Detection and quantitation of circulating cancer cells in the peripheral blood of lung cancer patients

Detection and quantitation of circulating cancer cells in peripheral blood may improve cancer staging and monitoring. This study explored the feasibility of using circulating cancer cell detection in peripheral blood for the rapid assessment of chemotherapeutic response. Cytokeratin 19 mRNA was amplified by nested reverse transcriptase-PCR in the peripheral blood of 29 healthy volunteers, 33 pneumonia patients, and 86 lung cancer patients. Circulating cancer cells in the peripheral blood were semiquantitatively determined by taking the ratio of cytokeratin 19 band intensity from the second round of nested PCR to the glyceraldehyde-3-phosphate dehydrogenase band intensity from the first round of PCR amplification. The detection limit of the method was 1 cancer cell in 107 peripheral blood mononuclear cells. The positive detection rate was 40% for lung adenocarcinoma patients of all stages, 41% for squamous carcinoma patients of all stages, and 27% for small cell lung cancer patients. Only one control sample from a pneumonia patient showed a positive result (1.6%). The quantitative method reliably and sensitively estimated cancer cell numbers in the peripheral blood of lung cancer patients. Serial measurement of the relative number of circulating cancer cells correlated with the tumor burden and treatment response of patients. This method may help rapidly assess the efficacy of anticancer treatment, redefine cancer staging, and facilitate the design of better therapeutic strategies for the treatment of cancer patients.

Hepatocyte growth factor and Met/HGF receptors in patients with gastric adenocarcinoma

Overexpression and amplification of Met/HGF receptor has been detected in gastric cancer tissues and cell lines. In this study hepatocyte growth factor (HGF) and Met/HGF receptors were localized in 32 gastric cancer and adjacent normal gastric tissues by the avidin-biotin-peroxidase complex technique. HGF (87.5%) and Met/HGF receptors (68.8%) were demonstrated in gastric cancer tissues. A high positive rate of HGF (87.0%) and Met/ HGF receptors (82.6%) presented in intestinal type gastric cancer. HGF immunoreactivity in gastric cancer tissues was a significant and powerful prognostic indicator (relative risk 15.9; p=0.01). These data suggest that HGF and Met/HGF receptors are involved in the morphogenesis of intestinal type gastric cancer. HGF may have other mechanism that favor gastric cancer spread and independently affect survival.

Morphology of M-cell axon arbors in striate cortex of monkeys reared with monocular aphakia

Although the effects of visual deprivation on the development of ocular dominance columns have been well described in primates, nothing is known in primates about the impact of the deprivation on the axonal profiles that make up the ocular dominance columns. We now show that the effects of monocular deprivation on the morphology of geniculostriate axons involve not only shifts in terminal arbor sizes, much as would be expected from the ocular dominance data, but also changes in the proliferation of terminal arbor branches. In macaque monkeys reared from birth with unilateral lens removal (aphakia), terminal arbors of geniculostriate axons were bulk-filled with horseradish peroxidase (HRP) in brain-slice preparations and reconstructed from serial sections through striate cortex (area 17). Our focus was on the arbors that terminate in the upper tier of layer IV, the target of cells in the magnocellular (M) layers of the LGN. Of the 26 M-cell arbors reconstructed from three aphakic monkeys, eight were unique in having few very simple terminal arbor branches. These also tended to be smaller in total extent than the average M-cell axons reconstructed from 1 normal monkey. In contrast, eight arbors had very rich terminal branching patterns, and seven of these were larger than any of those from the normal monkey. We propose that the small, sparse axon arbors are related to the deprived eye, and the large, dense arbors are related to the non-deprived eye. These morphological changes reflect abnormalities in the growth patterns of geniculostriate inputs that undoubtedly have important persisting consequences for visual performance.

Weekly etoposide, epirubicin, cisplatin, 5-fluorouracil and leucovorin: an effective chemotherapy in advanced gastric cancer

In order to optimize the therapeutic index of combining etoposide, epirubicin, cisplatin, 5-fluorouracil (5-FU), leucovorin (EEPFL) chemotherapy in the treatment of advanced gastric cancer, a trial of a novel schedule of weekly administration was conducted. Weekly EEPFL treatment consisted of a concomitant boost of etoposide 40 mg m(-2) i.v. over 30 min, epirubicin 10 mg m(-2) i.v. over 5 min to a backbone regimen, weekly PFL chemotherapy with cisplatin 25 mg m(-2), 5-FU 2200 mg m(-2), leucovorin 120 mg m(-2) given simultaneously by 24-h i.v. infusion. Response, survival and toxicity were evaluated. Forty-two patients were studied. Median age was 69 (range 31-84) years. Twenty-six per cent of patients showed complete response and 45% partial response. The overall response rate was 71% (95% confidence interval 58-84%). For a total of 507 weekly EEPFL cycles delivered, the incidence of grade 4 leucopenia was 1% of cycles. One patient died of neutropenia septicaemia. There was no other grade 4 toxicity. Grade 3 and 2 leucopenia occurred in 7% and 14% of cycles. The incidence of grade 3 and 2 mucositis was 1% and 3% of cycles. Grade 3 and 2 diarrhoea occurred in 0.4% and 1.6% of cycles. Overall median survival was 10 months (range 3-41+ months). Weekly EEPFL chemotherapy is an effective regimen with tolerable toxicities in the treatment of advanced gastric cancer. A randomized controlled clinical trial to formally assess the efficacy and benefit of EEPFL chemotherapy is under way.

Contribution to first-pass metabolism of ethanol and inhibition by ethanol for retinol oxidation in human alcohol dehydrogenase family--implications for etiology of fetal alcohol syndrome and alcohol-related diseases

The alcohol dehydrogenase (ADH) family is involved in the metabolism of both ethanol and retinoids. To quantitatively assess the potential contributions to first-pass metabolism of ethanol and the ethanol interference with retinoid homeostasis, saturation kinetics for ethanol oxidation as well as inhibition kinetics by ethanol for all-trans-retinol oxidation of human class I alpha alpha, beta1beta1, beta2beta2, gamma1gamma1, class II pi pi, class III chi chi, and class IV mu mu were evaluated and compared. Class I and class II ADHs exhibited substrate inhibition with inhibition constants ranging over 250-720 mM (except gamma1gamma1) ethanol. Class IV ADH displayed no appreciable inhibition up to 1 M ethanol. Activity of the class III enzyme (190 nM subunit) was undetectable at 250 mM ethanol. The kinetic simulations indicate that the hepatic pi pi and the gastric mu mu can most effectively contribute to first-pass metabolism of alcohol. The Michaelis constant (Km), turnover number (k(cat)), and catalytic efficiency (k(cat)/Km) for retinol oxidation relative to that for ethanol oxidation in class I, class II, and class IV ADHs ranged over 0.00022-1.3, 0.071-0.48, and 0.24-650, respectively. Ethanol was a competitive inhibitor against retinol for class I, II, and IV ADHs with apparent inhibition constants ranging over 0.037-11 mM, indicating that retinoic acid synthesis through the ADH pathways can be tremendously blocked during social/heavy drinking. These findings support the notion that first-pass metabolism of alcohol may occur mainly in the liver through class II pi pi and that cellular retinoid signaling may be perturbed by ethanol via ADH pathways.

Genetic heterogeneity for familial hypertrophic cardiomyopathy in Chinese: analysis of six Chinese kindreds

OBJECTIVE

Familial hypertrophic cardiomyopathy (FHCM) is a primary myocardial disease characterized by unexplained ventricular hypertrophy. The application of the techniques of reverse genetics has identified at least five chromosomal loci as the major causes for FHCM in diverse ethnic populations, suggesting substantial genetic heterogeneity for FHCM. Recently, the defective gene loci of two Chinese families with FHCM have been mapped to chromosome 11 and 14q1, respectively. For further understanding of the molecular basis of FHCM in Chinese, we analyzed the linkage between four other Chinese kindreds and DNA markers from chromosome 14q1.

METHODS

Six unrelated Chinese families with FHCM, including two previously reported, were studied. Totally 90 family members were included for analysis. DNA from 80 individuals was extracted and polymerase chain reactions were performed using the primers designed according to the sequences derived from the alpha and beta myosin heavy chain gene. Totally four polymorphisms were studied, including three polymorphic microsatellite sequences and one single strand conformation polymorphism. Genetic linkage analysis were performed using the Linkage program.

RESULTS

In the six studied families, 39 of the 90 family members were found to be affected diagnosed either by echocardiography or by clinical evaluation. The pattern of inheritance in all six studied families was most consistent with an autosomal dominant trait with a high degree of penetrance. Genetic linkage analysis using polymorphisms on the alpha and beta MHC genes showed a combined maximal lod score of 6.2 for trinucleotide repeat polymorphism AMHC-I 15 at theta = 0.00 for three studied families without recombination. Exclusion of linkage to the chromosome 14q1 location was noted in two of three other families with the maximal lod score of -2 or less.

CONCLUSIONS

These results provide further evidence that FHCM in Chinese is genetically heterogeneous. Chromosome 14q1 locus, probably the beta myosin heavy chain gene, is important as the molecular basis for FHCM in Chinese.

Serum tumor necrosis factor in patients with gastric cancer

We have measured serum TNF-alpha levels in 220 gastric cancer patients, 9 patients with gastric polyps or ulcers, 9 hepatitis B carriers and 85 normal controls. The results showed that no positive TNF-alpha value (> 10 pg/ml) was detected in Hepatitis B carriers and benign gastric lesions' patients and normal controls. In the cancer group, 17 out of 220 patients (7.7%) had positive-TNF-alpha values. The proportion of TNF-alpha positive was 6.8% in stage I disease, 6.5% in stage II disease, 3.7% stage III, and 12.9% stage IV. No clinicopathologic factors were related to positive TNF-alpha value. TNF-alpha value was not an independent prognostic indicator The role of TNF-alpha in gastric cancer remains obscures.

Ki-67 expression as a prognostic marker in patients with hepatocellular carcinoma

Ki-67 expression in tumours has been shown to be associated with prognosis in patients with hepatocellular carcinoma (HCC). In this study, primary HCC samples were obtained from 67 patients undergoing surgical resection. None of these patients had been subjected previously to any other form of therapy, such as arterial embolization or chemotherapy. Histologically normal liver tissues from liver resection for metastatic colon cancer were taken as controls (n = 8). Monoclonal antibody against Ki-67 was used for immunostaining and flow cytometry was used to measure tumour DNA ploidy. The mean Ki-67 labelling index (percentage of Ki-67-positive cells) of the HCC (26 +/- 22%; range 0.1-89%) was significantly higher than that of the normal controls (39 +/- 0.8%, P < 0.05). The mean Ki-67 labelling index (19 +/- 15%; n = 28) of the tumours with diploid DNA pattern was significantly lower than those with aneuploid DNA pattern (32 +/- 25%, n = 39; P = 0.01). Hepatocellular carcinoma patients (n = 47) with Ki-67 index > 10% had a significantly lower disease-free and overall survival than those (n = 20) with Ki-67 index < or = 10% (P = 0.0009 and P = 0.02, respectively). Multivariate analysis showed that Ki-67 expression and tumour node metastasis stage were two independent prognostic factors for disease-free and overall survival rates. Our results suggest that the expression of Ki-67 is an independent prognostic indicator for patients with HCC after resection and could be of assistance in the decision-making of adjuvant therapy.

Lectin coprecipitative isolation from crudes by Little Rock Orange ligand

Matrix ligands are intended for upstream use with dilute crudes on a large scale, splitting out sought-for proteins by coprecipitating them as dense, protected aggregates. Matrix ligand coprecipitation is rapidly, quantitatively reversible, by pH shifting and trapping matrix ligands on ion exchange resin, releasing the sought-for protein. Four lectins, wheat germ agglutinin, peanut lectin, concanavalin A, and Phaseolus vulgaris (red kidney bean) lectins, were coprecipitated from crude extracts, 0.05 to 0.4% crude protein, in a single step using Little Rock Orange matrix ligand. All were compared in specific activities (erythrocyte agglutination) and in SDS-PAGE analysis with the four corresponding commercial lectins purified by affinity chromatography. All four matrix-coprecipitated ligands were specifically active within range of the corresponding vendor (Sigma Co.) affinity chromatography-purified lectins. The matrix ligand coprecipitative technique requires optimization of ligand-protein (crude) ratios, denoted y, and determination of suitable pH ranges for coprecipitation relative to lectin isoelectric pH. These parameters control electrostatic ion pair association: ligand head anion binding to cationic target proteins. The coprecipitative and protective powers of new ligands like Little Rock Orange, their ability to scavenge sought-for lectins from dilute crudes, depend on ligand organic tail-tail association. After the strong anion heads of ligands bind to cationic proteins, their organic tails stack and draw the ligand-protein complexes together as aggregated coprecipitates.

A modified design of microwave tissue coagulator monopolar antenna for applications in laparoscopic hepatic surgery

Massive hemorrhage is of primary concern during hepatic surgery. In this study, we not only modified the monopolar antenna of the microwave tissue coagulator but also investigated its feasible applications in laparoscopic hepatic surgery. In addition, the conventional antenna of the microwave tissue coagulator was used as a model. A catheter was attached to the antenna. The network analyzer was used to analyze the impedance of the novel monopolar antenna. Moreover, we designed and constructed a novel monopolar antenna for the microwave tissue coagulator. The antenna is gas-leak-proof, having sufficient stiffness and length and retaining similar microwave emission strength, pattern, and shielding property as the conventional antenna. In vitro tests in porcine liver confirm the coagulation and hemostatic effects of the novel type laparoscopic monopolar antenna. Results presented herein confirm the effectiveness of a laparoscopic monopolar antenna for a microwave tissue coagulator with sufficient coagulation effects.

Correlation of hepatocyte growth factor-induced proliferation and calcium-activated potassium current in human gastric cancer cells

Hepatocyte growth factor (HGF) has been found to stimulate proliferation and migration of human gastric carcinoma cells. Whether the HGF-induced responses are correlated with the expressed level of HGF receptors or the changes of ionic currents is not clear. The present study investigated the effects of HGF on the proliferation and ionic currents of two human gastric adenocarcinoma cell lines, which were found to express different amounts of HGF receptor. Results showed that HGF induced a dose-dependent growth stimulation and accelerated cell cycle progression in SC-M1 cells. In patch clamp study, HGF treatment induced an outward K+ current and increased the slope conductance at -80 mV from 110+/-15 pS/pF to 207+/-15 pS/pF. The HGF-induced K+ current was abolished when tetraethylammonium chloride was added in bathing solution or a low Ca2+ solution was included in the recording pipette. Furthermore, HGF (10 ng/ml) induced an oscillatory Ca2+-activated K+ current with a lag period of 5+/-3 min in SC-M1 cells. In contrast, HGF did not induce mitogenesis, cell cycle progression and changes in ionic currents in KATO-III cells, although this cell line expressed a higher level of HGF receptors than SC-M1 cells did. These findings provide evidence that the activity of Ca2+-activated K+ channel may be involved in the HGF-induced cell proliferation in human gastric cancer cells, but it did not correlate with the density of HGF receptors.

Class I and class II major histocompatibility complex antigens expression on human hepatocytes and hepatoma cells: an approach with high sensitivity and specificity

The expression of gene products of the major histocompatibility complex (MHC) on the cell surface is known to play an important role in immunological responses. While some studies have reported the presence of MHC antigens on hepatocytes, information about specific, sensitive hepatocyte MHC antigen expression in various liver diseases is minimal. To investigate the expression of class I and class II MHC antigens on hepatocellular carcinoma (HCC) specimens, two-color flow cytometry was used to demonstrate MHC antigen expression on non-malignant and malignant hepatocytes using the hepatocyte-specific monoclonal antibody (MAb) 9B2 for selective gating and either MHC-specific W6/32 (class I) or Q5/13 (class II) MAb for MHC antigen detection. Non-malignant liver tissues demonstrated variable MHC antigen expression. Malignant hepatocytes isolated from resected HCC specimens as well as non-tumorous hepatocytes from these HCC specimens also disclosed various degrees of MHC antigen expression. Although we were not able to demonstrate a clear correlation between clinical outcome and MHC antigen expression in HCC, we conclude that the expression of MHC antigens on human hepatocytes and hepatoma cells can be accurately detected by flow cytometry using hepatocyte-specific MAb for selective gating and MHC-specific MAbs. Of note, two cases of non-malignant fetal liver tissues indicated that >95% of fetal hepatocytes expressed class I MHC antigens and <25% of fetal hepatocytes expressed class II MHC antigens. These findings may lead to further investigations into the progression of HCC cells or into the possible mechanisms of the hepatocellular carcinogenesis.

Allelic loss at BRCA1, BRCA2, and adjacent loci in relation to TP53 abnormality in breast cancer

Cells with abnormal TP53 lose cell cycle checkpoints, resulting in genomic instability and neoplastic transformation. However, the evidence linking the tumor-specific targets of genomic alteration to an abnormal TP53 is limited. The present study tested the hypothesis that TP53 abnormalities are correlated with an increased frequency of deletion of breast cancer susceptibility loci (17q and 13q) in breast carcinomas. Tumors from 90 patients were examined for TP53 abnormality and loss of heterozygosity (LOH) at 11 loci on 17q (17q11.2-21) and 13q (13q12-14), including the loci for BRCA1 and BRCA2. A higher frequency of LOH was consistently found at 17q or 13q loci in tumors with an abnormal TP53. The increased LOH in relation to TP53 abnormality was statistically significant at the BRCA1, D17S588, and D13S267 loci (P < 0.05) but not at the locus for BRCA2 (P = 0.64). These observations imply a possible link between an abnormal TP53 and specific genomic deletions of breast cancer susceptibility loci, which may provide clues to the role of TP53 during breast tumorigenesis.

Negative regulation of a heterologous promoter by human cytomegalovirus immediate-early protein IE2

The HCMV IE2 protein promiscuously activates transcription of many viral and cellular genes. IE2 also negatively autoregulates its own expression by binding to a strategically positioned IE2 binding site, called CRS, located immediately downstream of the TATA box of the HCMV major IE promoter. Here we show that IE2 is able to repress transcription driven by a heterologous promoter, RSV LTR. Repression of RSV LTR by IE2 is completely dependent of DNA sequences downstream of the TATA box of RSV LTR. A DNA sequence, 5'-CGATACAATAAACG-3', evidently matching the proposed CRS consensus sequence, is located between nucleotides -13 and +1 (relative to the transcription start site) of RSV LTR. Three lines of evidence support the notion that this RSV CRS element is involved in the IE2-mediated repression of RSV LTR. First, introduction of mutation to the RSV CRS element renders to the mutant RSV LTR resistance to IE2-mediated repression. Second, a mutant IE2 defective in DNA binding cannot downregulate transcription from RSV LTR. Third, IE2 specifically binds to the wild-type, but not the mutant, RSV CRS element in vitro. These data, in conjunction with previous works, demonstrate that IE2 can passively repress transcription of homologous and heterologous promoters that contain a CRS element.

Prognostic significance of surgical margin in hepatocellular carcinoma resection: an analysis of 165 Childs' A patients

BACKGROUND AND OBJECTIVES

The clinical significance of the width of the surgical margin in the resection of hepatocellular carcinoma (HCC) has yet to be clarified.

METHODS

Childs' A patients (165) who underwent resections of HCC were studied. Patients were divided into a wide margin group (1.0 cm or more, group W, n = 85), and a narrow margin group (< 1.0 cm, group N, n = 80).

RESULTS

Multivariate analysis showed that preoperative alpha-fetoprotein level (P = 0.0202), venous invasion (P = 0.0226), surgical margin (P = 0.0012), and TNM stage (P = 0.0023) were significant predictors of disease-free survival. By the log-rank test, the disease-free survival rate of the group W patients was significantly higher than that of the group N patients (P = 0.0007). Group N had a higher percentage of patients undergoing minor resection (wedge resection or subsegmentectomy) (44% vs. 26%, P = 0.016) and had a higher percentage of patients with centrally located tumor (62% vs. 29%, P = 0.000) than group W.

CONCLUSIONS

The results of this study indicated the significant influence of surgical margin on HCC recurrence after resection. Minor resection and centrally located tumor are factors related to a narrow surgical margin.

Prognostic significance of surgical margin in hepatocellular carcinoma resection: an analysis of 165 Childs' A patients

BACKGROUND AND OBJECTIVES

The clinical significance of the width of the surgical margin in the resection of hepatocellular carcinoma (HCC) has yet to be clarified.

METHODS

Childs' A patients (165) who underwent resections of HCC were studied. Patients were divided into a wide margin group (1.0 cm or more, group W, n = 85), and a narrow margin group (< 1.0 cm, group N, n = 80).

RESULTS

Multivariate analysis showed that preoperative alpha-fetoprotein level (P = 0.0202), venous invasion (P = 0.0226), surgical margin (P = 0.0012), and TNM stage (P = 0.0023) were significant predictors of disease-free survival. By the log-rank test, the disease-free survival rate of the group W patients was significantly higher than that of the group N patients (P = 0.0007). Group N had a higher percentage of patients undergoing minor resection (wedge resection or subsegmentectomy) (44% vs. 26%, P = 0.016) and had a higher percentage of patients with centrally located tumor (62% vs. 29%, P = 0.000) than group W.

CONCLUSIONS

The results of this study indicated the significant influence of surgical margin on HCC recurrence after resection. Minor resection and centrally located tumor are factors related to a narrow surgical margin.

Infra-red (ATR/FT) spectroscopic study on the conformational structure of the isolated human gastric mucus pretreated with ethanol

In order to investigate the conformational structure of isolated human gastric mucus gel pretreated with or without ethanol, gel samples were determined by attenuated total reflection/Fourier transform-infra-red (ATR/FT-IR) microspectroscopy. The result indicates that the secondary structure-dependent amide I band and the glycoprotein region were significantly different in the gastric mucus gels pretreated with and without 40% ethanol. The structural composition of beta-sheet structure (1640-1600 cm-1) increased from 38.48 to 55.08% (+16.6%) after 6-hour pretreatment with 40% ethanol, but the beta-turn structure, (1660-1700 cm-1) decreased from 41.38 to 24.29% (-17.05%). The peak area ranging from 1180 to 1000 cm-1, assigned to the glycoprotein region, was also different after pretreatment with ethanol for 6 h. The higher peak area of the carbohydrate band was obtained in the frequency region between 1000 and 1040 cm-1 and 1100 and 1180 cm-1 for mucus gel pretreated with 40% ethanol. However, the peak area ranging from 1100 to 1040 cm-1 mainly due to the symmetric phosphate stretching mode of proteins was somewhat lower for the ethanol-pretreated mucus gel than the native mucus gel. This result strongly reveals that ethanol significantly modified the conformational structure of proteins and carbohydrates of gastric mucus gel. We propose that the dehydration and interference of hydrophobic interactions in the isolated mucus gel after pretreatment with ethanol might be responsible for this conformational change.

Prognostic significance of surgical margin in hepatocellular carcinoma resection: an analysis of 165 Childs' A patients

BACKGROUND AND OBJECTIVES

The clinical significance of the width of the surgical margin in the resection of hepatocellular carcinoma (HCC) has yet to be clarified.

METHODS

Childs' A patients (165) who underwent resections of HCC were studied. Patients were divided into a wide margin group (1.0 cm or more, group W, n = 85), and a narrow margin group (< 1.0 cm, group N, n = 80).

RESULTS

Multivariate analysis showed that preoperative alpha-fetoprotein level (P = 0.0202), venous invasion (P = 0.0226), surgical margin (P = 0.0012), and TNM stage (P = 0.0023) were significant predictors of disease-free survival. By the log-rank test, the disease-free survival rate of the group W patients was significantly higher than that of the group N patients (P = 0.0007). Group N had a higher percentage of patients undergoing minor resection (wedge resection or subsegmentectomy) (44% vs. 26%, P = 0.016) and had a higher percentage of patients with centrally located tumor (62% vs. 29%, P = 0.000) than group W.

CONCLUSIONS

The results of this study indicated the significant influence of surgical margin on HCC recurrence after resection. Minor resection and centrally located tumor are factors related to a narrow surgical margin.

Selection of invasive and metastatic subpopulations from a human lung adenocarcinoma cell line

To better understand the mechanism(s) underlying lung cancer invasion and metastasis, a Transwell invasion chamber was used to select progressively more invasive cancer cell populations from a clonal cell line of human lung adenocarcinoma, CL1. Five sublines with progressive invasiveness, designated CL1-1, CL1-2, CL1-3, CL1-4, and CL1-5, were obtained through this in vitro selection process. Their invasive abilities through basement membrane matrix showed a 4- to 6-fold increase over that of the parental cells. Moreover, the sublines manifested an increase in their colony-forming ability on soft agar, tumorigenicity, and metastatic potency in severe combined immunodeficiency (SCID) mice. Examining the phenotypes of the cell lines revealed increased expression of 92 kD gelatinase and an increase in the cell population stained with anti-keratin-8 and -18 antibodies. Clonal isolation of anti-keratin-18-antibody-positive and -negative cell populations demonstrated a correlated enhancement of the invasiveness of these cells and their expression of keratin-18. These results support the notion that the metastatic behavior of lung cancer cells can be characterized with this in vitro system, and that the properties of these progressively invasive cancer cells can be clonally studied.

Effect of hepatocyte growth factor on cell cycle and c-met expression in human gastric cancer cells

Hepatocyte growth factor (HGF) was found to stimulate the growth and progression of gastric cancer cells through hepatocyte growth factor receptor (HGFR). In the present study, the effects of HGF on the expression of HGFR in relation to cell cycle progression of human gastric cancer cells were investigated by two-parameter flow cytometric analysis. We found that the expression of HGFR in SC-M1 and KATO-III gastric cancer cells was cycle dependent, the level of HGFR increased from GO-G1 to S phase and the highest level of HGFR was found in G2-M phases. The level of HGFR was higher in KATO-III than SC-M1 cells. However, HGF treatment induced a dose-dependent stimulation of growth as well as down-regulation of HGFR in SC-M1 cells but not in KATO-III cells. These results suggest that functional HGFR rather than overexpressed HGFR may be more important for the growth of gastric cancer cells.

Quality of life of patients with gastric adenocarcinoma after curative gastrectomy

Quality of life (QOL) was evaluated in 162 patients having radical gastrectomy for cancer. The results showed that more than half of the patients had a good appetite; they consumed a normal diet and a normal volume of food. Approximately 60% of the patients had weight loss of more than 5 kg. Patients who underwent a total gastrectomy had poor tolerance of normal food and frequent eating and body weight loss versus those who had a subtotal gastrectomy. Patients who underwent Billroth II reconstruction after a distal subtotal gastrectomy lost more body weight than those with a Billroth I anastomosis. The extent of lymphadenectomy did not influence the QOL. Patients under 65 years of age had a better QOL. Nearly all patients had normal work and daily living activities. Some patients appeared to lack energy or had a period of anxiety or depression. These data indicate that radical gastrectomy can be performed with an acceptable QOL for a potentially curable gastric carcinoma.

Intestinal obstruction after laparoscopic herniorrhaphy

Laparoscopic herniorrhaphy is still a controversial procedure. Two cases of intestinal obstruction after laparoscopic herniorrhaphy are reported. The clinical features, possible mechanisms, managements, and outcomes were analyzed. The results showed that preexisting mesenteric defect, fibrin depositions, and longer operation time were predisposing factors for post-laparoscopic herniorrhaphy intestinal obstruction. These findings suggest that cleansing of fibrin deposition and shorter operation times may be important to avoid postoperative intestinal obstruction.

Genomic deletion and p53 inactivation in cervical carcinoma

The tumor-suppressor gene p53 acts as "the guardian of the genome", sensing DNA damage and initiating protective responses. To examine the hypothesis that p53 abnormality leads to increased genomic alterations in primary tumor cells, our study utilized 51 primary tumors of cervical carcinoma and 10 microsatellite markers. These markers were mapped to the short arms of chromosomes 3 and 5, covering the regions 3p13-25 and 5p15.1-15.3. Genomic deletion on 3p and 5p was correlated with genetic or epigenetic p53 inactivation pathways, including p53 mutation, genetic deletion of p53 and cervical infection with human papillomavirus. The proportion of abnormal p53 was found to be significantly higher in the cases exhibiting loss of heterozygosity (LOH) on 5p (p < 0.001), supporting the hypothesis of the presence of a p53-dependent pathway to cervical tumorigenesis. In contrast, however, LOH on 3p was found to be independent of p53 inactivation. A common deletion region, 3p22-24, was identified in 44% of informative cases, and genomic loss at this specific region was correlated with early tumorigenic onset and poor grade of tumor differentiation. Diversity within the patterns of genomic alteration in the same form of cancer suggests different sets of risk/tumorigenic profiles, molecular pathogenesis, as well as prognosis and outcome.

Clinicopathological comparison of resectable hepatocellular carcinoma between the young and the elderly patients

BACKGROUND

Hepatocellular carcinoma (HCC) is one of the most common cancers in many parts of the world. In Taiwan it is the leading cause of death in male cancer patients. The peak age of onset of HCC varies according to geographic barriers, which indicates different hepatocarcinogenesis among different age groups. This study aims to evaluate whether there exists significantly different clinicopathological features between young and elderly HCC patients.

METHODS

During a six-year period, a total of 248 patients with HCC underwent liver curative resection at Veterans General Hospital-Taipei, Taiwan. Among them, 22 patients were younger than 40 years of age, and 43 patients were older than 70 years of age. Important clinicopathological characteristics of the patients (including sex, family history of HCC, smoking habits and alcohol consumption patterns, hepatitis B or C infection, indocyanine-green retention rate at 15 minutes (ICGR-15), serum alpha-fetoprotein value, tumor size, tumor number, tumor venous invasion, capsular formation, tumor staging, cirrhosis, and tumor DNA ploidy) and postresectional prognosis were compared between young and elderly HCC patients.

RESULTS

The frequency of presence of family history (22.7% versus 4.7%), hepatitis B surface antigen carrier rate (81.8% versus 48.8%), and patients with large-sized tumors (31.8% versus 7.0%) were significantly higher in young patients than in elderly patients. The male:female ratio (4.5:1 versus 42:1), degree of liver damage (reflected by the ICGR-15 value, 5.6 +/- 5.0% versus 13.1 +/- 8.8%) and the incidences of liver cirrhosis (18.2% versus 48.8%) were significantly lower in young patients than in elderly patients. However, there were no significant differences in postresectional survival rates between these two groups.

CONCLUSIONS

There are age-related differences in clinicopathological characteristics of HCC patients. Accordingly, different mechanisms of hepatocarcinogenesis may exist between young and elderly HCC patients.

Prognostic indicators for survival after curative resection for patients with carcinoma of the stomach

This study aims to determine prognostic indicators among patient-, tumor-, and treatment-related factors of gastric cancer patients. A total of 510 patients who underwent curative gastric resection were studied. Univariate analysis of patient-related factors showed a significantly lower survival in patients with a history of obstruction, hypoalbuminemia, and anemia. Tumor-related factors including gross appearance, location, and size of tumor; depth of cancer invasion; level, number, and frequency of lymph node metastasis; stromal reaction and tumor growth pattern; and histological classification all significantly affected survival. Surgical treatment related factors such as total or distal subtotal gastrectomy, extent of lymphadenectomy, and combined resection of adjacent organ(s) showed a statistically significant adverse influence on survival. Multivariate analysis identified only four tumor-related factors-number of metastatic lymph nodes, depth of cancer invasion, stromal reaction, and gross appearance of the tumor-as independently affecting survival. These findings suggest that only four tumor-related factors were prognostic indicators in patients with gastric cancer.