ABSTRACT
BACKGROUND: Tumor growth and metastasis depend on angiogenesis. Angiogenesis correlates with the expression of vascular endothelial growth factor (VEGF) and with the prognosis in some cancers. Angiogenesis may also play an important role in the growth and the metastasis of thyroid cancer. We determine whether the expression of VEGF and its receptors (flk-1/KDR, flt-1) correlates with vascularity, invasion to adjacent structure and lymph node metastasis of thyroid cancers. METHODS: Sixty-five specimens obtained from patients with benign thyroid disease and thyroid cancers investigated by immunohistochemical staining for factor VIII, VEGF, flk-1/KDR and flt-1. Vessels were counted by light microscopy (x200), and the intensity of staining for VEGF and receptors was assessed on a scale of 1 to 4 . Correlations between the expression of VEGF, microvessel density and various clinicopathologic factors were analyzed. RESULTS: 1) There were no differences in microvessel counts and expressions of VEGF and its receptors among sex, age and tumor size. 2) Microvessel counts in thyroid cancers (mean SD: 91.1+/-30.4, x200), especially anaplastic cancers (159.0+/-14.1) were higher than in follicular adenomas (56.3 13.6). 3) The expressions of VEGF, flk-1/KDR and flt-1 were higher in thyroid cancers (2.7+/-1.0, 2.1+/-0.9, 2.2+/-0.9) than in follicular adenomas (1.4+/-0.5, 1.4+/-0.5, 1.4+/-0.5), the expressions of VEGF, flk-1/KDR and flt-1 in anaplastic cancers (3.8+/-0.5, 3.8+/-0.5, 3.5+/-0.6) were higher than in differentiated cancers (papillary and follicular). But there were no differences of microvessel density and the intensity of VEGF, flk-1/KDR and flt-1 expression between absence and presence of the invasion to adjacent structure and lymph node metastasis in cancers. 4) The intensity of VEGF expression correlated with microvessel densities and that of its receptors. CONCLUSION: Angiogenesis and VEGF expression in thyroid cancer correlated with the grade of differentiation. But we did not found any differences in angiogenesis and VEGF expression with or without invasion to adjacent structures and lymph node metastasis in differentiated thyroid cancer. In the future, further study, including recurrent and distant metastatic thyroid cancers, will be needed.
Subject(s)
Humans , Adenoma , Factor VIII , Lymph Nodes , Microscopy , Microvessels , Neoplasm Metastasis , Prognosis , Thyroid Diseases , Thyroid Gland , Thyroid Neoplasms , Vascular Endothelial Growth Factor AABSTRACT
BACKGROUND: Solid tumors require neovasculization for growth and metastasis. Recently, several angiogenic factors have been identified. Vascular endothelial growth factor (VEGF) is thought to be one such angiogenic factor and is also thought to be a selective mitogen for endothelial cells. In this study, we examined the expression of VEGF and its relationship with microvessel density, and we also determined its prognostic significance in gastric cancer patients. METHODS: One hundred one specimens resected from patients with gastric carcinomas were investigated by staining with a polyclonal antibody against VEGF. Correlations between the expression of VEGF, the microvessel density, various clinicopathologic factors, and the patient's survival were studied. RESULTS: The normal gastric mucosa was not immunoreactive with an anti-VEGF antibody. VEGF was mainly localized to the cytoplasm or the membrane of the carcinoma cell. Of the 101 tumors, strong VEGF expression was detected in 48 (47.5%) tumors. VEGF expression was correlated with depth of tumor invasion, lymph-node metastasis, and stage. Microvessel density, determined by immunohistochemical staining for CD31, was significantly higher in VEGF-strong tumors than in VEGF-weak tumors. Also, patients with VEGF-strong tumors had a significantly poorer prognosis than those with VEGF-weak tumors. However, multivariate analysis indicated that the expression of VEGF was not an independent prognostic factor in patients with gastric cancer. CONCLUSIONS: The fact that VEGF expression in gastric carcinomas was more prevalent in more advanced tumors means that VEGF may contribute to the progression of the tumor. Further study is needed to evaluate the significance of VEGF as a prognostic factor.
Subject(s)
Humans , Angiogenesis Inducing Agents , Cytoplasm , Endothelial Cells , Gastric Mucosa , Membranes , Microvessels , Multivariate Analysis , Neoplasm Metastasis , Prognosis , Stomach Neoplasms , Vascular Endothelial Growth Factor AABSTRACT
BACKGROUND/AIMS: It is well known that N-nitrosobis(2-oxopropyl)amine(BOP)-induced pancreas cancer and cholangiocarcinoma in Syrian hamster is similar to that of humans in morphological, biological and immunological aspects. The cyclic administration of BOP and ethionine, choline-deficient diet and methionine is known to rapidly induce the ductal type of carcinoma in pancreas and bile duct. Authors studied whether the rapid production of this cancer can occur in Syrian hamster and what its features are. METHODS: Sixteen Syrian hamsters aged 6-7 weeks and weighing 100 gm were used. All hamsters received 70 mg/kg body weight of BOP followed by three cycles of dl-ethionine, choline-deficient diet, l-methionine and 20mg/kg BOP. Hamsters were killed 9, 10 and 11 weeks after the beginning of the experiment and their gross and histologic features were observed. RESULTS: Nine cases, killed withan 10weeks after the begining of experiment, showed no development of cancer. Of seven Syrian hamsters, killed more than 10weeks after the begining of experiment, the incidences of BOP-induced cancer included one case(14.3%) of pancreas cancer and five cholangiocarcinomas( 71.4%). The morphological change of pancreas carcinogenesis was shown at first in cell mitosis and atypia(6 weeks) and then in atypical ductal hyperplasia(9 weeks) and carcinoma in situ(10 weeks). The change in cholangiocarcinoma, first progressed with ductular proliferation and surrounding fibrosis(6 weeks) followed by focal cholangiocarcinoma(10 weeks) and multiple invasive cholangiocarcinomas( 11 weeks). CONCLUSION: Pancreas cancer and intrahepatic cholangiocarcinomas can be induced rapidly within 10 weeks by cyclic injections of carcinogens in Syrian hamsters initiated with Nnitrosobis( 2-oxopropyl)amine and the morphologic changes can be observed.
Subject(s)
Animals , Cricetinae , Humans , Bile Ducts , Body Weight , Carcinogenesis , Carcinogens , Cholangiocarcinoma , Diet , Ethionine , Incidence , Mesocricetus , Methionine , Mitosis , Pancreas , Pancreatic NeoplasmsABSTRACT
Gaucher's disease is an autosomal recessive genetic disorder of lipid metabolism. A deficiency of beta-glucocerebrosidase causes an accumulation of glucocerebroside in the reticulo-endothelial system and bone marrow. Total or partial splenectomy has been used in case of massive splenomegaly with hypersplenism and/or mechanical pressure symtoms. Partial splenectomy is preferred to prevent susceptibility to overwhelming postsplenectomy sepsis and to delay the massive deposition of glucocerebroside in the liver and bones. We report the case of a 20-year-old woman with Gaucher's disease and who had a splenic embolization 4 years ago. The spleen cross the midline of the abdomen reached to the true pelvis and elevated the left diaphragm. Angiotensin-converting enzyme, acid phophatase and ESR were increased but beta-glucocerebrosidase was normal. Osteosclerotic changes of the distal femur was observed. Hepatomegaly and splenomegaly with mutiple accessory spleens were seen on abdominal CT. On isotope scan for liver and spleen, multiple accessory spleens had isotope uptake, but spleen did not. We noted severe adhesion of spleen to neighboring structure and no viable splenic tissue for preservation. Total splenectomy with preservation of four accessory spleens was performed. We needed multiple transfusion during dissection and bleeding was continuous for 3 days postoperatively. The patient was discharged without problems on the postoperative 15 th day.
Subject(s)
Female , Humans , Young Adult , Abdomen , Bone Marrow , Diaphragm , Femur , Gaucher Disease , Glucosylceramidase , Hemorrhage , Hepatomegaly , Hypersplenism , Lesser Pelvis , Lipid Metabolism , Liver , Sepsis , Spleen , Splenectomy , Splenomegaly , Tomography, X-Ray ComputedABSTRACT
Ovarian tumors of an epithelial origin in pediatric age are uncommon and mucinous cystadenoma, borderline malignancy is extremely rare. We experienced a case of ovarian mucinous cystadenoma, borderline malignancy in a 14-year-old girl. She was admitted due to huge abdominal distension for 2 months. Her past history and family history were normal. The physical examination was normal except tense and distended abdomen. All laboratory findings were normal. On abdominal ultrasonography and CT scan, a huge cystic tumor filled with fluid and inner multiseptation was noted. Unilateral salphingo- oophorectomy was done and pathologic findings were compatible with ovarian borderline malignancy of mucionous cystadenoma. The postoperative course was uneventful.
Subject(s)
Adolescent , Female , Humans , Abdomen , Cystadenoma , Cystadenoma, Mucinous , Mucins , Ovariectomy , Physical Examination , Tomography, X-Ray Computed , Transcutaneous Electric Nerve Stimulation , UltrasonographyABSTRACT
Graves disease occur in association with myasthenia gravis is rare. We report a case of Graves disease and myasthenia gravis treated by bilateral subtotal thyroidectomy and total thymectomy simultaneously. A 37 year old woman was admitted with anterior neck mass and ptosis. Various examinations were compatible with combined Graves disease and myasthenia gravis. The bilateral subtotal thyroidectomy and total thymectomy were done simultaneously. The pathologic diagnosis was Graves disease and thymic hyperplasia. The patients postoperative course was uneventful. The thyroid function of patient became euthyroid and the clinical symptoms related with myastenia gravis resolved during follow up period.