Microcarcinoma of the stomach measuring less than 5 mm in the largest diameter and its histogenesis.
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Biomedical subjects
Publications and source records attributed to H Sugano.
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Serially obtained needle biopsy specimens of 30 prostatic adenocarcinoma patients were examined to clarify the therapeutic effect on histology. Histology of the tumours after radiotherapy (Linac, 6,440 rad on average) revealed gradual degeneration without the formation of massive necrosis. The rates of cancer-free cases were 22.2% and 41.2% less and more than 1 year after radiation therapy, respectively. The 5-year survival rate was 53.3%. Of 10 patients who survived 5 years, all died of recurrence within 10 years. This indicates the necessity for longterm follow up in prostatic cancer patients.
A 74-year-old female with a left breast mass was admitted to the Cancer Institute Hospital and underwent mastectomy. Upon study of a frozen section, a diagnosis of breast carcinoma was made. Histopathological examination revealed a non-invasive tumor whose slightly eosinophilic rich cytoplasm was positive for PAS and Alcian-green staining and argyrophilic staining. The tumor showed medullary arrangement, partly with glandular and rosette-like structures. Electron microscopically, many dense core granules (170 +/- 30 nm in diameter) were diffusely distributed in almost all the tumor cytoplasm, they were thought to be neurosecretory granules. A diagnosis of mucocarcinoid of the breast was made. The patient experienced no dyshormonal disorder during the course of the disease and is alive and well without recurrence.
We examined the distribution and frequency of metastasis in 135 breast carcinoma cases autopsied between 1946 and 1981 at the Cancer Institute, Tokyo, and studied the relationship between the results and various factors such as histological type, patient age, therapy and clinical course. Breast carcinoma metastasizes more widely and more frequently than other malignant tumors; there is a high rate of metastasis to the bone, adrenals, opposite breast, and thyroid. Medullary tubular carcinoma metastasizes more highly than other histological types. The frequency of metastasis is higher in the younger age group and in patients irradiated to the primary sites. There is little correlation between the frequency of metastasis and total duration.
During the past 5 years, 55839 individuals mass screening for breast cancer in Miyagi Prefecture. Breast cancer was detected in 51 of 49114 (0.1%) women examined at the local site and in 14 of 6725 (0.2%) women examined at the vocational site. At the Cancer Detection Center (CDC) breast cancer was detected in 75 of 3055 (2.4%) screened individuals. Of the 51 breast cancer patients identified at the local site, 35 had noted a breast lump before screening, 6 of 14 patients identified at the vocational site had noted a lump. All patients in whom cancer was detected at the CDC had noticed a breast lump before undergoing the examination. Tumors were detected at a relatively early stage at the vocational site. Classification of tumor size was not significantly different between the local and the CDC examination.
Two important subjects in natural history of human cancer were reviewed and discussed. It is noted high incidence of latent cancer or microcancer in the thyroid, prostate and stomach. From these results we postulate that cancerization and manifestation of microcancer is different steps in cancer development and manifestors play an important role for clinical manifestation of microcancer. We proposed the concept of the basic cancer and the variable cancer. The basic cancer is a proper cancer of a certain organ and stable in its incidence, while the variable cancer is a cancer whose incidence varies by environmental conditions.
Gastric carcinoma of the undifferentiated type in the fundic gland area has a higher tendency for submucosal invasion than carcinoma located in the pyloric gland area. To investigate whether a similar tendency is present also in a cancerous focus, we studied 147 patients with early gastric carcinomas with submucosal invasion. Out of 27 undifferentiated carcinomas located in the intermediate zone, 20 (54%) showed peripheral submucosal invasion; in 16(80%) of these, the invasion was located near or in the fundic gland area. These results indicate that submucosal invasion is more likely to occur towards the fundic area.
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The frequency of intramucosal cysts underneath focal (elevated) neoplastic lesions (which include epithelial dysplasia and early gastric cancer) was recorded in eighty-eight resected stomachs. The mean cyst index (i.e. the amount of intramucosal cysts divided by the amount--in cm--of gastric mucosa analyzed) underneath such lesions was 30.9 (SD +/- 16.9), while in adjacent normal-looking gastric mucosa it was 9.4 (SD +/- 8). The difference was significant (P less than 0.001). The cyst index was highest in female patients, underneath focal (elevated) dysplasias. Previous work indicated that the normal-looking gastric mucosa in Japanese patients with peptic ulcer disease was 3.4 (SD +/- 6.6). The present findings appear to suggest that cystic formation in gastric mucosa may herald an early neoplastic growth at the luminal aspect in some of the cysts.
The in vivo rates of protein synthesis in the peripheral nervous tissues of methylmercury-treated rats (10 mg/kg/day, for 7 days) have been estimated with improved methods by the injection of a large amount of [1-14C]valine of low specific activity. Protein synthesis activity in the dorsal root ganglia was inhibited to the extent of 60% of the control as early as day 5 and this continued to the symptomatic period (day 15) on which crossing of hind limbs, a typical sign of organomercurial poisoning, was observed in the animals. The sciatic nerves and dorsal roots increased protein synthesis by 56% at the symptomatic period. These increases in protein synthesis may be due to the stimulation of reactivity of Schwann's cells. On the contrary, the protein synthesis in the ventral roots showed a gradual decrease as the intoxication proceeded and decreased to 73% of the control at the symptomatic period, being similar to the case of brain. The double-labeling studies with sodium dodecyl sulfate/polyacrylamide gel electrophoresis exhibited that methylmercury inhibited the synthesis of the dorsal root ganglion proteins non-uniformly in various apparent molecular sizes, especially on day 10.
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In Japan, the incidence of breast cancer is remarkably lower than in Western countries. We examined tumor estrogen (ER) and progesterone receptors (PgR) in 1060 Japanese breast cancer patients. In Japan, 58% and 36% of breast cancers revealed measurable amounts of cytosol ER and PgR, respectively. These rates are slightly lower than those reported in Western countries, which were found to be 60-80% and 40-60%, respectively, though the difference is mainly confined to postmenopausal non-overweight (less than 60 kg) patients. The objective remission rates to endocrine therapy were 48% for ER+ tumors, 10% for ER-tumors, 66% for ER+, PgR+ tumors, 30% for ER+, PgR- tumors and 10% for ER-, PgR- tumors. These response rates are similar to those in Western breast cancer patients. ER and/or PgR in the breast cancer cytosol are useful markers for predicting response to endocrine therapy. The present findings also indicate that ER- tumors are estrogen independent but ER+ tumors include both estrogen-dependent and -independent tumors and that some of ER+ but endocrine-resistant tumors have postreceptor defect. The presence of ER+ but endocrine-resistant tumors may be due in part to the loss of hormone-dependency of estrogen-dependent breast cancer during endocrine therapy. The transformation of hormone-dependent mouse tumor cells into independent tumor cells was demonstrated as one of the mechanisms involved in the loss of hormone-dependency.
Historical review of the pathological investigation on stomach cancer in Japan shows that the central problem had been whether or not gastric cancer developed from chronic peptic ulcer. This theory of ulcer cancer sequence was developed from chronic peptic ulcer. This theory of ulcer cancer sequence was supported by many researchers after the war in the period of 1946-64. Subsequently, systematic studies made at the Cancer Institute revealed that carcinoma arises from the gastric mucosa independently of chronic ulcer. The pathological interest then shifted toward investigation of the histogenesis and biological characteristics of gastric carcinoma. It is concluded that gastric carcinoma can be classified into two types; undifferentiated carcinoma (UCA or gastric type) and differentiated one (DCA or intestinal type). The former arises from the ordinary mucosa and cancer phenotype of this carcinoma resembles to that of the ordinary mucosa, and the latter arises from the metaplastic epithelium of intestinal type showing a cancer phenotype resembling to that of the intestinal metaplastic epithelium. These two carcinomas are also different in biological behaviors, such as growth pattern, invasiveness, metastasis, and prognosis. The frequency of UCA is almost the same in both sexes. DCA, however, occurs more often in male than in female. The time trend data indicates that in both sexes the number of DCA decreased, but that of UCA is steady, so that the ratio of DCA to UCA decreased since 1965. These results combined with the concept of the basic and variable cancer leads to a conclusion that UCA is a basic cancer and DCA is a variable cancer of the stomach.
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The changes in histologic types of gastric carcinoma in Japan in recent years was studied utilizing the 4147 cases surgically resected at the Cancer Institute Hospital, Tokyo, from 1955 to 1974. All carcinomas were classified as either well-differentiated or poorly differentiated, and the ratio of the former to the latter (WPR) was calculated for the first decade (1955-1964) and the second decade (1965-1974). A decline in the WPR was observed, although the difference was not statistically significant. However, when the material was subdivided according to the site of the tumor in the stomach, a decrease in the WPR was markedly visible in the area designated as Fl-area, i.e., a part of the fundic area susceptible to intestinalization. When limited to this area, the difference was statistically significant (P less than 0.05).
A membrane protein fraction having a high affinity for polyribosomes was isolated from microsomal membranes of rat liver and was incorporated into liposomes made from microsomal lipids to evaluate the polyribosome-binding capacity of the reconstituted liposomes, with the following results. (1) The polyribosome binding to the reconstituted liposomes depended on the amounts of polyribosomes added to the binding mixture. (2) Liposomes made from lipids alone did not bind any polyribosomes. (3) The polyribosome-binding capacity of the reconstituted liposomes was very sensitive to proteolytic enzyme and strongly inhibited by addition of 0.1 mM-aurintricarboxylic acid or by increasing KCl concentration. These results suggest that the binding mechanism of polyribosomes to the reconstituted liposomes is much like that for rough microsomal membrane stripped of endogenous polyribosomes.
(1) A single injection of methylmercury chloride in the rat (10-50 mg/kg) increased both in vivo and in vitro rates of 14C-leucine incorporation into the protein of the post-mitochondrial supernatant fraction of the liver. In contrast, no stimulation of protein synthesis was observed in the brain of the methylmercury-treated rats. (2) Methylmercury administration also stimulated RNA polymerase activities in isolated hepatic nuclei, stimulation of Mg-dependent activity being higher than that of Mn-dependent activity. (3) In experiments with adrenalectomized rats, it was found that the stimulatory effect of methylmercury on protein and RNA synthesis in the liver was mediated partly through the adrenal gland. (4) Analysis of serum by starch-block electrophoresis revealed that synthesis of all serum proteins, including albumin and alpha-gamma globulin fractions, was stimulated by methylmercury treatment. (5) These results suggest that the observed effects of methylmercury on the liver depend on mechanisms other than enhancement of the synthesis of acute-phase proteins.