Multiple Primary Cancer in Stomach and Esophagus

Multiple primary cancer is relatively rare disease. But its study revealed a aspect of carcinogenesis and has changed our concept in second primary cancer. It is not a metastasis or recurrent cancer. Multiple primary cancer associated with gastric cancer is most common in Korea. Now we report two cases of multiple primary cancer in esophagus and stomach, successfully treated.

Human Papillomavirus Infection in Anal Carcinoma, Anal Condylomata and Rectal

In order to examine the association of human papilloma virus(HPV) infection with anal carcinoma, the authors used polymerase chain reaction(PCR) and in situ hybridization technique to detect HPV DNA in formalin fixed, paraffin-embedded tissues from 46 anal carcinoma patients. At the same time, 28 condyloma accuminata specimens and 25 rectal adecarcinomas were examined for HPV DNA with in situ hybridization(ISH). By PCR analysis, using type specific primers and probes for HPV 6, 11, 16, 18 and 33, HPV type 16 DNA was demonstrated in 30(65.2%) of 46 anal carcinoma specimens, but HPV type 6, 11, 18 or HPV type 33 was not identified. HPV DNA Positivity was different according to the site of the anal carcinoma. In anal marginal squamous celt carcinoma, 3(27.3%) of 11 contained HPV DNA but 27(77.1%) of 35 anal canal carcinoma contained HPV DNA. Among the anal canal carcinomas, the cloacogenic carcinoma contained HPV DNA in 11(84.6%) of 13 and squamous cell carcinoma contained in 16(72.7%) of 22 specimens. Two of six local recurrences and three of nine lymph node metastases had HPV-16 DNA. When the anal carcinomas were analysed using ISH technique for HPV type 6, 11, 16, 18, the frequency of Positivity decreased to 4(11.4%) of 35 and stained only for HPV type 16/18. Among the 28 condyloma accuminata specimens, 24(85.7%) contained HPV DNA type 6/11 and only 2(7.1%) contained type 16/18 by ISH technique. In contrast to anal carcinoma, male was predominent in condyloma accuminata patient(82.1% of 28) and 6 patients were homosexual man. HPV DNA was not demonstrated in all the cases of rectal adenocarcinoma by ISH. We conclude that HPV infections are associated with the development of anal canal carcinoma but are not associated with adenocarcinoma of the rectum. In anal carcinomas, anal canal carcinoma is more closely associated with HPV infection than anal marginal carcinoma. Among the HPV types studied, type 16, 18 are more closely linked with malignant transformation.

Detection of p53 Gene Mutations in Gastric Cancers: Comparative study of Single Strand Conformational polymorphism migration Technique (SSCP) and Non-Isotopic RNase Cleavage Assay (NIRCA) / 대한암학회지

PURPOSE: The aim of the present study was: (a) to determine the frequency of p53 mutations by single strand conformational polymorphism analysis of polymerase chain reaction products (PCR-SSCP), Non-Isotopic RNase Cleavage Assay (NIRCA) and immunohistochemical staining with monoclonal antibody; and (b) to compare the correlations among these methods. MATERIALS AND METHODS: Abberations of the p53 gene in 24 primary gastric carcinomas were examined by PCR-SSCP, NIRCA and immunohistochemical staining. Of these surgically resected gastric adenocarcinomas, 23 were advanced gastric carcinomas and 1 was early gastric cancer. Using PCR-SSCP and NIRCA, the presence of mutations in exons 4-9 was evaluated. Using the mouse specific anti-human p53 monoclonal antibody, we also looked for overexpression of the p53 protein in tissue sections. RESULTS: In 5 cases shifted bands were reproducibly identified by PCR-SSCP, and two mutations were identified in exon 4 and three in 5 & 6. The mutations of exon 4 were detected by NIRCA in 5 cases, exon 5 & 6 in 6 cases, and exon 7 in 2 cases. The p53 mutations detected by PCR-SSCP were also detected by NIRCA except one case. Thirteen of the tumor samples were positively stained with the monoclonal antibody for p53 protein. There was no correlation between p53 mutations detected by NIRCA and expression of p53 protein by immunohistochemical staining. CONCLUSIONS: Our results in this group of patients suggest that NIRCA is more sensitive than PCR-SSCP in detecting p53 mutations, and expression of p53 protein by immunohistochemical staining does not directely represent the genetic changes of p53 gene.