Granuloma gigantocelular de mandíbula en un niño de 6 años de edad: Reporte de un caso / Giant cell granuloma in the jaw in a 6-year-old child: A case report

El granuloma gigantocelular representa un tumor no odontogénico que se localiza por dentro del endostio de los maxilares (central) o en el periostio (periférico). Corresponde al 3-5 % de todas las lesiones benignas de los maxilares. Es más frecuente en niños y adultos jóvenes. Se presenta como un tumor de crecimiento lento y asintomático. Preferentemente, se ubica en la mandíbula, en la región de los incisivos, caninos y premolares. Se informa sobre un paciente de 6 años de edad que, conjuntamente con la extracción del premolar temporario inferior, presentó un tejido granulomatoso de crecimiento lento en la región premolar izquierda. La toma de la biopsia fue demostrativa para granuloma gigantocelular. Se realizó el tratamiento quirúrgico, con buena evolución, sin evidencia de recidiva hasta la actualidad. Es importante el diagnóstico temprano de esta lesión por el alto poder destructivo local que presenta y la derivación oportuna para el tratamiento quirúrgico.

Giant cell granuloma represents a non-odontogenic tumor. It is located inside the endosteum of the jaws (central) or in the periosteum (peripheral). Although it is a benign disease process, it can also be locally destructive. This condition is a slow-growing, asymptomatic lesion that usually affects children and young adults, predominantly females in its peripheral presentation and males in its central presentation. The mandible, the region of the incisors, canines and premolars are more affected. The etiology of the giant cell granuloma still remains to be defined. It has been reported that the origin of this lesion could be triggered by trauma or inflammation and hormonal factors. A 6-year-old patient presents a slow-growing lesion in the tooth extraction's region, two months ago. The treatment is surgical. It is important to have an early diagnosis because of the high local destructive behavior and timely referral because the treatment is surgical.

Gigantomastia gestacional: como abordar essa situação clínica / Gestational gigantomastia: how to address this clinical situation

A gigantomastia gestacional é uma desordem rara, na qual ocorre o crescimento excessivo e rápido das mamas, culminando com edema e congestão venosa das mesmas, além de ocasionar dor, ulceração da pele e infecção local. Estas complicações, em alguns casos, levam à necessidade de mastectomia de emergência ou abortamento induzido. A hipótese etiológica mais aceita é a de que exista uma estimulação anormal do tecido mamário, que pode ser desencadeada por níveis excessivos de hormônios ou por uma hipersensibilidade deste tecido a níveis hormonais normais. Apesar de a mama regredir após a gestação, raramente volta ao estado original; portanto, a redução da mama através de mastectomia ou mamoplastia geralmente é necessária. Além disso, é grande o risco de recorrências em gestações futuras. Os autores relatam o caso de gigantomastia em uma primigesta, com necessidade de interrupção da gravidez, devido ao risco de morte materna, e posterior intervenção cirúrgica com mamoplastia redutora.

Gestational gigantomastia is a rare disorder characterized by an excessive and rapid enlargement of the breasts, resulting in edema and venous congestion of breast tissue. It is a painful condition that causes skin ulceration and local infection. In some cases, these complications lead to an emergency mastectomy or induced abortion. The most probable etiology is an abnormal stimulation of breast tissue that is probably triggered by an abnormally elevated level of hormones or by the hypersensitivity of breast tissue to normal hormone levels. Although the breast volume decreases after pregnancy, it rarely returns to its original state; therefore, breast reduction through mastectomy or mammaplasty is usually necessary. Moreover, there is a high likelihood of recurrence in subsequent pregnancies. The authors report a case of gigantomastia in a primigravida that required pregnancy termination, because of the risk of maternal death, and a subsequent breast reduction surgery.

Metástase gigante de carcinoma papilífero / Giant metastasis of thyroid papillar carcinoma

O carcinoma papilífero da tireoide, o mais comum deste órgão, geralmente se apresenta como lesões parenquimatosas pequenas e, eventualmente, com metástases cervicais numerosas, raramente volumosas. É descrito um caso raro de uma paciente do gênero feminino, 44 anos, com um tumor cervical anterior, nodular e volumoso há nove anos. Após o tratamento cirúrgico, o anatomopatológico mostrou tratar-se de metástases linfonodais de carcinoma papilífero. O objetivo deste estudo é relatar um caso clínico de apresentação incomum de carcinoma papilífero da tireoide, de diagnóstico inicial difícil e apresentando-se com metástases linfonodais volumosas. Arq Bras Endocrinol Metab. 2014;58(9):967-9 Papillary thyroid carcinoma, the most common type of thyroid cancer is usually presented as small parenchymatous lesions and, eventually, with cervical lymph node metastasis, rarely voluminous. Here we describe a rare case of a 44-year-old woman presenting a visible anterior cervical tumor, nodullary and voluminous, for nine years. After surgical treatment, the anatomical pathology sample revealed that the mass was composed of several cervical lymph node metastatic lesions of a papillary thyroid carcinoma. We report the discovery of an uncommon papillary thyroid carcinoma manifestation, with a difficult initial diagnosis and presenting voluminous lymph node metastases.

Clinical characteristics and prognosis of three rare and poor-prognostic subtypes of primary liver carcinoma / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To explore the clinicopathological features and prognostic factors of three rare and poor-prognostic pathological subtypes of primary liver carcinoma, and improve the clinical diagnosis and surgical treatment.</p><p><b>METHODS</b>A retrospective analysis of clinicopathological data of 69 patients with rare pathological subtypes of primary liver carcinoma, diagnosed by postoperative pathology in our hospital from October 1998 to June 2013 was carried out. The data of 80 cases of common poorly differentiated hepatocellular carcinoma treated in the same period were collected as control group. Kaplan-Meier method was used to analyze the survival rate, and Cox proportional hazards model was used for prognostic analysis in the patients.</p><p><b>RESULTS</b>Thirty-four cases were combined hepatocellular carcinoma and cholangiocarcinoma (CCC, 28 males, 6 females), with a median age of 52 years (range, 33 to 73). Ninteen cases were giant cell carcinoma (GCC, 16 males and 3 females), with a median age of 59 years (range, 38 to 66). Sixteen cases were sarcomatoid carcinoma (SC, 14 males and 2 females), with a median age of 57 years (range, 46 to 70). The survival analysis revealed that median survival time and the 1-, 3-, 5-year survival rates for these 3 groups were 20 months, 61.8%, 29.4%, and 20.6% in the CCC patients, 13 months, 52.6%, 31.6%, and 0% in the GCC patients, and 8 months, 31.3%, 0%, 0% in the SC patients, respectively. The median survival time and survival rate of the SC group were significantly lower than those of the other three groups (P < 0.05). However, in the SC group, the incidences of hilar lymph nodes metastasis, vascular tumor emboli and invasion of adjacent organs were significantly higher than those in the other three groups (P < 0.05). There were no statistically significant differences among the other three groups (P > 0.05). The levels of carcino-embryonic antigen were higher in the three rare subtype groups than that of the control group. The incidences of multiple tumors of the three rare subtype groups were higher than that of the control group (P < 0.05). Positive surgical margin was an independent unfavorable prognostic factor.</p><p><b>CONCLUSIONS</b>The combined hepatocellular carcinoma and cholangiocarcinoma, giant cell carcinoma and sarcomatoid carcinoma have a poor prognosis. Among them sarcomatoid carcinoma is the most malignant and poor prognostic one. Radical resection is recommended.</p>

Artrodesis de radio distal con autoinjerto masivo de cresta iliaca en tumor de células gigantes: reporte de un caso / Arthrodesis of the distal radio with massive iliac crest bone autograft in a giant cell tumor: a case report

El tumor de células gigantes se presenta en cerca del 5% de todos los tumores óseos benignos en adultos; es un tumor que a pesar de su naturaleza benigna, la mayoría de las veces tiene un comportamiento agresivo, lo cual causa severa incapacidad y limitación funcional. Existen técnicas descritas para manejo de este tipo de tumor en el radio distal, mediante resección, aplicación de aloinjerto, curetaje intralesional y aumentación con cemento. En este artículo reportamos el caso de una mujer con un tumor de células gigantes del radio distal tratado mediante resección ampliada de la lesión y reconstrucción con un autoinjerto masivo de cresta iliaca. Se describe la técnica y se reporta el resultado funcional.

Giant cell tumors appear in approximately 5% of all benign bone tumors in adults; despite its benignity, it is usually aggressive, leading to severe functional disability and limitations. Techniques have been described for the management of this type of tumor in the radio distal using surgical resection, application of allograft, intralesional curettage and cement augmentation. In this article we report on the case of a female patient with a giant cell tumor in the radio distal treated with wide resection of the lesion and reconstruction with massive iliac crest bone autograft. The technique is described and a report is provided on the functional result.

Osteoclast-Like Giant Cell Carcinoma of the Distal Ureter

Extraskeletal osteoclast-like giant cell (OGC) tumors are uncommon and have mainly been found in the breast and pancreas. OGC neoplasms of the urinary tract are extremely rare. Most cases found in the renal pelvis and bladder are associated with either an in situ urothelial malignancy or a conventional high-grade urothelial carcinoma. These malignancies tend to be associated with a poor prognosis and disease course. To our knowledge, no cases of OGC tumors of the distal ureter only have been published. Here, we present the case of a 76-year-old man who underwent hand-assisted laparoscopic nephroureterectomy because of painless gross hematuria with right flank pain. Pathologic examination showed OGC carcinoma of the right distal ureter. No local tumor recurrence or distant metastasis was found at the 5-month follow-up.

PAR-1 regulation of intracellular Ca²(+) mobilization in pulmonary giant cell carcinoma cell line PLA801D/PLA801C / 中华病理学杂志

<p><b>OBJECTIVES</b>To investigate molecular mechanisms of PAR-1 regulation on intracellular Ca²(+) mobilization in lung giant cell carcinoma cells in vitro and its involvement in tumor metastasis.</p><p><b>METHODS</b>Free intracellular Ca²(+) ([Ca²(+)]i) was measured in lung giant cell carcinoma PLA801C and PLA801D cells by confocal microscopy. Sense and anti-sense PAR-1 expression vectors were transfected into PLA801C (C+)and PLA801D(D-) cells, respectively. The effects of PAR-1 expression were investigated by thrombin and TRAP-induced mobilization of [Ca²(+)]i in the C+ and D-cells.</p><p><b>RESULTS</b>There were significant differences of the mean values of [Ca²(+)]i between PLA801D (59.55) and PLA801C cells (35.46, P < 0.01). The mean [Ca²(+)]i of C+ cells (45.77) was significantly higher than that of its control CV cells (35.46, P < 0.05), and the mean [Ca²(+)]i of D-cells (48.42) was significantly lower than that of its control DV cells (59.55, P < 0.05). The peaks of [Ca²(+)]i of C+ and CV cells were 48.19 ± 9.84 and 45.64 ± 9.87 (P < 0.05) respectively at 80 s and 100 s after thrombin treatment, but were 111.31 ± 25.00 and 52.93 ± 11.21 (P < 0.05) respectively at 60 s after TRAP treatment. The peaks of [Ca²(+)]i of D- and DV cells were 40.71 ± 5.89 and 61.07 ± 21.36 (P < 0.05) respectively at 60 s after thrombin treatment, but were 84.98 ± 11.23 and 102.58 ± 21.48 (P < 0.05) respectively at 40 s after TRAP treatment.</p><p><b>CONCLUSIONS</b>The high metastatic potential of PLA801D and PLA801C may be related to [Ca²(+)]i of the tumor cells. PAR-1 may play an important role in the metastasis of lung giant cell carcinoma cells by up-regulating the intracellular Ca²(+).</p>

Giant cell tumour of talus--a case report.

Giant cell tumour of the talus bone is rare and is usually seen in skeletally mature adults. Here a case of giant cell tumour of the talus in a skeletally immature boy of 15 years is reported. The patient presented with swelling and tenderness of the left ankle with an osteolytic lesion seen in the talus on x-ray. A trephine biopsy followed by left talar excision was done. Following the biopsy report the patient underwent arthotomy and joint clearance. There was no recurrence noted at six months follow-up.

Functional aspects of protease-activated receptor 1 in promoting metastasis of lung cancer / 中华病理学杂志

<p><b>OBJECTIVE</b>To study the functional aspects of protease-activated receptor 1 (PAR-1) gene involved in tumor metastasis.</p><p><b>METHODS</b>Two human lung giant cell carcinoma cell lines PLA801C (low metastasis potential) and PLA801D (high metastasis potential) were chosen as in-vitro human cancer model systems. Sense and anti-sense expression constructs of PAR-1 gene (pC/PAR1s and pC/PAR1as) were transfected into PLA-801C and PLA-801D cells by lipofection. PAR-1 expression was determined by RT-PCR and western blot analysis. MTT growth, flow cytometry analysis, fibronectin adhesion, and matrigel invasion assays were used to study the effect of PAR-1 expression on the proliferation, adhesion, and invasion of the transfected cells.</p><p><b>RESULTS</b>Appropriate up-regulation or down-regulation of protein expression of PAR-1 was observed in both transfected cell lines (PLA801C and PLA801D) to express PAR-1s or PAR-1as, respectively. Expression of the sense PAR-1 markedly increased cellular proliferation, adhesion and invasion of PLA-801C cells. In contrast, anti-sense PAR-1 significantly inhibited cell growth, adhesion and invasion capabilities, along with cell arrest at G0/G1 phase of the PLA-801D cells.</p><p><b>CONCLUSIONS</b>Successful up- and down- regulation of expression of PAR-1 can be achieved by in-vitro transfection of sense and antisense PAR-1 constructs. PAR-1 may enhance metastasis of lung cancer through its regulation of cellular proliferation, adhesion and invasion. Down-regulation of expression of PAR-1 may provide a new therapeutic strategy against lung carcinoma.</p>

Carcinosarcoma of Pancreas

Carcinosarcoma of the pancreas is a rare malignant tumor that shows a combined or mixed proliferation of carcinomatous and sarcomatous cells. This tumor has been variously called carcinosarcoma, pleomorphic large cell carcinoma, giant cell carcinoma, and undifferentiated carcinoma. A 52-year-old man was hospitalized for evaluation of his epigastric pain and jaundice. An abdominal computed tomography revealed the presence of a poorly enhancing mass, arising from the head of the pancreas. Pylorus preserving pancreaticoduodenectomy was performed. The final pathologic diagnosis was undifferentiated carcinoma with 2 distinct components. One component was a conventional infiltrating pancreatic ductal adenocarcinoma, and the other component was sarcoma. We present here a case of carcinosarcoma of the pancreas along with a review of the literatures.

Inhibitory effect of anti-type IV collagenase intrabody on invasiveness of human pulmonary giant cell carcinoma PG cells in vitro / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To explore the inhibitory effects of endoplasmic reticulum-retained intrabody on the secretion of type IV collagenase and the invasion of human pulmonary giant cell carcinoma PG cells in vitro.</p><p><b>METHODS</b>Two expression plasmids were constructed, pcDNA3.1-CP.scFv and pcDNA3.1-ER.scFv encoding cytoplasm-retained and endoplasmic reticulum-retained single chain antibodies against the type IV collagenase, respectively. The intracellular antibody genes were transfected into the human pulmonary giant cell carcinoma PG cells. Western blot was performed to detect the expression of pcDNA3.1-CP.scFv and pcDNA3.1-ER.scFv. Gelatin zymography was performed to detect seretion of type IV collagenase in PG cells and Matrigel assay was employed for determination of the cell invasiveness.</p><p><b>RESULTS</b>Both of cytoplasm-retained and endoplasmic reticulum-retained introbodies, CP.scFv and ER.scFv, were expressed in PG cells. ER.scFv, significantly inhibited the secretion of type IV collegenase. As shown, matrix metalloproteinase 9 and matrix metalloproteinase 2 were inhibited by 85.7% and by 51.2%, respectively. However, CP.scFv did not show such inhibitory effect. The ER.scFv encoding gene-transfected PG cells were much less invasive than parental or vector control cells, the inhibition rate was 76.3% (P < 0.05), whereas CP.scFv encoding gene-transfected PG cells showed no reduction in invasiveness.</p><p><b>CONCLUSION</b>Those findings demonstrate that endoplasmic reticulum (ER)-retained intracellular antibody technology may selectively abrogate the activity of type IV collagenase in the protein trafficking and secretory pathway and effectively inhibit tumor cell invasion in vitro. Anti-type IV collagenase intrabody may be further used in cancer gene therapy.</p>

Combined Large Cell Neuroendocrine Carcinoma with Component of Adenocarcinoma: A case report / 대한흉부외과학회지

Combined large cell neuroendocrine carcinoma is an uncommon lung cancer that include large cell neuroendocrine carcinoma with components of adenocarcinoma, squamous cell carcinoma, giant cell carcinoma and/or spindle cell carcinoma histologically. We report a case that pathologically diagnosed as combined large cell neuroendocrine carcinoma with component of adenocarcinoma after right pneumonectomy and mediastinal lymph node dissection. A 44-year-old man with intermittent chest pain was referred to our hospital for lung mass on the right mid lung field.

Differentially expressed genes in human giant-cell lung cancer lines with different metastatic potentials / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To screen genes differentially expressed in two human giant-cell lung cancer lines of same origin but with different metastasis potentials.</p><p><b>METHODS</b>Suppression subtractive hybridization (SSH) was done twice on two giant-cell lung cancer lines, PLA-801C and PLA-801D (hereafter abbreviated as C and D), of same origin but with low (C) and high (D) metastatic potentials. In the first round, SSH C was used as tester and D as driver, while in the second round, the tester and driver were interchanged. The sequences acquired from both rounds of SSH were spotted on glass slides respectively and screened by hybridizing with two-color fluorescence probes. Clones that had different expression levels on chips were also confirmed by RNA dot blot or Northern blot.</p><p><b>RESULTS</b>There were 16 sequences with high expression in C as compared to those in D, and 79 sequences with high expression in D compared to those in C. After sequencing, most of them were found to be highly homologous to those encoding the following proteins: (1) cytokines and their receptors; (2) kinases and related proteins; (3) other proteins including enzymes, heat shock proteins, receptors, proteins of cell skeleton and mitochondria, products of oncogenes, etc; (4) some proteins deduced from gene sequences with yet unknown functions.</p><p><b>CONCLUSION</b>The alterations in expression of some known genes, including HSP70, AXL receptor tyrosine kinase and 14-3-3zeta, might have impact on metastasis of giant-cell lung cancer. Whether some differentially expressed genes newly revealed are metastasis-related needs further study.</p>

Study on differentially expressed molecules influencing the metastatic potential between highly and poorly metastatic human lung giant cell carcinoma / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To study the metastasis-associated molecules differentially expressed in highly and poorly metastatic sublines and the mechanism of metastasis in lung giant cell carcinoma.</p><p><b>METHODS</b>Highly and poorly metastatic sublines (PLA801D and PLA801C)were used as metastasis model. Cell motility and invasion assay in vitro were first compared between the two sublines. Then, gelatin zymography analysis was used to determine the MMP-2 and MMP-9 activity. The protein expression level of secreted MMP-2, MMP-9, TIMP-1, TIMP-2 and intracellular expression level of p53, p16, PCNA, CD44(V6) isomeride, E-cadherin, CK18, nm23-H1 as well as the mRNA expression level of MMP-2, MMP-9, TIMP-1, TIMP-2, VEGF were compared through Western blot. Semi-quantitative RT-PCR analysis was used to determine the intracellular mRNA expression of MMP-2, MMP-9, TIMP-1, TIMP-2 and VEGF.</p><p><b>RESULTS</b>The in vitro cell invasion potential of highly metastatic subline PLA801D was significantly higher than that of poorly metastatic subline PLA801C by about 4 folds, while the cell motility potential was similar. The secreted MMP-2 activity was notably higher in PLA801D, which was initiated by the higher expression of MMP-2 at protein and mRNA level. In addition, the expression level of p53, PCNA, CK18 protein and VEGF mRNA were significantly higher, while the expression level of p16, E-cadherin and nm23-H1 protein were significantly lower in PLA801D. Some molecules such as MMP-9, TIMP-1, TIMP-2, CD44(V6) isomeride, which had been reported to be associated with tumor metastasis, were not observed to change significantly between the two sublines.</p><p><b>CONCLUSION</b>There are significant differences in metastatic potential and phenotypes between highly and poorly metastatic sublines of lung giant cell carcinoma. Some differentially expressed molecules might be playing roles in promoting or inhibiting metastasis of lung giant cell carcinoma, which may be useful to elucidate the mechanism of metastasis.</p>

Function of IL-18 in promoting metastasis of lung cancer / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To study the function of IL-18 in promoting metastasis of lung cancer.</p><p><b>METHODS</b>The differential expression of IL-18 protein or mRNA level between highly and poorly metastatic sublines of human lung giant cell carcinoma metastatic model was detected by Western blot, semi-quantitative RT-PCR and northern blot analysis. The poorly metastatic PLA801C subline or highly metastatic PLA801D subline was transfected with constructed IL-18 sense or IL-18 antisense expressed plasmid by lipofectamine stable transfection technique. The metastasis-related effect mediated by IL-18, the metastatic phenotype differences, cell motility and cell invasion potential in vitro determined by MICS system and the expression level of metastasis-associated biomarkers detected by Western blot analysis, were compared between IL-18 stably transfectants and mock control, i.e. between PLA801C/IL-18(S) and PLA801C/pcDNA3.1, or between PLA801D/IL-18(As) and PLA801D/pcDNA3.</p><p><b>RESULTS</b>IL-18 was only present in highly metastatic PLA801D subline at either protein or mRNA level, which implied that IL-18 might play a role in promoting metastasis of lung cancer. After IL-18 sense expressed plasmid was transfected into poorly metastatic PLA801C subline, IL-18 fused protein with myc tag detected by Western blot analysis using either IL-18 or myc tag monoclonal antibody. In addition, cell motility ability in vitro was significantly increased about 3 times and E-cadherin protein was significantly down-regulated at about 50% in PLA801C/IL-18(S) transfectants compared with mock control. While IL-18 expressed plasmid was transfected into highly metastatic PLA801D subline, IL-18 protein and mRNA were simultaneously decreased by 30%. In addition, cell invasion ability in vitro was significantly decreased at about 75% and E-cadherin protein was significantly up-regulated in PLA801D/IL-18(As) transfectants compared with mock control.</p><p><b>CONCLUSION</b>IL-18 might play a role in enhancing tumor metastasis of lung cancer by down-regulating E-cadherin protein expression.</p>

Postbronchoscopy expectoration of tumour tissue in lung cancer.

A case of undifferentiated giant cell type bronchogenic carcinoma in an old man is reported. Following bronchoscopy, the patient expectorated tumour mass tissue in his sputum and was relieved of breathlessness to a great extent.

1 Case: Pulmonary Giant Cell Carcinoma / 대한흉부외과학회지

The pulmonary giant cell carcinoma is classified as a variant of a large cell carcinoma and is diagnosed by the minimum component of 10% huge, pleomorphic and multinucleated giant tumor cell and emperipolesis of the neutrophils into the tumor cells. This tumor is characterized by local recurrences and early metastasis with extremely short patient survival. However, there are some reports that state that the survival time was extended by the operative resection and postoperative adjuvant chemotherapy and radiotherapy. A 46-year old male was admitted with complaint of hemoptysis for 2 months. Through chest X-ray and chest CT, a 5cm sized mass was found in the apical segment of the right upper lobe. During the preoperative evaluation, stenotic lesion in the left anterior descending coronary artery was found and treated by percutaneous transarterial coronary angioplasty. Four weeks later, right upper lobectomy was performed and the mass was proven to be a giant cell carcinoma. The patient received adjuvant chemotherapy and radiotherapy.

Study on the metastatic mechanisms of human giant-cell lung carcinoma comparison between the strains C and D.

The biologic characteristics of the two human giant-cell lung carcinoma strains with high (strain D) and low metastatic potential (strain C) were studied, including karyotype of chromosome, intracellular free calcium ([Ca2+]i), morphologic changes of cell surface and the expression of nm23-H1, p53, ras, c-myc, c-erbB2, bcl-2 genes and PCNA. The correlation between different biologic features and the metastatic potential of the two strains was analyzed. We found: 1) Both strains had the karyotypic abnormality of -13, -14, -15, +20, +21 with seven same marker chromosomes. Only strain D had the karyotypic abnormality of +7, -17, -18, +X, 7p+; 2) [Ca2+]i of the strain C (984.7 +/- 573.8) and D (517.6 +/- 216.6) was significantly different (p < 0.05). The amplitude of intracellular calcium oscillations of strain C was lower than the one of strain D; 3) strain C had more villous-like protrusions on the cell surface, whereas strain D had more bubble-like protrusions; 4) The expression of nm23-H1 and p53 protein of strain C was all higher than that of strain D. The expression of PCNA of strain C was lower than strain D; 5) nm23-H1 mRNA levels of strain C was lower than that of strain D. We consider that the karyotype of chromosomes, intracellular free calcium, the structure of cell membrane and the expression of nm23-H1 gene, p53 gene, PCNA could be closely related to the metastatic potential of human giant-cell lung carcinoma. They could be used as the sign for judging whether the tumor will metastasize in clinical practice as well as in judging the prognoses of patients.