Yutaka Tagawa

Chromosome instability evaluated by fluorescence in situ hybridization in hereditary non-polyposis colorectal cancer

Abstract: Numerical aberrations of chromosome 17 and nuclear DNA content were compared in patients with hereditary non-polyposis colorectal cancer (HNPCC) and those with sporadic colorectal cancer (SCRC). During a period of 22 years, 30 cases (3.2%) from 28 families satisfied the Japanese clinical criteria of HNPCC. Using freshly frozen tissue samples, we investigated chromosomal aberration with fluorescence in situ hybridization with alpha satellite DNA probe for chromosome 17. Flow cytometric quantification of nuclear DNA content showed DNA aneuploidy in 9 of 15 patients (60.0%) with HNPCC and in 160 of 234 patients (68.4%) with SCRC; there was no significant difference between HNPCC and SCRC. The mean proportion of nuclei with aneusomy 17 (numerical chromosome aberration index; NCAI) in 14 patients with HNPCC was significantly higher than that in 42 patients with SCRC (46.8 ± 5.0% vs 39.0 ± 10.3%, P < 0.01). NCAI increased in proportion with the progression of the disease in SCRC (26.1% in stage I, 33.3% in stage II, 38.8% in stage IIIa, 42.7% in stage IIIb, and 46.2% in stage IV, P < 0.01), whereas NCAI in HNPCC was high in all stages (43.5%–49.2%). The proportion of patients with multiple numerical aberration of chromosome 17 was significantly higher in HNPCC (9/14) than among SCRC (11/42). Our data suggest that chromosome 17 is present in an unstable condition in HNPCC.

Transhiatal Esophagectomy for Intrathoracic Esophageal Cancer

Surgical treatment is the best management for the patients with dysphagia and resection should be performed unless there are any contraindications. It is generally accepted that the standard radical operation for thoracic esophageal cancer is a subtotal or total thoracic esophagectomy with intrathoracic and intra-abdominal lymph node dissection through right thoracotomy and laparotomy [1]. However, transthoracic esophagectomy has high morbidity and mortality rates [2, 3]. Therefore, for the patients with poor nutritional condition and low cardiopulmonary reserve, transhiatal esophagectomy without thoracotomy for esophageal cancer may have lower morbidity and mortality [4, 5].

A Clinical Study of Esophageal Cancer with Invasion of Contiguous Structures

Esophageal cancer invading contiguous structures is associated with a poor prognosis. Lymph node metastases are present in the majority of cases. When the lesion extends to the diaphragm, lung, or pericardium, combined resection is relatively easy. However, when the lesion invades the aorta or tracheobronchial tree, combined resection may be technically demanding. Herein, we evaluate the indications for surgery, patient selection, and outcome after surgery in a group of patients with esophageal cancer invading contiguous intrathoracic structures.

The prognostic singnificance of cellular DNA content in colorectal cancer using multivariate analysis.

大腸癌核DNA量の予後因子としての価値を検討する目的で, Coxの比例ハザードモデルにより多変量解析を試みた. 方法はパラフィンブロックを用いたB.Schutteらの方法に準じflow cytometerで核DNA量を測定した. 236例中DNA diploidyは97例 (41.1%) であり, DNA aneuploidyは139例 (58.9%) であった. DNA ploidyは臨床病理学的因子の中で, 壁深達度, リンパ節転移との間に有意差を認め, Coxの比例ハザードモデルにおいては, 回帰係数β値は0.7739危険率0.0033であり, 他の病理組織学的因子に優る有意性が認められた. 以上の結果より, 大腸癌核DNA量は独立した予後因子として有用であることが明かとなった.