Immunohistochemical study of genetic alterations in intraductal and invasive ductal tumors of the pancreas.

BACKGROUND/AIMS: Multiple genetic alterations are involved in the development of pancreatic neoplasm. Here we investigated the incidence of p53, ras, bcl-2 and c-erbB-2 gene alterations in intraductal papillary-mucinous tumors and invasive ductal adenocarcinoma of the pancreas by immunohistochemical method to identify and analyze their relationship in terms of these genetic alterations. METHODOLOGY: Fifty-four pancreatic lesions, including 18 benign (hyperplasia (3) and intraductal papillary adenoma (15)), and 16 malignant (carcinoma in situ (2) and intraductal papillary adenocarcinoma (14)) cases of intraductal papillary-mucinous tumor; and 20 cases of invasive ductal adenocarcinoma, were immunostained by avidin-biotin peroxidase conjugate method. RESULTS: p53 and rasp21 expressions were significantly greater in malignant intraductal (P < 0.01, P < 0.05) and invasive ductal (P < 0.01, P < 0.01) tumors than in benign intraductal papillary-mucinous tumors; while bcl-2 and c-erbB-2 expressions were significantly greater in invasive ductal adenocarcinoma than both benign (P < 0.01, P < 0.05) and malignant (P < 0.05, P < 0.05) intraductal papillary-mucinous tumors. CONCLUSIONS: Different groups of genetic alterations are involved in different phases of pancreatic tumorigenesis. p53 and ras gene alterations occur at an early stage during the development of intraductal papillary-mucinous tumor, while additional alterations of bcl-2 and c-erbB-2 occur during the development of invasive ductal adenocarcinoma of the pancreas.

Immunohistochemical analysis of expression of molecular biologic factors in intraductal papillary-mucinous tumors of pancreas--diagnostic and biologic significance.

BACKGROUND/AIMS: In this study we investigated the expressions of molecular biologic factors, p53, rasp21, bcl-2, c-erbB-2, and Ki-67 by immunohistochemical method in intraductal papillary-mucinous tumor of the pancreas to identify their diagnostic values and to determine their relations to the degree of histopathologic abnormalities. METHODOLOGY: Thirty-eight different histologic lesions from 28 patients of intraductal papillary-mucinous tumor of the pancreas, comprising normal pancreatic duct (n = 6), intraductal papillary hyperplasia (n = 6), intraductal adenoma (n = 15), and intraductal carcinoma (n = 11) were immunostained by the avidin-biotin peroxidase conjugate method. RESULTS: p53 and Ki-67 expressions were significantly greater in malignant intraductal papillary-mucinous tumor than in their benign counterpart (p = < 0.0001), while rasp21 showed gradual increase in the frequency of expression from normal pancreatic duct (0%), to intraductal hyperplasia (16.7%), to intraductal adenoma (26.7%), and ultimately to intraductal carcinoma (63.6%). bcl-2 and c-erbB-2 were not expressed in any lesions. CONCLUSIONS: These results suggest that p53 and Ki-67 expressions have significant diagnostic values in differentiating benign intraductal papillary-mucinous tumors from malignant ones and thus can facilitate in the pre-operative planning of treatment in individual cases. Secondly, gradual stepwise increase in the frequency of rasp21 expression with increasing degree of cellular atypia supports the presence of adenoma-carcinoma sequence in the carcinogenesis of this tumor.

[A case report of esophageal small cell carcinoma responding well to chemotherapy of 5-FU and cisplatin combined with radiotherapy].

A seventy-eight year-old man with esophageal small cell carcinoma was reported. He was treated with chemotherapy of 5-FU and Cisplatin combined with radiotherapy. After 3 Courses of chemotherapy, the tumor almost disappeared. A biopsy specimen revealed moderate dysplasia but did not show residue of small cell carcinoma. The patient had lived with no evidence of cancer recurrence for 1.5 years. He died of lung metastasis and pleuritis carcinomatosa about two years after the first treatment with chemotherapy. Chemotherapy of 5-FU and Cisplatin (combined with radiotherapy) is one of the useful treatments for patients with small cell carcinoma of the esophagus.

[Randomized controlled trial of MMC + UFT and MMC + 5-FU therapy in advanced gastric cancer].

To compare the effects of MMC + UFT (A) with MMC + 5-FU (B) therapy on the response rate, survival time and changes with time in quality of life (QOL) in unresectable or recurrent gastric cancer, we carried out a study by a multicenter, randomized controlled trial from June 1990 to August 1992. 39 patients were randomly divided into A group and B group, including 6 incompletely evaluated cases and 3 in eligible cases. Responses were recognized in 3 out of 13 evaluable cases (23.1%) treated with regimen A and in one out of 15 evaluable cases (6.7%) treated with regimen B. Mean survival time was 150 days (A) and 116 days (B), respectively. These results suggested that MMC + UFT therapy is one of the effective regimens for advanced gastric cancer and as useful as MMC + 5-FU therapy. Moreover, it showed that regimen A was superior to B on QOL.