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Domenico Coppola

Publications and source records attributed to Domenico Coppola.

65 records · Page 4Linked to original sources

Diagnostic and pathogenetic implications of colorectal carcinomas with multidirectional differentiation: a report of 4 cases.

Multidirectional differentiation in colorectal carcinomas is a rare phenomenon. Four cases are reported herein, and their clinical and pathologic characteristics are discussed. Two men and 2 women between the ages of 56 and 76 years who presented with abdominal symptoms are included in this report. Two tumors were located in the right colon, one in the splenic flexure, and one in the descending colon. Distant metastases were evident at presentation in 3 of 4 cases. Histologically, two tumors exhibited neuroendocrine and glandular differentiation; the third tumor was an adenocarcinoma with a sarcomatous component and the fourth tumor showed 3 lines of differentiation (glandular, squamous, and sarcomatoid). In all tumors evaluated, areas of adenocarcinomas were positive for low-molecular weight cytokeratin (CAM 5.2) and mucicarmine, but negative for high-molecular weight cytokeratin (AE3). The squamous cell component was AE3 positive and CAM 5.2 negative. The neuroendocrine component was highlighted by neuroendocrine markers and the sarcomatoid component revealed smooth muscle differentiation. All tumors (except one mucinous tumor) were negative for cytokeratin-20 staining. One patient was on supportive care for terminal metastatic carcinoma, and 2 patients were being treated with adjuvant chemotherapy at the time of this report. Colon carcinoma with multidirectional differentiation is a rare event and may originate from stem cells within the gastrointestinal mucosa, and/or represent the convergence of multiple tumors arising at the same site. This type of tumor should be considered in the differential diagnosis of a bowel biopsy with multiple histopathologic variants.

Adenocarcinoma↗

Immunohistochemical staining for c-Kit (CD117) is a rare event in human colorectal carcinoma.

Recent studies have suggested that the presence of a c-Kit/c-Kit ligand autocrine loop may be an important regulator of proliferation and progression of human colorectal cancer, capable of affecting the prognosis of these patients. If present, the c-Kit alteration may provide a suitable target for therapy, similar to what has been observed in gastrointestinal stromal tumors. To determine the incidence of c-Kit expression in human colorectal carcinomas, we studied the immunohistochemical c-Kit expression in a selection of 126 colorectal carcinomas of different stage, using stage-oriented human cancer tissue microarrays. Formalin-fixed, paraffin-embedded tissues of each case were immunostained using the avidin-biotin-peroxidase method and the antihuman c-Kit (CD117) rabbit polyclonal antibody. High cytoplasmic c-Kit staining (Allred score of 7-8) was observed in 1.6% of the colon carcinoma patients evaluated. The c-Kit-positive tumors were poorly differentiated carcinomas arising at the anorectal junction. The remaining tumors revealed no detectable expression of c-Kit. Twenty-seven non-neoplastic tissues, normal colonic mucosa, and adenomas were also CD117 negative. We show the rare expression of c-Kit in normal and neoplastic colorectal tissues, suggesting that routine screening for c-Kit by immunohistochemistry to identify c-Kit-positive carcinomas may be cost ineffective. However, further study of c-Kit expression in poorly differentiated colon cancers may be useful since these generally chemoresistant tumors may respond to therapy with inhibitor compounds directed against c-Kit.

Adenocarcinoma↗

Combination therapy with AG-490 and interleukin 12 achieves greater antitumor effects than either agent alone.

Constitutive activation of Janus kinases (JAKs) and signal transducers and activators of transcription (STAT) occurs at very high frequency in various hematopoietic malignancies and solid tumors. It has been demonstrated that the tyrosine kinase inhibitor, AG-490, selectively blocks JAK activity and completely eliminates leukemia cells in a severe combined immunodeficient (SCID) mouse model. Because many cytokines, including interleukin (IL)-12, have been shown to signal through JAK/STAT pathways, AG-490 may inhibit cytokine-based cancer therapy. In this study, we evaluated the effects of AG-490 on IL-12 functional signaling and IL-12-mediated antitumor response in vivo. Previous studies have established the critical roles of macrophages and IFN-gamma in mediating IL-12-induced antitumor effects. Our results show that in vivo administration of AG-490 causes tumor cell apoptosis but does not inhibit IL-12-mediated macrophage activation and IFN-gamma production by lymphocytes. Furthermore, our data indicate that combined therapy with AG-490 and IL-12-induces greater antitumor effects than either agent alone in a murine myeloma tumor model. These results suggest that JAK/STAT inhibitors deserve further investigation for use with IL-12 therapy in treating human cancers with elevated JAK/STAT activity.

Animals↗

Osteopontin identified as colon cancer tumor progression marker.

Identifying molecular markers for colon cancer is a top priority. Using a pooled sample approach with Affymetrix GeneChip technology, we assayed colon cancers derived from a series of clinical stages to identify molecular markers of potential prognostic value. Of 12000 genes assessed, osteopontin emerged as the leading candidate tumor progression marker. Osteopontin is a secreted glycoprotein known to bind integrins and CD44. Its actual molecular function remains elusive but its increased expression correlates strongly with tumor progression.

Biomarkers, Tumor↗

Neoadjuvant chemoradiotherapy is not associated with a higher complication rate vs. surgery alone in patients undergoing esophagectomy.

Recent studies have claimed a higher rate of perioperative complications related to the use of neoadjuvant chemoradiotherapy in the treatment of esophageal cancer. We tested the hypothesis that neoadjuvant chemoradiotherapy has no significant effect on the perioperative complication rate. Data on 155 patients with esophageal carcinoma treated between 1996 and 2001 were collected in a prospective database. This included 61 patients (40%) treated with neoadjuvant chemoradiotherapy (group I) and 94 patients (60%) who underwent esophagectomy alone (group II). Neoadjuvant therapy consisted of two courses of cisplatinum and continuous-infusion 5-fluorouracil with radiation followed by esophagectomy. Ivor-Lewis esophagectomy was performed in 146 (94%) and a transhiatal resection in nine (6%). The two groups (I vs. II) were comparable in terms of age (61.3+/-11 years vs. 64.8+/-11 years), diagnosis (adenocarcinoma: 82% vs. 83%; squamous cell carcinoma:11% vs. 16%), and stage (stage 0 to I: 39% vs. 38%; stage II: 25% vs. 34%; stage III: 30% vs. 24%; and stage IV: 6% vs. 4%). The neoadjuvant group had 23 complete responses, 11 partial responses, and 27 nonresponses. There were 39 complications (25.1%) for the cohort, which included three deaths (1.9%) and four anastomotic leaks (2.6%) demonstrated by Gastrografin swallow (1 in group I vs. 3 in group II. Only one leak required reoperation (group II); all others responded to conservative treatment. Group I had 14 complications (22.9%) vs. 25 (26.5%) in group II (P=NS). Groups were comparable with respect to the rate of pulmonary events (4.9% vs. 6.3%), arrhythmias (6.5% vs. 8.5%), and stricture formation (6.5% vs. 7.4%). Neoadjuvant chemoradiotherapy in patients with esophageal cancer was not associated with increased perioperative morbidity or mortality. Complete response to chemoradiotherapy also did not affect the complication rate (26% vs. 22%).

Adenocarcinoma↗

Insulin-like growth factor 1 receptor activates c-SRC and modifies transformation and motility of colon cancer in vitro.

Colorectal carcinomas have been found to express increased levels of IGF1 and IGF1-R, as compared to normal or adenomatous colonic mucosa, and it has been postulated that a subset of colorectal cancers are under the autocrine regulation of the IGF1/IGF1-R system. In this study, we selected human colorectal carcinoma cell lines with high (SW620, HT29, L4A) and low (CaCo2, and HCT 116) expression of IGF1-R by flow cytometry. Compared to the IGF1-R(-) cells, the IGF1-R(+) cells revealed a more aggressive phenotype as demonstrated by a higher proliferation rate (approximately 2-fold increase) in response to IGF1, higher degree of transformation (approximately 5-to-15-fold increase in colony formation in soft agar), increased resistance to serum deprivation-induced apoptosis [1-7 apoptotic cells/5 microscopic fields, as compared to 37 to 101 apoptotic cells/5 microscopic fields of the IGF1-R(-) cells], and higher migratory capability measured by a wounding assay [IGF1-R(+) cells migrated a distance of up to 15 millimeters from the cut edge of the monolayer, while the IGF1-R(-) cells were able to migrate only 2-3 millimeters away from the same reference point]. While the cell lines overexpressing the IGF1-R had higher levels of Src activation, the use of a Src inhibitor reduced the IGF1-R protein expression, slowed down the proliferation of IGF1-R(+) cells, and reduced their colony formation in soft agar. Based on the above observations, we conclude that an overexpressed and activated IGF1-R may increase the degree of transformation and motility of colon cancer cells by activating c-Src.

Adenocarcinoma↗

Glutathione-S-transferase pi expression and activity is increased in colonic neoplasia.

Glutathione-S-transferase (GST) isoenzymes are involved in the conjugation of glutathione to electrophilic carcinogens. Recent studies have shown increased levels and activities of GST in different tumors suggesting their role in carcinogen detoxification. This study compared GST activity levels and GST-pi protein expression in paired samples of colorectal cancer, adenoma and adjacent normal mucosa from a total of thirteen patients. GST was isolated from human colorectal specimens and assayed spectrophotometrically; Western immunoblot analysis was used to quantify GST-pi levels. GST activity was greater in both colorectal cancer and adenomas than in adjacent normal colonic tissue, although statistical significance was achieved only when comparing colorectal cancer to normal tissue. Based on these observations, we conclude that increased GST activity may be a useful marker of colonic neoplasia.

Adenoma↗

Role of p53, CD44V6 and CD57 in differentiating between benign and malignant follicular neoplasms of the thyroid.

The distinction between follicular adenoma (FAD) and follicular carcinoma (FCA) of the thyroid can be particularly challenging in routine practice of diagnostic surgical pathology. It often requires examination of several histologic sections in order to identify the presence of unequivocal capsular and/or vascular invasion. To investigate the role of immunohistochemical markers in the differential diagnosis of follicular lesions of the thyroid, we studied the pattern of expression of p53, Bcl-2 and of the adhesion molecules CD44V6 and CD57, in 20 FADs and 21 FCAs of the thyroid. Ninety percent of FCAs exhibited strong nuclear p53 expression. p53 stain was seen in only 15% of FADs (p<0.0001), and it was weak. Bcl-2 cytoplasmic immunoreactivity was observed in 57% of FCAs and 60% of FADs (p=1.00). Similarly, membranous CD44V6 staining was seen in 81% of FCAs, but in only 20% of FADs (p=0.0001). CD57 was present in the cytoplasm of 71% of FCAs and 15% of FADs (p=0.0004). None of the markers studied correlated with tumor size. The results of this study indicate that immunohistochemical detection of p53, CD44V6 and CD57 may have practical utility in the differential diagnosis of FCAs from FADs in routine surgical pathology.

Adenocarcinoma, Follicular↗

Immunocytochemical detection of members of the caspase cascade of apoptosis in high-grade astrocytomas.

During the physiological process of PCD, the cell initiates a sequence of events culminating in the disintegration of the cell into small, membrane-bound apoptotic bodies. The intrinsic part of the PCD program arises from the mitochondria when it releases cytochrome c from the mitochondrial intermembrane space into the cytosol, forming the caspase-activating complex or apoptosome. The family of caspases is involved in the execution of genetically controlled PCD. Caspase-3 is expressed in normal and neoplastically transformed human cells and, like other caspases, is synthesized as an inactive, 32kDa proenzyme. Caspase-6 cleaves nuclear mitotic apparatus protein (NuMA) and mediates the shrinkage and fragmentation of cell nuclei. Caspase-8 is an initiation caspase that activates the caspase cascade during apoptosis, while caspase-9 is the initiator caspase in the caspase cascade in apoptotic normal and neoplastically transformed cells. During our immunocytochemical study, a sensitive, four-step, alkaline phosphatase conjugated antigen detection technique was employed. The results did in fact demonstrate the presence of high apoptotic activity within the cellular microenvironment of high-grade astrocytomas and glioblastomas. The observations identified cytoplasmic expression of caspase-3 and caspase-6 in more than 50 per cent of tumor cells, caspase-8 and caspase-9 in more than 10 per cent of tumor cells in high-grade anaplastic ASTR and glioblastoma. The immunocytochemical expression pattern in about 10 per cent of the tumor cells for caspase-3 and caspase-6 and about 1 to 5 per cent of the tumor cells for caspase-8 and caspase-9 demonstrated a translocation tendency from the cytoplasm to the cell nuclei in the apoptotic cells. This phenomenon may play an important role in these tumors' maintenance of immune privilege and evasion of immune attacks. We suggest that caspase-3, -6, -8 and -9 immunocytochemistry could have prognostic and immunotherapeutic significance in the treatment of these highly malignant glial tumors.

Adolescent↗

Ascorbyl stearate inhibits cell proliferation and tumor growth in human ovarian carcinoma cells by targeting the PI3K/AKT pathway.

Ascorbyl stearate is a lipophilic, vitamin C derivative with antitumorigenic properties. The molecular mechanism(s) underlying the anticarcinogenic effect of this compound have not been well documented. The effect of ascorbyl stearate was studied in a panel of human ovarian epithelial cancer cells. Treatment with ascorbyl stearate caused a dose-dependent inhibition of the cell proliferation. The antiproliferative effect was due to the arrest of cells in the S/G2-M-phase of the cell cycle. Treatment of OVCAR-3 cells with ascorbyl stearate also inhibited PI3K/AKT activity. The presence of a constitutively active AKT protected OVCAR-3 cells from the effects of ascorbyl stearate, suggesting that this nutraceutical targets the PI3K/AKT pathway. The administration of ascorbyl stearate by gavage induced involution of human ovarian carcinoma xenografts in nude mice. These studies indicate that the antiproliferative effect of ascorbyl stearate on ovarian epithelial cancer cells is associated with decreased PI3K/AKT activity, and point toward the PI3K/AKT signaling pathway as a target for this drug.

Ascorbic Acid↗