DNA distribution pattern in chronic gastritis. I. DNA ploidy and cell cycle distribution.

DNA distribution patterns were flow cytometrically recorded in gastric biopsy specimens from patients with chronic gastritis (CG) and chronic atrophic gastritis (CAG). DNA aneuploidy was found in 3 of 58 patients with CG and in 7 of 82 patients with CAG. Cell cycle analysis disclosed significantly higher percentages of cells in S-phase and G2M-phase, respectively, in CAG than in CG. With regard to the proliferative activity the total CAG group could be partially differentiated by the degree of severity. CAG with total atrophy showed significantly higher percentages of cells in S-phase than CAG with mild and moderate atrophy. CAG without dysplasia showed lower percentages of cells in S-phase and G2M-phase than CAG with severe dysplasia (p greater than 0.05). The occurrence of intestinal metaplasia was correlated to a significantly higher percentage of cells in G2M-phase.

[Ultrasound-guided fine needle biopsy in tumor diagnosis]. / Ultraschall-geleitete Feinnadelbiopsie in der Tumordiagnostik.

Ultrasound guided fine needle biopsy led in 92 of 100 patients with suspected tumours to correct diagnostic results which determined the diagnostic and therapeutic management. Ultrasound-tomography may thus in connection with fine needle biopsy enlarge and simplify tumour diagnosis.

DNA ploidy and proliferation characteristics of bowel polyps analysed by flow cytometry compared with cytology and histology.

56 human adenomatous bowel polyps and 44 samples of macroscopically unchanged bowel mucosa taken at a distance of 2-10 cm from the polyp were investigated by histology, cytology, and flow cytometry in respect to their dysplasia grade and DNA distributions. 30 human adenomatous polyps of the same localization were investigated by histology and flow cytometry; in 14 cases in addition to the DNA-patterns per se their changes mediated by heparin, a polyanion, were recorded. Histological and cytological investigations revealed mild dysplasia in 25 cases, moderate dysplasia in 43 cases and severe dysplasia in 18 cases. DNA aneuploidy was correlated with the histological finding of mild dysplasia three times, of moderate dysplasia twice and severe dysplasia five times. All other cases, also macroscopically unchanged bowel mucosa revealed DNA diploidy. In these diploid cases, cell cycle stage analysis yielded a higher proportion of cells in S-phase and G2M phase in adenomas with severe dysplasia in comparison to adenomas with moderate and mild dysplasia (P less than 0.05). Macroscopically unchanged bowel mucosa showed about the same values as adenomas with mild dysplasia. The heparin mediated increase in fluorescence intensity is different for adenomas with mild and moderate dysplasia, and attributed to the latter a higher proliferative activity (P less than 0.05).

Automated microscope image analysis in the cytological tumor diagnostics. Results on borderline-cases of mammary tumors.

50 fine-needle biopsies of mammary tumors (20 medullary carcinomas, 20 fibroadenomas, and 10 false negative judged cases) were studied by automated microscopic image analysis. Eight morphometric and densitometric features of the tumor cell nuclei were determined on Papanicolaou stained smears. It was analyzed whether smears false judged as negative can be rightly allocated as carcinomas by the automated method. The results of this study have shown that it was possible by means of three cell nucleus parameters (standard deviation of the area, mean area ratio, and skewness of the grey value gradient at contours) with 100% correct separation of the unequivocal cytologies into malignant and benign smears to recognize about 90% of the false judged smears rightly as carcinomas. The results are reproducible and can be obtained in a time of 2-5 min per smear. The first results show that the automated microscope image analysis may be a valuable tool in the diagnosis of borderline-cases of mammary tumors.

Characterization of human adenomatous polyps of the colorectal bowel by means of DNA distribution patterns.

64 human adenomatous polyps of the colorectal bowel were investigated by histological examination and by flow cytometrical analysis providing DNA distribution patterns. The histological investigation yielded tubular adenomas (TA) in 41 and tubulo-villous adenomas (TVA) in 23 cases. Epithelial dysplasia or carcinomatous degeneration was found in 23 TA and in 11 TVA. Cell cycle stage analysis revealed no different values for TA and TVA without dysplasia, neither for TA and TVA with mild to moderate dysplasia. TVA with severe dysplasia exhibited a significantly higher proportion of cells with G2M phase DNA content than cases without dysplasia or mild to moderate dysplasia. TA and TVA without dysplasia were characterized by diploid DNA distribution patterns. TA with dysplasia showed aneuploid DNA stem lines in 4 of 20 cases, carcinomas arisen from TA in all 4 cases investigated. TVA with dysplasia were characterized by aneuploid DNA stem lines in 1 of 8 cases, carcinomas arisen from TVA in all 4 cases examined. It may be concluded that the DNA distribution patterns do not attribute different biological values to TA and TVA, 2 groups of adenomatous polyps which are characterized by different histological criteria.

[Endoscopic and histologic findings in malignant non-Hodgkin lymphomas of the stomach]. / Endoskopische und histologische Befunde bei malignen Non-Hodgkin-Lymphomen des Magens.

The authors have carried out a retrospective analysis of primary malignant Non-Hodgkin-lymphomas of the stomach verified histologically by surgical specimens, with the patients being submitted preoperatively to a gastroscopy with biopsy. The endoscopic and histological findings are outlined. Endoscopically the diagnosis of a malignant lymphoma was established only once, while an ulcerated carcinoma was diagnosed in almost two-thirds of the cases. The histological diagnosis of a malignant lymphoma was established in 10 cases, and a malignant lymphoma suspected in 6 cases. A carcinoma was diagnosed in 4 patients. The results are compared with the literature data and diagnostic problems discussed.

[Primary malignant non-Hodgkin's lymphoma of the stomach in the Kiel classification]. / Das primäre maligne Non-Hodgkin-Lymphom des Magens in der Kiel-Klassifikation.

Resection preparations from 30 cases of primary malignant non-Hodgkin lymphomas of the stomach were reclassified using the Kiel-classification. In 17 cases centroblastic malignant lymphomas were found a further 4 were centroblastic-centrocytic, 4 were immunoblastic malignant lymphomas, and 5 immunocytic malignant lymphomas. Although preoperative gastroscopies and biopsies were carried out in 22 cases, certain diagnoses of lymphoma were possible in 9 cases only. Seven patients died within a month postoperatively. The two-year survival rate was more than one-third, and the five-year survival rate, less than one-fourth of all cases. The results are compared with data from the literature.

[Prognostic significance of cellular stromal reaction at the tumor margin and the reaction in the regional lymph nodes in rectal adenocarcinoma. Patient follow-up studies after curative abdominoperineal rectal amputation]. / Die prognostische Bedeutung der zellulären Stromareaktion am Tumorrand und der Reaktion in den regionalen Lymphknoten bei Adenokarzinomen des Rektums. Verlaufsstudien bei Patienten nach kurativer abdominoperinealer Rektumamputation.

A significant correlation was found between the prognosis, expressed by the tumorfree survival time after resection of the rectum and the stage of tumor, the grading of histological differentiation, and the cellular stromal infiltration at the margin of the tumor. The stage of the tumor ranked first in influence on prognosis followed, unexpectedly, by the granulocytic stromal reaction, relative lymphocyte value in the peripheral blood, the histological grading, and the adjuvant therapy variants. The prognostic relevance of the immunologic reactions in the regional lymph nodes (follicular hyperplasia, paracortical macrophage activity, sinushistiocytosis) and of the round-cellular stromal reaction at the margin of the tumor can be seen in the correlation analysis but is no longer evident in the steplike multiple regression analysis.

[Parietal cell antibodies and stomach cancer]. / Belegzellantikörper und Magenkarzinom.

Sera of 101 patients with histologically confirmed gastric cancers were investigated for parietal cell antibodies, which are the serological markers of chronic atrophic gastritis type A. These autoantibodies were more often found in patients with early than with advanced gastric cancers. They were more frequent in intestinal than in diffuse gastric cancers. It is discussed that in advanced cancers the frequency of parietal cell antibody is diminishing because of loss of antigene or binding of antibodies in immune complexes. Early gastric cancers therefore seem to be more suitable than advanced cancers to study the relation between gastric cancer and gastritis type.

Flow cytometry, cytomorphology, histology and autoradiography in human gastric hyperplastic polyps and the surrounding mucosa.

43 cases of gastric hyperplastic polyps, 33 tissues adjoining the polyps and 7 tissue samples of the corpus mucosa were investigated by flow cytometry, cytomorphology, autoradiography and histology, respectively. All cases revealed diploid DNA distribution patterns. The results attributed an increased proliferative tendency to special cases of hyperplastic polyps and the surrounding mucosa.