Incidence of apoptosis increases with age in colorectal cancer

The incidence of cancer increases with advancing age, but the biological behavior of cancer is known to be less aggressive in elderly people. Thus, the proliferative activity and extent of apoptosis of cancer cells were assessed in samples from 163 cases of colorectal cancer focusing on the age of patients, using Ki-67 labeling index (LI) and apoptotic index (AI) by terminal deoxynucleotidyl transferase (TdT)-mediated d-UTP nick end labeling method and staining for activated caspase-3.

The Ki-67 LI of colorectal cancer ranged from 2.33 to 80.4% (mean 32.2%), while the AI ranged from 0.00 to 14.8% (mean 3.57%). Concerning the aging effect, linear and positive correlations were found for the Ki-67 LI of cancer with age (p<0.05) and the AI of cancer with age (p<0.05). However, in normal colorectal mucosa, aging of patients revealed a significant correlation only with the AI but not with the Ki-67 LI. The AI in earlier stages of cancers (stages 0 and 1) revealed a significant difference between younger cases (age<65) and more elderly cases (age≥65) (p<0.05), however, the Ki-67 LI did not exhibit a significant difference. Therefore, an increased frequency of apoptosis in colorectal cancer tissues, especially in the earlier stages, may possibly explain the slower growth of colorectal cancers in the elderly. Next, the expressions of several regulatory molecules for the proliferation/apoptosis of tumor cells were determined. The results demonstrated a tendency for stronger and more frequent expressions of c-myc, Bak and Bax despite a rather weaker expression of Bcl-2 in cancer tissues from the elderly compared with those from the younger patients. The potential roles of these regulatory molecules on age-change in the proliferation/apoptosis of colorectal cancers are discussed.     

Telomerase activity significantly correlates with cell differentiation, proliferation and lymph node metastasis in colorectal carcinomas

Telomerase activity was examined by the telomeric repeat amplification protocol assay, in a total of 37 colorectal adenocarcinomas, including stages A, B and C according to the Astler and Collier classification, and correlated with clinicopathological features. Of 17 stage C lesions, 13 were positive (76.5%; P<0.01), demonstrating a significant correlation with lymph node metastasis. In contrast, only 6 of 20 stage A and B␣carcinomas were positive (30.0%), this being significantly lower (P<0.05). Moderately or poorly differentiated subtypes were more predominant in the telomerase-positive than in the telomerase-negative groups (P<0.05) with greater elevation of mitotic and Ki-67 labeling indices (P<0.0001). No significant relation was found between telomerase activity and p53 protein accumulation or Bcl-2 protein expression. The good correlation with tumor staging, lymph node metastasis, differentiation, and mitotic and Ki-67 labeling indices suggests that this parameter might have potential application in estimation of prognosis. Received: 28 February 1998 / Accepted: 30 April 1998     

Enhanced cellular proliferative activity and cell death in chronic thyroiditis and thyroid papillary carcinoma

For the analysis of cellular proliferative activity and cell death in thyroid diseases, the Ki-67 labeling index, bcl-2 protein expression and cell death of follicular epithelia by immunohistochemistry and in situ DNA nick-end labeling methods were evaluated in normal thyroid tissues as well as in surgical specimens from cases of Hashimoto's disease (16 cases), focal lymphocytic thyroiditis (13 cases), Graves' disease (15 cases), follicular adenoma (20 cases) and papillary carcinoma (43 cases). Cellular proliferative activity and cell death were both enhanced in cases of thyroiditis, including Hashimoto's disease and focal lymphocytic thyroiditis. Thyroids from patients with follicular adenoma and papillary carcinoma also showed increased cellular proliferative activity and cell death. In addition, predominant high cellularity and partial loss of bcl-2 protein expression in papillary carcinoma suggested that the overgrowth and dedifferentiation were associated with malignancy.     

survivin基因在大肠癌组织中的表达及其与bcl-2和p53基因的相关性探讨

目的 探讨survivin在大肠癌组织中的表达及其与bcl-2、p53基因表达的相关性。方法 应用免疫组织化学方法检测大肠腺癌组织中survivin及bcl-2、p53的表达,并与其在正常大肠黏膜、增生性息肉及腺瘤组织中的表达进行比较。结果survivin在正常大肠黏膜无表达,大肠腺瘤（62.5%）、大肠癌（70.9%）中survivin表达率显著高于正常大肠黏膜和增生性息肉（16.7%）（P〈0.01）;survivin表达与与肿瘤浸润深度和淋巴结转移明显相关（P均〈0.05）;大肠癌组织中bcl-2、p53基因与survivin基因表达显著相关（P均〈0.05）。结论 survivin参与了大肠癌的发生和发展,可作为判断预后的参考指标;抑癌基因p53的失活和bcl-2的表达上调与survivin基因的表达可能在大肠癌的发生、发展中起协调作用。     

巨噬细胞移动抑制因子在大肠癌中的表达及其与细胞凋亡的关系

目的观察巨噬细胞移动抑制因子在大肠癌中的表达及其与细胞凋亡的关系。方法应用免疫组化技术及DNA原位末端标记TUNEL法分别测定43例大肠癌及10例正常大肠组织中的MIF蛋白表达和细胞凋亡。结果大肠癌组织中的MIF表达率为65．1％（28／43），明显高于正常大肠组织0．0％（0／10），二者之间有显著性差异（P〈0．01）。MIF表达与大肠癌组织学类型及Dukes分期无明显相关（P〉0．05），但与大肠癌分化程度、淋巴结转移呈显著相关（P〈0．05）。MIF蛋白的表达与细胞凋亡指数呈负相关（r=-0．436，P〈0．01）。结论MIF蛋白的异常表达而引起的细胞凋亡抑制或逃避，在大肠癌的发生、发展中起一定的作用。联合检测MIF蛋白和凋亡指数，有助于对肿瘤细胞的分化程度作出正确评价，以指导临床治疗及估计预后。     

Prognostic influence of p53 nuclear overexpression in colorectal carcinoma

PURPOSE: The aim of this study was to test the prognostic influence of p53 nuclear overexpression in colorectal carcinoma. METHODS: We performed an analysis of the prognostic influence of the nuclear overexpression of p53 with immunohistochemistry in 126 cases of colorectal carcinoma operated on in our hospital between 1987 and 1992, with a minimum follow-up time of 60 months (5 years). RESULTS: Our results show a statistically significant prognostic influence of p53 overexpression on disease-free survival time, but not on the overall survival time, in univariate analysis, but this influence is lost in multivariate analysis. CONCLUSIONS: Our results confirm recent reports by other authors that failed to show the independent prognostic value of p53 in colorectal carcinoma.     

肝癌组织中p27蛋白表达与肿瘤增殖凋亡活性的研究

研究肝细胞癌组织中p27表达对细胞增殖与凋亡活性的影响.采用Elivision法检测47例肝癌及相应癌旁肝组织中p27及PCNA的表达,TUNEL法检测原位细胞凋亡.结果显示肝癌组织中细胞增殖与凋亡指数明显高于癌旁肝组织.肝癌组织中p27染色指数明显低于癌旁肝组织与正常肝组织.低分化肝癌组织中p27表达和凋亡指数均明显降低.存在肝外转移的肝癌组织中p27表达降低而增殖指数明显增高.进一步研究显示,p27高表达组肝癌组织中凋亡指数明显高于低表达组,而增殖指数却显著降低.提示p27蛋白表达降低与肝癌的发生和进展有着密切关系,并可能是导致肝癌细胞增殖凋亡失衡的因素之一.     

Gallbladder carcinoma: the role of p53 protein overexpression and Ki-67 antigen expression as prognostic markers

BackgroundThe overexpression of p53 protein and the expression of Ki-67 antigen may affect the survival of patients with gallbladder carcinoma. This association has been tested in a series of 41 patients with relatively early carcinoma of the gallbladder.MethodsForty-one surgical specimens from patients with a postoperative histological diagnosis of gallbladder carcinoma were studied. All patients were operated by simple cholecystectomy only because the tumours were not advanced and/or their general condition was poor. Patients submitted to radical operations were excluded. p53 expression was calculated from nuclear staining according to the intensity and extent of positive cells, as graded on a scale from 1 to 3; a combined score of >3 was considered as overexpression. Ki-67 expression was calculated by the MIB-I index: the percentage of positively stained tumour cell nuclei out of the total tumour cells counted (n = 1000); >20% of stained cells was considered positive.ResultsTwenty-nine gallbladder carcinomas (71%) overexpressed p53 protein in the cell nuclei. No significant differences were found in relation to cell differentiation on the level of tumour infiltration through the gallbladder wall. Five-year survival of patients with gallbladder carcinoma overexpressing p53 was 17.2%, while survival of patients without p53 overexpression was 30% (not significant). Twenty-four cases (58.5%) were considered positive for the MIB-I index. There were no differences between the grade of cell differentiation and wall infiltration. Five-year survival of the patients with a MIB-I positive index was 9.2% as opposed to 27.7% for those with a negative index (not significant).Conclusionsp53 protein nuclear overexpression and Ki-67 protein expression in gallbladder carcinoma were not related to histological differentiation, level of gallbladder wall invasion or patient survival.     

Cyclooxygenase (COX)-2 immunoreactivity and relationship to p53 and Ki-67 expression in colorectal cancer

The tumor-suppressive effects of nonsteroidal antiinflammatory drugs (NSAIDs) have been suggested to be due to a reduction in cyclooxygenase (COX)-2 activity, although the effects of COX-2 in the colonic mucosa and in colorectal cancer have not been determined. Ki-67 immunoreactivity in cancers is also attracting attention, as Ki-67 reflects cell proliferation, while p53 immunoreactivity is also of interest, as it reflects the malignancy of colorectal lesions. Accordingly, to determine these correlation, we investigated the distribution and intensity of COX-2, p53 and Ki-67 expression in both cancerous and non-cancerous tissues from patients with sporadic and ulcerative colitis (UC)-associated colorectal cancer. We selected 21 colorectal cancer specimens, obtained by surgical resection or colonoscopic biopsy, from 21 patients, including 3 with UC (13 men and 8 women; aged 42–78 years). Histological examination of hematoxylin and eosin-stained specimens revealed that 9 were well differentiated; 11, moderately differentiated; and 1 was a poorly differentiated adenocarcinoma. We used anti-COX-2, p53, and Ki-67 antisera to perform immunohistochemical staining by the labelled streptavidin biotin method and then assessed and graded the staining intensity and distribution. COX-2 staining was more intense in cancer tissue than in non-cancerous areas. Colorectal cancers associated with UC were not stained intensely. COX-2, p53, and Ki-67 positivity rates in were 38.1%, 38.1%, and 47.6%, respectively. There were no relationships among the distributions or intensities of COX-2, p53, and Ki-67 expression. Our results indicate that colorectal cancer tissues overexpress COX-2, but that there are no relationships between COX-2, p53, and Ki-67 expression, suggesting that COX-2 expression may not be related to cell proliferation or to the grade of malignancy. However, it is necessary to determine whether COX-2 in cancer tissue is involved in carcinogenesis or whether it is simply a product of cancer. (Received: July 7, 1998; accepted: Oct. 23, 1998)     

大肠癌组织中血管生成与凋亡、增殖的关系

目的　研究血管内皮生长因子 (VEGF)、微血管密度 (MVD)在大肠癌组织中的表达 ,并探讨血管生成与细胞增殖和凋亡的关系。方法　应用RT PCR检测 5 2例大肠癌组织 ,4 8例癌旁黏膜组织中VEGFmRNA表达 ,序列分析验证PCR扩增的正确性 ;免疫组化法检测 5 2例大肠癌组织中VEGF蛋白的表达及MVD、凋亡指数 (AI)和增殖指数 (PI)。结果　大肠癌组织中VEGFmRNA阳性表达率为 76 .9% ,癌旁组织为 5 2 .1 % (P <0 .0 1 ) ,VEGFmRNA在大肠癌远处转移组表达高于无转移组 (P <0 .0 5 ) ,DukesD期高于DukesA、B期 ,差异有显著性 (P值均 <0 .0 1 )。扩增的VEGF与人VEGF序列具有 98%的同源性。大肠癌组织中VEGF蛋白阳性表达率为 5 5 .8% (2 9/5 2 )。VEGF表达阳性组的MVD(2 1 .1± 8.2 )与阴性组 (1 3.9± 5 .0 )比较差异有显著性 (P <0 .0 1 ) ,阳性组PI(5 6 %± 2 1 % )与阴性组(4 2 %± 1 6 % )比较差异有显著性 (P <0 .0 5 ) ,阳性组AI(0 .86 %± 0 .4 2 % )与阴性组 (0 .95 %± 0 .36 % )比较差异无显著性 (P >0 .0 5 )。VEGF表达与MVD(r=0 .5 39,P <0 .0 1 )、PI(r =0 .4 0 9,P <0 .0 1 )呈正相关 ,而与AI(r=- 0 .2 6 4 ,P >0 .0 5 )无明显相关关系。结论　VEGF不仅与大肠癌的血管生成有关 ,而且在大肠癌的细胞增殖中起     

肝细胞癌和肝硬化组织中增殖细胞核抗原及Ki-67抗原的表达及意义

为探讨肝细胞癌 (HCC)和肝硬化组织中增殖细胞核抗原 (PCNA)及 Ki- 67抗原的表达及意义 ,采用免疫组织化学技术检测 PCNA和 Ki- 67抗原在 HCC和肝硬化组织中的标记指数 (L I)。结果显示 , 、 、 级 HCC的 PCNA L I分别为 (2 6.9± 17.4) %、 (3 3 .1± 2 2 .7) %、 (73 .8± 16.3 ) % ,各级之间差异均有显著性(P均 <0 .0 5 ) ;Ki- 67L I分别为 (2 5 .8± 15 .6) %、 (5 8.2± 18.6) %、 (75 .3± 2 0 .2 ) % ,各级之间差异均有显著性 (P均 <0 .0 5 ) ;但各级 HCC中的 PCNA L I和 Ki- 67L I差异均无显著性 (P均 >0 .0 5 )。肝硬化组织中 PCNAL I为 (8.8± 5 .2 ) % ,Ki- 67L I为 (7.9± 4.4) % ,两者之间差异无显著性 (P>0 .0 5 )。提示 HCC及肝硬化组织中 PCNA和 Ki- 67抗原的阳性率基本一致 ,HCC的分化程度与 PCNA或 Ki- 67密切相关 ;原位检测 HCC组织中PCNA或 Ki- 67抗原的表达 ,有助于判断 HCC分化程度及预后     

曲古抑菌素A抑制乳腺癌细胞MCF-7生长增殖及促进凋亡的机制

目的 探讨曲古抑菌素A(TSA)对乳腺癌细胞系MCF-7细胞生长增殖、凋亡及p21、p53表达的影响.方法 分别以不同浓度的TSA处理MCF-7细胞,采用MTT比色法测定细胞增殖活性;用流式细胞仪检测细胞凋亡率;用RT-PCR方法检测细胞p21、p53mRNA的表达水平;用Western印迹法检测MCF-7细胞的p21、p53蛋白表达.结果 TSA作用后,各组细胞均出现显著的生长抑制作用,存活率明显降低,并呈剂量依赖性.流式细胞仪分析,在100 ～ 400 nmol/L范围内凋亡率随TSA浓度的升高而升高(P＜0.01).经不同浓度TSA处理的细胞p21mRNA和蛋白表达水平明显上调(P＜0.01);、而p53mRNA和蛋白表达水平则没有明显变化.结论 TSA显著抑制MCF-7细胞生长,促进凋亡可能与TSA维持p53的稳定表达,从而促进其下游因子p21的表达有关.     

Potential Role of Apoptosis and Apoptotic Regulatory Proteins in Colorectal Neoplasia: Correlations with Clinico-Pathological Parameters and Survival

An imbalance between apoptotic and proliferative processes is believed to underlie colorectal neoplasia. We evaluated the expression of bcl-2, p53, mdm2 proteins, and apoptosis in colorectal neoplasms, as well as their correlation with clinico-pathological parameters, using image analysis. Biopsies from 46 colorectal cancers, 121 adenomas, and 25 controls were studied using monoclonal antibodies against p53, bcl-2, mdm2 and the terminal deoxynucleotidyl-transferase-mediated dUTP nick end labeling (TUNEL) method for apoptosis. P53 and bcl2 protein expression was higher in adenomas ≥1 cm (P < 0.03) and tubulovillous-villous adenomas (P < 0.03), and correlated with dysplasia (P < 0.03). In Cox regression analysis, Dukes’ stage was the most significant independent prognostic indicator of a worse survival (P < 0.019), whereas when stage was eliminated, bcl-2 expression was also a powerful predictor for bad prognosis (P = 0.02). In conclusion, both bcl-2 and p53 immunohistochemical profiles may be useful adjuncts in detecting adenomas with a malignant potential, whereas bcl-2 could be used in combination with Dukes’ stage as a predictor of prognosis in colorectal cancer.     

Bcl-2 expression and its association with cell kinetics in human gastric carcinomas and intestinal metaplasia

Thebcl-2 protooncogene was initially discovered at the t(14;18) chromosomal breakpoint in follicular lymphomas. It has been demonstrated thatbcl-2 protein (Bcl-2) expression blocks apoptosis and plays an important role in cell development and maturation. In the present study, Bcl-2 expression was immunohistochemically examined in 103 cases of gastric carcinoma, as well as 64 cases of non-carcinous gastric mucosa, and its correlation with apoptosis, cell proliferation and p53 immunoreactivity was investigated. Bcl-2 was detected in 18.0% of differentiatedtype gastric carcinomas (9 of 50) and 7.5% of the undifferentiated type (4 of 53). In adjacent intestinal metaplastic gastric epithelium, the incidence of Bcl-2 positivity in the incomplete type (21/23, 91.3%) was significantly higher than in the complete type (23/41, 56.1%) (P<0.04). Double immunostaining for Bcl-2 and Ki-67 clearly revealed the majority of Bcl-2-positive cancer cells to be in a nonproliferating state, although some cancer cells expressed both proteins together. Statistical assessment demonstrated that the average Ki-67 labeling index and apoptotic labeling index in Bcl-2-positive foci were significantly lower than in Bcl-2-negative foci (P<0.0001,P<0.0003). In addition, a significant dissociation between Bcl-2 and p53 immunoreactivity was found in cancer tissues. These results indicate that aberrant Bcl-2 expression in gastric carcinomas possibly originates from intestinal metaplastic epithelium, and suggest a possible role in tumor development and growth.Abbreviation IM intestinal metaplasia     

Heterocyclic complexes of ruthenium(III) induce apoptosis in colorectal carcinoma cells

Purpose The ruthenium complex salt indazolium trans-[tetrachlorobisindazole-ruthenate(III)] (KP1019) and the analogous sodium salt KP1339 are effective tumor-inhibiting drugs in experimental therapy of autochthonous colorectal carcinomas in rats. This paper examines the cell biological mechanisms underlying their antineoplastic effects.Methods Colorectal tumor cell lines were used to analyze uptake of the ruthenium(III) complexes into the cells and the mechanism as well as the efficacy of their cytotoxic effects.Results KP1019 and KP1339 are efficiently taken up into the cells: 100 µM ruthenium(III) complex in the growth medium led to the uptake of 120–160 ng ruthenium per 10⁶ cells within 30 min. Uptake of KP418 was tenfold lower correlating with its lower cytotoxic efficiency. KP1019 and KP1339 induced apoptosis in SW480 and HT29 cells predominantly by the intrinsic mitochondrial pathway as indicated by loss of mitochondrial membrane potential. Correspondingly sensitivity of the cells paralleled expression of bcl₂ while it was only slightly affected by mutations in Ki-ras.Conclusions Our data demonstrate that trans-[tetrachlorobisindazole-ruthenate(III)] complex salts are promising candidate drugs in the second-line treatment of colorectal cancers resistant to other cytostatic drugs and has been introduced into phase I clinical trials.     

Nuclear cyclin D1 overexpression is a critical event associated with cell proliferation and invasive growth in gallbladder carcinogenesis

Cyclin D1 overexpression is remarkably frequent in several human carcinomas and is believed to be a critical event in oncogenesis. We examined cyclin D1 expression, p53 expression, and the Ki-67 labeling index by immunostaining in human gallbladder mucosa in conditions varying from normal to malignant tissue. We also examined K-ras codon 12 mutations in these tissues with a two-step polymerase chain reaction. Nuclear cyclin D1 overexpression was observed in 48% of carcinomas occurring independently of adenoma, but not in adenomas, carcinomas arising in adenomas, or nonneoplastic lesions. Cytoplasmic cyclin D1 overexpression was observed in about 15% of abnormal specimens, irrespective of the type of epithelial abnormality. Carcinomas showing nuclear cyclin D1 overexpression had significantly higher Ki-67 labeling indexes than those with no overexpression. Moderately to poorly differentiated adenocarcinomas showed a higher incidence of nuclear cyclin D1 overexpression than papillary to well differentiated carcinomas. Specimens with cyclin D1 overexpression showed a high incidence of lymph permeation, venous permeation, and lymph node metastasis. We conclude that nuclear cyclin D1 overexpression is a critical event importantly associated with cell proliferation and invasive growth in gallbladder carcinogenesis, and that cyclin D1 immunostaining may become a useful marker for evaluating gallbladder carcinomas. Received: March 9, 1999 / Accepted: July 23, 1999     

Hepatic expression of the proliferative marker Ki-67 and p53 protein in HBV or HCV cirrhosis in relation to dysplastic liver cell changes and hepatocellular carcinoma

To evaluate hepatic expression of the nuclear proliferative marker Ki-67 and the p53 oncoprotein in hepatitis B virus (HBV)/HCV cirrhosis in relation to dysplastic liver cell changes and hepatocellular carcinoma (HCC). We studied needle liver biopsies from 107 patients with cirrhosis and no HCC (52 HBV, 55 HCV) who had been assessed for protocol studies, and 57 cirrhotic patients with HCC (40 HBV, 17 HCV). We evaluated small and large cell dysplastic changes along with the expression of Ki-67 and p53 by immunohistochemistry. The labelling index (LI) was defined as the proportion (%) of positive-stained nuclei of the 500 measured. Large and small cell dysplastic changes were observed in 12 and 9% of specimens respectively. Only small cell changes were associated with Ki-67 expression. Ki-67 LI was 5.50 +/- 5.7 in cirrhosis (13.90 +/- 3.84 in those with small cell dysplastic changes vs 4.64 +/- 4.98 in those without, P < 0.01), 10.2 +/- 5.95 in cirrhosis with HCC (P < 0.05) and 18.56 +/- 10 in HCC (P < 0.01). Neither the presence of small cell dysplastic changes nor the expression of Ki-67 was related to severity or aetiology of cirrhosis. Expression of p53 was observed in 30% of the non-tumorous and in 53% of the neoplastic tissue obtained from patients with HCC, with no differences between HCV and HBV. Ki-67 and p53 expression was associated with the tumour grade (P < 0.001). Our observations clearly demonstrate the association between the proliferation activity and the morphological changes in the cirrhotic liver from the non-dysplastic to dysplastic lesion to HCC. They also support the hypothesis that p53 alterations are a rather late event in carcinogenesis and related to HCC grade. And finally, they suggest that the final steps of hepatocarcinogenesis are common and independent of the aetiology of the chronic viral infection.     

High-level mRNA quantification of proliferation marker pKi-67 is correlated with favorable prognosis in colorectal carcinoma

Purpose The present study retrospectively examines the expression of pKi-67 mRNA and protein in colorectal carcinoma and their correlation to the outcome of patients.Methods Immunohistochemistry and quantitative RT-PCR were used to analyze the expression of pKi-67 in 43 archival specimens of patients with curatively resected primary colorectal carcinoma, who were not treated with neo-adjuvant therapy.Results We determined a median pKi-67 (MIB-1) labeling index of 31.3% (range 10.3–66.4%), and a mean mRNA level of 0.1769 (C_T: range 0.01–0.69); indices and levels did not correlate. High pKi-67 mRNA C_T values were associated with a significantly favorable prognosis, while pKi-67 labeling indices were not correlated to prognostic outcome. A multivariate analysis of clinical and biological factors indicated that tumor stage (UICC) and pKi-67 mRNA expression level were independent prognostic factors.Conclusion Quantitatively determined pKi-67 mRNA can be a good and new prognostic indicator for primary resected colorectal carcinoma.     

Relationship between COX-2 and cell cycle-regulatory proteins in patients with esophageal squamous cell carcinoma

AIM: To investigate the correlation between cyclooxygenase-2 (COX-2) and cell cycle-regulatory proteins in patients with esophageal squamous cell carcinoma (ESCC). METHODS: One hundred and two surgically obtained specimens of ESCC were randomly collected. All specimens were obtained from patients who had not received chemoor radiotherapy prior to surgical resection.Twenty-eight specimens of normal squamous epithelium served as controls. The expression of COX-2, Ki-67, cyclin A and p27 was examined by immuno...