Tetsuro Saka

Histological changes during progression of adenoid cystic carcinoma.

Eight cases of adenoid cystic carcinoma were reviewed to determine whether and how the histological features of the tumour vary with the progress of the disease. The tumours were classified by their histological patterns as tubular, cribriform, trabecular or solid. The relative amount of each pattern seen in routine light microscopic sections was calculated histomorphometrically and compared in the primary tumour and recurrent and/or metastatic lesions in the same case. In the early stage, the tubular pattern predominated. Later, the highest percentage shifted to the cribriform, then to the trabecular and finally, in the late stage, to the solid pattern. There was no reverse direction of histological transformation from the solid to the tubular pattern. These results may help to explain previous reports that the tubular pattern usually represents a favourable prognosis, the solid pattern a poor prognosis and the cribriform pattern an intermediate prognosis.

Comparative cytofluorometric DNA analysis of pleomorphic adenoma and adenoid cystic carcinoma of the salivary glands

SummaryThe nuclear DNA content in the tumor cells of 17 pleomorphic adenomas (PA) and 26 adenoid cystic carcinomas (ACC) was assayed by cytofluorometry to clarify the etiology of the differences in their biological nature. Aneuploidy was found in only two solid-pattern ACC samples; all the other samples had diploid stemlines. With respect to the polyploid cell rate and the S+G2M fraction, the differences between the four histological patterns of PA were not significant. In the ACC, the S+G2M fraction was significantly higher in solid pattern than in cribriform or trabecular pattern tumors, which may indicate that proliferative activity is higher in the solid pattern than in the other two. The polyploid cell rate in ACC was significantly higher in the solid pattern than in the cribriform pattern carcinomas. There was no significant difference in the mean polyploid cell rate between PAs and ACCs. The mean S+G2M fraction was significantly higher in all histological patterns of ACCs than in PAs. These results suggest that proliferative activity is greater in any one of the histological patterns of ACC than in PA. These findings may largely explain the biological differences between the two tumors.

Nucleolar organizer regions in adenoid cystic carcinoma of the salivary glands

In this study of proliferative activity of adenoid cystic carcinomas (ACCs) with different histological patterns, the argyrophilic staining method of nucleolar organizer regions (AgNORs) was applied to paraffin sections from 25 tumors. Sixteen of the neoplasms showed a mixture of different histological patterns in the same section. The AgNOR numbers in the different histological pattern areas in the same tissue sections of all 16 tumors were lowest in the cribriform, intermediate in the trabecular, and highest in the solid pattern areas. The mean AgNOR number was highest in the solid pattern (3.33 ± 0.52), and lowest in the cribriform pattern (2.12 ± 0.43). The results show the order of proliferative activity in the different histological pattern areas of ACC, and explain the previous clinical finding that the prognosis of ACC is poorest in solid pattern ACCs. AgNOR staining appears to be a useful technique for evaluation of the proliferative activity of each histological pattern area of ACC, expecially when there are different histological pattern areas in the same tissue section.

Estimation of Proliferative Activity of Experimental Tongue Carcinoma in Rats Immunohistochemical and DNA Cytofluorometric Analysis

Precancerous lesions and carcinomas were produced in rat tongues by oral administration of 0.001% 4-nitroquinoline 1-oxide (4NQO) in drinking water, and the biological characteristics and tumor kinetics were studied. Bromodeoxyuridine labeling index (BrdU L.I.) was determined immunohistochemically, and the nuclear DNA content was measured by DNA cytofluorometry. The BrdU L.I. was lowest in normal epithelium (3.49 +/- 0.49%), higher in papillomas (8.24 +/- 1.76%) and highest in squamous cell carcinomas (13.36 +/- 4.40%). Normal lingual epithelial cells, papillomas and 18 of the 25 squamous cell carcinomas showed a diploid pattern, while 7 squamous cell carcinomas showed a diploid plus tetraploid pattern. The correlation between polyploidization and tumor progression was significant, but the correlation between BrdU L.I. and tumor progression was not significant. The results suggest that while polyploidization of tumors increases with tumor progression the growth rate of tumors does not necessarily do so.

Prognostic value of nucleolar organizer regions in supraglottic carcinoma

The relationship of nucleolar organizer regions (NORs) to proliferative activity and tumor progression was studied in 16 supraglottic carcinomas. The number of NORs stained by a silver colloid staining method (AgNOR staining method) was determined. The mean AgNOR number tended to be higher (but not significantly so) in poorly differentiated tumors. Moreover as T and N categories and stage of the tumor rose, the AgNOR number also rose, but not significantly. More interestingly, the mean AgNOR number was significantly higher in the presence than in the absence of lymph node metastasis. These studies indicate that the AgNOR number might be of clinical value as a predictor of lymph node metastasis of supraglottic carcinomas.

Nucleolar organizer regions in glottic carcinomas: Comparison of DNA cytofluorometry and clinicopathological analysis

The significance of nucleolar organizer regions (NORs) and nuclear DNA content in 73 glottic carcinomas was assessed for proliferative activity and tumor progression. NORs stained with silver colloid were counted, and nuclear DNA content was assayed by cytofluorometry. The cytofluorometric study demonstrated that the percentage of tumors with aneuploidy tended to increase as histological differentiation decreased. Survival rates of patients with diploid and aneuploid tumors were not significantly different. AgNOR staining revealed that mean AgNOR numbers rose as histological differentiation of tumors decreased. Moreover, as T and N categories and stages showed advancing malignancy, mean AgNOR numbers tended to rise. However, there was no significant difference in survival rates between tumors with low and with high AgNOR counts. These studies indicate that while AgNOR staining is better than DNA cytofluorometry for determining histological differentiation of glottic carcinoma, neither is of prognostic value at the present time.

Tracheo-esophageal shunt speech: report of an unusual case.

A rare case of laryngectomee who acquired TE shunt speech is reported. Our patient was a 64-year-old woman with laryngeal cancer (glottic type T3N0M0). She underwent laryngectomy in 1990, and a Komorn tracheo-esophageal shunt operation was performed simultaneously. A voice prosthesis (BIVONA) was inserted into the shunt, but the voice valve was not used. She acquired shunt speech soon after the operation, and there was no need to close the tracheostoma during phonation. Fiberoptic, X-ray and aerodynamic findings of the shunt and esophagus were as follows: (i) The one-way valve of the voice prosthesis was open during inspiration and closed during phonation. (ii) Swallowing of air, as seen in esophageal speech, was not observed. (iii) The neoglottis was in the upper part of the esophagus. It was concluded that the air for the vibration of the neoglottis entered the esophagus through the T-E shunt during inspiration.