Correlated expression of matrix metalloproteinases and ets family transcription factor E1A-F in invasive oral squamous-cell-carcinoma-derived cell lines

Matrix metalloproteinases (MMPs) have been implicated in invasion and metastasis of tumor cells. Transcription regulatory regions of MMP genes often contain binding sites for ets transcription factors. We recently isolated a cDNA encoding human E1A-F, a member of the ets oncogene family, and showed that E1A-F can upregulate MMP genes by CAT assay. We attempted to investigate the relationship between E1A-F mRNA expression and MMP protein expression in four different types of oral squamous-cell-carcinoma-derived cell lines (HSC 3, SAS, KB, and Ca 9.22). HSC 3 and SAS are highly invasive cell lines when they are injected in the tongue of nude mice. Raft culture of HSC 3 and SAS revealed the same characteristics as seen in tumors implanted in vivo. Both type I collagenase (MMP-1) and 92-kd type IV collagenase (MMP-9) were detected in cultured HSC 3 and SAS cells. E1A-F mRNA was demonstrated to be highly expressed in HSC 3 and SAS by Northern blotting, and in situ hybridization confirmed E1A-F mRNA expression at the invasion front of tumor cells seeded on collagen gel. On the other hand, KB and Ca 9.22 have little potential for invasion, and MMP-1 and MMP-9 protein and E1A-F mRNA could not be detected. These results suggest that the ets-related E1A-F participates in the regulation of invasion-associated MMP genes and is involved in presenting invasive activity in tumor cells of oral squamous cell carcinoma.

Induction of adenocarcinomas in the submandibular salivary glands of female Wistar rats treated with 7,12-dimethylbenz(a)anthracene

In 12 male and 12 female Wistar rats, 7-9 weeks of age, a solution of 0.05 ml of 1% 7,12-dimethylbenz(a)anthracene (DMBA) dissolved in acetone was injected directly into the submandibular glands biweekly, after the gland had been injured. In some rats the carcinogen was injected 1 week after the injury. Each rat received six to seven injections. Swelling was observed in the submandibular gland region as early as 4 weeks after the last injection. The animals were killed 4-8 weeks after the last injection and glands with tumour tissues were processed for light microscopy. The control rats of the same age that received a corresponding amount of acetone only (three male, three female), carcinogen injection alone (three male, five female), and injury only (four male, four female) were killed at the same time. Histological examination revealed adenocarcinomas of the submandibular gland in 12/12 (100%) female rats, six of which were associated with fibrosarcomas. The adenocarcinomas basically consisted of ductal and glandular structures. Sometimes tubular, cystic, papillary-cystic and cribriform-like structures were also observed. Male rats mainly developed fibrosarcomas, although there was one squamous-cell carcinoma. The reasons for the sex difference are not known. One adenocarcinoma developed in the submandibular gland of a female rat (1/5) that received carcinogen injections alone. Thus direct injections of DMBA into the submandibular gland produce adenocarcinomas in female Wistar rats.

Resistance to retinoic acid and altered cytokeratin expression of human papillomavirus type 16-immortalized endocervical cells after tumorigenesis

Human papillomaviruses (HPVs) and cigarette smoking are epidemiologically associated with cervical cancer. We recently found that HEN-16 and HEN-16-2 HPV type 16-immortalized endocervical cells form tumors after treatment with cigarette smoke condensate and derived 2 tumor cell line cultures, HEN-16T and HEN-16-2T, respectively. Here, we examine the molecular pathologic effect of tumorigenesis. HEN-16T and HEN-16-2T exhibit unchanged status and expression of integrated HPV 16 DNA. However, the expression of the cytokeratin CK7 and CK13 endocervical cell markers is more homogeneous in monolayer and organotypic raft cultures after tumorigenesis. For the effect of retinoic acid on monolayers for growth inhibition, HEN-16T were significantly less sensitive than the normal and immortalized non-tumorigenic cells. HEN-16-2T were completely resistant. Moreover, the rafts from both tumorigenic cell line cultures were resistant to retinoic acid and continued to display thick rafts and homogeneous severe dysplasia/carcinoma in situ. In contrast, the non-malignant HEN-16 and HEN-16-2 rafts were thinner, and treatment with retinoic acid blocked the formation of severe dysplasia, reconstructing an epithelium resembling that of the normal endocervix. Our results support the significance of non-viral factors in the mechanism by which cigarette smoking induces tumorigenesis in the late stages of HPV-initiated progression to cervical cancer. Importantly, our data indicate that the sensitivity to retinoic acid of the HPV-containing endocervical cells is lost following tumorigenesis in vitro and possibly in women.

Detection of human papillomavirus DNA sequences in oral squamous cell carcinomas and their relation to p53 and proliferating cell nuclear antigen expression

BACKGROUND

The etiology of oral squamous cell carcinoma (SCC) is still obscure. Since human papillomavirus (HPV) DNAs are associated with carcinoma of the uterine cervix, carcinomas of the oral cavity were investigated to ascertain if these viruses are present in squamous carcinomas of this anatomic site.

METHODS

Seventy-seven oral mucosal SCCs were examined for the presence of HPV DNAs by polymerase chain reaction and dot blot hybridization. Immunohistochemical detection of proliferating cell nuclear antigen (PCNA) and p53 was performed and single strand conformation polymorphism analysis for p53 was undertaken. In situ hybridization detection of HPV-16 DNA also was performed.

RESULTS

Human papillomavirus-16 DNA was detected in 23 cases of oral SCC and both HPV-16 and HPV-18 DNA were detected in one case of tongue SCC. Human papillomavirus DNAs were detected of 11 of 33 tongue, 4 of 15 gingival, 2 of 4 palate, 2 of 5 buccal mucosa, 3 of 7 maxillary sinus, and 2 of 11 the floor of the mouth SCCs. None were detected in SCCs of the retromolar region (0/2). Immunohistochemical examination for p53 was performed in 26 cases of oral SCC and the accumulation of p53 protein was observed in 6 cases (i.e., in 4 of 17 HPV DNA-negative cases and in 2 of 9 HPV DNA-positive cases). Single strand conformation polymorphism analysis confirmed gene mutations in all 6 cases. Human papillomavirus-16 DNA was predominantly identified in cancer cells that showed a morphologic resemblance to basal cells and its hybridized signal in keratinized cells was reduced by in situ hybridization detection. Immunohistochemical detection of PCNA revealed its cooccurrence with HPV-16 DNA in cancer cells.

CONCLUSIONS

These results suggest that HPV-16 DNA sequences may have the capability to maintain the proliferative state of epithelial cells, and may contribute to the production of malignant phenotypes.

[A case of graft-versus-host disease following red cell concentrate (MAP-CRC) transfusion]

We report a case of transfusion-associated graft-versus-host disease (GVHD). A 79-year-old woman with Hodgkin's disease, respiratory failure and severe anemia who had been treated with two courses of chemotherapy was transfused with red cell concentrate (MAP-CRC) and fresh frozen plasma (FFP) in the ICU. On the 7-9th days after transfusion, she developed a diffuse erythematous rash mainly on the chest, high fever, liver dysfunction and thrombocytopenia. Despite treatment with immunoglobulin products and methylprednisolone, her condition deteriorated rapidly, and she died of multiple organ failure on the 7th day after appearance of rash. Skin biopsy demonstrated typical features of acute GVHD, suggesting that MAP-CRC-associated GVHD had occurred.

[Tele-ECG transmission for patients with out-of-hospital cardiac arrest in Osaka City]

The efficacy of a tele-ECG transmission system for transmission of electrocardiograms from ambulance to Osaka City University Hospital for 59 patients with out-of-hospital cardiac arrest was evaluated from December 1992 to November 1993. Authorized emergency life saving technicians (ELSTs) transmitted electrocardiograms by automobilephone connected with electrocardiogram from the location of out-of-hospital cardiac arrest recognized by them to the ICU. Successful tele-ECG transfer was achieved in 34 cases (57.6%). The most common reason for failure of transmission was interference by large buildings located in our urban location, which occurred in 12 of the 25 cases. Defibrillary shock was applied in 9 of 10 cases of ventricular fibrillation, and one patient among them could return to work. In most cases, laryngeal mask airway insertion was performed. The group with tele-ECG transmission required longer time for transfer to the hospital. The time required for insertion of the laryngeal mask airway and tele-ECG transmission appeared to be the main reason for the delay in transport. Although use of tele-ECG transmission can be useful for patients with out-of-hospital cardiac arrest, further improvement on the transmission system will be needed.

Prevention of carcinoma in situ of human papillomavirus type 16-immortalized human endocervical cells by retinoic acid in organotypic raft culture

OBJECTIVE

To determine the effect of retinoic acid on the development of severe dysplasia or carcinoma in situ from endocervical cells containing human papillomavirus (HPV) type 16.

METHODS

Two independent lines of HPV 16-immortalized endocervical cells were reconstructed into two squamous epithelial tissues using the organotypic raft culture system to examine the differentiated phenotype. The effect of retinoic acid on dysplastic morphology of differentiation of the epithelia was examined by light microscopy of stained sections and electron microscopy. The endocervical cell type cytokeratin expression pattern was determined by indirect immunofluorescence using specific monoclonal antibodies. Ribonucleic acid expression of the HPV 16 E7 oncogene was examined by in situ hybridization.

RESULTS

Untreated HPV 16-immortalized endocervical cells were reconstructed into squamous dysplastic lesions resembling carcinoma in situ observed in women. Retinoic acid-treated rafts formed epithelia composed of two to three cell layers of columnar-like cells resembling simple epithelium of the endocervix. Electron microscopy and cytokeratin expression patterns confirmed the histology of a differentiated endocervical phenotype after treatment with retinoic acid. Expression of HPV 16 E7 was modestly lower in treated epithelia, preferentially in basal cells.

CONCLUSION

Retinoic acid prevents the histology and cytokeratin differentiation markers of carcinoma in situ of HPV 16-immortalized endocervical cells. Because the epithelia closely mimic HPV 16-containing severe dysplasias and native endocervical epithelium in women, this immortalized endocervical cell-raft system may be useful as a model to assess the efficacy of agents such as retinoic acid for preventing progression of these lesions to malignant cervical carcinoma.

Human papillomavirus type 18 DNA and E6-E7 mRNA are detected in squamous cell carcinoma and adenocarcinoma of the lung

To provide an accurate evaluation of the association of human papillomavirus (HPV) with lung cancer, 36 cases of lung cancer were analysed for HPV DNAs by polymerase chain reaction (PCR) with dot-blot and Southern blot analyses, and for the transcripts from the E6-E7 transforming region by in situ hybridisation (ISH). HPV-18 DNA was detected in three (8%) of 36 specimens; histologically, in one (10%) of 10 squamous cell carcinomas and two (9%) of 22 adenocarcinomas. Neither HPV-16 nor -33 DNA was detected in any cases examined. Expression of E6-E7 mRNA was confirmed in the cases which contained, HPV-18 DNA. HPV-18 may play an important role in the development and progression of cancer in some cases of both squamous cell carcinoma and adenocarcinoma of the lung.

Flow cytometric analysis of nuclear DNA content in oral leukoplakia: relation to clinicopathologic findings

DNA ploidy of 50 biopsy specimens of oral leukoplakia was investigated by flow cytometry, and the results were compared with the clinicopathologic appearances. The aneuploidy rate of the leukoplakias was 17/50 (34%), and the mean DNA index (DI) of the aneuploid lesions was 1.22, with a range from 0.70 to 1.84. The incidence of the aneuploidy was significantly (P < 0.01) higher in nonhomogeneous leukoplakias (11/18) than in homogeneous lesions (6/32). The aneuploidy rate of the severely dysplastic leukoplakias (11/17) was significantly higher than those of the mildly dysplastic (4/22; P < 0.01) and the nondysplastic (2/11; P < 0.02) lesions. A significant (P < 0.01) difference in the aneuploidy rate was also observed between tongue (12/23) and gingival (2/18) leukoplakias.

Abnormal p53 expression in human lung cancer is associated with histologic subtypes and patient smoking history

Among the most common mutations in human lung cancer are those affecting the p53 gene. The expression of p53 in the nucleus is considered an immunohistochemical reflection of the nuclear accumulation of mutant p53 protein, which is coded by the p53 gene with missense mutation and has a prolonged half-life. In the present study, p53 expression detected by means of immunohistochemistry occurred frequently in human lung cancer and was associated with histologic subtypes. The alteration in the p53 gene was found to be a relatively early genetic event in the development and progression of lung cancer and to be maintained in the process of metastasis: abnormal p53 expression was found in both the early and late clinical stages, and identical p53 expression was detected consistently among primary and metastatic lesions from the same patients. Furthermore, an observed association between abnormal p53 expression and the patients' smoking history suggests that the p53 gene could be a common target of tobacco-associated carcinogenesis in lung cancer.

Sjögren's syndrome in the adolescent. Report of four cases

We report three cases of Sjögren's syndrome and a case with a probable diagnosis of Sjögren's syndrome at the ages of 16 (2 cases), 17, and 18 years. Two patients were affected by systemic lupus erythematosus. All four patients showed periductal lymphocytic infiltration in the labial glands. Two of the three patients underwent parotid sialography that revealed punctate or globular sialectasis. A decrease in stimulated parotid flow rate was noted in three of the cases compared with age-matched healthy females, whereas only one patient was diagnosed as having keratoconjunctivitis sicca.

Flow cytometric analysis of nuclear DNA content in tongue squamous cell carcinoma: relation to cervical lymph node metastasis

The relationship between DNA ploidy and the incidence of cervical lymph node metastasis in 36 patients with tongue squamous cell carcinoma (SCC) was investigated. The aneuploidy rate of tongue carcinomas was 15/36 (42%), and the mean DNA index (DI) was 1.23, with a range from 0.87 to 3.54. Histologically identified cervical lymph node metastasis was observed in 11 cases, and the incidence of the cervical lymph node metastasis was significantly (P < 0.02) higher in the aneuploid cases (8/15) than in the diploid cases (3/21). Recurrence of the primary lesions was seen in nine cases 0.3-2.5 years after the initial treatment. No obvious difference in the incidence of the recurrence was noted, however, between the diploid (5/21) and the aneuploid (4/15) cases. These results indicate a significant relationship between aneuploidy and incidence of the regional lymph node metastasis, in contrast to the absence of a positive relationship between aneuploidy and recurrence of tongue SCC.

A case of verrucous carcinoma associated with human papillomavirus type 16 DNA

We report here a case of verrucous carcinoma which occurred on the penis of a 75-year-old male. The nodule was first noted six months earlier and was whitish, cauliflower-like, and 17 x 19 mm in size. The histopathological examination revealed hypertrophic epidermal proliferation with pale staining keratinocytes, extending into the deep dermis. Partial penectomy and inguinal lymph node dissection were done. No lymph node metastasis was recognized. DNA was isolated from the frozen tumor tissue and examined for the presence of human papillomavirus (HPV) 16, 18, and 33 DNA by the polymerase chain reaction (PCR), using common and specific primers. A 140 base pair (bp) band was amplified and finally determined to be the HPV16 sequence by dot-blot hybridization.

[Radiation injury of the lung following postoperative radiotherapy of breast cancer using a single large portal technique--CT study]

When postoperative radiotherapy for breast cancer is indicated, we employ a single large portal technique with electron beams using a bolus made of MIX-R (soft tissue equivalent material) for the chest wall. The entire lymph node groups as well as the chest wall are irradiated uniformly, and the total dose is 50 Gy, 2 Gy/fraction, 5 days/week. Radiation changes of the lung in 35 breast cancer patients irradiated by this technique were evaluated by computed tomographic (CT) studies. Radiation injuries were detected in 12 patients out of 35 (34%). Among patients who were irradiated by three portal techniques without bolus, radiation injuries were detected in all 4 patients (100%) by CT and in 39 patients out 72 (54%: historical control group) by plain chest film. These results indicated the superiority of the single large portal technique. Radiation injuries were identified in CT studies at 135 day after commencement of radiotherapy, and their distributions were localized to areas of 80-100% dose level. Measurements in CT revealed that the thickness of the chest wall varied extremely according to surgical procedures, so that the adequacy of the selection of energy of electron beams in each patient by CT was indispensable.

Detection of human papillomavirus DNA sequences in tongue squamous-cell carcinoma utilizing the polymerase chain reaction method

Twenty-four cases of tongue squamous-cell carcinoma (SCC) were analyzed for human papillomavirus (HPV) DNAs by the polymerase chain reaction (PCR) method and the dot-blot hybridization technique. HPV DNAs were detected in 8 cases. One specimen histopathologically diagnosed as poorly differentiated grade-III SCC contained both HPV-16 and HPV-18 DNA, and 7 other cases contained HPV-16 DNA.

Relationship between sialographic findings of parotid glands and histopathologic finding of labial glands in Sjögren's syndrome. Relation to clinical and immunologic findings

We investigated a relationship between sialographic findings of parotid glands and histopathologic changes of labial glands, in relation to Sjögren's syndrome. We examined 107 patients, suspected to have Sjögren's syndrome because of dry mouth and dry eyes, in whom no other autoimmune diseases were diagnosed. Parotid sialography identified 37 patients with punctate, globular, cavitary, or destructive sialectasia (S-positive group). These sialographic findings were not seen in the other 70 patients (S-negative group). Among these patients, 54 demonstrated periductal lymphocytic infiltration in the labial glands (H-positive group), whereas the other 53 patients did not demonstrate this histologic finding (H-negative group). Significant differences in stimulated parotid salivary flow rate and incidence of keratoconjunctivitis sicca were observed between patients in the S-positive and the S-negative groups. Differences in the salivary flow rate and the incidence of keratoconjunctivitis sicca were also seen between patients in the H-positive and the H-negative groups, although the differences were not statistically significant. The rate of incidence of serum rheumatoid factor, anti-SS-A, and anti-SS-B antibodies were significantly higher in the S-positive and the H-positive groups than in their negative counterparts.

DNA analysis of oral leukoplakia by flow cytometry

DNA ploidy of 19 oral leukoplakias with and without epithelial dysplasia was investigated and the results were compared with 11 normal gingival biopsies, 14 oral benign tumours and 50 oral squamous cell carcinomas. The results suggest a possible relationship between DNA aneuploidy and oral leukoplakias or squamous cell carcinomas, as 32% of the oral leukoplakias and 48% of the oral squamous cell carcinomas were aneuploid although all the normal gingival biopsies and the benign oral tumours examined were diploid. No significant relationship was observed, however, between DNA ploidy and epithelial dysplasia in the leukoplakias.

Periductal lymphocytic infiltration of salivary glands in Sjögren's syndrome with relation to clinical and immunologic findings

We studied 113 patients who were suspected to have Sjögren's syndrome (SS) because they had dry mouth and dry eyes, and who were determined as not having any other autoimmune disease, to clarify the relationship of periductal lymphocytic infiltration of salivary glands to clinical and immunologic findings in relation to SS. Periductal lymphocytic infiltrations were observed in the labial and/or the parotid glands of 57 patients (P-group). The salivary glands of the other 56 patients did not demonstrate obvious histologic changes (N-group). The stimulated salivary flow rate of parotid glands of the patients in both the P- and N-groups was significantly reduced when compared with healthy persons. However, no difference in the flow rate was observed between the P- and N-groups. In contrast, the percentage of patients in the P-group with keratoconjunctivitis sicca was significantly higher than that of patients in the N-group. Percentage of gamma-globulin fraction and IgG level in the sera of the patients in the P-group were both significantly higher than those in the N-group. The percentages of patients who demonstrated the serum rheumatoid factor, anti-SS-A, and anti-SS-B antibodies were also significantly higher in the P-group than in the N-group.

Histopathologic study of squamous cell carcinoma of the gingiva in edentulous and dentulous jaws of hamsters treated with N-methylnitrosourea

Unilateral maxillary or mandibular molars were extracted from twenty-four, 25-day-old male syrian golden hamsters; 25 days after extraction, 20 received MNU intragastrically twice a week for 3 months. All animals were killed 1 month later. High degrees and incidence of invasion of gingival SCC were observed in dentulous jaws without functional occlusion, followed by dentulous jaws with functional occlusion and edentulous jaws. Invasion of carcinomas with extensive bone destruction was observed commonly in the gingiva of dentulous maxillary jaws without functional occlusion, but was scarcely observed in the gingiva of edentulous jaws. By analogy, disuse atrophy of the periodontium due to loss of functional occlusion may result in early deeper invasion, while loss of periodontal ligament due to tooth extraction and disappearance of so-called inner gingival epithelium may result in less invasive carcinomas.

Osteochondroma of the coronoid process of the mandible. Report of a case showing histological evidence of neoplasia

A case of unilateral enlargement of the coronoid process of the mandible is presented. The patient, a 37-year-old woman complained of restricted mandibular movement and swelling in the left zygomatic region. Coronoidectomy was performed intraorally, producing improved mandibular movement. The specimen consisted of a large amount of cartilage and mature bone. Most of the cartilage showed a marked disturbance in endochondral ossification. The histopathological diagnosis was osteochondroma. A review of the basic nature of the disease in the reported cases is presented. The value of computed tomography in deciding on a surgical procedure is briefly mentioned.