Shigeru Deguchi

Analyses of microsatellite instability and the transforming growth factor‐β receptor type II gene mutation in sporadic breast cancer and their correlation with clinicopathological features

To determine the incidence of microsatellite instability (MSI) and its relationship with both clinicopathologic parameters and patient survival, 101 cases of breast cancer were investigated. In addition, transforming growth factor‐β (TGF‐β) receptor type II (RII) gene mutation was also examined to clarify the relation to MSI in breast cancer development. MSI and RII gene mutation were screened by single strand conformation polymorphism (SSCP). The mutations of the RII gene were confirmed by a direct sequence. An association between the MSI status and the clinicopathological features was examined to assess the potential of the MSI status as a prognostic indicator in sporadic breast cancer cases. MSI was detected in 12 of 101 (11.9%) breast cancer cases. The positive MSI breast cancer cases showed relatively more advanced disease than negative MSI cases, and also exhibited relatively poorer prognoses. No RII gene mutations were observed in any of the breast cancer cases. Our data suggest that the MSI status may thus be a useful indicator for the prognosis of sporadic breast cancer cases. However, the breast seems to be an infrequent target organ for cancer development through RII gene mutations. As a result, tumor progression through this pathway appears to be related to organ specificity. For positive MSI breast cancers, other target genes therefore still need to be identified.

Flow Cytometric Analysis to Assess the Malignant Potential of Phyllodes Tumor.

To evaluate DNA content as a prognostic indicator in phyllodes tumor of the breast, flow cytometric DNA analyses were performed retrospectively in 13 patients who were selected, based on the availability of paraffin-embedded tumor specimens. All were women with an average age of 41. 9 years and a mean follow-up of 51.2 months. Pathologically, 3 patients (23.0%) had malignant tumor and 10 (77.7%) had benign lesions. The patients with malignant tumors tended to be older and had larger tumors. Aneuploidy was seen in one patient with malignant tumor (7.7%), with the S-phase fraction ranging from 0.8 to 12.6. This patient died of lung metastases 6 months after mastectomy. One benign tumor showing diploid, developed local recurrence 100 months after lumpectomy. DNA stem cell lines were not detected in the only patient with aneuploid tumor. There was no significant correlation between DNA content and local recurrence. In this series, the number of patients was too small to draw the certain conclusions from data. However, it appears that, compared to diploid tumors, aneuploid tumor are more often malignant and have poorer prognosis. Our study indicates that DNA content has little prognostic value, DNA aneuploidy appears to be associated with a poor prognosis.

Phyllodes tumor of the breast with a grossly malignant appearance: A case report

A huge phyllodes tumor of the breast that appeared grossly malignant in a 43-year-old woman is described. The patient suffered from a large breast tumor that suddenly increased in size over 5 months to occupy the entire breast. The tumor was hard, ulcerated and 20 cm in greatest diameter. Diagnostic imaging (US, CT and MRI) demonstrated a circumscribed mass with a large cystic cavity. She underwent total mastectomy under a diagnosis of malignant breast tumor. Grossly, the cut surface of the tumor showed a large cystic cavity surrounding a fleshy, hemorrhagic and necrotic mass with a lobulared or trabeculared appearance. Unexpectedly, benign phyllodes tumor (PT) without any stromal overgrowth was diagnosed histologically. She has been doing well since total mastectomy. In our case and in many other reported cases, PT does not show any distinctive correlation between pathologic findings and tumor behavior. Thus wide local excision is the preferred initial treatment for PT.

A Novel Ploidy Typing of Flow Cytometric DNA Histogram for the Detection of DNA Heterogeneity.

Flow cytometry (FCM) によるDNAヒストグラムの新しい分類を行い, 1検体での定量による腫瘍内heterogeneityの検出を試みた. そして, 顕微蛍光測光法 (static cytonuor6 metory, SCM) による成績と比較してその精度を検討し, さらに臨床病理学的所見や予後との関連を検討した. 大腸癌30例を対象とした. コンピューターによるDNAヒストグラムのシミュレーション結果を参考にして, aneuploid patternをcoettcient of variation (CV) 値を示用しAl patternとA2 patternに分類した. Diploid pattem 10例中9例 (90%) がSCMでhomogeneity, A2 pattem 12例中10例 (83.3%) がSCMでheterogeneityを示し, SCMの成績とよく一致した. 肝転移, リンパ節転移はA2 pattem症例に陽性率が高く, 進行度はA2 pattem症例に進行した症例が多い傾向がみられた. 本分類はheterogeneityの検出に有用であり, 臨床病理学的所見との関連を追及するのに有用な分類法であると考える.