An Enzyme- and Immunohistochemical Study of Malignant Lymphomas

Thirty-three cases of malignant lymphoma were studied enzyme-histochemicallyin relation to their immunologically determined surface markersand tissue intracellular immunoglobulins by the peroxidase-antiperoxidasemethod. There were 18 B-cell derived, 11 T-cell derived andone nonT-nonB cell lymphomas and three cases of Hodgkin's disease.Two cases of infectious mononucleosis were also studied. Adenosine triphosphatase (ATPase) activity was found in sixof the B-cell lymphomas. However, two of the T-cell lymphomasalso showed ATPase activity. One of seven follicular lymphomasshowed both ATPase and alkaline phosphatase activities. Acidphosphatase activity was seen in three of the T-cell lymphomas,whereas it was also present in one of the six B-diffuse largecell type lymphomas and one B-diffuse mixed type lymphoma. These results, in addition to other enzyme activities, indicatethat enzyme histochemical activity is not sufficient for identifyingthe T- or B-cell nature of the neoplastic cells. They seem ratherto indicate the functional status of neoplastic cells.     

Magnifying Observation of Ectopic Gastric Mucosa of the Cervical Esophagus

We attempted to investigate the fine mucosal patterns of inlet patches using a transparent-tip-hood-fitted magnifying electronic endoscope (Olympus, GIF-200Z). The prevalence of inlet patch was 10.1%, 26 out of 257 patients undergoing screening endoscopic examination using a GIF-200Z. This rate was higher than that of previous reports in Japan, higher in the young group than in the aged group, and higher in males than in females. The mean inlet patch size, measured by the new method using a transparent hood, was 5.2 mm. Large inlet patches, above 8.1 mm, were found more frequently in males than in females. The number of inlet patches in one patient was one in 19 patients and two in seven. The inlet patches were oval and had a smooth margin in 23 (69.7%) cases, and irregular in 10 (30.3%). The oval patches with smooth margins were significantly larger than those with an irregular form. The fine mucosal pattern of inlet patches was mixed with B, BC and C type. Inlet patches with acid production were suggested to be fewer in number than expected, and patients with an inlet patch appear to have minimal, if any, complaints. A transparent-tip-hood-fitted magnifying electronic endoscope was thought to facilitate accurate diagnosis of the inlet patch.     

Para-Aortic Nodal Irradiation in the Treatment of Carcinoma of the Uterine Cervix: A Report of 22 Cases

Twenty-two patients with previously untreated carcinoma of theuterine cervix were treated by para-aortic nodal irradiationfor the macroscopical metas-tases found at the operation withor without pathological confirmation, at the National CancerCenter Hospital from 1962 to 1980. The irradiation was givenwith 6 MeV X rays. Total doses ranged from 42 to 99 with anaverage of 69 in Time Dose Fractionation factors. All of thepatients died of the tumor within 42 months. The initial siteof relapse was intrapelvic for two patients, extrapelvic for18, and both intra- and extrapelvic for two. Of 12 patientsupon whom autopsies were performed, only one of the patientswho had multiple metastatic tumors of less than i cm in maximumdiameter had the tumor controlled in the irradiated region.     

Fluorescence in situ hybridization analysis of c-myc amplification in stage T3N0M0 prostate cancer in Japanese patients

OBJECTIVE: Genetic aberration such as the amplification of c-myc has been commonly found in advanced prostate cancer. The aim of this study was to elucidate chromosome 8 alteration, including a gain and amplification of 8q24 (c-myc gene), related to the progression and survival in advanced (Stage C) prostate cancer. MATERIALS AND METHODS: We used dual-probe fluorescence in situ hybridization with a centromere-specific probe for chromosome 8 (8cen), and with a region-specific probe for c-myc (8q24) to evaluate genetic changes in tumor samples from 50 patients who had undergone radical retropubic prostatectomy from 1986 to 2001. RESULTS: We classified the 8cen and c-myc copy numbers as normal, gain and amplification. The carcinoma foci with extra copies of c-myc, which was defined in 35 cases (70%), were divided into two groups: (a) a simple gain of the whole chromosome 8 (no increase in the c-myc copy number relative to the chromosome 8 centromere), which was identified in 15 cases (30%); and (b) a substantial amplification of c-myc (additional increases [AI] in the c-myc copy number relative to the chromosome 8 centromere), which was detected in 20 cases (40%). AI-c-myc was strongly associated with higher histopathological grades and Gleason's scores (P = 0.0330, 0.0190, respectively). Patients with the AI-c-myc had earlier disease progression (P = 0.0029) and earlier cancer death (P = 0.0087) than did patients with normal patterns. CONCLUSION: Identification of an AI-c-myc may serve as a potential marker of prostate cancer progression.     

Prostate-specific antigen failure within 2 years of radical prostatectomy predicts overall survival

OBJECTIVE: This study attempts to determine whether prostate-specific antigen (PSA) failure following radical retropubic prostatectomy (RRP) affects patients' long-term overall survival. METHODS: This study examined 155 men diagnosed as clinical stages T1b-T3a who received RRP as primary therapy. To evaluate whether PSA failure following RRP affects overall survival, the patients were grouped into those who experienced PSA failure within 2 years and those who did not. Clinical failure-free survival, prostate cancer-specific survival and overall survival were used as endpoints. Comparisons of survival curves were performed using the log-rank test. Logistic regression analysis was performed to determine the variable most predictive of PSA failure within 2 years of surgery. RESULTS: At 10 years, the PSA failure-free survival rate, clinical failure-free survival rate, prostate cancer specific survival rate and overall survival rate of the 155 patients were 40.1%, 83.1%, 94.9% and 84.2%, respectively. The overall survival curve for patients with PSA failure within 2 years of surgery was significantly lower than for patients with no PSA failure within 2 years of surgery (P = 0.042). The multivariate logistic regression analysis demonstrated that PSA greater than 20 ng/mL and poor differentiation of the tumor were significant independent predictors of PSA failure within 2 years of surgery. CONCLUSION: These results imply that prospective studies should be conducted to detect patients at high risk for PSA recurrence in whom metastasis may occur early and to investigate postoperative treatments for these high-risk patients to improve overall survival.