Hiroyuki Shibanuma

Influence of E-cadherin dysfunction upon local invasion and metastasis in non-small cell lung cancer.

E-Cadherin (ECD), a transmembrane cell adhesion molecule, is associated with three kinds of cytoplasmic proteins (alpha-catenin, beta-catenin and plakoglobin), and formation of the cadherin-catenins adhesion complex is indispensable for tight cell-to-cell adhesion in adherence junctions. There is a high possibility that dysfunction of ECD reflects increased potential for local invasion and distant metastasis. We investigated the relationship between the expression of cadherin-catenin adhesion complex and the clinicopathological features in 81 cases of non-small cell lung cancer. There were statistically significant relationships between the expression of ECD and lymph node metastasis (P = 0.016) and between the expression of ECD and pathological stage (P = 0.006). Reduction of alpha-catenin expression was associated with local invasion and pathological stage. Dividing the 81 cases into two groups based on ECD function revealed a statistically significant relationship between ECD function and all clinicopathological factors investigated (local tumor invasion P = 0.033, lymph node metastasis P<0.001, pathological stage P<0.001). Evaluation of ECD function using the expression of cadherin-catenin adhesion complex is useful to evaluate tumor malignancy of non-small cell lung cancer.

Cytologic features based on the expression of E-cadherin and catenins in lung adenocarcinoma

OBJECTIVE To investigate the relationship between E-cadherin-associated cell-to-cell adhesion and cytologic features in preoperative cytologic lung adenocarcinoma specimens. STUDY DESIGN Evaluation of the relationship between cell-to-cell adhesion, formation of cellular clusters and frequency of single cells in 31 cases of primary lung adenocarcinoma, collected by brush and needle cytology preoperatively. RESULTS Most cases with remarkable overlapping of cells in compact cellular clusters and a few solitary cells maintained cell-to-cell adhesion. Cellular clusters that had a slight tendency to overlap, a small cell-to-cell adhesion area and a high frequency of solitary cells tended to lack E-cadherin-associated cell-to-cell adhesion. CONCLUSION Formation of cellular clusters and the appearance of solitary cancer cells are closely related to E-cadherin-associated cell-to-cell adhesion. Therefore, it is highly likely that cytologic features may indicate malignant behavior, such as local invasion and lymph node metastasis, in primary lung adenocarcinoma.

Endoscopic diagnosis and treatment of a case of respiratory papillomatosis.

Respiratory papilloma is a rare lesion that arises in the larynx, trachea and bronchus. We describe a patient with laryngeal papilloma that spread to the trachea and which was effectively treated by Nd-YAG laser. Two years after the initial treatments of the laryngeal and tracheal papillomas, a recurrent lesion (solitary papilloma) was observed on the membranous portion of the trachea. We examined the recurrent lesion by bronchoscopy including bronchoscopic ultrasound (US), helical computed tomography (CT) and tracheal biopsies. Respiratory papillomatosis sometimes shows either malignant transformation or invasion to tracheal wall without displaying cytohistological atypia. Therefore, we concluded that bronchoscopic US and helical CT were useful for deciding on therapeutic strategy in cases of recurrence of tracheal papilloma.

Multifoci of atypical adenomatous hyperplasia with multiple adenocarcinomas of the lung.

定期検診にて右肺上葉に2ヵ所の異常陰影を指摘された61歳の男性の喀痰に杯細胞癌と考えられる重積性のある大型細胞集団が認められた.各病巣の穿刺細胞診が行われ, 1つからは壊死物質とともにN/C比の高い濃染核とレース状の細胞質を特徴とする重積性のある異型細胞の集団が, そしてもう1つからは, シート状配列を示す多角形異型細胞が採取され, それぞれ腺癌と診断されたため, 右肺上葉切除が行われた.組織学的には3ヵ所で組織型の異なる腺癌が認められた.S2bに高分化粘液産生性乳頭状腺癌.そしてS2aに非連続性の低分化腺癌および高分化乳頭状腺癌があった.さらに, その他多数の微小な異型腺腫様過形成病巣および腺腫様過形成病巣が認められた.3ヵ所の癌と異型腺腫様過形成病巣のうち10ヵ所に対しCEA, EMA, p53の免疫染色を行ったが, 癌ではいずれの異型腺腫様過形成巣より強く反応が認められた. 一方, CAS-200を用いた核DNAの測定結果では, 癌巣のすべてがAneuploidyであったが, 異型腺腫様過形成巣では3ヵ所がAneuploidyで, 7ヵ所がDiploidyであった.この結果は, 形態学的に異型腺腫様過形成と診断した病巣にも, 腫瘍性病変が含まれることを示唆するものである.

A unique case of adenoid cystic carcinoma of the left main bronchus.

A unique case of adenoid cystic carcinoma of the left main bronchus is reported.