Haruo Sugano

Mucinous carcinoma of the breast in Japan. A prognostic analysis based on morphologic features

In 175 women with mucinous carcinoma (MC) of the breast, the morphologic features, the clinicopathological features (age, tumor size, and nodal status) and prognoses were investigated. They were divided into two types, those with “unmixed type” (n = 140) showing no component of invasive ductal carcinoma (IDC) and “mixed type” (n = 35) including an IDC component. The unmixed type showed less frequent (P < 0.01) nodal involvement and a higher degree (P < 0.005) of extracellular mucus production than the mixed type. The presence of nodal metastases showed no correlation with the degree of mucus production. The 10‐year survival rate of the unmixed type (90.4%) was better (P < 0.001) than in the mixed type (66.0%). In the unmixed type, a higher level of mucus production showed trends toward a better prognosis, younger age and smaller tumor size (P < 0.01). In the mixed type, the degree of mucus production showed no significant correlation with either the age, tumor size, or prognosis. It is more important for the prognosis of patients with MC to have no IDC component than to show abundant mucus within the tumor.

Circumscribed carcinoma of the uterine cervix, with marked lymphocytic infiltration.

The present study was carried out to investigate a distinctive type of carcinoma of the uterine cervix categorized under the designation as circumscribed carcinoma with lymphocytic infiltration. Grossly this carcinoma is characterized by defined circumscription with a superficial ulceration. A microscopic feature characteristic of this tumor is the presence of a loose fibrillary stroma infiltrated densely and uniformly by lymphocytes throughout the tumor mass. The tumor is arranged in solid cords separated by a lymphoid stroma with evidence of minimal squamous differentiation. The authors picked up 709 patients with carcinoma of the uterine cervix who underwent radical hysterectomy and pelvic lymphadenectomy at the Cancer Institute Hospital, Tokyo, between 1956–1967, without preoperative radio‐ or chemotherapy. Among them, 39 or 5.5% were identified as this type of carcinoma. Patients with this types of carcinoma had a significantly better prognosis than those with other types of cervical carcinoma of the same stage (p < 0.05). This favorable prognosis is probably due to the less regional node metastases found in the group. A proposal was made to segregate this particular type of carcinoma from other types of cervical carcinoma on the basis of its morphologic and prognostic distinctiveness.

Comparative Pathological Study of Breast Carcinoma among American and Japanese Women

Breast carcinoma among Japanese females is characterized by a relatively low incidence and good prognosis.(6) The recent annual death rate due to breast carcinoma among Japanese females is 5 per 100,000. This death rate is about one sixth of that among American females. According to Cancer Incidence in Five Continents,(2) the annual incidence of breast cancer per 100,000 Japanese females ranged from 12.1 in Osaka Prefecture to 16.6 in Okayama Prefecture. This incidence is very low when compared with that of American females. In Connecticut, the incidence is 71.7 per 100,000 females.

Bilateral breast cancer and familial aggregations.

Abstract Bilateral breast cancer and familial aggregation among Japanese female patients with breast cancer were studied and results were compared with those among American female patients. Out of 3365 female patients with breast cancer mastectomized at the Cancer Institute Hospital, Tokyo from 1946 to 1975, 92 cases were primary bilateral breast cancer. The crude incidence of bilateral cancer was 2.7%, whereas it was reported to range between 3.0% and 6.8% among American female patients. The true incidence rate of breast cancer after operation for unilateral breast cancer was calculated to be 3.4 per 1000 Japanese patients per year, while it was reported to be between 5.8 and 7.1 among American patients. These figures for American patients are roughly twice as large as those for Japanese females. In the bilateral breast cancer group, there was a high frequency of familial history of breast cancer, about three times higher than that in the unilateral breast cancer group. Further, in the bilateral breast cancer group, about half of the patients were nulliparous and 60% of the patients had breast cancers associated with fibrocystic disease in the same breast tissues. These figures were about three times greater than for those in the unilateral breast cancer group.

Biopsy Interpretation in Diagnosis of Gastric Carcinoma

The interpretation of biopsy specimens from clinically obvious carcinomas, whether they appear in early or advanced stages, does not usually present any great problem. However, it is sometimes extremely difficult to evaluate changes because of the limited amounts of tissue available when small specimens are taken from so-called “borderline lesions”, i.e., neoplasias that are difficult to define as benign or malignant even when complete (surgically removed), or when artifacts are present due to the sampling process. Here, we present the histological criteria (group classification) widely used for diagnosis of gastric carcinoma in Japan and discuss how to manage problematic cases as well as several changes easily mistaken for carcinoma in routine examinations.

Heme synthesis in Friend ascites tumor cells.

Summary Significant heme synthesis was observed in 2 Friend ascites tumor cell lines, when radioiron incorporation was measured and compared to Ehrlich ascites tumor cells and SN-36 ascites lymphoma cells.

Differentiation of Friend Virus-induced Leukemia Cells

A long-term cultured Friend leukemia cell is able to differentiate along the erythrocytic series following treatment with some substances and that can be demonstrated by a conjugated erythrocyte membrane-specific antibody technique. Differentiation is induced by inhibition of DNA synthesis and by dimethylsulfoxide (DMSO), erythropoietin (EP) and Vitamin B12 (B12), and other agents. The effective substances were divided into 2 groups by the mode of differentiation of Friend cells. A differentiated state continues for several days when cells are re-cultured in the medium without substances. The decreased tumorigenecity of differentiated cells is proved by back transplantation to mice.

United States-Japan Cooperative Cancer Research Program

The formalization of long-standing cooperative joint research efforts between Japanese and U.S. scientists has resulted in the development of specific areas of mutual program interest. The overall future objective of this program is to foster and encourage collaboration of mutual interest and benefit.