Primary liver cell carcinoma. New insight for a more correct approach to its classification

Hepatocellular carcinomas, cholangiocellular carcinomas, and "indeterminate" forms have been studied by immunohistochemical detection of several antigens: alpha-fetoprotein and CEA, as well as type IV collagen, laminin, and keratin. While the first two antigens were variably detectable in different samples, in the poorly differentiated areas of hepatocellular carcinoma type IV collagen and laminin were both absent. These basement membrane glycoproteins constantly surrounded the cholangiocellular carcinoma tubular structures and were always present in those areas of the "indeterminate" group where the cells were organized as pseudoglandular or ductular aggregates. Keratin was absent in all cases of hepatocellular carcinoma, was variably detectable in the "indeterminate" neoplasms and was always present in cholangiocellular tumors. The neoplasias with mixed histopathological features usually showed morphological and biochemical biliary differentiation at the periphery, in contact with the collagenous stroma. We postulate that in some cases hepatocarcinoma cells undergo metaplastic transformation giving rise to cholangiocellular forms. Type IV collagen, laminin, and keratin seem to be accurate markers of phenotypical differentiation and show that a continuous phenotypical spectrum exists between hepatocellular and cholangiocellular entities.     

Mesangial cell proliferation in long-term streptozotocin-induced diabetes mellitus in the rat and the renoprotective activity of heparin.

At present, it is not clear whether mesangial proliferation underlies mesangial expansion in diabetic nephropathy. To address this issue and the relationship between heparin's renoprotective and antimitogenic activities, we studied three streptozotocin-induced diabetic rat groups 5 and 12 months after diabetes induction: two groups were administered a modified heparin, each with a different protocol, and two healthy rat groups, one of which was treated with the same heparin, served as controls. Untreated diabetic animals developed clear evidence of nephropathy, namely expansion of the glomerular extracellular matrix, as expressed by glomerular basement membrane thickening, and increased mesangial deposition of type IV collagen. These alterations were prevented/cured by heparin treatment. Kidney sections were processed immunohistochemically for proliferating cell nuclear antigen and smooth muscle alpha-actin which is expressed only by proliferating mesangial cells. The number of proliferating cell nuclear antigen positive nuclei and alpha-actin-positive cells per glomerulus did not differ between groups at both 5 and 12 months. In conclusion, there is no evidence that mesangial proliferation is increased in late experimental diabetic nephropathy, and heparin seems to be renoprotective through mechanisms other than antiproliferation.     

Changes in myocardial collagen in spontaneously hypertensive rats (SHR)]

The aim of this study was to evaluate whether left ventricular hypertrophy in spontaneously hypertensive rats (SHR) is accompanied by myocardial collagen quantitative and/or qualitative changes. 15 SHR and 20 control normotensive rats (WKR) of three months of age were used. At this age, hypertension has already caused a significant increase in the ratio of the ventricular mass to body weight (mg/g) in hypertensive animals (SHR: 5.11 +/- 0.21; WKR: 3.40 +/- 0.22; p less than 0.001). With respect to body mass, the amount of collagen elicited from the hydroxyproline concentration increases in SHR but remains percentually the same with respect to the biventricular mass. In SHR, changes in the amount of type-1 alpha chains and type-V alpha chains, and the presence of a low molecular weight collagenous fraction have been observed. Moreover, we have found an increase in the ratio of type-1 alpha 1 chains to type-1 alpha 2 chains. This change might be related to the appearance of a type-1 alpha 1 trymer. The presence of such a type-1 alpha trymer and of low molecular weight collagenous fractions may suggest the appearance of fetal collagenous isoforms in ventricular myocardium, due to the increased pressure load as well as to the increased turnover (an index of a remodelling activity of cardiac stroma). These changes might play a role in the transformation of myocardial viscoelastic properties in SHR with a progressive diastolic stiffness of the ventricular wall.     

PRIMARY LIVER CELL CARCINOMA New Insight for a More Correct Approach to its Classification

Hepatocellular carcinomas, cholangiocellular carcinomas, and "indeterminate" forms have been studied by immunohistochemical detection of several antigens: a-fetoprotein and CEA, as well as type IV collagen, laminin, and keratin. While the first two antigens were variably detectable in different samples, in the poorly differentiated areas of hepatocellular carcinoma type IV collagen and laminin were both absent. These basement membrane glycoproteins constantly surrounded the cholangiocellular carcinoma tubular structures and were always present in those areas of the "indeterminate" group where the cells were organized as pseudoglandular or ductular aggregates. Keratin was absent in all cases of hepatocellular carcinoma, was variably detectable in the "indeterminate" neoplasms and was always present in cholangiocellular tumors. The neoplasias with mixed histopathological features usually showed morphological and biochemical biliary differentiation at the periphery, in contact with the collagenous stroma. We postulate that in some cases hepatocarcinoma cells undergo metaplastic transformation giving rise to cholangiocellular forms. Type IV collagen, laminin, and keratin seem to be accurate markers of phenotypical differentiation and show that a continuous phenotypical spectrum exists between hepatocellular and cholangiocellular entities. ACTA PATHOL. JPN. 37:929–940, 1987.     

Hepatocellular carcinoma: expression of basement membrane glycoproteins. An immunohistochemical approach

The identification and characterization of collagenous and non-collagenous glycoproteins have made it possible to use specific antibodies as tools for the topographical localization of the various connective tissue components, and thus to follow the progression of parenchymal-stromal interactions. This investigation is an approach to the study of in vivo relationships between basement membrane components (type IV collagen, laminin) and neoplastic cells of hepatocellular carcinoma. Ten cases of hepatic carcinomas were analysed and paraffin-embedded sections were immunostained with anti-laminin and anti-type IV collagen antibodies. The avidin-biotin-peroxidase complex technique was used. In well differentiated neoplasms with hepatic tumour cells organized in a trabecular pattern lined by sinusoid structures, type IV collagen was always detected at the sinusoidal level. Laminin was evident only in two cases with a prominent intraparenchymal vascular bed. In less differentiated neoplasms, sinusoids were almost absent and only large tumour vessels were positive for both laminin and type IV collagen. At the interface between tumour tissue and the surrounding stroma, some carcinomatous elements were surrounded by laminin and type IV collagen. Our data further support the hypothesis that basement membrane phenotypic expression may be influenced both by the degree of tumour differentiation and by the characteristics of the micro-environment.     

Immunohistochemical study of basement membrane antigens in bronchioloalveolar carcinoma

Bronchioloalveolar carcinoma (BAC), not yet completely defined as a biologic entity, has recently been classified into two different types. Immunohistochemical investigations, aimed at characterizing basement membrane (BM) behavior in the two types of BAC, revealed different distribution patterns. The first (Type I BAC) showed a linear staining for laminin and Type IV collagen similar to normal lung. Fibronectin was widely present in the septal interstitium and patchily distributed along the BM. The second (Type II BAC) showed a variable reaction for Type IV collagen and fibronectin, whereas laminin was absent or appeared as short, interrupted tracts around the epithelial neoplastic population, similar to conventional adenocarcinoma of the lung. These results suggest that only Type I BAC shows structural characteristics different from those of conventional adenocarcinoma of the lung.