Diagnosis experience of sarcomatoid renal cell carcinoma / 中华泌尿外科杂志

Objective Explore the diagnosis experience of sarcomatoid renal cell carcinoma (SRCC).Method There were 5 cases of SRCC from April 2011 to June 2013,3 of them were females and 2 were males,with a mean age of 49 (27-71).All the patients were presented with pain accompanied with other symptoms such as hematuria,fever and polyuria.CT urography suggested renal occupied lesions,withuneven density and enhancement,and malignancy was highly suspected.The mean diameter of tumors was 9.2 cm(4-18 cm).Radical nephrectomy was performed on all patients,tumors were located in renal parenchymal,and with adherence to other tissues.One patient with lung metastasis was found before surgery.Result Pathologic findings of the resected tissues after operation noted SRCC.Under the microscope,a large number of spindle shaped cells were seen,and Vimentin and PCK were all positive in immunohistochemical.Three patients with metastases were found after surgery (adrenal gland,liver,pancreas).Postoperative pathological stages were one T2N0M1,three T4N0M1 and one T3N0M0.One patient received IL-2 immunotherapy.All patients died within 9 months after surgery with a median survival of 3.8 months.Immunohistochemistry in the postoperative,there were four patients with the level of Ki-67 LI ＞ 50％,with distant metastasis and survival time was 1-4 moths.Conclusion The disease develops rapidly,and the prognosis of the patients is very poor.The Ki-67 LI may be considered as a prognosis marker and the patients with sarcomatoid differentiation can benefit little from surgery alone.

Correlation of Ki-67, nm23-H1 and the VEGF Expression with the Clinicopathological Variables for Distant Recurrence after Curative Surgery for Carcinoma of the Ampulla of Vater

PURPOSE: Not a few patients show early distant recurrence after curative resection for carcinoma of the ampulla of Vater, and this recurrence is not just related to the clinicopathological factors. This study was performed to determine the correlation of the clinicopathological and biological characteristics with early distant recurrence after surgery for carcinoma of the ampulla of Vater. METHODS: Of the 158 patients who underwent curative resection for carcinoma of the ampulla of Vater at the Samsung Medical Center between December 1994 and August 2004, 38 patients (the recurrence group) with distant recurrence within a year after surgery and 32 patients (the non-recurrence group) without recurrence for more than 3 years after surgery were retrospectively analyzed. Evaluation of their clinicopathological characteristics and their immunohistochemical staining for Ki-67 antigen, nm23-H1 protein and vascular endothelial growth factor (VEGF) were carried out. RESULTS: Of the recurrence group, 24 patients (63.2%) had multiple recurrence sites and 10 (26.3%) were TNM stage I after surgery. The TNM stage was significantly advanced in the recurrence group. Both the Ki-67 labeling index (LI) (10.2% vs. 5.8%, respectively) and positive rate (50.0% vs.18.8%, respectively) according to the cut-off value of Ki-67 LI (i.e. 9%) were significantly higher in the recurrence group. The immunoreactivity for nm23-H1 protein and VEGF was not different between the two groups. Only lymph node metastasis was statistically significant on the multivariate analysis for early distant recurrence after surgery. CONCLUSION: The recurrence group showed an advanced TNM stage and increased Ki-67 LI. Lymph node metastasis was the single independent poor indicator for early distant recurrence after curative resection for carcinoma of the ampulla of Vater.

Proliferative Markers of Breast Cancer / 한국유방암학회지

PURPOSE: The mitotic index (MI) and Ki-67 labeling index have been used as cell proliferative markers in the various tumors. Topoisomerase II alpha (Topo II alpha) is also expressed in proliferating cells. The aim of this study was to evaluate the correlations between the MI, Ki-67, and Topo II alpha expression as proliferative markers of breast cancer. METHODS: The cell proliferative activity of 181 breast cancers was measured using MI, Ki-67 labeling index and Topo II alpha expression. The correlation between the measured markers was also analyzed. RESULTS: The MI, Ki-67, and Topo II alpha were significantly correlated with each other(p < 0.000). The MI and Ki-67 labeling index were associated with high histological grade, and absence of hormone receptor (p < 0.000). Topo II alpha expression was correlated with high histological grade (p < 0.000), absence of hormone receptor and HER-2/neu overexpression (p < 0.043). The MI, Ki-67, and Topo II alpha were not associated with any other clinical variables, such as age, tumor size, and lymph node status. CONCLUSION: The three proliferative indices were significantly associated with aggressive features of breast cancer, and significantly correlated with each other.

Malignant Variant of the Central Neurocytoma

Central neurocytoma is a rare, well-differentiated neuronal tumor and is usually located in the lateral or third ventricle of young adults. Its overall prognosis is excellent with a low proliferative index. The majority of previously reported malignant variants rarely did recurred after tumor removal and regarded as benign tumor despite of histopathological malignant feature. Nevertheless, we experienced a case of malignant variant of the central neurocytoma with high proliferative index(Ki-67 labeling index >30%), which showed recurrence immediately after surgery and died within 3 months POD. Here, we describe the case with a review of the literatures.

Correlation of Clinical Stage and Presumptive Prognostic Factors in Renal Cell Carcinoma

Renal cell carcinoma is the most common primary cancer of the kidney. The tumor stage is a reliable prognostic marker in renal cell carcinoma which is significantly associated with patient survival. But assessment of other prognostic factors has produced varying and often conflicting results. We reevaluated the significance of varied prognostic parameters in 33 cases of renal cell carcinoma; clinical stage, cell type, histologic pattern, DNA ploidy, Ki-67 labeling index, and bcl-2 oncoprotein expression. We could not statistically prove that DNA ploidy and bcl-2 expression were related to any examined parameters. Cell type was not related to clinical stage nor nuclear grade but there was a significant correlation (p=0.002) between cell type and histologic pattern. Nuclear grade (p=0.007) and Ki-67 labeling index (p=0.036) were significantly related to clinical stage, suggesting their value as complementary prognostic markers for renal cell carcinoma.

Correlation of Clinical Stage and Presumptive Prognostic Factors in Renal Cell Carcinoma

Renal cell carcinoma is the most common primary cancer of the kidney. The tumor stage is a reliable prognostic marker in renal cell carcinoma which is significantly associated with patient survival. But assessment of other prognostic factors has produced varying and often conflicting results. We reevaluated the significance of varied prognostic parameters in 33 cases of renal cell carcinoma; clinical stage, cell type, histologic pattern, DNA ploidy, Ki-67 labeling index, and bcl-2 oncoprotein expression. We could not statistically prove that DNA ploidy and bcl-2 expression were related to any examined parameters. Cell type was not related to clinical stage nor nuclear grade but there was a significant correlation (p=0.002) between cell type and histologic pattern. Nuclear grade (p=0.007) and Ki-67 labeling index (p=0.036) were significantly related to clinical stage, suggesting their value as complementary prognostic markers for renal cell carcinoma.