gene protein and c-erbB-2 protein. This new technique, which can be applied in every pathology laboratory, will facilitate the application of immunohistochemical methods for research and diagnostic work.

Prevalence and physical state of human papillomavirus DNA in anal carcinomas

Epidemiologic studies suggest that human papillomavirus (HPV) plays an important role in the development of squamous cell carcinoma of the anal canal. However, in previous studies the prevalence of HPV found in tumor varied from 0 to 85%. This study was performed to investigate the prevalence and physical state of HPV DNA in anal carcinomas. HPV infection was examined using in situ hybridization and polymerase chain reaction. HPV DNA was detected in 80/99 (81%) of the tumors, including 66/74 (89%) from females and 14/25 (56%) from males. HPV16 was demonstrated in 84% of the females and 52% of the males. HPV18, HPV31, and HPV33 could be demonstrated in 5% or less of the cases. In situ hybridization technique showed that 100% of the virus-infected cases had punctate signal and 67% had in addition a diffuse signal, indicating integrated and episomal virus DNA, respectively. The integrated and episomal HPV DNA coexisted in the majority of the tumor cell nuclei. This study indicates that infection and integration of HPV DNA may play an important role in the pathogenesis of anal canal carcinomas.

The expression of c-erbB-2 (HER-2/neu) oncogene in invasive ovarian malignancies

The expression of c-erbB-2 oncogene has been studied in 74 formalin fixed paraffin embedded invasive epithelial ovarian malignancies using a monoclonal c-erbB-2 protein antibody. Only four (5.4%) tumors showed membrane immunostaining. FIGO stage, size of residual disease after primary surgery, histologic type and tumor grade, were identified by the log rank test as prognostic factors for survival. No difference in survival was observed between those with and without membrane staining (24 months probability of survival: 50% and 55.4% respectively). Our results did not show any adverse prognostic effect of c-erbB-2 protein expression in our patients.

Expression of laminin, collagen IV, fibronectin, and type IV collagenase in gastric carcinoma. An immunohistochemical study of 87 patients

BACKGROUND

This study attempted to determine if there is a pattern of matrix/matrix-degrading-enzyme immunoreactivity related to the morphologic types of gastric carcinoma or to their invasiveness.

METHODS

The authors performed an immunohistochemical study of the basement membrane antigens laminin and collagen IV, fibronectin, and Type IV collagenase in a series of 87 gastric carcinomas and their respective nodal metastases (n = 329).

RESULTS

Laminin expression was observed almost exclusively in carcinomas of the intestinal type. The expression of collagen IV was significantly higher in intestinal (52%) and atypical (44%) carcinomas than in diffuse (10%) carcinomas; collagen IV expression also was significantly correlated with lymphatic invasion and aneuploidy. Ninety percent of the carcinomas expressed fibronectin, mostly in the connective tissue at the invading edge of the tumors; fibronectin expression was significantly related to the expanding growth pattern of the neoplasms. Eighty-six percent of the tumors expressed Type IV collagenase, regardless of the histologic type or invasive properties. No relationship was observed between the expression of any of the antigens and the S-phase fraction of the tumors. No significant differences were found between the immunohistochemical profile of the primary tumors and their metastases.

CONCLUSIONS

The authors conclude that the expression of basement membrane antigens is related to the type of gastric carcinomas, rather than the cell differentiation or proliferative activity of the tumors. The putative prognostic meaning of the relationship between collagen IV immunoreactivity and aneuploidy and lymphatic invasiveness of the carcinomas remains to be clarified.

Coexistence of episomal and integrated HPV16 DNA in squamous cell carcinoma of the cervix

AIMS

To investigate the integration of human papillomavirus (HPV)16 in 13 HPV16 positive cervical squamous carcinomas.

METHODS

Samples were investigated by Southern blot analysis of the Pst I digestion pattern, two-dimensional gel-electrophoresis, and in situ hybridisation.

RESULTS

Integration of HPV16 was found in all cases. In 12 biopsy specimens episomal HPV16 DNA and integrated HPV16 DNA were seen. The episomal DNA occurred as dimers and multimers. In situ hybridisation showed that both integrated and episomal HPV16 DNA were present in the same cell in most tumour cell nuclei.

CONCLUSIONS

An intact episomal E2 gene is present in most cases of these cervical cancers, and could therefore replace the regulatory function of an integrated defective E2 gene.

Retinoblastoma and p53 tumour suppressor gene protein expression in carcinomas of the thyroid gland

One hundred and thirty-one thyroid tumours were examined immunohistochemically for expression of retinoblastoma (RB) and p53 protein. The results demonstrate that RB protein is not lost in any cases, indicating that inactivation of the RB gene is unlikely to play a central role in the pathogenesis of thyroid tumours. Eighteen of 24 (75 per cent) undifferentiated carcinomas, 6 of 32 (19 per cent) papillary carcinomas, 5 of 29 (17 per cent) follicular carcinomas, and 6 of 46 (13 per cent) medullary carcinomas showed p53 protein nuclear staining. In 46 per cent of the undifferentiated carcinomas many of the tumour cells had accumulated p53 protein, whereas in the other positive cases less than 5 per cent of the cells had increased p53 protein levels. Our results strongly suggest that p53 protein abnormalities play a crucial role in the progression of well-differentiated to undifferentiated thyroid carcinomas.

Immunohistochemical profile of synovial sarcoma with emphasis on the epithelial-type differentiation. A study of 49 primary tumours, recurrences and metastases

The relationship between biphasic (BSS) and monophasic (MSS) subtypes of synovial sarcoma (SS) as well as the relationship between cells of solid/glandular areas and the spindle cells of BSS remain controversial. In order to further evaluate the immunohistochemical phenotype of SS we studied 34 primary tumours (15 BSS; 19 MSS), 7 recurrences (4 from primary BSS; 3 from primary MSS) and 8 metastases (7 BSS; one MSS), using several antibodies (EMA, CEA, keratins 1, 4, 5/6, 7, 8, 13, 18, 19, 20, vimentin, collagen IV and laminin) that work in paraffin-embedded material. Spindle cells outside solid/glandular areas of BSS and in MSS showed immunoreactivity for keratins 5/6, 7, 8, 18 and 19. The transition of solid/glandular areas to surrounding spindle cells also showed keratin staining and failed to show a distinct separation regarding the immunoreactivity for laminin and collagen IV. Peripheral cells of solid/glandular areas were immunoreactive for vimentin. No major differences were observed between immunophenotypical cell profiles of BSS and MSS, apart from the exclusive immunostaining of solid/glandular areas of BSS for keratin 13 and CEA. Downgrading of keratin and extracellular matrix antigens immunoreactivity was observed when primary tumours were compared to recurrent and/or metastatic tumours of both subtypes (MSS and BSS). We conclude that SS should be regarded as carcinomas of soft tissues with an immunohistochemical phenotype depending on the degree of epithelial differentiation: spindle cells (MSS and BSS) predominantly expressing simple keratins, and poorly differentiated (solid/glandular) as well as well-differentiated (glandular) areas (BSS) expressing, in addition, complex epithelial-type keratins.

Small cell carcinoma of the cervix. A clinicopathologic study of 26 patients

BACKGROUND

Small cell carcinoma of the cervix is a rare and aggressive tumor. Most gynecologic oncology centers have little experience with this tumor, and only small series have been published.

METHODS

Twenty-six patients with small cell carcinoma of the uterine cervix were treated at the Norwegian Radium Hospital. Clinical data, immunohistochemical characteristics, and infection with human papillomavirus were studied.

RESULTS

Twelve tumors were of oat cell type and 14 of intermediate cell type. Twelve tumors were associated with other forms of carcinoma: squamous cell carcinoma (6 tumors), adenocarcinoma (5 tumors), and adenocarcinoma in situ (1 tumor). Neuroendocrine differentiation was expressed in 79% of the tumors. Human papillomavirus (HPV)-18 was detected in 40% of the tumors and HPV-16 in 28%. Fifteen patients had Stage I disease, 7 had Stage II, 2 had Stage III, and 3 had Stage IV. Fourteen patients with Stage I and II disease underwent radical hysterectomy with pelvic lymph node dissection. In four, the operation was preceded by intracavitary radiation treatment. The patients with Stage II, III, and IV disease were treated with a combination of intracavitary radium, external beam radiation therapy, and chemotherapy. The 5-year survival rate was 14%. Four patients are alive, one with recurrent disease 50 months after diagnosis. Three patients free of disease have been followed up 26, 54, and 101 months, respectively.

CONCLUSIONS

Small cell carcinoma of the cervix is an aggressive tumor with a propensity for rapid recurrence; it is associated with high mortality.

Expression of laminin, collagen IV, fibronectin, and type IV collagenase in gastric carcinoma. An immunohistochemical study of 87 patients

BACKGROUND

This study attempted to determine if there is a pattern of matrix/matrix-degrading-enzyme immunoreactivity related to the morphologic types of gastric carcinoma or to their invasiveness.

METHODS

The authors performed an immunohistochemical study of the basement membrane antigens laminin and collagen IV, fibronectin, and Type IV collagenase in a series of 87 gastric carcinomas and their respective nodal metastases (n = 329).

RESULTS

Laminin expression was observed almost exclusively in carcinomas of the intestinal type. The expression of collagen IV was significantly higher in intestinal (52%) and atypical (44%) carcinomas than in diffuse (10%) carcinomas; collagen IV expression also was significantly correlated with lymphatic invasion and aneuploidy. Ninety percent of the carcinomas expressed fibronectin, mostly in the connective tissue at the invading edge of the tumors; fibronectin expression was significantly related to the expanding growth pattern of the neoplasms. Eighty-six percent of the tumors expressed Type IV collagenase, regardless of the histologic type or invasive properties. No relationship was observed between the expression of any of the antigens and the S-phase fraction of the tumors. No significant differences were found between the immunohistochemical profile of the primary tumors and their metastases.

CONCLUSIONS

The authors conclude that the expression of basement membrane antigens is related to the type of gastric carcinomas, rather than the cell differentiation or proliferative activity of the tumors. The putative prognostic meaning of the relationship between collagen IV immunoreactivity and aneuploidy and lymphatic invasiveness of the carcinomas remains to be clarified.

TP53 allele loss, mutations and expression in malignant melanoma

p53 alterations at the DNA, mRNA and protein levels were studied in tumour metastases sampled from 30 patients with malignant melanoma. Paraffin-embedded sections from these and an additional 12 patients were examined for the presence of p53 protein. TP53 gene aberrations were found in 7 of 30 (23%) of the patients, six of which showed loss of heterozygosity (LOH). Point mutations were detected in only two cases, one of which had LOH whereas the other was non-informative. Increased levels of p53 mRNA were present in only one tumour with, but in six cases without, detectable DNA abnormalities. Four of the latter and six tumours with normal transcript levels had immunohistochemically detectable levels of p53 protein. In 25 cases in which corresponding primary and metastatic lesions could be compared, closely similar immunoreactivity patterns were observed. Increased expression of the MDM2 gene was found in only one tumour in parallel with overexpression of p53. Altogether, the data indicate that inactivation of the p53 regulatory pathway is not of major significance in the tumorigenesis of malignant melanoma. However, a significant association was found between p53 immunoreactivity and the relapse-free period in patients with superficial spreading melanoma. That increased protein expression was predominantly found in tumours without DNA alterations might suggest a role for the wild-type p53 protein in restricting malignant cell proliferation in these cases.

Expression of the neuroectodermal intermediate filament nestin in human melanomas

Nestin is a newly identified intermediate filament expressed in proliferating neuronal progenitor cells, but not in the adult brain. Nestin expression reappears in many tumors of the central nervous system and has in human glioblastomas been associated with a high degree of malignancy. Because melanocytes are of neuroectodermal origin, we studied nestin expression in benign and malignant cells of the melanocytic lineage using Northern blot and immunohistochemical analyses. Nestin mRNA was detected in 24 of 34 metastatic melanomas and in 1 of 4 benign nevi, whereas the protein was expressed in 10 of 15 primary melanomas, in 29 of 34 metastatic tumors, and in 3 of 4 nevi. Neither normal melanocytes nor any of 4 basal cell carcinomas showed detectable levels of the protein. The high fraction of melanocytic tumors which express nestin, particularly the metastatic melanomas, suggests that nestin may be a useful marker for such malignancies. Furthermore, although no significant correlation between nestin expression and tumor malignancy was observed, the protein was most abundantly expressed in the infiltrating part of the tumors, indicating a possible involvement of nestin in tumor invasion.

Transitional cell carcinoma of the renal pelvis and its expression of p53 protein, c-erbB-2 protein, neuron-specific enolase, Phe 5, chromogranin, laminin and collagen type IV

Expression of p53 protein, c-erbB-2 protein, neuron-specific enolase (NSE), Phe 5, chromogranin, laminin and collagen type IV was studied by immunohistochemistry in formalin-fixed and paraffin-embedded specimens from 20 patients with renal pelvic carcinoma. Positive membrane-bound c-erbB-2 staining was not found in any case. Two tumors stained for p53 protein. Focal immunoreactivity for laminin was present in 55% and for collagen type IV in 80%. 25% of the cases were NSE positive. None of the tumors stained for Phe 5 or chromogranin. The results were compared with the clinical outcome and the immunohistological findings of p53 protein and c-erbB-2 protein in 13 cases of bladder carcinoma in the same patient group. Four of the thirteen bladder cancer specimens, but only 2 of the 20 renal pelvic cancer specimens, expressed p53 protein. As for renal pelvic carcinoma, c-erbB-2 protein was not expressed in bladder carcinoma. We conclude that p53 gene abnormalities may be of importance in the development of carcinoma in the renal pelvis and urinary bladder, but c-erbB-2 protein expression does not play a major role.

Microsatellite instability is associated with tumors that characterize the hereditary non-polyposis colorectal carcinoma syndrome

Microsatellite instability implying multiple replication errors (RER+ phenotype) characterizes a proportion of colorectal carcinomas, particularly those from patients with the hereditary non-polyposis colorectal carcinoma syndrome. We studied the incidence of microsatellite instability in more than 500 sporadic tumors representing 6 different types of cancer. Apart from colorectal carcinoma [see the paper by Lothe et al. (Cancer Res., 53:5849-5852, 1993)] the RER+ phenotype was found in 18% (6 of 33) of gastric carcinomas and 22% (4 of 18) of endometrial carcinomas. In contrast, no evidence of this abnormality was detected in cancers of the lung (N = 85), breast (N = 84), and testis (N = 86). Importantly, the first three cancers, as opposed to the latter three, are characteristic of the hereditary non-polyposis colorectal carcinoma syndrome. These findings suggest that the cancers belonging to the hereditary non-polyposis colorectal carcinoma tumor spectrum may have essential pathogenetic steps in common, including a tendency to multiple replication errors.

p53 protein expression in squamocellular carcinomas of the lip

Twenty-six cases of squamocellular carcinomas of the lip were immunostained for p53 protein. Nuclear accumulation of p53 protein was observed in 88% of the 26 carcinomas, in 64% of adjacent "normal" epithelium and in all four cases with adjacent atypical squamous epithelium. 93% of the specimens (13/14) with p53 protein accumulation in "normal" epithelium demonstrated evidence of solar elastosis. UV radiation may induce p53 gene mutation as an early event in the neoplastic transformation.

Genetic alterations of the TP53 gene, p53 protein expression and HPV infection in primary cervical carcinomas

Primary cervical carcinomas from 92 patients were investigated for genetic alterations in the tumour suppressor gene TP53. Studies of allelic imbalance (AI) were performed by Southern blot analysis and by using two PCR (polymerase chain reaction) polymorphisms within the TP53 gene. AI in the tumour was observed in 22 per cent (11 of 52 informative patients) and was significantly associated with recurrence both in a univariate (P = 0.013) and in a multivariate (P = 0.045) analysis. The DNA samples were subjected to mutation analysis of four of the conserved domains in the TP53 gene, using PCR followed by constant denaturant gel electrophoresis (CDGE). Mutations were observed in 2 of 92 tumours (2 per cent), of which one was a silent mutation and the other a frameshift. Overexpression of the p53 protein was found by immunostaining of sections from formalin-fixed, paraffin-embedded material in 55 per cent (51/92) of the tumours. In 88 per cent (45/51) of these, overexpression was present in less than 5 per cent of the tumour cells. Overexpression was significantly associated with relapse-free survival only in a univariate analysis (P = 0.045). AI of the TP53 locus did not correlate with p53 expression or mutation. The important gene on 17p, responsible for the shorter disease-free survival for patients with AI of TP53, may therefore be another gene closely linked to TP53. In addition, the 92 tumour samples were tested for the presence of human papillomavirus (HPV) types 16 and 18. Fifty-four per cent (50/92) of the samples were positive for HPV 16 using in situ hybridization, and 93 per cent (86/92) using the PCR technique. The numbers for HPV 18 were 15 per cent (14/92) and 23 per cent (21/92), respectively. Twenty-one per cent (19/92) were positive for both HPV 16 and HPV 18, while 4 per cent (4/92) were negative for both HPV 16 and 18. The tumour with the frameshift TP53 mutation was HPV 16-positive, and the four samples negative for HPV 16 and 18 did not contain TP53 mutations within the conserved domains but had elevated p53 protein expression.

Prognostic significance of TP53 alterations in breast carcinoma

Constant denaturant gel electrophoresis (CDGE) was used to screen 179 breast carcinomas for mutations in the conserved regions of the TP53 gene (exons 5 through 8). Mutations were found in 35 of 163 primary tumours (21%) and in 5 of 16 metastases (31%) and resided predominantly in exon 7. The majority of the mutations were G:C-->A:T transitions. Immunohistochemistry demonstrated nuclear accumulation of p53 protein in 35 of 162 primary tumours (22%) and in four of 15 metastases (27%). TP53 mutation was strongly associated with nuclear accumulation of p53 protein. In total 42 of 163 primary tumours (26%) and 5 of 16 metastases (31%) were demonstrated to contain TP53 alterations (mutation and/or nuclear protein accumulation). TP53 alteration in primary tumour was significantly associated with the following parameters: positive node status, T status > 1, negative oestrogen receptor status, negative progesterone receptor status, presence of ERBB2 gene amplification, and invasive ductal histology. Furthermore, there were statistically significant associations, independent of other prognostic factors, between TP53 alterations in primary tumour and disease-free and overall survival.

[Injuries of the hand caused by high-pressure air]

Based on two cases of accidental high-pressure air injection injury to the hand, we describe pathology, symptoms and therapeutic principles. Despite nontoxicity of injected air, the importance of acute surgical intervention must be emphasized, as there is a risk of high-pressure soft tissue damage. The treatment suggested is: 1) systemic medication including tetanus toxoid and antibiotics, 2) adequate incision, decompression, exploration, drainage and debridement under either general, plexus or i.v. anaesthesia. Postoperatively, the hand should be elevated, and a program of physical mobilisation should be started as soon as possible.

Laminin production and fibronectin immunoreactivity in breast carcinomas

Eighty-nine cases of primary breast carcinoma were evaluated immunohistochemically for basement membrane laminin and fibronectin (FN). 58 of the cases were also examined by transmission electron microscopy (TEM). Intraductal carcinomas were all positive for laminin and FN and by electron microscopy a continuous BM was found in all of them. Among invasive tumors, immunoreactivity for laminin was expressed in 31% of cases and FN in 66%, whereas TEM revealed BM in only 4 out of 52 (8%) studied cases. Tumors measuring 10 mm or less were more often laminin-positive and FN-negative than larger tumors. There was a tendency for lymph node negative tumors to express laminin more often, but there was no relation between lymph node status and FN. Laminin immunostaining proved to be very useful in identifying vascular invasion. The laminin and FN immunoreactivity showed no significant correlation with overall survival and disease-free survival (DFS) of the breast cancer patients. DFS for cases with laminin positive tumors was 50% and for laminin negative tumors 46.8%. For cases with tumors immunoreactive for FN, DFS was 50%, and for tumors lacking FN 43.5%.