Tumor-associated carbohydrate antigens in primary pulmonary adenocarcinomas and their metastases.

To better understand the metastatic behavior of pulmonary adenocarcinoma, we studied the differences in carbohydrate antigens between primary tumors and their metastases using three monoclonal antibodies (FH-2 defining Lewis [Le]x, AH-6 defining Le(y), and FH-6 defining sialyl Le(x-i)) on 56 autopsy cases (including 15 cases in which primary tumors were surgically resected) and 116 cases of surgically resected pulmonary adenocarcinoma. Metastatic lesions were divided into two groups according to the route of metastasis: group 1 comprised lymphatic metastases, such as lymph node and contralateral lung metastases, and group 2 comprised hematogenous metastases, such as extrathoracic spread. Both primary tumors and metastatic lesions with well-differentiated glandular patterns showed higher positive rates for Le(y) than the poorly differentiated lesions. Such a difference in the antigen expression in relation to tumor differentiation was barely demonstrated for Le(x) and sialyl Le(x-i). Discordance in antigen expression between primary and metastatic lesions (ie, positive primary tumors with negative metastatic lesions and negative primary tumors with positive metastatic lesions) was observed in the following order of frequency: extrathoracic metastatic lesion, contralateral lung, mediastinal lymph node (N2), and ipsilateral peribronchial and hilar (N1) lymph nodes. This study revealed increased biologic diversity of pulmonary adenocarcinoma in cell surface antigens following tumor progression, especially in extrathoracic metastasis.     

TTF-1、SP-A在肺腺癌诊断及鉴别诊断中的价值

目的 评价甲状腺转录因子-1(TTF-1)、肺泡表面活性蛋白A (SP-A)在肺腺癌中表达的敏感性和特异性,探讨他们在肺腺癌诊断及鉴别诊断中的价值.方法 选择经组织学和临床资料证实的肺原发性腺癌40例、转移性腺癌13例,采用免疫组化EnVision法检测TTF-1及SP-A的表达情况.结果 40例肺腺癌中有32例表达TTF-1、27例表达SP-A;13例转移性腺癌中只有1例肝细胞癌胞质表达TTF-1、无SP-A表达.TTF-1和SP-A在肺腺癌中表达的敏感性分别为80%和67.5%、特异性均为100%.结论TTF-1在肺腺癌中表达有较高的敏感性和特异性,在排除甲状腺癌可能后,可作为鉴别肺原发性和转移性腺癌的可靠标记;而SP-A敏感性较低且随分化程度降低表达下降,故TTF-1对肺腺癌鉴别诊断的价值优于SP-A.     

Apoptosis and proliferation in paired primary colorectal adenocarcinomas and their liver metastases

The proliferation potentials and the level of apoptosis were compared in paired primary colorectal adenocarcinomas and their liver metastases within each individual. From a total of 22 patients 44 specimens of paired primary and metastatic tumors were obtained for analysis. The levels of spontaneous apoptosis (a spontaneous apoptosis index, SAI: % apoptotic nuclei among a total of 1000 nuclei) and of proliferation (KI-67 index: % positively stained cells for KI-67 among a total of 1000 cells) were analyzed between primary and metastatic tumors. Survival rates and its relationship with the clinical parameters were also analyzed. The overall survival rate at 5 years was 16.9% with the median survival time of 45 months. T-stage (p=0.005) and time to liver metastasis (synchronous versus metachronous, p=0.03) showed statistical significance in relation to survival. The mean SAI of primary tumors was 1.35 +/- 0.25, which was not statistically different from the 1.58 +/- 0.18 of metastatic tumors (p=0.33). The mean KI-67 indices in primary and metastatic tumors were 23.9 +/- 3.4 and 16.4 +/- 2.5, respectively, and this difference was statistically significant (p=0.016). Subset analysis showed significant difference in the KI-67 index in the synchronous group but not in the metachronous group. No significant difference was shown in the relative ratios of apoptosis to proliferation between the primary tumor and the metastasis within each individual. The results in this study may partly explain the indolent behavior of liver metastasis from colorectal cancer and provides a rationale for the active treatment of metastatic tumors as well as of primary disease.     

Surfactant apoprotein in nonmalignant pulmonary disorders.

Formalin-fixed, paraffin-embedded lungs exhibiting a variety of nonmalignant disorders were studied by immunoperoxidase staining using antibodies specific for surfactant apoprotein, IgG, IgM, IgA, albumin, fibrinogen, and lysozyme. Normal Type II pneumocytes showed staining for surfactant apoprotein in the perinuclear region only. The extent and intensity of staining for apoprotein was markedly increased in reactive Type II pneumocytes. This increase appeared to be a nonspecific reaction to lung injury. The intra-alveolar material in pulmonary alveolar proteinosis stained intensely for surfactant apoprotein, indicating that the accumulated proteinaceous material contained pulmonary surfactant. Type II pneumocytes in pulmonary alveolar proteinosis exhibited hyperplasia as well as hypertrophy. The few macrophages in lung affected by pulmonary alveolar proteinosis stained intensely for lysozyme. The excessive intraalveolar accumulation of proteinaceous material in pulmonary alveolar proteinosis may be the result of both an over-production as well as a deficient removal of pulmonary surfactant.     

The reactivities of Bauhinia purpurea and Lens culinaris lectins to mouse B Lymphocytes and their subsets

The use of lectins for the separation of murine spleen lymphocyte subsets was examined. Bauhinia purpurea agglutinin was found to be effective for the enrichment of B cells by differential agglutination. When the differential agglutination technique using lectins was applied to the separation of B cell subsets, Lens culinaris agglutinin was found to be able to fractionate B cells into high responding and low responding subsets for dextran sulfate. A different expression of cell surface IgD was also observed between the cell populations showing different agglutinability with Lens culinaris agglutinin.     

Prognostic significance of expression of matrix metalloproteinase in colorectal adenocarcinomas and their metastases

Expression of matrix metalloproteinases 2 and 9 was studied in primary tumors and their metastases in patients with colorectal cancer. The correlation of immunoreactivity with clinical morphological signs, prognosis of the disease, and development of metastases in the liver was analyzed. The level of expression and distribution of markers in patients with colorectal cancer with metastases in the liver differed from that in control patients without metastases. Enhanced expression of matrix metalloproteinases 2 and 9 was detected in colorectal cancer patients with distant metastases. Increased expression of matrix metalloproteinase 9 was associated significantly with low histological differentiation of the tumor, deeper tumor invasion, and was more often observed in tumors of colorectal cancer patients with unfavorable prognosis. Thus, matrix metalloproteinase 9 is a valuable marker for clinical observation and prognosis in patients with this location of the tumor process. __________ Translated from Byulleten’ Eksperimental’noi Biologii i Meditsiny, Vol. 143, No. 4, pp. 434–437, April, 2007     

Immunocytochemical localization of the surfactant apoprotein and Clara cell antigen in chemically induced and naturally occurring pulmonary neoplasms of mice.

The localization of surfactant apoprotein (SAP) and the Clara cell antigen(s) (CCA) was studied in naturally occurring and experimentally induced pulmonary hyperplasias and neoplasms by avidin-biotin peroxidase complex (ABC) immunocytochemistry. Lungs of B6C3F1 and A strain mice with naturally occurring lesions, B6C3F1 mice given injections of N-nitrosodiethylamine (DEN), BALB/c nu/nu or nu/+ mice exposed transplacentally on Day 16 of gestation to ethylnitrosourea (ENU), or BALB/c nu/+ mice exposed to ENU at 8-12 weeks of age were preserved in formalin or Bouin's fixative. After ABC immunocytochemistry, SAP was found in the cytoplasm of normal alveolar Type II cells; in the majority of cells in focal alveolar and solid hyperplasias originating in peribronchiolar or peripheral locations; and in solid, tubular, papillary, and mixed adenomas and carcinomas. The larger mixed-pattern neoplasms and small or large tubular neoplasms usually had the least number of cells with SAP. The majority of large papillary adenomas and carcinomas in BALB/c mice exposed to ENU and in untreated A strain mice contained SAP in the nuclei of many neoplastic cells but only in the cytoplasm of a few neoplastic cells. CCA was found in normal Clara cells of bronchi and bronchioles but not in any hyperplastic or neoplastic lesion of any mouse studied. This study provided immunocytochemical evidence that the vast majority of naturally occurring and experimentally induced pulmonary neoplasms of mice are alveolar Type II cell adenomas and carcinomas.     

Comparison of genetic changes in primary sarcomas and their pulmonary metastases.

The aims of the present study were to compare genetic aberrations in primary sarcomas and their pulmonary metastases and to explore the pathways associated with disease spreading. The primary tumor and its subsequent pulmonary metastasis of 22 patients were analyzed by comparative genomic hybridization. All samples were obtained before the initiation of chemo- or radiotherapy. The mean total number of aberrations per tumor was 7.6 (range, 0-17) in primary tumors and 7. 5 (range, 0-19) in metastases. The mean numbers of high-level amplifications per tumor were similar (0.32 in primary tumors and 0. 36 in metastases). The frequencies of the most common aberrations were relatively similar in primary tumors and metastases: the most frequent gain affected 1q (minimal common regions 1q21-q23 in 36% of primary tumors and 1q21 in 45% of metastases). The most frequent losses were detected at 9p (9p22-pter in 32% of primary tumors and 9p21-pter in 32% of metastases), 10p (10p11.2-p12 in 41% of primary tumors and 10p11.2-pter in 32% of metastases), 11q (11q23-qter in 36% of primary tumors and 32% of metastases), and 13q (13q14-q21 in 45% of primary tumors and 50% of metastases). No aberrations specific to metastases were detected. An increase in the total number of changes during progression was a predominant feature in a majority of these paired samples. Also, the number of differences in the genetic profile outnumbered common changes in a majority of the samples. However, despite the heterogeneous and numerous changes, all pairs with aberrations in both specimens had some shared alterations in both samples. Genes Chromosomes Cancer 25:323-331, 1999.     

P-glycoprotein expression in gastroesophageal adenocarcinomas, their metastases, and surrounding mucosa: a mapping study.

Previously, we identified P-glycoprotein in primary gastroesophageal adenocarcinomas and in adjacent mucosa. This study is a further investigation of P-glycoprotein expression in adenocarcinomas and benign mucosa. Sixteen resection specimens were studied (seven for gastric adenocarcinoma, seven for esophageal adenocarcinoma, one for adenocarcinoma at the gastroesophageal junction, and one for severe dysplasia in Barrett's esophagus). Multiple samples of tumor and mucosa were submitted according to a specimen diagram. Lymph node and distant metastases were studied when available. P-glycoprotein expression was identified in paraffin-embedded tissues by immunohistochemistry using monoclonal antibody C219 and was scored as the percentage of cells stained. P-glycoprotein was identified in six of 16 resection specimens. Intratumoral variability of C219 score was noted in three resections. No increase in expression was identified in lymph node or distant metastases as compared with primary tumors or in the invasive margin of the tumor as compared to the center. For every case in which tumors expressed P-glycoprotein, it was also diffusely present in all types of benign gastric and Barrett's mucosa, both adjacent to and distant from (up to 8 cm) the tumor. We also studied biopsies from 10 patients with Barrett's esophagus who did not have carcinoma. P-glycoprotein was only focally present in one of the 10 biopsies. Mucosa expressing P-glycoproteins may be the substrate from which a P-glycoprotein positive tumor arises.     

Ossification in lung metastases of primary colorectal adenocarcinomas

Ossification of lung tissue is a rare phenomenon, which can be found in association with carcinoid tumors of the lung or pulmonary blastomas. Very rarely, ossifications are observed in lung metastases of extrathoracal epithelial tumors. In these cases, the most probable primary focus is a colorectal adenocarcinoma. Our question was, whether ossifications in lung metastases are pathognomonic for colorectal adenocarcinomas and how they can be pathogenetically arranged. A total of 15 lung metastases with ossifications from 5 patients suffering from a colorectal adenocarcinoma were examined by means of immunohistochemistry. Thereby, we found an increased expression of bone morphogenetic protein (BMP) 2/4 and osteonectin in tumor cells, as well as an increased stromatogenous expression of collagen type III. We conclude that there is strong evidence of a primary colorectal adenocarcinoma when ossifications in lung metastases are found. In these cases, a common metastatic spread of tumor cells and tumor stroma seems to be probable.     

Immunohistochemical expression of metallothionein in normal human colorectal mucosa, in adenomas and in adenocarcinomas and their associated metastases

The immunohistochemial distribution pattern of metallothionein, a low molecular weight protein with strong affinity for divalent heavy metal ions, has been investigated in normal and neoplastic conditions of the large bowel. Utilizing a monoclonal mouse antibody the following formalin-fixed paraffin-embedded surgical or biopsy samples were studied: tubulo-villous adenomas (8 cases); adenocarcinomas with various degree of differentiation (85), nine of which were mucinous-type; synchronous tubular or tubulo-villous adenomas separate from carcinomas (30); transitional mucosa (45); metastases in lymph nodes (43); and distant metastases (45). Twenty biopsies from the right and left colon of 10 patients affected by irritable bowel syndrome were also analyzed. Normal colonic mucosa as well as transitional mucosa showed metallothionein immunopositivity in enterocytes at the luminal surface and crypts. Evident nuclear and cytoplasmic staining was encountered in tubulo-villous adenomas; the same reactivity was noted in the basal glandular component of colorectal carcinomas-synchronous adenomas, while less intense staining was noted in the apical villous portions. A variable metallothionein immunostaining was observed in adenocarcinomas (62.3%), in lymph node (55.8%) and distant hepatic (17.2%) and omental (43.8%) metastases, although it was not always concordant with that reported in the corresponding primary tumour. Whether the metallothionein positivity observed in normal and neoplastic cells is the result of expression of a stable form of the protein or an accumulation in the nucleus and cytoplasm remains to be clarified.     

Endocrine cells in adenocarcinomas and their prestages in the glandular stomach and duodenum of rats after MNNG administration. Histochemical, electron microscopical and radioimmunological studies

Tumours of the glandular stomach and upper small intestine were induced in rats by oral administration of MNNG. In most cases the lesions were identified histologically as adenocarcinomas and their prestages, such as polypeous and downward growing adenomatous hyperplasias. Out of 48 adenomatous hyperplasias and adenocarcinomas of the stomach and 24 well differentiated adenocarcinomas of the small intestine, we observed argyrophilic cells in nearly the half of the cases. Endocrine cells were also identified by electron microscopy. The frequency of endocrine cells was reduced with decreasing degree of tissue differentiation. In poorly differentiated carcinomas, including signet ring cell carcinomas, no argyrophilic cells were found. Out of 10 adenomatous hyperplasias and tumours of the stomach investigated immunohistochemically, 5 cases showed gastrin producing cells. Most of these animals were radioimmunologically characterized by strongly elevated serum gastrin levels. Derivation and potential relevance of the endocrine cells in tumours are discussed.     

Topographical distribution of allelic loss in individual lung adenocarcinomas with lymph node metastases.

Adenocarcinomas of the lung are characterized by morphological heterogeneity, and since carcinogenesis has been suggested to be a multistep process involving sequential accumulation of multiple genetic alterations, the morphological heterogeneity may represent a cross-sectional view of genetic alterations within individual tumors. Therefore, to elucidate whether, and which, genetic alterations accumulated in relation to morphological cancer progression, we examined 56 microdissected sites for topographical distribution of loss of heterozygosity (LOH) in 12 adenocarcinomas of the lung with bronchioloalveolar (BA) and invasive components in their primary tumors and metastases to lymph nodes. The morphological changes from noninvasive BA lesions to invasive and metastatic components were characterized by a significant rise in the prevalence of allelic losses (P<0.05). Individually, eight cases (67%) showed accumulation of genetic alterations from BA lesions to metastases. LOHs in multiple foci in one case were compared to determine whether they were shared at all tumor sites as an early event or localized in metastases as an additional event. LOHs at 5q and 17p may be crucial steps in the early phase of development to metastasis, while 18q loss may be an additional step. These findings suggested that the cancer cells in some pulmonary adenocarcinomas evolved from the BA lesions to the invasive and metastatic lesions.     

Histochemical detection of sugar residues in chick embryo developing lingual glands with horseradish-peroxidase conjugated lectins.

Tongue anlage were taken in chick embryos from the 7th to the 21st d of incubation and in 3 d old chicken. A battery of 7 different horseradish peroxidase-conjugated lectins (PNA, ConA, DBA, SBA, LTA, WGA, UEA I) was used to study the carbohydrate residues of glycoconjugates at the epithelial cells of the anterior and posterior lingual glands. Some sugar residues, detected at the surface of the epithelial cells in early developmental stages of glandular primordia, seemed to play a role in inducing and regulating the first differentiative steps of the glands. Differences in type, amount, time of appearance and cellular localization between the 2 groups of glands were detected. The group of the anterior lingual glands, adjacent to the entoglossal cartilage (paraentoglossal glands), showed some peculiar histochemical characteristics.     

Liver metastases from colorectal adenocarcinomas grow in three patterns with different angiogenesis and desmoplasia.

The liver is a highly vascularized organ which frequently hosts metastases in patients with colorectal adenocarcinomas. The hypothesis of this study is that the hypoxic drive of angiogenesis might be minimal or absent in those growing liver metastases which are capable of preserving the stromal structure, including the numerous sinusoidal blood vessels. Representative paraffin sections of liver metastases from 26 patients with colorectal adenocarcinoma were investigated. Three different growth patterns were found. In the desmoplastic and in the pushing growth patterns (42% and 46% of all metastases, respectively), the architecture of the liver parenchyma was not preserved. In the replacement growth pattern (12% of all cases), the reticulin pattern of the liver parenchyma was conserved within the metastases at the tumour-liver parenchyma interface. The endothelial cells of the blood vessels near the interface in the metastases of the replacement type did not express CD34, nor were they surrounded by alpha-smooth muscle actin-positive mural cells. In the desmoplastic and in the pushing growth patterns, 23% and 52% of all blood vessels in this area were covered by pericytes. The fraction of proliferating endothelial cells was low in the metastases with a desmoplastic or a replacement growth pattern (about 3%), compared with metastases with a pushing growth pattern (11%). Tumour cell apoptosis was highest in the pushing-type metastases and was inversely correlated with microvessel density in liver metastases. The ratio of the proliferating tumour cell fraction and the proliferating endothelial cell fraction, roughly representing the degree of angiogenesis-dependent growth, was three- to four-fold higher in the replacement-type metastases compared with the other metastases. In summary, the present study has demonstrated that liver metastases are a heterogeneous group, with different growth patterns which predict the fraction of immature blood vessels, the fraction of proliferating endothelial cells, and the fraction of apoptotic tumour cells. The replacement growth pattern expands with minimal angiogenesis by co-opting the stroma with the sinusoidal blood vessels of the liver.     

Overexpression of pulmonary surfactant apoprotein A mRNA in alveolar type II cells and nonciliated bronchiolar (Clara) epithelial cells in streptozotocin-induced diabetic rats demonstrated by in situ hybridization.

Pulmonary surfactant is critical for gas exchange and is composed of both phospholipids and specific surfactant-associated proteins. The most abundant surfactant protein is termed surfactant apoprotein A (SP-A). This protein is thought to be important in the formation of tubular myelin, in absorption of surfactant to the air-liquid interface, in recycling of surfactant in alveolar type II cells, and in the regulation of secretion. We have examined the expression and localization of SP-A mRNA in streptozotocin-induced diabetic rats by in situ hybridization using a specific rat cDNA probe. Diabetes was induced by intraperitoneal injection of 60 mg/kg streptozotocin. After 10 wk, lungs were excised and examined by in situ hybridization and by light and electron microscopy. The ultrastructural examination demonstrated the marked changes of endoplasmic reticulum of alveolar type II cells, as reported previously. Immunohistostaining of SP-A in diabetic lungs was weak in alveolar type II cells. However, by autoradiographs of in situ hybridization, compared with the control lungs, a larger number of silver grains for the SP-A mRNA were shown in alveolar type II cells and also in some bronchiolar epithelial (Clara) cells from the diabetic lungs. Alveolar type II cells having high contents of silver grains were also increased in number. These results were confirmed by measurement of the SP-A content and by Northern blot analysis. The present study demonstrates an overexpression of SP-A mRNA despite the ultrastructural changes in the endoplasmic reticulum of alveolar type II cells in the diabetic lungs, which will provide new information on the regulatory mechanism of SP-A gene expression.(ABSTRACT TRUNCATED AT 250 WORDS)     

Ventilation and secretion of pulmonary surfactant

Summary Various factors are involved in the regulation of surfactant secretion: chemical agonist; local environmental factors such as mediators, locally produced hormones, and possibly pH; and finally, mechanical stress occurring during lung inflation. Here we suggest a model of regulation which is grouped into three levels: a basal autoregulatory mechanism with local factors being superimposed and a systemic level acting through hormones reaching the lung via the bloodstream. Depending on the situation, the different levels may vary in their importance. For the normal situation, in the absence of stress factors, we suggest the autoregulation of stretch-induced secretion and SP-A inhibition as indicated by in vitro experiments to be the prominent regulatory mechanism for surfactant secretion. From this model, mechanisms can be derived which indicate involvement of the surfactant system in, for example, obstructive lung disease. Support from the literature for this hypothesis is reviewed. Because quantitative measurement of the amount of surfactant-associated phospholipids cannot be done adequately at this time, we suggest testing the relatively risk-free application of exogenous surfactant in a pilot phase based on indications for its involvement and usefulness derived from animal and in vitro experiments.Abbreviations [Ca⁺⁺]_i intracellular free calcium - ARDS adult respiratory distress syndrome - ATP adenosine triphosphate - BAL bronchoalveolar lavage - cAMP cyclic adenosine monophosphate - COPD chronic obstructive pulmonary disease - DAG diacylglycerol - DPPC di-palmitoyl-phosphatidylcholine - EDRF endothelium-derived relaxing factor - IP₃ inositoltriphosphate - IRDS infant respiratory distress syndrome - LT D₄ leukotriene D₄ - LT E₄ leukotriene E₄ - LTC₄ leukotriene C₄ - PC phosphatidylcholine - PEEP positive end expiratory pressure - PIP₂ phosphatidylinositol diphosphate - PMN polymorphonuclear (leukocyte) - SP-A surfactant protein A - SP-B surfactant protein B - SP-C surfactant protein C - SP-D surfactant protein D - TPA 12-O-tetradecanoyl-phorbol-13-acetate