Deoxyribonucleic acid content in bronchogenic carcinoma with special reference to polypoid cell nuclei. A preliminary report

The biologic features of intramucosal gastric carcinoma with lymph node metastasis

This review concentrates on the clinicopathologic studies and molecular biologic studies of intramucosal gastric carcinomas (IMGCs) with lymph node metastasis that have been published to date. There have been several reports in which IMGCs with lymph node metastasis were compared with IMGCs without lymph node metastasis from the view of clinicopathologic features. However, there have been a few reports in which IMGCs with lymph node metastasis were compared with IMGCs without lymph node metastasis from the view of molecular biologic features. In general, IMGCs with lymph node metastasis have been commonly reported to be large lesions, poorly differentiated adenocarcinoma, and associated with peptic ulcer, in comparison with IMGCs without lymph node metastasis. Regarding genetic studies or molecular biologic studies, only DNA distribution pattern, proliferative cell nuclear antigen and the monoclonal antibody Ki-67, or matrix metalloproteinases 2 and 9 have been investigated in IMGCs with lymph node metastasis. The malignant potential of the carcinoma cells cannot been evaluated by a clinicopathologic study with the use of hematoxylin and eosin staining. It may be unavoidable that minimal operation is widely accepted for the treatment of IMGCs. It may be more essential to establish the staging by both clinicopathologic and molecular biologic examinations to rule out the presence of IMGCs with lymph node metastasis.

The application of microspectrocytofluorometric measurement of Feulgen nuclear DNA content to experimental tumors of rat submandibular gland. 1. Pathogensis and nuclear DNA content

Pellets containing 9,10-dimethyl-1,2-benzanthracene (DMBA) were inserted into the submandibular glands of 65 male Fischer rats to determine the nuclear DNA content of both metaplastic epithelium during the process of development of squamous metaplasia (noted at 1, 2, 5, 7, 9, 10, 11, 13 and 15 weeks after insertion) and tumor cells of squamous cell carcinoma 24 weeks after insertion. From the second week of insertion onward, squamous metaplasia was found in excretory duct remaining epithelium in the tissues around the pellet. Dysplasia or a lining of metaplastic epithelium with atypia adjacent to pellets (i.e., formation of an epidermal cyst) was observed 5 weeks after insertion. Coincident with this dysplasia or metaplastic epithelium with atypia, variation in the nuclear DNA content was observed, showing the emergence of octaploids and a widespread histogram pattern with many peaks. Between 7 and 15 weeks, 25%-66% of the lining metaplastic epithelium showed variation in the nuclear DNA content due to shift of a peak (major mode) to a triploid as well as a vague major mode with the appearance of octaploids, etc. Tumors of the submandibular gland were recognized at 24 weeks in 11 (55%) of 20 rats. Nine were keratinized squamous cell carcinomas and the remaining 2 were carcinosarcomas. Marked abnormalities in the nuclear DNA content were observed in 5 of the 11 rats (45.5%), 3 with keratinizing squamous cell carcinoma and 2 with carcinosarcomas. In contrast, no marked variation in the nuclear DNA content was found in 5 rats in which the tumor was associated with cysts.

Preoperative detection of a highly malignant type of early gastric carcinoma by cytophotometric DNA analysis

A cytophotometric DNA analysis was made of gastroendoscopically biopsied materials of 43 patients with early gastric carcinoma and the data were compared with the DNA patterns of the resected specimens of these patients. The DNA patterns could be classified into two types, Low Ploidy and High ploidy, according to the degree of dispersion of the DNA value. The Ploidy to Ploidy coincidence of the DNA patterns between biopsied material and the resected specimen in the same lesion was noted in 93 per cent (39/42). The DNA patterns of the resected specimens were consistent in the majority of cases, regardless of the areas examined, center or periphery, and mucosa or submucosa of the same lesion. This study provides evidence that a highly malignant type of early gastric carcinoma, Pen A type, could be differentiated in gastroendoscopically biopsied materials by a cytophotometric DNA analysis.

Prognostic significance of nuclear DNA content in small cell carcinoma of the lung

The relationship between the nuclear DNA histogram patterns of tumor cells obtained by brushing via bronchoscopy and the survival time of 39 patients with small cell carcinoma of the lung was investigated. The brushing smears were stained by a modified Feulgen method. The nuclear DNA content was measured at 550 nm using a microspectrophotometer. The DNA histogram pattern was classified into type I, which contained a higher proportion of G0G1-phase cells, and type II, which contained a higher proportion of S, G2M-phase cells. The median survival times for the patients with limited disease of type I, type II and the patients with extensive disease of type I, type II were 17.2 months, 10.2 months, 10.0 months, and 5.6 months, respectively. Patients with limited disease of type I had a significantly longer survival time than patients with limited disease of type II. A distinct correlation was found between the histogram pattern and the survival of the patients. These results indicated that the nuclear DNA histogram pattern may be an indicator to allow speculation as to the prognosis of patients with small cell carcinoma of the lung.

Differentiation of growth patterns of early gastric carcinoma determined by cytophotometric DNA analysis

Cell nuclear DNA content was microspectrophotometrically measured in 60 cases of early and six of advanced gastric carcinoma. DNA distribution pattern was classified into Types I, II and III, according to the degree of dispersion on the DNA histogram. Five of 6 cases of the advanced carcinomas were Type III. In early carcinoma, the majority of Super (superficially spreading) type were Type II, while all of Pen A (expansively penetrating growth) type were Type III. In Pen B (infiltratively penetrating growth) type, six of ten cases were Type II and the other four were Type III. Thus, there was a distinct difference in the DNA pattern between Super and Pen Types, i.e., the DNA analysis reflected these growth types. Since about 20% of those with small mucosal carcinomas, not classifiable into the Super or the Pen types presented Type III, the cytophotometric DNA analysis should be useful in the detection of Pen A like carcinoma, in its early stage. The development from early to advanced carcinoma was discussed in terms of the similarity of the DNA histogram patterns.

Flow microfluorometry and transrectal fine-needle biopsy in the classification of human prostatic carcinoma

Flow microfluorometry (FMF) and transrectal fine-needle biopsy were used for obtaining DNA histograms from 50 patients suffering from various prostatic lesions. Based on the cytomorphological pattern, the material was classified as benign prostatic hyperplasia (29 cases), suspected carcinoma (1 case), well-differentiated carcinoma (6 cases), moderately differentiated carcinoma (12 cases) and poorly differentiated carcinoma (2 cases). The biopsy material was prepared for FMF analysis according to a new detergent technique. It was observed that increasing anaplasia paralleled an increasing occurrence of cell populations in the tetraploid and octoploid DNA region. According to the DNA histograms the moderately differentiated carcinomas could be divided into two groups: one with no or a few tetraploid cells (similar to the well-differentiated carcinomas), and another with a high percentage of tetraploid and octoploid cells (similar to the poorly differentiated carcinomas). FMF analysis in combination with fine-needle biopsy is therefore proposed as a valuable addition to the cytomorphological classification of human prostatic carcinoma.

Deoxyribonucleic acid content in the laryngeal mucosa with special reference to polyploid cell nuclei

The DNA content was measured by microphotometry in morphologically normal squamous epithelium of the larynx, in hyperplastic epithelium of the vocal cords and in invasive squamous-cell carcinoma. The average nuclear DNA content in the squamous-cell carcinoma was elevated in comparison with that of normal epithelium, and the values showed a much wider dispersion. During premitotic DNA synthesis, the nuclear content of DNA is doubled. Polyploid cell nuclei with a nuclear DNA content of more than twice the model value (the stem cell of the tumour) are therefore a distinct sign of an abnormally elevated content of DNA. In morphologically normal epithelium no polyploid cell nuclei were revealed, while such nuclei were present in all cases of invasive squamous-cell carcinoma. Polyploid cell nuclei were found in six out of 20 patients with hyperplasia of the epithelium of the vocal cords. Among these six patients, manifest invasive carcinoma developed inthree, carcinoma in situ in one, while the condition remained benign in two, probably because the pathological tissue was completely removed. The presence of polyploid cell nuclei should thus arouse a strong suspicion of malignancy and calls for close supervision of the patient.