Takehiro Nohara

Prognostic value of tumor-infiltrating dendritic cells expressing CD83 in human breast carcinomas

DCs are the most potent antigen‐presenting cells that play a major role in initiating the antitumor immune response. Although the clinical significance of TIDCs has been investigated in a variety of human cancers, few studies have focused on the in situ maturation status of DCs. We have analyzed the maturation‐specific significance of TIDCs in the prognosis of patients with breast carcinoma. We evaluated 130 breast carcinomas for the presence of TIDCs using immunohistochemistry with an anti‐CD1a antibody for immature DCs and an anti‐CD83 antibody for mature DCs. Intratumoral expression of immunosuppressive cytokines was also examined. All samples contained CD1a+ TIDCs, and 82 (63.1%) samples contained CD83+ TIDCs. The number of CD83+ TIDCs was inversely correlated with lymph node metastasis and with tissue expression of VEGF and TGF‐β, whereas the number of CD1a+ TIDCs was not. Kaplan‐Meier analysis (log rank statistics) revealed a significant association of increasing number of CD83+ TIDCs with longer relapse‐free (p = 0.002) and overall (p < 0.001) survival. Furthermore, among patients with lymph node metastasis, the survival rate of those with larger numbers of CD83+ TIDCs was significantly better than that of patients with fewer CD83+ TIDCs. Multivariate analysis revealed that CD83+ TIDCs had independent prognostic relevance in breast carcinomas. The infiltration of tumors by mature DCs expressing CD83 may be of great importance in initiating the primary antitumor immune response and is confirmed as an independent, immunologic prognostic parameter for survival in patients with breast cancer.

Prognostic Significance of p27kip1 Protein Expression and Spontaneous Apoptosis in Patients with Colorectal Adenocarcinomas

Tumor cell apoptosis, proliferation and p27 expression using an in situ apoptosis detection kit, anti-Ki67 antibody and anti-p27 antibody were investigated in 171 colorectal adenocarcinoma specimens, together with the assessment of mutated p53 expression. No apparent association was observed among p27 expression, mutated p53 accumulation, the Ki67 labeling index and the apoptotic index (AI). In the multivariate analysis using the median values as the cut-off points (46.8% for p27 expression and 0.89% for AI), p27 expression was identified as an independent and significant predictor for overall survival. When the present series of patients were dichotomized by these cut-off points to categorize the cases into 4 subgroups, the patients in the group with low p27 expression and a low AI had the poorest prognosis. The assessment of p27 expression and AI therefore may prove valuable in identifying patients with colorectal adenocarcinoma who may have a poor prognosis.

Expression of Cell-Cycle Regulator p27 Is Correlated to the Prognosis and ER Expression in Breast Carcinoma Patients

Cell cycle inhibitor p27 is variously expressed in breast carcinoma. A possible association between the expression of p27 and the prognosis of breast carcinoma remains to be elucidated. We investigated the expression of p27 and cyclin D1 in a retrospective series of 216 breast carcinomas immunohistochemically. Expression of p27 (p27 LI) ranged from 0 to 93.6% (median 62.4%). There was a positive association between p27 LI and cyclin D1 (p < 0.01) and between p27 LI and ER (p < 0.0001). In the combination study of p27 LI and cyclin D1 expression, the patients classified as low p27 LI/cyclin D1 negative had a poorer prognosis than those in other categories. p27 was identified as an independent prognostic factor by the multivariate Cox proportional hazard model with a relative risk of death of disease of 4.1 (p < 0.05; vs. high p27 LI compared to the median). Assessment of p27 expression and examination of both p27 LI and cyclin D1 expression may identify breast carcinoma patients who would benefit from adjuvant therapy.

Intraductal Lipid-Rich Carcinoma of the Breast with a Component of Glycogen-Rich Carcinoma

We report a rare case of intraductal lipid-rich carcinoma of the breast with a component of glycogen-rich carcinoma. An impalpable tumor that was revealed by mammography and magnetic resonance imaging was excised. Histologic examination showed vacuolated neoplastic cells in the mammary ducts, and electron microscopy confirmed lipid droplets in the cytoplasm. The coexistence of glycogen-rich carcinoma was shown. Lipid-rich carcinoma that is coexistent with glycogen-rich carcinoma is rare, and most lipid-rich carcinomas are invasive. Intraductal lipid-rich carcinoma is difficult to detect without echography or mammography.

Esthetic result of rhomboid flap repair after breast-conserving surgery for lower quadrant breast cancer lesion with skin invasion: Report of two cases

Breast-conserving surgery (BCS) has been increasingly performed as a standard operative strategy for patients with breast cancer. The primary purpose of BCS is to acquire both local control and good cosmetic results. An insignificant difference in cancer treatment results has been shown between BCS and total mastectomy. However, achieving sufficiently cosmetic results can be difficult, particularly in patients with tumors that are large or localized to the lower quadrant. To avoid breast deformities and asymmetries after BCS, immediate reconstruction using autologous tissue has been accepted as the standard option. Rhomboid skin and adipose flap repair is a simple, less invasive procedure than the myocutaneous flap, which has primarily been performed in patients with upper quadrant lesions. We herein report the cases of two patients with lower quadrant breast cancer with skin invasion, who underwent BCS with immediate breast repair using a rhomboid flap. This procedure is therefore worth considering as one of the first options for immediate repair after BCS.