Omental Actinomycosis Coexisting with Colon Cancer

Actinomycosis is a rare infection caused by Actinomyces species, normal commensal inhabitants of the human bronchial and gastrointestinal tract. Infection occurs after preceding mucosal break-down by variable causes. A preoperative diagnosis is difficult because of its nonspecific clinical features, mimicking malignancy, tuberculosis or other inflammatory diseases. We report a case of abdominal actinomycosis presenting as an omental mass, which coexists with ascending colon cancer. Actinomycosis was diagnosed by histopathologic demonstration of sulfur granules in a specimen resected by laparoscopic exploration. Following surgery, the patient was treated with IV penicillin (20 million IU/day) for 3 weeks, and follow-up colonoscopy showed adenocarcinoma in the ascending colon. The patient underwent right hemicolectomy, then treated with intravenous penicillin for 4 weeks postoperatively and oral penicillin for 6 months. The patient has been free of recurrence for 6 months.

Clinical Significance of MUC2 and MUC5AC Expression in Gastric Adenocarcinomas

PURPOSE: We examined the clinical significance of MUC2 and MUC5AC gene expression in gastric adeno-carcinoma tissues. METHODS: Two hundred specimens were obtained from gastric carcinoma patients who underwent gastric cancer operations at Samsung Medical Center between January 2001 and January 2005. MUC2 and MUC5AC expression were examined immunohistochemically, and correlated with clinicopathologic features and prognostic significance. RESULTS: MUC2 expression was positive in 88 tissues (44.0%) and MUC5AC expression was positive in 125 tissues (62.5%). MUC2 expression was associated with cancer advancement, lymph node metastasis, T classification, distant metastasis, and endolymphatic invasion. Loss of MUC5AC expression was significantly related to cancer advancement, lymph node metastasis, advanced T stage, and distant metastasis. MUC2 expression was usually negative in early gastric cancer (78%), but usually positive in advanced gastric cancer (66%). MUC5AC was usually positive in early gastric cancer (74%). The prognosis of the MUC2(-) group was significantly better than the MUC2(+) group (P<0.001). There was no relationship with MUC5AC expression and survival. Multivariate analysis showed that T classification, lymph node metastasis, distant metastasis, endolymphatic invasion, and MUC2 expression were independent prognostic factors, but MUC5AC expression was not. CONCLUSION: MUC2 and MUC5AC expression correlated with several clinicopathologic parameters (cancer advancement, lymph node metastasis, advanced T classification, distant metastasis). MUC2 expression was a significant independent prognostic factor and positive MUC2 expression suggested poor prognosis. MUC2 expression may have prognostic significance in gastric adeno-carcinomas.

Expression of Proteins Related Cell Cycle and Apoptosis during Diethylnitrosamine (DEN)-induced Hepatocarcinogenesis in Rats

PURPOSE: To explore the role of cell cycle and apoptosis regulators during hepatocarcinogenesis, the expression of cell cycle-related proteins (cyclin D1 and p27kip1) and apoptosis-related proteins (p53, survivin, caspase 3). METHODS: Sprague-Dawley rats were given 120 ppm diethylnitrosamine (DEN) as a carcinogen and sequentially sacrificed. The expression of cell cycle and apoptotic related proteins were examined by light microscopy and immunohistochemistry. RESULTS: During the DEN-induced hepatocarcinogenesis, sequential histologic changes from preneoplastic lesions (altered hepatic cellular foci, hyperplastic nodules, and hepatocellular adenomas) and ultimately overt hepatocellular carcinomas and metastatic lesions were noted. The cyclin D1 were progressively increased from preneoplastic lesions to hepatocellular carcinomas. However, the p27kip1 and the survivine proteins did not show any other difference with the increasing degree of carcinogenesis. The p53 and caspase 3 proteins were more significantly increased in hepatocellular carcinomas than preneoplastic lesions. The cyclin D1 protein expression did not show any correlation with the expression of p27Kip1 protein, but the p53 expression was related to the expression of survivin and caspase 3. CONCLUSION: From the above results, over-expression of cyclin D1 plays a role in the early and late stages of hepatocarcinogenesis. In addition p53 and caspase 3 might be useful markers for evaluating the risk of malignant transformation.

The Prognostic Significance of Chromosome 18 Monosomy in the Colon Cancer: Correlations with the Expressions of Smad4 and TGF-beta Receptor II Proteins

PURPOSE: Chromosomal instability of chromosome 18 and inhibition of the transforming growth factor beta (TGF-beta) signaling pathway, which is mediated through Smad4, play important roles in the tumorigenesis of colon cancer. This study evaluated the value of the expression of chromosome 18 monosomy in colon cancer as a prognostic factor and its correlations with the expressions of Smad4 and TGF-beta receptor II proteins. METHODS: We analyzed the rate of the expression of chromosome 18 monosomy in 66 colon cancers with using chromogenic in situ hybridization (CISH) and we evaluated its value as a prognostic factor by determining its correlation with the pathologic factors and immunohistochemical expressions of Smad4 and TGF-beta receptor II proteins. RESULTS: Of the 66 colon cancers, monosomy of chromosome 18, as determined by CISH, was observed in 18 cases (27.3%), and the decreased expression of Smad4 and TGF-beta receptor II proteins was observed in 30 cases (45.5%) and 25 cases (37.9%), respectively. The monosomy of chromosome 18 and the decreased expression of Smad4 proteins showed statistically significant correlations with the histologic differentiation, the presence of tumor emboli, the nodal status and the stage. The decreased expression of TGF-beta receptor II proteins had statistically significant correlations with the histologic differentiation, the T-stage, the nodal status and the stage. The monosomy of chromosome 18 showed a statistically significant correlation with the decreased expression of Smad4 and TGF-beta receptor II proteins. CONCLUSION: These results suggested that chromosome 18 monosomy may have prognostic value for colon cancer.

Amplification of the HER-2/neu Oncogene and Topoisomerase II-alpha by Chromogenic in Situ Hybridization in Breast Cancer

PURPOSE: HER-2/neu is the most frequently amplified oncogene in breast cancer. Topoisomerase II-alpha is a key enzyme in DNA replication and it is a molecular target for many anti-cancer drugs that are called topo II inhibitors; in addition, it is a new marker of proliferation. Because of the physical proximity of the ER-2/neu and topoisomerase II-alpha genes, co-amplification of the HER-2/neu and topoisomerase II-alpha may be important determinates of the response to chemotherapy for advanced breast cancer patients. METHODS: We studied the correlation of gene amplification of HER-2/neu and topoisomerase II-alpha by chromogenic in situ hybridization (CISH) in 43 infiltrating duct carcinomas of the breast. The over-expression of HER-2/neu protein and the staining index for the proliferation marker of topoisomerase II-alpha were examined immunohistochemically. The correlations between the status of HER-2/neu and topoisomerase II-alpha and the other clinicopathologic variables such as tumor size, lymph node metastasis, TNM stage, histologic grade, nuclear grade, and the estrogen receptor and progesteron receptor were investigated. RESULTS: Of the 43 infiltrating ductal carcinomas, the amplifications of HER-2/neu and topoisomerase II-alpha by CISH were observed in 8 cases (18.6%) and 14 cases (32.6%), respectively. Amplification of HER-2/neu showed the statistically significant correlations with tumor size, histologic grade and the topoisomerase II-alpha staining index. Amplification of topoisomerase II-alpha showed statistically significant correlations with axillary lymph node metastasis, the stage, the nuclear grade and the estrogen receptor status. CONCLUSION: These data suggest that amplification of HER-2/neu oncogene and topoisomerase II-alpha by CISH may be valuable for determining the response to chemotherapy, and detection of HER-2/neu and topoisomerase II-alpha in tumor sections may have prognostic value in human breast cancer.

Expression of Survivin and HSP90 in Colorectal Cancer and its Relationship with Clinicopathologic Factors

PURPOSE: Survivin is an inhibitor of apoptosis protein and it is overexpressed in most human cancers. Recent data demonstrated that survivin-HSP90 complex regulate apoptosis. We assessed expression of survivin and HSP90 by using immunohistochemistry with colorectal cancer tissue and correlate it with clinicopathologic prognostic parameters. METHODS: Using immunohistochemistry, survivin and HSP90 expression were evaluated on paraffin sections of fifty-six colorectal carcinomas. Various clinicopathologic parameters including histologic differentiation grade, T-stage, nodal metastasis, stage were obtained from pathologic records. RESULTS: Survivin expression were observed in 30 cases (53.6%). The expression of survivin showed no statistically significant correlation with histologic differentiation grade, T-stage, nodal metastasis, stage. HSP90 expression were observed in 31 cases (55.4%). The expression of HSP90 showed a statistically significant correlation with histologic differentiation grade (P=0.035) and stage (P=0.017). There were a significant correlation between survivin expression and HSP90 expression (P=0.018). CONCLUSION: Survivin and HSP90 was expressed in colorectal cancer. The expression of HSP90 correlates with histologic differentiation grade, stage. The above results suggest that HSP90 could be a prognostic marker of poor outcome in colorectal carcinoma.

Correlation of C-erbB-2 Oncogene Amplification by Chromogenic in situ Hybridization and Expressions of Cell Cycle Regulatory Proteins in Infiltrating Duct Carcinoma of the Breast

PURPOSE: Gene amplification and/or over-expression of the c-erbB-2 are linked with poor prognosis in breast cancer. There has been only a few reports about the connection of c-erbB-2 oncogene amplification with cell regulatory proteins such as p27(kip1), cyclin D1, Rb, and E2F-1. The purpose of this study is to determine the correlation the amplification of the c-erbB-2 oncogene and protein expressions of p27(kip1), cyclin D1, Rb, and E2F-1. METHODS: Using Chromogenic in situ Hybridization (CISH) the amplification the c-erbB-2 oncogene were determined from paraffin sections of 48 infiltrating duct carcinomas (IDC). The protein expressions of p27(kip1), cyclin D1, Rb, and E2F-1 were studied immunohistochemically. RESULTS: Among the 48 evaluated IDC patients, amplifications of the c-erbB-2 oncogene by CISH were observed in 14 cases (29.1%). The amplification of the c-erbB-2 oncogene showed a significant correlation with tumor size and stage (P=0.0001 and P=0.001). The proteins of p27(kip1), cyclin D1, Rb, and E2F-1 were expressed by IHC in 23 cases (47.9%), 17 cases (35.4%), 27 cases (56.3%), and 22 cases (45.8%), respectively. Down- regulation of protein expressions showed a significant correlation with tumor size (P=0.031) in p27(kip1) and estrogen and progesterone receptor status (P=0.026 and P=0.001) in Rb. The expression of the E2F-1 protein showed a significant correlation with tumor size, stage, and histologic grade (P=0.003, P=0.030, and P=0.036). The amplification of the c-erbB-2 oncogene between down-regulation of p27(kip1) protein and E2F-1 protein showed a statistically significant correlation. CONCLUSION: The amplification of the c-erbB-2 oncogene may be correlation with cell cycle regulatory proteins such as p27(kip1) and E2F-1.

Metachronous Tripple Primary Malignant Neoplasm

According to the development of new diagnostic techniques and the extension of aging population, the diagnosis of multiple primary malignant neoplasm has increased. We report a 76 years old man who had prostate cancer, colon cancer and stomach cancer metachronously and review literatures about the history, criteria, incidence and causes of the multiple primary malignant neoplasm.

Correlation of EGFR and c-erbB-2 Gene Amplifications and Expression of COX-2 Protein in Invasive Ductal Carcinomas of the Breast

PURPOSE: Abnormalities of epidermal growth factor receptor (EGFR) and c-erbB-2 have been actively investigated in breast cancer. Cyclooxygenase-2 (COX-2) seems to be involved in critical steps of cancer onset and progression. The purpose of this study is to determine the correlation between the gene ampilfications of the EGFR and c-erbB-2 and expression of the COX-2. METHODS: Using Chromogenic in situ Hybridization (CISH) the gene amplification of the EGFR and c-erbB-2 were studies on paraffin sections of 47 invasive ductal carcinomas. The expression of COX-2 was studied immunohistochemically (IHC). RESULTS: Of the 47 invasive duct carcinomas, gene amplifications of the EGFR and c-erbB-2 by CISH were observed in 21 cases (44.7%) and 14 cases (29.8%), respectively. The gene amplification of EGFR was significantly correlated with tumor size, nodal metastasis, and stage. The gene amplification of c-erbB-2 showed a statistically significant correlation with tumor size and stage. The protein of COX-2 was expressed by IHC in 30 cases (63.8%). The expression of the COX-2 protein showed a statistically significant correlation with tumor size, nodal metastasis, and stage. The gene amplifications of the EGFR and c-erbB-2 between expression of COX-2 protein showed a statistically significant correlation. CONCLUSION: The gene amplification of the EGFR and c- erbB-2 may be correlated with expression of COX-2 protein in the breast cancer.

The Immunohistochemical Expression of DNA Topoisomerase II-alpha and E2F-1 in the Breast Carcinoma and Their Relationship with Clinicopathologic Factors

PURPOSE: Clinical courses of breast cancer are very different, and concern for finding a predictable marker of breast carcinomas has increased. This study focused on the relationship between the expressions of DNA topoisomerase II-alpha as a proliferative marker, and E2F-1 as a transcription factor, with clinicopathological factors of infiltrating duct carcinomas of the breast. METHODS: We investigated the expressions of E2F-1 and DNA topoisomerase II-alpha in 43 patients with infiltrating ductal carcinomas using immunohistochemical staining, and the results were analyzed with regard to clinicopathological parameters. RESULTS: Among 43 infiltrating ductal carcinomas, 24 (55.8%) were immunohistochemically negative on E2F-1 and 19 (44.2%) were positive. The expression of E2F-1 correlated with increased tumor size, positive axillary lymph node meta stasis and high stage. The topoisomerase II-alpha index correlated with increased tumor size, positive lymph node metastasis, high stage, high histological grade and negative estrogen receptor. The expression of E2F-1 and the topo II-alpha index were significantly correlated. CONCLUSION: These results suggest that the expressions of DNA topoisomerase II-alpha and E2F-1 play some role as prog nostic factors for infiltrating duct carcinomas of the breast, but much more study will be required.

Expression of p16(INK4A), Rb and E2F-1 Proteins in Colorectal Carcinoma

PURPOSE: An altered cell cycle regulation may underline the development and progression of human malignancies. The purpose of this study was to determine whether the degree of p16(INK4A), Rb and E2F-1 expressions are related to certain parameters such as histologic differentiation, T-stage, lymph node metastasis and TNM stage in colorectal carcinoma. The correlation between the above proteins were compared. METHODS: Immunohistochemical stain was perfomed, for p16(INK4A), Rb and E2F-1 on 84 formalin-fixed paraffin-embedded tissue sections of colorectal adenocarcinomas. RESULTS: The overall expression frequencies of the p16(INK4A), Rb and E2F-1 were 54.8 (46/84), 76.2 (64/84) and 48.8% (41/84), respectively. Loss of the p16(INK4A) expression frequency was higher with a poorly differentiated histologic grade, the presence of nodal metastasis and higher TMN stage. The expression of Rb was not correlated with any of the parameters studied. The frequency of the E2F-1 expression was higher with a poorly differentiated histologic grade, the presence of nodal metastasis and higher TNM stage. A highly significant inverse correlation between the expressions of p16(INK4A) and E2F-1 was observed. CONCLUSION: These data suggest that the loss of p16(INK4A) expression and the expression E2F-1 may play roles in the progression of colorectal adenocarcinomas and could possibly be used as prognostic factors. Further studies to determine the relationships in the expressions of p16(INK4A), Rb and E2F-1 will be required.

A Case of Femoral Neuropathy after Renal Transplantation / 대한이식학회지

A few cases of femoral neuropathy that were developed after renal transplantation have been reported in western literature. The possible causes of this neuropahty that discussed in recent studies are compression of nerve by self-retaining retractor during operation, ischemia of femoral nerve by iliac muscle hematoma etc. We experienced one case of femoral nerve neuropathy after right iliac fossa renal transplantation that developed at first postoperative day without definitive etiology in all study. It was improved symptomatically after 2 weeks of postoperative day, so we reported this case with brief review of the literatures.

The Effect of COX-2 Inhibitor on the Growth and Metastasis of Gastric Cancer Xenograft

PURPOSE: Tumor invasion and metastasis are known to be extremely important factors in the prognosis of cancer patients. Although recent studies have demonstrated that cyclooxygenase-2 (COX-2) is overexpressed in various cancers including gastric cancer, the mechanisms underlying the contribution of COX-2 to tumorigenesis and tumor promotion remain unclear. METHODS: In order to determine the role of COX-2 in tumor growth and metastasis, we investigated COX-2 expression, apoptosis and the expression of E-cadherin, CD44v6, MMP-2 and TIMP-2 in gastric cancer xenografts treated with meloxicam (a selective COX-2 inhibitor). RESULTS: Cells from the MKN45 gastric cancer cell line that overexpress COX-2 were inoculated subcutaneously into athymic mice. Oral administration with meloxicam reduced the tumor volume (P<0.01), induced apoptosis of cancer cells (P<0.01), suppressed the proliferation rates (P<0.01), increased the expression of E-cadhrin (P<0.05) and reduced the expression of MMP-2 and TIMP-2. CONCLUSION: The above data showed that COX-2 inhibitors can inhibit tumor growth and suppress metastatic potential by expression of adhesion molecules and suppression of metalloproteinases, suggesting that this inhibitor can be used as an additive anti-cancer drug in cases of stomach cancer with radical resection, although further evaluation is required.

Expression of p27(kip1) in the Thyroid Neoplasms

PURPOSE: Cyclin-dependent kinase inhibitor, p27(kip1) is an important cell-cycle regulator. In recent studies, the loss of p27(kip1) expression has been examined in many neoplasms including colorectal cancer and breast cancer. The aims of this study are to evaluate the correlation between p27 expression and carcinogenesis of the thyroid gland and to determine its clinical applications. METHODS: Immunohistochemical staining for p27(kip1) was performed in 10 nodular goiters, 12 follicular adenomas, 8 minimally invasive follicular carcinomas, 6 widely invasive follicular carcinomas, and 26 papillary carcinomas. RESULTS: p27(kip1) was expressed in 90.0% (9/10) of nodular goiters, 66.7% (8/12) of follicular adenomas, 62.5% (5/8) of minimally invasive follicular carcinomas, 33.3% (2/6) of widely invasive follicular carcinomas, and 46.2% (12/26) of papillary carcinomas (P>0.05). The expression of p27(kip1) was not found to be correlated with tumor size in either neoplasms or nodal metastasis in papillary carcinoma. CONCLUSION: These results suggest that p27kip1 does play some role in the tumorigenesis of thyroid cancer but is not a prognostic factor.

The Effect of Meloxicam on Tumor Growth and Angiogenesis of Human Gatric Cancer Cell Line Xenograft in Nude Mice

PURPOSE: In general, tumor growth is dependent on angiogenesis. COX, known as modulator of angiogenesis, consists of two at least isozymes constitutive COX-1 and stress- induced COX-2. The latter is known in case of gastric cancer to be overexpressed in neoplastic tissue but not in adjacent normal tissue. To clarify the effect of COX-2 inhibitors on tumor growth and angiogenesis, we investigated the effects of Meloxicam (a selective COX-2 inhibitor) on gastric cancer xenograft in nude mise that overexpress COX-2. METHODS: MKN45 gastric cancer cell lines that overexpress COX-2 were inoculated subcutaneously into athymic mice. The mean tumor volume, apoptotic index, proliferative index, microvessel count and angiogenic factors (VEGF and bFGF) were measured in the control group (12 cases) and the meloxicam treated group (23 cases). RESULTS: There was no significant difference of COX-2 expression between the control and meloxicam treated groups in mRNA level as measured by RT-PCR, nor in protein level by Western blotting. However, in the meloxicam treated group, apoptosis was increased to a statistically significant degree (P<0.01) while the proliferation index as measured by Ki-67, the mean tumor volume and angiogenesis were all significantly decreased, as compared with the control group (P<0.01). CONCLUSION: The possible suppression of angiogenesis and tumor growth in gastric cancer xenograft by meloxicam suggests potentially. Novel and promising applications of COX-2 inhibitors in the adjuvant treatment of gastric cancer. However, further clinical study will be needed to determine its efficacy in such treatment modalities.

Prognostic Value of HSP 70 in Colorectal Cancer

PURPOSE: To evaluate the relationships between the expression of HSP 70 and prognostic factors, including T-stage, lymph node metastasis, distant metastasis, stage, differentiation and survival rate in colorectal cancer. METHODS: We studied 62 patients with colorectal cancer in order to evaluate the relationships between the expression of HSP 70 and multiple prognostic factors, including T-stage, lymph node metastasis, distant metastasis, stage and differentiation. RESULTS: There was no statistically significant correlation among HSP 70, T-stage, lymph node metastasis, distant metastasis, stage and differentiation. However, in our study, the expression of HSP 70 was slightly elevated in case with no lymph node metastasis, a lower stage and well differentiated colorectal cancer. In regards to survival, the overall survival rate was lower in the group with positive HSP 70 vice the negative group, and this was statistically significant. CONCLUSION: HSP 70 expression and the prognostic factors of colorectal cancer appear not to be correlated to each other, although HSP 70 may play a certain role in colorectal cancer. Further studies are required for determining the prognostic factors in colorectal cancer.

Efficacy of Hooked-Wire Needle Localization for Nonpalpable Breast Lesions

PURPOSE: The more frequent use of screening mammography, along with improved imaging equipment and techniques, is today resulting in an increasing detection rate for suspicious nonpalpable lesion and thus an increasing need for needle localizations and biopsies. We evaluate the efficacy of hooked-wire fine needle localization. METHODS: From August 1992 to August 1999, 146 hooked-wire needle biopsies were performed at our institution for nonpalpable mammographically detected abnormalities. Specimen roentgenographies were done in all cases. The clinical datas, including mammographic findings and pathologic results, were reviewed retrospectively. RESULTS: Patients ranged in age from 13 to 74 years (a mean of 45.7 years). Of the total 146 cases, 23 (15.7%) were found to be malignants (52.2 percent of these malignancies were carcinomas in situ and 47.8 percent were invasive carcinoma). The chance of a biopsy containing a malignant lesion was 17.2 percent if the biopsy was done for a microcalcification found on a mammograms, 7.7 percent for mass densities, and 28.6 percent if both were present. Benign pathological lesions were proven in 123 cases (84.3%) of the total 146 cases. The most common benign lesion was fibrocystic disease. A minor complication of the hooked-wire needle insertion occurred in one patient who had a hematoma requiring evacuation. Three patients experienced faintness, dizziness, and syncope during needle localization. The morbidity and the mortality rates for biopsies of the breast were nil. CONCLUSION: These results suggest that hooked-wire needle localization for nonpalpable lesion in the breast is a most useful diagnostic modality.

A Clinical Review of Reoperation after Intraabdominal Operation

The need for a relaparotomy shortly after an initial abdominal operation indicates a serious complication and may frequently constitute a surgical failure. Many of the postoperative symptoms that might indicate the onset of complications may be masked by the usual postoperative course. Reported findings vary widely. Thus there is no clear picture for a surgeon to use as a guide. In an attempt to obtain more definite guidelines regarding the indications for and the timing of reintervention a retrospective study based on a 7-year survey was undertaken to assess the problem of reoperation after abdominal surgery. This study consisted of a retrospective clinical analysis made an 95 patients who required reoperation due to postoperative complications and planned stage operations during 7 years from January 1990 to December 1996. The number of reoperations was 95 cases (24%) among 3932 patients who had undergone abdominal operations at our department. The sex distribution for the reoperations was 58 males and 37 cases in females. The peak age incidence was the 6th decade in 25 cases(26.3%). The most common physical findings of the patient who required reoperations were abdominal pain and tenderness (56.8%). The main cause necessitating reoperation was intestinal obstruction (25.3%). The most common types of reoperations were common bile duct exploration with T-tube insertion(24.2%). The time interval between initial operation and reoperation was within 10 days in 10 cases (10.5%) and 25 months grouped in separate admission in 36 cases (37.9%). The most frequent complication was wound infection(15.8%) and the mortality rate was 4 cases (4.2%). Conservative treatment cannot be recommended for severe complications, such as postoperative bleeding or peritonitis, due to free anastomotic leakage. However, in doubtful cases, when there is mild peritonitis of an undetermined origin, ileus, well-controlled billiary or duodenal leaks, and the like, the high mortality associated with reintervention should be borne in mind. In these cases, conservative treatment with close supervision of the patient may prove the most prudent course.

Immunohistochemical Analysis of the EGFR and VEGF Expression in Human

The EGFR has been proposed as a stimulator of cell growth in some neoplasms. The VEGF play an important role in angiogenesis of several tumors. This study aimed to determine the EGFR and VEGF expression in colorectal adenocarcinoma and to correlate the expression of these gene with variable prognostic factors. Significant relationship was observed between the EGFR and histopathologic differentiation or lymph node involvement. But EGFR had no relation to depth of invasiveness or serum CEA level. On the other hand, VEGF had only relation to histopathologic differentiation. VEGF had no relation to lymph node involvement, depth of tumor invasiveness or serum CEA level. We conclude that EGFR expression in human colorectal adenocarcinoma was significantly associated with prognosis. But VEGF expression was not associated with prognosis. More studies are needed to determine whether EGFR expression is a clinically valuable prognostic factor.

Hepatic Cryosurgery

The optimal treatment of primary or metastatic liver cancer is the complete surgical excision of the tumors. Hepatoma has a poor prognosis, especially in the case of unresectable hepatoma. In such cases, variable therapeutic modalities have been tried in attempts to improve the prognosis of the hepatoma patients. One of these modalities is hepatic cryosurgery, which has received increased attention recently. We have experienced four cases of hepatic cryosurgery on unresectable hepatomas at the ChungAng University Hospital in Korea, the first such cases, from September 1995 to December 1995. There was an excellent therapeutic outcome in one case. We expect that hepatic cryosurgery will serve as a new and effective therapeutic modality for unresectable hepatoma.