Basil Ch. Golematis

Heat shock protein 70 and HLA-DR molecules tissue expression. Prognostic implications in colorectal cancer.

PURPOSE: The expression of 70,000-Da heat shock protein (HSP 70) and HLA-DR molecules on cancer cells influences immunologic mechanisms that may be of some prognostic significance. The purpose of this study was to examine the relationship among immunohistochemical HSP 70, HLA-DR expression, and clinicopathologic tumor variables, as well as patient survival in a series of 128 colorectal carcinomas. METHOD: A three-step immunoperoxidase staining technique was undertaken for detection of both markers. RESULTS: Of the examined carcinomas 77.3 percent were HSP 70-positive and 74.2 percent were HLA-DR-positive. Increased HSP 70-positive expression correlated significantly with low differentiation (P<0.05), showed a tendency to characterize advanced stages of disease, and was clearly associated with worse overall survival (P<0.05). The highest rate of HLA-DR positivity was demonstrated in early stages and was significantly associated with more favorable prognosis (P<0.001). HSP 70-positive/HLA-DR-negative patients had worse overall survival compared with the rest (P<0.001). CONCLUSIONS: The resulting opposite effects on prognosis of examined markers seem to be related to different pathophysiologic functional roles on tumor immunology.

Evaluation of Cathepsin D immunostaining in colorectal adenocarcinoma

Cathepsin D (CD), an estrogen‐regulated lysosomal protease, has been detected in a variety of tissues. CD expression has been correlated with the invasive potential of breast cancer, acting as an autocrine mitogen or as a protease that degrades the extracellular matrix. The role of CD expression in predicting prognosis or invasive potential in colorectal carcinomas is mostly unknown.

Increased estrogen receptor and epidermal growth factor receptor gene product co-expression in surgically resected gastric adenocarcinomas

Evidence exists that estrogens influence the action of epidermal growth factor (EGF) and its receptor (EGF‐R) at multiple levels. Estrogen and antiestrogen action on gastric and other gastrointestinal malignancies has been evaluated by several groups with conflicting results, and EGF‐R has been implicated in the current growth factor‐mediated models for gastric cancer progression.

Oncogenes in cancer of the pancreas

A three-step immunoperoxidase staining technique was used in order to estimate the immunohistochemical expression of K-ras, c-fos, c-myc and c-erbB-2 oncoproteins, in paraffin sections of 20 patients, with histologically proven adenocarcinoma of the pancreas. The two oncogenes that were found to be associated with pancreatic adenocarcinoma were K-ras and c-erbB-2. in 15 patients (75%) and four patients (20%), respectively. Positive immunostaining was intense, cytoplasmic and was noted in a great percentage of cancer cells. The same model of expression was observed in the examined cases of metastatic tissue from liver and lymph node metastases. The expression of myc and fos oncogenes was nuclear, weak and was observed in a small number of patients.

Correlation between immunohistochemical expression of proliferating cell nuclear antigen and flow cytometry parameters in colorectal neoplasia

PURPOSE: Proliferating cell nuclear antigen immunohistochemical expression and flow cytometry techniques were used in this study to estimate the proliferation tendency and biologic aggressiveness in benign and malignant epithelial tumors of the colon and rectum. METHODS: Thirty-five adenomas and 60 adenocarcinomas were studied immunohistochemically concerning proliferating cell nuclear antigen positivity in tumor cell nuclei. In addition, flow cytometry techniques were used to estimate the DNA content and percentage of tumor cells in the S-phase. RESULTS: The mean proliferating cell nuclear antigen score for adenomas was 38 percent compared with a mean score of 50.4 percent for adenocarcinomas that were studied (P<0.05). In dysplastic areas of malignantly transformed adenomas (n=5), the highest proliferating cell nuclear antigen score (80 percent) was focally observed. Taking flow cytometry parameters into account, we found out that proliferating cell nuclear antigen can be used as an indirect indicator of the number of cells in the S-phase (SPF) but not as an independent prognostic factor. Statistical significance was found between Type III (aneuploid carcinomas) and increased proliferating cell nuclear antigen expression (proliferating cell nuclear antigen score ⩾ 60 percent). Furthermore, aneuploidy was especially found on cancer located on the left colon (44 percentvs.14 percent of right colon neoplasms). Considering DNA ploidy of the above neoplasms, the aneuploid adenocarcinomas had a tendency for poorer prognosis especially if they were related to Dukes Stage C female patients. CONCLUSIONS: The comparative assessment of the above parameters might be of considerable importance in the study of the proliferation activity of any form of colorectal neoplasia.

Expression of receptors for estrogen and progesterone in malignant colonic mucosa as a prognostic factor for patient survival.

Estrogen receptors (ER) and progesterone receptors (PR) have been detected in both normal and malignant colonic mucosa, but the prognostic value of this observation is unknown. We aimed to define the prognostic significance of the presence of ER and PR in malignant cells from colorectal adenocarcinoma specimens.

Use of the pylorus for preventing ileostomy complications

PURPOSE: Conventional ileostomy, as it is well known, presents with persistent watery diarrhea, among other complications. The present-day modified methods of conventional ileostomy cannot effectively prevent these unpleasant consequences. The purpose of this study was to try to use the sphincter mechanism of the pylorus in ileostomy in dogs experimentally to prevent the above symptoms. METHOD: Following a highly selective vagotomy, the antrum with the pylorous and a 3-cm segment of the duodenum were separated from the gastrointestinal tract along with its vasculature and innervation, and the distal duodenal end was closed. Then, the terminal loop of ileum (before an ileostomy was performed) was dissected, and the distal segment was anastomosed with the proximal end of duodenum; the proximal segment of this loop was anastomosed with the stump of the antrum. The gastrointestinal continuity was established by anastomosis of the gastric stump to the first loop of the jejunum. RESULTS: After the procedure, the sphincter mechanism of the pylorus was preserved, and bowel movements became solid and infrequent, so a colostomy bag could be applied consistently. CONCLUSIONS: Similarity of anatomy and physiology of the alimentary tract in dogs and humans favors possible application of this procedure to humans, with better results than with conventional ileostomy.

Site distribution of carcinoma of the large intestine

The site distribution of large-bowel adenocarcinomas was studied in a retrospective study compromising 600 patients. These patients were divided into two groups according to the year of their operation; group A included patients operated upon between 1978 and 1982, and group B patients were operated upon between 1983 and 1987. Comparing these two five-year periods, a statistically significant increase in the incidence of right colon tumors was noted (P<0.05). There was no difference in the distribution pattern of the carcinomas according to sex or age between the two groups (P<0.1). The shift to the right of large-bowel neoplasms may indicate the need for an alteration of the diagnostic procedures concerning this disease, with more emphasis given to total colonoscopy and or double-contrast barium enema.