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1.
Int J Colorectal Dis ; 18(3): 239-47, 2003 May.
Article in English | MEDLINE | ID: mdl-12673490

ABSTRACT

BACKGROUND AND AIMS: Photodynamic therapy (PDT) is a new treatment modality for early esophageal neoplasia. With two absorption maxima in the visible light range (550 and 588 nm) hypericin is a very promising photosensitizer for PDT with incoherent light sources. We studied the effects of photosensitizing hypericin in both primary cell cultures and cell lines (squamous: Kyse-140 and adenocarcinoma: OE-33) of human esophageal cancer using an incoherent white light source. MATERIALS AND METHODS: Esophageal cancer cells were preincubated (4-24 h) with hypericin (10 nM-1 micro M) and then irradiated with a light energy dose of 30 J/cm(2). RESULTS: Hypericin showed strong phototoxic effects and induced apoptosis in a dose-dependent fashion. The IC(50) value of hypericin phototoxicity was approximately 30 nM in both squamous and adenocarcinoma cells. In the concentrations used nonphotoactivated hypericin showed no toxic or apoptotic potency. The phototoxicity of hypericin was compared to that of delta-aminolevulinic acid (5-ALA), which is already being used for photodynamic therapy of gastrointestinal cancer. 5-ALA produced similar phototoxic effects but at a much higher dose (IC(50) 182+/-8 micro M in Kyse-140 and 308+/-40 micro M in OE-33 cells). Moreover, 5-ALA did not induce apoptosis to a relevant extent. CONCLUSION: Hypericin is a very promising new photosensitizer for innovative photodynamic therapy of esophageal cancer. Both the well known clinical safety of hypericin and the lower costs of broad band light sources argue in favor of clinical trials.


Subject(s)
Adenocarcinoma/drug therapy , Antineoplastic Agents/therapeutic use , Carcinoma, Squamous Cell/drug therapy , Esophageal Neoplasms/drug therapy , Perylene/analogs & derivatives , Perylene/pharmacology , Photochemotherapy/methods , Photosensitizing Agents/therapeutic use , Aminolevulinic Acid/therapeutic use , Anthracenes , Apoptosis/drug effects , Dose-Response Relationship, Radiation , Female , Humans , Male , Middle Aged , Time Factors , Tumor Cells, Cultured/drug effects
2.
Br J Cancer ; 88(8): 1217-22, 2003 Apr 22.
Article in English | MEDLINE | ID: mdl-12698187

ABSTRACT

Patients with (previous) head and neck cancer (HNC) are at high risk for developing second squamous cell cancer of the oesophagus. The role of cyclooxygenase-2 (COX-2) in oesophageal squamous carcinogenesis has not yet been investigated in this high-risk group. Therefore, this study examined COX-2 mRNA and protein expression in oesophageal biopsies and resected tissues of 44 HNC patients. The evaluation covered 55 oesophageal tissue samples (18 invasive oesophageal squamous cell cancers, four high- and eight low-grade dysplasias, 25 normal squamous epithelia) from the 44 patients. mRNA levels of COX-2 were measured by real-time PCR using a LightCycler. COX-2 protein expression was studied immunohistochemically and graded by a staining score. COX-2 mRNA was detected in all samples, and its levels correlated positively with the immunohistochemical staining score (P<0.05). COX-2 expression was upregulated during oesophageal squamous carcinogenesis in HNC patients, that is COX-2 expression increased significantly from normal oesophageal squamous epithelium to low- and high-grade dysplasia and finally to invasive squamous cell cancer (P<0.001). Our findings suggest that COX-2 upregulation contributes to oesophageal squamous carcinogenesis in HNC patients. Prospective studies are needed to evaluate the chemopreventive potential of COX-2 inhibitors in this high-risk group.


Subject(s)
Carcinoma, Squamous Cell/enzymology , Esophageal Neoplasms/enzymology , Head and Neck Neoplasms/enzymology , Isoenzymes/genetics , Prostaglandin-Endoperoxide Synthases/genetics , Base Sequence , Carcinoma, Squamous Cell/genetics , Cyclooxygenase 2 , DNA Primers , Esophageal Neoplasms/genetics , Gene Expression Regulation, Enzymologic/genetics , Gene Expression Regulation, Neoplastic/genetics , Head and Neck Neoplasms/genetics , Humans , Membrane Proteins , RNA, Messenger/genetics , Transcription, Genetic/genetics
3.
Br J Cancer ; 86(2): 239-43, 2002 Jan 21.
Article in English | MEDLINE | ID: mdl-11870513

ABSTRACT

Due to advanced disease at the time of diagnosis the prognosis of oesophageal cancer is generally poor. As mass screening for oesophageal cancer is neither feasible nor reasonable, high-risk groups should be identified and surveilled. The aim of this study was to define the risk of oesophageal cancer in patients with (previous) head and neck cancer. A total of 148 patients with (previous) head and neck cancer were prospectively screened for oesophageal cancer by video-oesophagoscopy and random oesophageal biopsies. Even in a macroscopically normal looking oesophagus, four biopsy specimens were taken every 3 cm throughout the entire length of the squamous oesophagus. Low- or high-grade squamous cell dysplasia was detected histologically in 10 of the 148 patients (6.8%). All but one dysplasias were diagnosed synchronously with the head and neck cancers. In addition, oesophageal squamous cell carcinoma was diagnosed in 11 of the 148 patients (7.4%). Most invasive cancers (63.6%) occurred metachronously. The risk of squamous cell neoplasia of the oesophagus is high in patients with (previous) head and neck cancer. Surveillance is recommended in this high-risk group.


Subject(s)
Carcinoma, Squamous Cell/drug therapy , Esophageal Neoplasms/diagnosis , Head and Neck Neoplasms/complications , Mass Screening , Precancerous Conditions/diagnosis , Aged , Biopsy , Carcinoma, Squamous Cell/etiology , Esophageal Neoplasms/etiology , Female , Humans , Male , Middle Aged , Neoplasms, Multiple Primary , Neoplasms, Second Primary , Prospective Studies , Risk Assessment
4.
Br J Cancer ; 86(4): 636-44, 2002 Feb 12.
Article in English | MEDLINE | ID: mdl-11870549

ABSTRACT

Extracellular ATP is known to inhibit growth of various tumours by activating specific purinergic receptors (P2-receptors). Since the therapy of advanced oesophageal cancer is unsatisfying, new therapeutic approaches are mandatory. Here, we investigated the functional expression and potential antiproliferative effects of P2-purinergic receptors in human oesophageal cancer cells. Prolonged incubation of primary cell cultures of human oesophageal cancers as well as of the squamous oesophageal cancer cell line Kyse-140 with ATP or its stable analogue ATP gamma S dose-dependently inhibited cell proliferation. This was due to both an induction of apoptosis and cell cycle arrest. The expression of P2-receptors was examined by RT-PCR, immunocytochemistry, and [Ca(2+)](i)-imaging. Application of various extracellular nucleotides dose-dependently increased [Ca(2+)](i). The rank order of potency was ATP=UTP>ATP gamma S>ADP=UDP. 2-methylthio-ATP and alpha,beta-methylene-ATP had no effects on [Ca(2+)](i). Complete cross-desensitization between ATP and UTP was observed. Moreover, the phospholipase C inhibitor U73122 dose-dependently reduced the ATP triggered [Ca(2+)](i) signal. The pharmacological features strongly suggest the functional expression of G-protein coupled P2Y(2)-receptors in oesophageal squamous cancer cells. P2Y(2)-receptors are involved in the antiproliferative actions of extracellular nucleotides. Thus, P2Y(2)-receptors are promising target proteins for innovative approaches in oesophageal cancer therapy.


Subject(s)
Carcinoma, Squamous Cell/metabolism , Cell Division/drug effects , Esophageal Neoplasms/metabolism , Nucleotides/pharmacology , Receptors, Purinergic P2/metabolism , Tumor Cells, Cultured/drug effects , Apoptosis/drug effects , Calcium/metabolism , Carcinoma, Squamous Cell/pathology , Caspase 3 , Caspases/metabolism , Cell Cycle/drug effects , DNA Primers/chemistry , Esophageal Neoplasms/pathology , Fluorescent Antibody Technique , Humans , In Situ Nick-End Labeling , Receptors, Purinergic P2Y2 , Reverse Transcriptase Polymerase Chain Reaction , Sodium/metabolism
5.
Int J Colorectal Dis ; 16(3): 154-66, 2001 Jun.
Article in English | MEDLINE | ID: mdl-11459289

ABSTRACT

Extracellular nucleotides induce apoptosis and inhibit growth of colorectal cancer cells. To understand the underlying signaling pathways, we investigated the role of nucleotide-sensitive P2 receptors and focused on the receptor-mediated signaling of intracellular Ca2+ and cyclic adenosine monophosphate (cAMP) in two colorectal carcinoma cell lines (HT29, Colo320 DM). Expression and functionality of P2 receptor subtypes evaluated by RT-PCR and [Ca2+]i imaging revealed that solely metabotropic P2 receptors of the subtype P2Y2 were expressed on a functional level in both cell lines. Short-term stimulation of P2Y2 receptors caused Ca2+ mobilization from intracellular stores and a subsequent transmembrane Ca2+ influx. The receptor-induced [Ca2+]i elevation was shown to increase basal-stimulated [cAMP]i moderately and to potentiate forskolin-stimulated [cAMP]i vigorously, since the effects were dose-dependently inhibited by preloading the cells with the [Ca2+]i chelator BAPTA. In contrast, activation of protein kinase C (PKC) did not contribute to a receptor-mediated rise in [cAMP]i, since the PKC inhibitor staurosporine completely failed to reduce P2Y2 receptor-induced increases in [cAMP]i. Prolonged application of P2Y2 receptor agonists induced a time-dependent increase in apoptosis (up to 50% above control values) in both cell lines and caused dose-dependent inhibition of cell proliferation of up to 85% (Colo320 DM) or 64% (HT29). Chelating [Ca2+]i with BAPTA almost completely abolished P2Y2 receptor-induced cell death. Rises in [cAMP]i elicited by either forskolin or cAMP derivatives inhibited growth in both cell lines, too. In line with the potentiating effect of P2Y2 receptors on forskolin-stimulated [cAMP]i increases, costimulation with forskolin and P2Y2 receptor agonists led to synergistic antiproliferative effects. Moreover, a synergistic growth inhibition was observed when coincubating the cells with the P2Y2 receptor agonist ATP and the cytostatic drug 5-fluorouracil, which forms the basis for most currently applied chemotherapeutic regimes in colorectal cancer treatment. Our results demonstrate the growth inhibitory potency of P2Y2 receptors in colorectal carcinoma cells. Receptor-induced [Ca2+]i signaling appears to play a major role in the observed antiproliferative and apoptosis-inducing effects.


Subject(s)
Apoptosis , Calcium/metabolism , Colorectal Neoplasms/pathology , Cyclic AMP/metabolism , Receptors, Purinergic P2/physiology , Adenosine Triphosphate/pharmacology , Antimetabolites, Antineoplastic/therapeutic use , Cell Division/drug effects , Colorectal Neoplasms/metabolism , Fluorouracil/therapeutic use , Humans , Receptors, Purinergic P2/metabolism , Receptors, Purinergic P2Y2 , Reverse Transcriptase Polymerase Chain Reaction , Tumor Cells, Cultured/drug effects , Uridine Triphosphate/pharmacology
6.
Gut ; 47(1): 63-73, 2000 Jul.
Article in English | MEDLINE | ID: mdl-10861266

ABSTRACT

BACKGROUND/AIMS: Alterations in synthesis and breakdown of extracellular matrix components are known to play a crucial role in tissue remodelling during inflammation and wound healing. Degradation of collagens is highly regulated by a cascade of matrix metalloproteinases (MMPs). The current study was therefore designed to determine gene expression patterns of MMPs and their tissue inhibitors (TIMPs) in single endoscopic biopsies of patients with inflammatory bowel disease (IBD). PATIENTS/METHODS: mRNA expression was measured by quantitative competitive polymerase chain reaction (PCR) in biopsies from patients with ulcerative colitis (n=21) and Crohn's disease (n=21). Protein expression was analysed by western blotting and immunohistochemistry. RESULTS: MMP-2, MMP-14, and TIMP-1 mRNAs were marginally increased in inflamed, but 9-12-fold increased in ulcerated colonic mucosa in IBD whereas TIMP-2 mRNA expression remained unchanged. MMP-1 and MMP-3 mRNA expression correlated well with the histological degree of acute inflammation, resulting in more than 15-fold increased MMP-1 and MMP-3 mRNA levels in inflamed versus normal colon samples from patients with ulcerative colitis and Crohn's disease. CONCLUSION: Profound overexpression of MMP-1 and MMP-3 mRNA transcripts suggests an important role for these enzymes in the process of tissue remodelling and destruction in inflammatory bowel disease.


Subject(s)
Colon/enzymology , Inflammatory Bowel Diseases/enzymology , Matrix Metalloproteinases/metabolism , Tissue Inhibitor of Metalloproteinases/metabolism , Acute Disease , Blotting, Western , Colitis, Ulcerative/enzymology , Colitis, Ulcerative/metabolism , Colon/metabolism , Crohn Disease/enzymology , Crohn Disease/metabolism , Gene Expression , Humans , Immunoenzyme Techniques , Inflammatory Bowel Diseases/metabolism , Intestinal Mucosa/enzymology , Intestinal Mucosa/metabolism , Matrix Metalloproteinase 1/metabolism , Matrix Metalloproteinase 3/metabolism , Matrix Metalloproteinases/genetics , Procollagen/genetics , Procollagen/metabolism , RNA, Messenger/metabolism , Reverse Transcriptase Polymerase Chain Reaction , Tissue Inhibitor of Metalloproteinases/genetics
7.
Eur J Cancer ; 34(10): 1607-11, 1998 Sep.
Article in English | MEDLINE | ID: mdl-9893637

ABSTRACT

CD44v6 expression appears to be associated with adverse prognosis and propensity for metastasis in patients with colorectal cancer. However, expression of CD44 variants in different tumour stages has been poorly characterised. CD44 variant expression was investigated in normal colonic mucosa (n = 36), colorectal adenomas (n = 15), carcinomas (n = 62) and metastases (n = 6) by reverse transcriptase-polymerase chain reaction (RT-PCR) and Southern blotting with exon-specific probes. High frequencies of CD44 standard (CD44s) and CD44 epithelial (CD44e) were observed in normal and neoplastic tissue. CD44v2 was seen predominantly in adenomas (27%) and UICCI carcinomas (29%). CD44v5 expression was low in normal mucosa (3%), higher in adenomas and carcinomas (29-33%), independent of tumour stage. CD44v6 expression was low in normal mucosa (6%) and higher in adenomas (47%) and carcinomas (42%). Surprisingly, a significant decrease of CD44v6 was observed in metastatic primary tumours (8%) and metastases (17%) (UICCIV) (P < or = 0.05). Therefore, the concept of CD44v6 conferring metastatic potential to malignant cells cannot be supported by our data.


Subject(s)
Adenoma/metabolism , Antigens, Neoplasm/metabolism , Colorectal Neoplasms/metabolism , Hyaluronan Receptors/metabolism , Adenoma/genetics , Alternative Splicing , Antigens, Neoplasm/genetics , Blotting, Southern , Colorectal Neoplasms/genetics , Humans , Hyaluronan Receptors/genetics , Neoplasm Metastasis , Neoplasm Staging/methods , Reverse Transcriptase Polymerase Chain Reaction/methods
8.
Gastroenterology ; 112(2): 532-42, 1997 Feb.
Article in English | MEDLINE | ID: mdl-9024307

ABSTRACT

BACKGROUND & AIMS: The initial step in tumor invasion and metastasis is determined by adhesion of tumor cells to basement membranes. To evaluate their potential therapeutic use in controlling local growth and metastasis, the effects of retinoids on the adhesive properties in the human pancreatic carcinoma cell line DAN-G were examined. METHODS: The effects of retinoids on cellular adhesion were assessed by adhesion assays in vitro. The expression of laminin-binding proteins was characterized by Northern blotting, radioimmunoprecipitation, and flow-cytometric analysis. RESULTS: Treatment with retinoids results in a time- and dose-dependent inhibition of DAN-G cell adhesion to fibronection and laminin but not to collagens I, IV, and VI. The adhesion of DAN-G cells to laminin could be blocked completely by anti-alpha 6 and anti-beta 1 antibodies but not by the synthetic peptide YIGSR. Flow-cytometric analysis of DAN-G cells showed no quantitative difference for alpha 6-integrin expression in retinoid-treated and -untreated DAN-G cells. Furthermore, radioimmunoprecipitation showed no difference in the appearance of alpha 6 beta 1-integrin expression after retinoid incubation. CONCLUSIONS: Retinoids decrease pancreatic carcinoma cell adhesion to laminin via an as yet unidentified mechanism involving alteration of the alpha 6 beta 1-integrin receptor function and thereby open interesting perspectives for the modulation of infiltrative growth and metastasis in pancreatic cancer.


Subject(s)
Carcinoma/physiopathology , Integrins/metabolism , Laminin/physiology , Pancreatic Neoplasms/physiopathology , Retinoids/pharmacology , Animals , Carcinoma/pathology , Cell Adhesion/drug effects , Integrin alpha6beta1 , Integrins/physiology , Pancreatic Neoplasms/pathology , Rats , Stereoisomerism , Tretinoin/pharmacology , Tumor Cells, Cultured
9.
Gastroenterology ; 106(1): 19-27, 1994 Jan.
Article in English | MEDLINE | ID: mdl-8276181

ABSTRACT

BACKGROUND/AIMS: Following malignant transformation, epithelial cells of colorectal carcinomas, unlike normal colonic epithelial cells, no longer express the alpha 5 beta 1 fibronectin receptor. We hypothesized that the loss of alpha 5 beta 1 expression might facilitate the tumorigenicity of transformed colonic cells. METHODS: To examine this hypothesis, we established subclones of the human colon adenocarcinoma cell line HT 29, which differ in their fibronectin receptor expression and tested their tumorigenicity in nude mice. RESULTS: Our data indicate that the capacity to form tumors in nude mice after subcutaneous injection was significantly lower for alpha 5-positive than for alpha 5-negative cell clones. In addition, tumors from clones expressing no detectable levels of alpha 5 beta 1 grew rapidly, whereas tumors expressing elevated levels of fibronectin receptor grew slowly. Despite similar rates of adhesion to fibronectin for alpha 5-positive and alpha 5-negative cell clones in vitro, deposition of fibronectin in tumor-surrounding stroma was increased in tumors derived from alpha 5-positive cells. CONCLUSIONS: Our results indicate that an increase of the alpha 5 beta 1-mediated interaction of malignant cells with the extracellular matrix may be responsible for decreased tumorigenicity of malignant transformed cells in colorectal carcinomas.


Subject(s)
Adenocarcinoma/metabolism , Colonic Neoplasms/metabolism , Neoplasm Transplantation , Receptors, Fibronectin/metabolism , Adenocarcinoma/pathology , Adenocarcinoma/physiopathology , Animals , Carcinogenicity Tests , Cell Adhesion , Colonic Neoplasms/pathology , Colonic Neoplasms/physiopathology , Extracellular Matrix/metabolism , Female , Fibronectins/physiology , Humans , Integrins/metabolism , Mice , Mice, Inbred BALB C , Mice, Nude , Tumor Cells, Cultured/transplantation
10.
Gut ; 34(6): 829-36, 1993 Jun.
Article in English | MEDLINE | ID: mdl-8314518

ABSTRACT

The integrin mediated interactions between tumour cells and the surrounding extracellular matrix are thought to play crucial parts in the complex process of invasion and metastasis. It has been previously shown that the expression of integrins is differently diminished in a chain-specific manner in human colorectal cancer. To further characterise the integrins still expressed in colorectal carcinomas, immunoblots with monoclonal antibodies against the beta 1 integrin subunit have been performed. In isolated cell membranes of colorectal cancers a second smaller beta 1 chain (105 kD non-reduced) was found as well as the mature beta 1 chain (116 kD non-reduced) present in normal mucosa of the colon. This smaller beta 1 chain comigrates with the diminished glycosylated precursor form of the beta 1 chain. The role of N-glycosylation for the function and expression of integrins in vitro was therefore investigated, with deoxymannojirimycin (DMJ) and deoxynojirimycin (DNJ) as specific inhibitors of N-glycan processing. Pretreatment of human colon adenocarcinoma derived HT-29 cells with DMJ resulted in an expression of the 105 kD beta 1 precursor chain and of smaller forms of the alpha 1, alpha 3, alpha 6, and alpha v integrin subunits in a time and dose dependent manner. HT-29 cells treated with DMJ adhered poorly to laminin (8% of untreated controls), collagen type IV (40%), and fibronectin (35%). Pretreatment of the cells with DNJ did not alter the molecular weight of the integrin chains expressed and reduced HT-29 adhesion to laminin and fibronectin only to 68% and 49% respectively. Adhesion to collagen type IV was increased to 124% by DNJ. These results show that N-glycan processing is essential for the function and expression of integrins in human colorectal cancer cells. An altered glycosylation of these adhesion receptors may contribute to a more invasive or metastatic phenotype in colorectal cancer.


Subject(s)
Adenocarcinoma/metabolism , Colorectal Neoplasms/metabolism , Extracellular Matrix/metabolism , Integrins/metabolism , Aged , Aged, 80 and over , Cell Adhesion/physiology , Cell Membrane/metabolism , Colorectal Neoplasms/pathology , Female , Flow Cytometry , Glycosylation , Humans , Immunoblotting , Male , Middle Aged , Tumor Cells, Cultured
11.
Med Klin (Munich) ; 88(4): 175-80, 1993 Apr 15.
Article in German | MEDLINE | ID: mdl-8492771

ABSTRACT

Following malignant transformation, epithelial cells of colorectal carcinomas unlike normal colonic epithelial cells do not any longer express the classical alpha 5 beta 1 fibronectin receptor. We speculated that the loss of alpha 5 beta 1 expression may facilitate the tumorigenicity of transformed colonic cells. To examine this hypothesis, we established subclones of the human colon adenocarcinoma cell line HT29 which differ in their fibronectin receptor expression and tested their tumorigenicity in nude mice. Our data indicate that the capacity to form tumors in nude mice after subcutaneous injection was significantly lower for alpha 5 beta 1-positive than for alpha 5 beta 1-negative cell clones. In addition, tumors from clones expressing to detectable levels of alpha 5 beta 1 grew rapidly, while tumors expressing elevated levels of fibronectin receptor grew slowly. Deposition of fibronectin in tumor-surrounding stroma was increased in tumors derived from alpha 5 beta 1-positive cells compared to tumors derived from alpha 5 beta 1-negative cells. Our results indicate that a reduction of the alpha 5 beta 1-mediated interaction of epithelial cells with the extracellular matrix may be responsible for increased tumorigenicity of malignant transformed cells in colorectal carcinomas.


Subject(s)
Cell Transformation, Neoplastic/genetics , Colorectal Neoplasms/genetics , Gene Expression Regulation, Neoplastic/physiology , Receptors, Fibronectin/genetics , Tumor Cells, Cultured/pathology , Cell Line , Cell Transformation, Neoplastic/pathology , Cloning, Molecular , Colorectal Neoplasms/pathology , Epithelium/pathology , Humans
12.
Gut ; 33(3): 342-6, 1992 Mar.
Article in English | MEDLINE | ID: mdl-1568652

ABSTRACT

Integrins are transmembrane molecules that mediate cell-cell and cell-substratum adhesion. Because alterations in the adhesive properties of tumour cells are thought to influence tumour cell invasion, the expression of integrin alpha and beta chains in 19 human colorectal carcinomas, eight adenomas, and eight normal colon tissues was examined immunohistochemically using an indirect immunofluorescent technique. Normal colonic epithelial cells were found to express the integrin alpha 3, alpha 5, alpha 6, beta 1, and beta 4 chains, whereas the alpha 2 chain was expressed only on epithelial cells lining the base of the crypts and was absent from cells lining the mouth of the crypts or the surface epithelium. No epithelial staining of the alpha 1, alpha 4, beta 2, and beta 3 chains was observed. A progressive reduction of all normally expressed alpha and beta chains was associated with increasing neoplastic transformation. The expression of the alpha 3 and alpha 5 chains was already noticeably reduced in adenomas, and was completely absent in most colonic carcinomas. In contrast, alpha 6, beta 1, and beta 4 expression was maintained in adenomas, whereas the transformation from benign to malignant neoplasms associated with infiltrative growth was characterised by diminished or lost expression of alpha 6, beta 1, and beta 4 chains. Thus, the decreased expression of integrins in human colon carcinomas may contribute to the altered adhesion and migration properties of these tumour cells.


Subject(s)
Cell Adhesion Molecules/analysis , Colonic Neoplasms/chemistry , Colorectal Neoplasms/chemistry , Integrins/analysis , Adenocarcinoma/chemistry , Adenoma/chemistry , Adult , Aged , Aged, 80 and over , Antibody Specificity , Female , Fluorescent Antibody Technique , Humans , Male , Middle Aged
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