Expression of Bcl-2 protein in human primary breast carcinomas and its correlation with multifocality, histopathological types and prognosis.

The Bcl-2 gene product prevents programmed cell death (apoptosis) and possibly promotes tumour development. This protein has mainly been demonstrated in the cytoplasm of various normal and neoplastic cells, including normal mammary epithelia and breast carcinomas. The aim of this retrospective study was to correlate the immunohistochemical expression of Bcl-2 protein with the multi-unifocality and the histology of the two main types of breast carcinoma. We used monoclonal antibody 124 to investigate Bcl-2 expression in paraffin sections of 62 primary breast carcinomas. Bcl-2 expression was associated mainly with this lobular carcinoma. High Bcl-2 protein positivity was found in this type, and was statistically significant in comparison to the level of Bcl-2 in ductal, NOS carcinomas (lobular versus ductal, NOS, P < 0.0001). In the entire group, including all histological types, Bcl-2 expression was higher in multifocal tumours (P = 0.005). Statistical significance (P < 0.03) was also found within the group of ductal, NOS cases, showing that Bcl-2 protein expression is associated with multifocality, irrespective of the histology of breast carcinomas. No definite association between Bcl-2 expression and prognosis was found. Our results suggest that Bcl-2 protein plays some role in the development of multifocality in breast carcinomas.

Upper gastrointestinal endoscopic and histologic findings before and after vertical banded gastroplasty.

BACKGROUND: A total of 30 consecutive morbidly obese patients, six males and 24 females, who underwent vertical banded gastroplasty (VBG) between January 1992 and December 1994 and were followed up by endoscopy and biopsy were included in this study with the aim to determine the short- and mid-term complications and to investigate alterations in esophageal, gastric, and duodenal mucosa after surgery. METHODS: All patients underwent endoscopy before operation. Postoperatively, 28 patients were reendoscoped at 6 months, 26 at 12 months, and 22 at 18 months. Biopsies were taken from the lower part of esophagus, just below the esophagogastric junction (vertical part of the partitioned stomach), corpus, antrum, and duodenal bulb. RESULTS: Before operation 5 patients (16.6%) had a hiatus hernia and four of them (13.3%) had esophagitis. Endoscopic gastritis was diagnosed in nine patients (30%) and endoscopic duodenitis in two (6. 6%). Histologically, in 15 patients (50%) esophagitis was recognized; in 24 patients (80%) corpus gastritis; in 27 patients (90%) antral gastritis; and in 23 (76.6%) duodenitis. Helicobacter pylori was found in 20 (66.6%) patients. Postoperatively, three patients developed a mild stoma stenosis and were treated only by passing the endoscope 6 months after operation; one patient, with a severe stoma stenosis, was treated by Eder-Puestow dilatations and surgery. Gastric ulcer was found in two patients 6 and 12 months after surgery. One patient developed an endostomach channel because of staple line dehiscence 18 months after VBG. An increasing incidence of esophagitis and gastritis of the vertical part of the stomach was found at 6 and 12 months. Endoscopic and histologic gastritis of the corpus and antrum, as well as endoscopic and histologic duodenitis decreased gradually after surgery. CONCLUSIONS: Our findings suggest that postoperative complications of VBG can be diagnosed by endoscopy, and some of them can easily be managed. Vertical banded gastroplasty causes not only no harm to the esophageal, gastric, and duodenal mucosa but also influences them favorably.

Immunohistochemical phenotyping and PCNA detection in gastrointestinal stromal tumors.

The immunohistochemical profile and the expression of proliferating cell nuclear antigen (PCNA) were studied in a series of 44 mesenchymal tumors of the gastrointestinal tract (GIT). On routinely hematoxylin-eosin stained sections 31 cases were classified as leiomyomas or leiomyomatoid tumors, 12 as leiomyosarcomas and 1 as a neurilemmoma. Immunohistochemical stains for smooth muscle antigen (SMA), S-100 protein, glial fibrillary acidic protein (GFAP), vimentin and desmin were performed with the peroxidase-antiperoxidase method on paraffin sections. The streptavidin-biotin method for PCNA immunostaining was applied using the monoclonal antibody PC 10. On the basis of immunohistochemical findings, 32 cases were identified as leiomyomatoid tumors or leiomyosarcomas (SMA positive, S-100 protein negative), 2 cases as nerve sheath tumors (SMA negative, S-100 protein and GFAP positive), whereas 8 cases presented a mixed phenotype (SMA positive and S-100 protein positive). Two cases were negative for both SMA and S-100 protein. All tumors showed positive immunostaining for vimentin and a negative one for desmin. There was a correlation between the histologic grade and proliferating score, displayed by PCNA expression in tumors of smooth muscle origin. The PCNA expression in tumors of mixed phenotype was intermediate to that seen in leiomyosarcomas (high expression) and in leiomyomas (low expression).

[Sarcoidosis of the large intestine]. / Sarkoidosebefall des Dickdarms.

A 68-years old female patient suffering over a period of several weeks from fatigue, weight loss, recurrent diarrheas and mild fever was admitted in our clinic. A few months ago, sarcoidosis of a cervical lymph node had been diagnosed and had been treated with steroids. During the present admission, the extensive study of the gastrointestinal system revealed a tumor of the ascending colon, obstructing the lumen. The patient was subjected to laparotomy due to persistent symptomatology of intestinal obstruction. A right hemicolectomy was performed. The pathological findings were persistent with sarcoidosis of the large bowel. Post-operatively, the patient has been symptom-free over a period of more than one year.

Immunohistochemical detection of the c-myc oncogene product in normal, hyperplastic and carcinomatous endometrium.

The expression and the distribution of the c-myc oncogene product (p62) was studied by a 3-step immunoperoxidase technique using the monoclonal antibody myc 1-6 E10 in 22 cases of normal endometrium (11 proliferative and 11 secretory phase), 43 endometrial hyperplasias (24 adenomatous and 19 adenocystic) and 26 endometrial carcinomas. Increased expression of c-myc product appeared in endometrial carcinomas compared with respective non-neoplastic tissue (p < 0.001). The immunolocalization of the c-myc protein shows a consistent difference between the various histologic patterns of non-neoplastic and neoplastic endometrium. Nuclear staining of the c-myc product was demonstrated in epithelial cells of the proliferative phase and predominantly in poorly differentiated forms of endometrial carcinomas. On the other hand cytoplasmic staining was found predominantly in the secretory phase and in well differentiated carcinomatous endometrium. In hyperplastic endometrium an intermediate immunohistochemical pattern was observed. The results of the present study emphasize that c-myc product overexpression and localization plays an important role in initiation, differentiation and progression of endometrial carcinomas.