Search PubMed⌕ Search

Biomedical subjects

G Steele

Publications and source records attributed to G Steele.

At least 37 records · Page 2Linked to original sources
PubMed1996

The DCC protein and prognosis in colorectal cancer.

BACKGROUND: Allelic loss of chromosome 18q predicts a poor outcome in patients with stage II colorectal cancer. Although the specific gene inactivated by this allelic loss has not been elucidated, the DCC (deleted in colorectal cancer) gene is a candidate. We investigated whether the expression of the DCC protein in tumor cells is a prognostic marker in colorectal carcinoma. METHODS: The expression of DCC was evaluated immunohistochemically in 132 paraffin-embedded samples from patients with curatively resected stage II and III colorectal carcinomas. The Cox proportional-hazards model was used to adjust for covariates including age, sex, tumor site, degree of tumor differentiation, and use of adjuvant therapy. RESULTS: The expression of DCC was a strong positive predictive factor for survival in both stage II and stage III colorectal carcinomas. In patients with stage II disease whose tumors expressed DCC, the five-year survival rate was 94.3 percent, whereas in patients with DCC-negative tumors, the survival rate was 61.6 percent (P<0.001). In patients with stage III disease, the respective survival rates were 59.3 percent and 33.2 percent (P=0.03). CONCLUSIONS: DCC is a prognostic marker in patients with stage II or stage III colorectal cancer. In stage II colorectal carcinomas, the absence of DCC identifies a subgroup of patients with lesions that behave like stage III cancers. These findings may thus have therapeutic implications in this group of patients.

Aged↗
PubMed1996

Implantation of human colorectal carcinoma cells in the liver studied by in vivo fluorescence videomicroscopy.

In vivo fluorescence videomicroscopy (IVFM) was used to analyse the behavior of weakly and highly metastatic human colorectal carcinoma (CRC) cells during implantation in the liver. A highly metastatic human CRC cell line, CX-1, and a weakly metastatic line, Clone A, were double-labeled with rhodamine B isothiocyanate-dextran (Rd-Dx) to locate cells and with calcein AM to assess cell metabolic activity in an experimental metastasis model. Double-labeled CRC cells (2.0 x 10(6)) were injected into the spleens of groups of nude mice and the livers observed by IVFM over the next 72 h. CRC cells were implanted within 30 s after injection into either portal venules or the proximal third of hepatic sinusoids. Approximately 0.5% of CRC cells traversed the liver through portal-central venous shunts and implanted in the lung. The number of CX-1 cells in the liver was similar to that of Clone A cells during the first 12 h. However, more CX-1 cells than Clone A cells remained in the liver at 4 h and were in groups of 8-12 cells whereas only a few, single Clone A cells were detected in the liver at 72 h. Not all Clone A cells are committed to die within 4 h of implantation because cells harvested 4 h after hepatic implantation proliferated normally in vitro when removed from the hepatic microenvironment. Since the stress of mechanical deformation during implantation may cause differences in cell survival, CX-1 and Clone A cells were passed through filters with 8 microM pores in vitro at 10-15 cm of water pressure to recreate the trauma of hepatic implantation. Approximately 50% of both CX-1 and Clone A cells were lysed. Furthermore, both CRC lines remained metabolically active when co-cultivated with liver cells for at least 24 h in vitro. Thus, the difference in metastatic potential between the two CRC lines may reside in their response to the combination of mechanical implantation and subsequent growth in the liver parenchyma.

Animals↗
PubMed1996

Natural History Studies and the Evolution of Regional Treatment Modalities for Patients With Isolated Liver Metastases From Primary Colon and Rectum Carcinoma.

Estimates for 1995 indicate that 150,000 cases of colon and rectum adenocarcinoma occurred in North America, 58,000 patients died of colorectal cancer, and 18,000 patients died with liver as the predominant or only site of metastatic disease from recurrent colon and rectum adenocarcinoma. Results from several trials can now better define the therapeutic and survival benefit of surgical resection, cryosurgical ablation, and intrahepatic arterial therapy in the treatment of patients with metastatic colorectal cancer in the liver.

Journal Article↗
PubMed1995

Increased incidence of p53 mutations is associated with hepatic metastasis in colorectal neoplastic progression.

Within a panel of 15 colon carcinoma cell lines we have characterized the p53 gene status using immunocytochemistry (ICC), SSCP and direct sequence analysis. Extension of this analysis to the use of ICC on 104 colonic lesions, representative of different stages of colonic neoplastic progression, showed an absence of detectable p53 nuclear staining in preneoplastic polyp lesions (20 cases) with staining of 52% (25/48) of primary colon carcinomas and 81% (29/36) of hepatic metastases, suggestive of an increased incidence of p53 mutations in late stage lesions of colonic cancer. To address this issue more directly, we analysed 18 primary colon carcinomas and hepatic metastases excised coincidentally from the same patients. In ICC, p53 nuclear staining was recorded in matching lesions from eight individuals where direct sequencing revealed identical mutations in each case. In four individuals no ICC staining was detected in either lesion and molecular analysis revealed wild type sequence in exons 4-9. In six individuals p53 nuclear staining was observed in the hepatic metastases of patients but not the primary lesion. Molecular analysis revealed point mutation events in hepatic metastases from these patients which were not detected in the primary tumor. The point mutations identified in colon carcinomas were predominantly transition events (83%) located in previously characterized colon hotspot regions. These results demonstrate an increased incidence of p53 mutations associated with secondary lesions of colorectal tumors suggestive of a role for p53 in the establishment of colorectal hepatic metastases.

Amino Acid Sequence↗
PubMed1995

The effect of transfection of the CEA gene on the metastatic behavior of the human colorectal cancer cell line MIP-101.

Carcinoembryonic antigen (CEA) has been shown to increase the metastatic potential of some human colorectal cancer cell lines. To investigate further the mechanisms involved we have produced three clones (6, 8 and 17) from the poorly differentiated human colorectal cancer cell line MIP-101 that have been transfected with the full length cDNA encoding for human carcinoembryonic antigen (CEA). They produce CEA with a mol. wt. of 180000 by Western blotting and secrete it into the culture medium. Clone 6 is a high CEA producer, clones 8 and 17 are intermediate producers. The doubling time for clone 8 was similar to that of the parent cell line while clones 6 and 17 had doubling times nearly twice that of the parent cells. These clones are tumorigenic when injected subcutaneously in nude mice are positive for CEA by immunoperoxidase staining and the mice have elevated blood levels of CEA. Clone 6 formed large aggregates in culture while clone 17 formed smaller aggregates. Clone 8 behaved like the parent cell line with rare cell/cell contact. Clones 6 and 17 also adhered to CEA coated plastic while clone 8, a neo-transfected control and the parent cell line did not. A significant increase in the incidence of hepatic tumors was observed with clone 6 (P < 0.01) and clone 17 (P < 0.02) following intrasplenic injection into nude mice. Immunohistopathology of the hepatic tumors showed strong CEA staining from clones 6 and 17 with weak staining from clone 8. The parent cell line was negative for CEA as were the neo-transfected controls. Of the neo controls none of 10 had liver colonies. Mice injected with clone 6 which developed liver metastasis had the highest plasma levels of CEA (37.3 +/- 8.8 ng/ml). We observed strong CEA staining in Kupffer cells in the normal liver adjacent to the CEA producing tumors. This study provides further evidence for the involvement of CEA in the metastatic process.

Adenocarcinoma↗
PubMed1995

K-ras status does not predict successful hepatic resection of colorectal cancer metastasis.

OBJECTIVE: To establish whether specific K-ras alterations are predictive of less aggressive tumor behavior and subsequently those patients who are most likely to benefit from resection of hepatic metastases from colorectal carcinoma. DESIGN: Evaluation of long-term survivors of hepatic resection for metastases of colorectal carcinoma (median survival, 85 months). RESULTS: DNA, extracted from 26 paraffin-embedded hepatic metastases from 19 patients, was analyzed using single-strand conformation polymorphism and direct sequence analysis of codons 12 and 13 of the K-ras gene. Seven of 19 patients were found to harbor K-ras mutations. A similar frequency and spectrum of K-ras mutational events was detected in 14 patients with short-term survival following pathologic diagnosis of hepatic metastasis. CONCLUSIONS: Neither the presence of a K-ras mutational event nor the precise nucleotide change are predictive of less aggressive tumor behavior, and genetic alterations at this locus alone cannot be used to select patients undergoing resection of hepatic metastases from colorectal carcinoma.

Adenocarcinoma↗
PubMed1995

Sucrase-isomaltase is an independent prognostic marker for colorectal carcinoma.

PURPOSE: Expression of disaccharidase sucrase-isomaltase (SI) is significantly enhanced during neoplastic transformation of colonic epithelium. Our study was designed to determine whether expression of SI within primary tumors was significantly associated with survival in patients with colorectal carcinoma (CRC). METHODS: SI expression was analyzed by immunohistochemistry in paraffin sections from 182 Stage I to III CRC that had been resected for cure at the New England Deaconess Hospital between 1965 and 1977. Expression was scored as absent or present in 1 to 50 percent or more than 50 percent of tumor cells. Associations were explored among SI expression, other clinical or pathologic variables, and overall survival. The data set is mature, with 91 (56 percent) patients who had died of CRC at a median follow-up of 96 months. RESULTS: Fifty-five percent of primary CRC expressed SI. When the multivariate Cox analysis was performed, nodal status, T stage, primary site, grade, and SI expression were independent covariates. SI expression was not associated with the expression of other clinicopathologic variables but increased the risk of death from colorectal carcinoma by 1.83-fold. DISCUSSION: These results indicate that SI is a prognostic marker for CRC that is independent of stage-related variables in patients who have undergone potentially curative resections.

Aged↗
PubMed1995

Advances in the treatment of early- to late-stage colorectal cancer: 20 years of progress.

BACKGROUND: Numerous scientific and clinical advances have made significant changes in our understanding of the etiology of colorectal cancer and in the diagnosis and treatment of patients with large bowel malignancy or its precursor lesions. METHODS: A personal view of 20 years of progress was presented at the Commission on Cancer lecture during the 1993 Clinical Convocation of the American College of Surgeons. RESULTS AND CONCLUSIONS: Improvement in the diagnosis and treatment of early bowel cancers, significant benefit from multimodality therapy of more advanced resectable bowel cancers, and better articulated selection criteria in patients with recurrent colorectal cancers are reviewed. Most importantly, both physical and emotional consequences of our therapies are shown to have diminished without sacrificing the ability to cure. Perhaps the next major challenge is for the general surgeon to assume responsibility as the primary medical manager of any patient with gastrointestinal cancer from the time of diagnosis onward.

Colonic Neoplasms↗
PubMed1995

Role of the E-cadherin/alpha-catenin complex in modulating cell-cell and cell-matrix adhesive properties of invasive colon carcinoma cells.

BACKGROUND: The clinical behavior of colorectal cancer depends on its ability to invade and metastasize. Metastatic cells must dissociate from other cells and invade through basement membrane and stroma. Cell-cell adhesion in epithelial cells is mediated by the cell surface protein E-cadherin in association with alpha- and beta-catenin, which link E-cadherin to the cytoskeleton. Decreased cell-cell adhesion and increased motility on laminin have been correlated with more poorly differentiated and aggressive carcinomas. METHODS: In this study, the RKO cell line, previously shown by us to lack E-cadherin expression, was transfected with the complementary DNA for E-cadherin. The transfectants were selected for high levels of surface expression by sequential FACS and examined in functional assays. RESULTS: In comparison to control transfectants, the E-cadherin transfectants exhibited a more epithelial-like morphology, a 30% increase in Ca(2+)-dependent cell-cell aggregation, and a markedly reduced motility on the matrix proteins, collagen I and laminin. CONCLUSIONS: These data demonstrate that correction of a defect in the cadherin/catenin cell-cell adhesion complex, often found in poorly differentiated and highly invasive tumors, facilitates increased cell-cell adhesion and retards tumor cell migration on basement membrane and stromal proteins.

Basement Membrane↗
PubMed1995

An educational intervention in the surgical intensive care unit to improve ethical decisions.

BACKGROUND: The objective of this study was to determine whether an educational intervention on medical ethics offered during a surgical intensive care unit (SICU) rotation could effect meaningful change in a tertiary SICU. METHODS: A case-based education program was presented weekly to the surgical residents during their SICU rotation. Cases for study were designed to deal with specific ethical issues common to the SICU. Cases were studied with the residents in a group facilitated by a SICU attending physician and a nursing director. The effect of the course was monitored by case review and by the length of stay (LOS) assessment for patients who died in the SICU during 1990, the base year, through 1993. RESULTS: Discussions of an ethical nature occurred more regularly and earlier during these 4 years as determined by case reviews. For patients who died after being in the SICU a minimum of more than 30 days, a marked decrease occurred in the SICU LOS from 27.8 +/- 3.7 days in 1990 to 15.7 +/- 2.4 days in 1993 (p < 0.05). The number of deaths per year and the average acuity measured by the diagnosis related group score were similar during the 4 years. The LOS in the hospital for dying patients from non-SICU services remained similar during the same time frame. These changes resulted in the dying patients using 1003 SICU days in 1993, down from the 2028 days used in 1990 (p < 0.05). CONCLUSIONS: We conclude that through offering a clinical ethics program during the SICU portion of the residency training, residents increased knowledge and skill in addressing and integrating practical ethical issues into their surgical resident practice. In addition, patient care directly improved with an associated reduced SICU LOS and reduced cost.

Critical Care↗
PubMed1995

Inhibition of N-linked glycosylation of P-glycoprotein by tunicamycin results in a reduced multidrug resistance phenotype.

Characterisation of altered glycosylation of P-glycoprotein (P-gp) found associated with the absence of a multidrug resistance (MDR) phenotype in cell lines prompted an investigation to assess the role of post-translational processing in establishing P-gp efflux pump functionally. The clone A cell line used in this study displays a strong MDR phenotype mediated by high constitutive levels of expression of P-gp. Incubation of clone A cells with tunicamycin for different periods resulted in a time-dependent increase in daunorubicin accumulation, reflecting a reduction in P-gp function. Parallel experiments conducted with verapamil resulted in no loss of P-gp functionality in clone A cells. Reduction in surface-associated P-gp following exposure to tunicamycin was established by FACS analysis, Western blot analysis and immunoprecipitation of surface-iodinated P-gp. In addition, immunoprecipitation of P-gp from 32P-orthophosphate-labelled cells demonstrated reduced phosphorylation of P-gp associated with tunicamycin exposure. From these studies we conclude that glycosylation of P-gp is required to establish the cellular MDR phenotype.

ATP Binding Cassette Transporter, Subfamily B, Mem↗
PubMed1994

Kupffer cell/tumor cell interactions and hepatic metastasis in colorectal cancer.

The degree of interaction with Kupffer cells of two moderately well differentiated cell lines, CX-1 and CCl-188 of high metastatic potential (61%) were compared to two poorly differentiated cell lines, MIP-101 and Clone A of low metastatic potential (6%) in the intrasplenic injection model for liver metastasis. MIP-101 and Clone A bound significantly better to mouse Kupffer cells in vitro than either CX-1 or CCL-188. We also identified specific cell surface proteins mediating attachment of colorectal carcinoma cells to murine Kupffer cells. Kupffer cells were radiolabelled and their surface proteins incubated with MIP-101 and CX-1. Two radiolabelled proteins from murine Kupffer cells of 14 and 34 kDa were identified consistently binding to the tumor cells. Binding of both proteins was inhibited by asialofetuin but not by fetuin. This suggests that the major binding proteins between Kupffer cells and colorectal cancer cells are galactose binding lectins.

Animals↗
PubMed1994

Desialylation of metastatic human colorectal carcinoma cells facilitates binding to Kupffer cells.

Cell surface hypersialylation of human colorectal carcinoma (HCRC) cells correlates with increased metastatic potential after intrasplenic injection, while desialylation with various agents has been shown to inhibit hepatic metastases. In this study we examined the effects of desialylation of HCRC cell lines with a novel intracellular inhibitor of the CMP-sialic acid transport protein (KI-8110). HCRC cells, which are poorly differentiated and poorly metastatic in nude mice (Clone A and MIP-101) were compared to well-differentiated, highly metastatic cells (CX-1 and CCL-235). KI-8110 treatment has previously been shown to reduce sialic acid levels in each of these cell lines and to reduce hepatic metastases in CX-1 and CCL-235 cell lines. This study attempts to identify a mechanism by which desialylation inhibits hepatic metastases. After KI-8110 treatment, in vitro adhesion assays were performed with each cell line to examine binding to Kupffer cells and the extracellular matrix protein fibronectin. Binding of Clone A, CX-1, and CCL-235 to Kupffer cells was significantly increased after KI-8110 treatment. Desialylation had no significant effect on binding of HCRC cell lines to fibronectin. While the metastatic cascade involves many complex interactions, the cytotoxic effects of Kupffer cells in the hepatic sinusoid are known to be an important mechanism of host defense against tumor cells. Cell surface sialic acids may well mask Kupffer cell binding to HCRC cells, preventing their cytotoxic effects and enhancing the metastatic potential of circulating tumor cells.

Animals↗
PubMed1994

Normal colonic epithelium adheres to carcinoembryonic antigen and type IV collagen.

BACKGROUND/AIMS: Human colorectal carcinoma cells bind to collagen and laminin in the basement membrane as well as to carcinoembryonic antigen (CEA) on neighboring cells. The purpose of this study was to determine whether normal colonic epithelial cells bind to CEA, collagen, or laminin. METHODS: Intact colonic crypts were isolated from normal mucosa in 13 specimens resected for colorectal carcinoma or colonic diverticulitis. Colonocytes were released from the crypts by treatment with collagenase and deoxyribonuclease and tested for adhesion to CEA, type IV collagen, and laminin in a solid-phase adhesion assay. RESULTS: Twelve percent to 25% of colonocytes in all specimens bound to CEA. Colonocytes from seven specimens also bound to type IV collagen, but none of the colonocyte preparations bound significantly to laminin. Monoclonal antibodies to CEA and to the hyaluronate receptor CD44 and enzymatic removal of membrane CEA blocked the adhesion of colonocytes to CEA. CONCLUSIONS: First, colonocytes use the same epitopes on CEA and CD44 as colorectal carcinoma cells to adhere to solid-phase CEA. Second, colonocytes bind to solid-phase CEA through CEA-to-CEA homophilic binding. Third, CEA and type IV collagen, but not laminin, are adhesion ligands for human colonocytes.

Antibodies↗
PubMed1993

Standard postoperative monitoring of patients after primary resection of colon and rectum cancer.

The goal of monitoring after primary treatment of any solid tumor, including colon and rectum carcinoma, is to help the patient. The general parameters include prevention of secondary tumors or precancers (because most patients with solid tumors are at greater risk than the general population for second tumors of the same histology), the cure of symptomatic or asymptomatic tumor recurrences, and the palliation of symptomatic tumor recurrences. Additional rationale for more stringent follow-up is somewhat dependent upon the venue of patient care, including the necessity for more frequent studies if the patient happens to be in a protocol in which disease-free survival and/or patterns of recurrence are being investigated. Keeping these parameters in mind, most prevalent follow-up plans remain empiric and probably are not justifiable, on the basis of either cost-effective analysis or real benefit to the patient.

Colonic Neoplasms↗