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PubMed2003

Exophytic pedunculated gastrointestinal stromal tumor with remarkable cystic change.

A 59-year-old man with bloody stools, and previously diagnosed with sigmoid colon carcinoma, visited our hospital. Preoperative abdominal ultrasonography (US) showed another tumor, with an uneven irregular surface, measuring about 9 x 5 cm, below the left hypochondrium. The tumor consisted of several cysts. Abdominal computed tomography (CT) showed a multicystic tumor attached to the stomach, and its septum and marginal region were intensely stained on contrast imaging. On magnetic resonance imaging (MRI), low and markedly high signals were revealed in the tumor on T1-weighted and T2-weighted sequences, respectively. Contrast imaging of the upper digestive tract showed extramural compression of the greater curvature of the antral stomach by the tumor. The tumor was partially imaged by endoscopic ultrasonography (EUS), but continuity to the stomach was not confirmed. On abdominal angiography, the tumor was slightly stained via the gastroepiploic arteries. Surgical treatment was performed to excise both the gastric tumor and the sigmoid colon carcinoma. The gastric tumor was removed with gastric wall tissue where the tumor was attached to a 2-cm pedicle. It was multicystic, contained watery fluid, and had a smooth outer surface. Histologically, the tumor consisted of multiple irregular cysts without epithelial lining, and solid epitheloid cell nests in between. The tumor cells had clear or eosinophilic cytoplasm and round nuclei. No mitotic figures were seen. The tumor cells in the pedicle were connected with the muscularis propriae of the stomach. Immunohistochemistry showed c-kit-positive, CD34-positive smooth muscle actin (SMA)-negative, and S-100-negative staining of tumor cells. The final diagnosis was gastrointestinal stromal tumor (GIST).

Gastrointestinal Neoplasms↗
PubMed2003

Identifying and quantifying apoptosis: navigating technical pitfalls.

Apoptosis or programmed cell death is often altered in malignancies and is frequently determined by the terminal transferase-mediated nick end labeling technique (TUNEL). However, commercially available protocols can produce high background and false-positive staining, which renders the distinction between apoptosis and necrosis difficult. In an attempt to develop a rapid and reproducible method for detecting and quantifying apoptosis, we coupled optimization of the Apoptag Plus Peroxidase In Situ Apoptosis Detection kit with quantitative histomorphometric computer imaging software using the Bacus Laboratories Incorporated Slide Scanner (BLISS). Multiple (200-350) unique 40x images were scanned using the BLISS system and downloaded into the WebSlide Browser program, creating a permanent, scanned record of the area assessed. The stored images were counted, with the final analysis simultaneously taking into account cells that were immunohistochemically positive and the histology of the surrounding cells to reduce the possibility of false positive and negative staining. In addition, cells with equivocal staining can be simultaneously reviewed by other technologists with networked WebSlide Browser access to the same images. Our data show that the advantages offered by the BLISS imaging software greatly reduce the potential drawbacks of using the TUNEL method as a sole means of quantification.

Adenocarcinoma↗
PubMed1994

A frequent alteration of p53 gene in carcinoma in adenoma of colon.

In general, colorectal carcinoma is thought to originate mainly from adenoma, and this pathway is called the adenoma-carcinoma sequence. Carcinoma in adenoma is an appropriate model for analysis of this mechanism, because adenoma and carcinoma tissues coexist in the same polyp and the carcinoma is thought to have originated from the surrounding adenoma. Expression of the p53 protein was analyzed in 36 cases of carcinoma in adenoma in the colon by immunohistochemistry using an anti-human p53 monoclonal antibody (PAb1801). Alterations of the p53 gene were analyzed by the polymerase chain reaction for microanalysis of normal mucosa, adenoma, and carcinoma from histological slides. Mutations were assessed by the polymerase chain reaction-single strand conformation polymorphism analysis and identified by DNA sequencing in some cases. Loss of heterozygosity was studied by polymerase chain reaction-restriction fragment length polymorphism analysis. Positive staining for p53 was detected in three (8%) of 37 adenomas and 20 (53%) of 38 focal carcinomas. One (7%) of 15 adenomas with mild dysplasia, three (14%) of 22 adenomas with moderate dysplasia, and 16 (42%) of 38 focal carcinomas had a mutation in exon 5 through exon 8 of the p53 gene. As for allelic loss in the p53 gene locus, only one adenoma with moderate dysplasia had loss of heterozygosity, whereas six (40%) of 15 focal carcinomas had loss of heterozygosity. Of those tumors (3 of 37 adenomas and 20 of 38 focal carcinomas) that reacted with PAb1801, 78% (18 of 23) showed genetic alterations. Among 52 tumors which showed negative staining, five tumors had a p53 mutation and four of them were nonsense mutations. Putting all of these results together, 71% (24 of 34) of the cases underwent p53 gene and protein alterations during the conversion from adenoma to focal carcinoma. These data clearly indicate that genetic alterations of p53 are involved mainly in the malignant transformation from adenoma to focal carcinoma in colon carcinogenesis. In addition, some cases show heterogeneity of the p53 gene in carcinoma in adenoma of the colon. There may be other pathways than p53 responsible for malignant change in the colon.

Adenocarcinoma↗
PubMed2001

Acute lymphoblastic leukaemia with giant intracytoplasmic inclusion--a case report.

Acute Lymphoblastic Leukaemia (ALL) with intracytoplasmic inclusions is a rare and unusual subtype of acute leukaemia. Here we describe a case of ALL with intracytoplasmic inclusions in an adult female. These inclusions stained negative for Myeloperoxidase (MPO), Sudan Black B (SBB) and Alpha-naphthyl acetate estarase (ANAE) and positive for Periodic Acid Schiff (PAS). This case is being presented for its unusual occurrence and to recognise the characteristics of this subtype of ALL to avoid a misdiagnosis of AML (Acute Myeloid Leukaemia).

Adult↗
PubMed2003

Comparison between the expression of basement membrane zone antigens of human interfollicular epidermis and anagen hair follicle using indirect immunofluorescence.

BACKGROUND: The composition of the basement membrane zone (BMZ) or dermal-epidermal junction in the interfollicular skin has been well documented. However, little is known about the BMZ or connective tissue-epithelial junction along the hair follicle. OBJECTIVES: To determine whether the BMZ antigens in the interfollicular epidermis are also present in the BMZ of the anagen hair follicle and to compare whether the expression and distribution of the BMZ components vary between the interfollicular epidermis and the anagen follicle and within different regions of the hair follicle. METHODS: Longitudinal cryostat sections of scalp margin specimens from four adult patients undergoing cosmetic surgery, and without known pathology were stained with a panel of monoclonal and polyclonal antibodies to different BMZ constituents using standard indirect immunofluorescence. RESULTS: All the BMZ antigens found in the normal interfollicular epidermis were expressed in the anagen follicle; however, there were regional variations in the intensity and patterns of fluorescence. All the antigens were expressed in a continuous linear pattern along the BMZ of the interfollicular skin, the infundibulum, and the middle part of the hair follicle. Differences were observed in the lower follicle and the hair bulb. There was continuous expression throughout the BMZ of the follicle of laminin-1 and collagen IV, but in contrast, expression of other antigens decreased down the lower follicle. There was weak or even negative staining with antibodies to alpha 6 beta 4 integrin, laminin-5, anchoring filaments, and type VII collagen in the outer aspect of the bulb compared with the hair papilla. In addition, there were special patterns observed along the bilateral middle and lower follicle. CONCLUSIONS: Despite the common embryological origin between the interfollicular epidermis and the hair follicle, there is variation in the expression of the BMZ antigens. This may be explained by the histological specialization and functional requirements that reflect the dynamic hair growth cycle.

Adult↗
PubMed1994

Studies on the diagnosis of Tyzzer's disease in laboratory rat colonies with antibodies against Bacillus piliformis (Clostridium piliforme).

To develop a system to be used for confirming diagnosis of Tyzzer's disease in seropositive rat colonies, 38 Mol:SPRD, BB/Wor/Mol-BB, and Stroke-Prone rats suffering from megaloileitis were examined. All affected rats had been found by a systematic examination of 5-week-old male rats from barrier-protected colonies, sero-positive to Bacillus piliformis, the agent of Tyzzer's disease. The rats were evaluated by serologic testing, histologic examination of the ileum, liver, and heart (hematoxylin and eosin and Warthin-Starry staining), and immunofluorescence staining of tissue smears of the ileum and liver. The presence of B. piliformis was verified in 24 of the rats. All animals that had the agent in the liver or heart also had it in the ileum. The sensitivity of immunofluorescence staining for identification of the agent was higher than that for Warthin-Starry staining. Thirty-seven rats had histologic changes indicative of Tyzzer's disease in the liver, and 23 had histologic changes in the myocardium. All rats had a high titer of antibodies against B. piliformis. Having verified the presence of the agent, germ-free sentinels were placed in one of the colonies. These also became infected, as did germ-free sentinels caged with the infected rats outside the barrier unit. The number of sentinels infected increased with the age of the sentinels at introduction. To prove the absence of Tyzzer's disease in a seropositive colony, it is considered necessary to examine approximately 3,000 5-week-old rats for abdominal distension and demonstrate negative staining of the ileum for B. piliformis.

Animals↗
PubMed1999

Giant syncytia and virus-like particles in ovarian carcinoma cells isolated from ascites fluid.

Ovarian cancer cells were isolated from ascites fluid of 30 different patients diagnosed with cystadenocarcinoma of ovaries. Large colonies of malignant ASC cells were observed during the first week of cell growth in vitro. Colony formation was followed by fusion of cells and formation of large multinucleated and highly vacuolated syncytia. In contrast, cells isolated from the ascites fluid produced by patients with benign mucinous cystadenoma of ovaries did not form syncytia. Nonmalignant Brenner tumor cells, isolated from the ascites fluid, also did not form syncytia. Syncytia, but not the nonmalignant tumor cells, were immunofluorescence stained with an anti-human immunodeficiency virus type 1 (HIV-1) gp120 monoclonal antibody (MAb) and MAb RAK-BrI. Both MAbs recognized cancer-associated antigens RAK (for Rakowicz markers) p120, p42, and p25. Exposure of ASC cells to either the anti-HIV-1 gp120 MAb or MAb RAK-BrI inhibited syncytium formation. PCR with HIV-1 Env-derived primers revealed DNA sequences with over 90% homology to HIV-1 gp41 in syncytia and in ovarian cancer cells but not in normal ovary cells. Electron microscopic analysis revealed viral particles, hexagonal in shape (90 nm in diameter), with a dense central core surrounded by an inner translucent capsid and dense outer shell with projections. Negative staining detected membrane-covered particles (100 to 110 nm in diameter) in the cell culture medium. Incubation of normal breast cells with viral particles resulted in drastic morphological changes and syncytium formation by the transformed breast cells. The cytopathic effects of the identified virus resembled those of spumaviruses, which, in addition to their epitopic and genetic homology to HIV-1, might suggest a common phylogeny.

Amino Acid Sequence↗
PubMed2002

Caveolin-1 is incorporated into mature respiratory syncytial virus particles during virus assembly on the surface of virus-infected cells.

We have employed immunofluorescence microscopy and transmission electron microscopy to examine the assembly and maturation of respiratory syncytial virus (RSV) in the Vero cell line C1008. RSV matures at the apical cell surface in a filamentous form that extends from the plasma membrane. We observed that inclusion bodies containing viral ribonucleoprotein (RNP) cores predominantly appeared immediately below the plasma membrane, from where RSV filaments form during maturation at the cell surface. A comparison of mock-infected and RSV-infected cells by confocal microscopy revealed a significant change in the pattern of caveolin-1 (cav-1) fluorescence staining. Analysis by immuno-electron microscopy showed that RSV filaments formed in close proximity to cav-1 clusters at the cell surface membrane. In addition, immuno-electron microscopy showed that cav-1 was closely associated with early budding RSV. Further analysis by confocal microscopy showed that cav-1 was subsequently incorporated into the envelope of RSV filaments maturing on the host cell membrane, but was not associated with other virus structures such as the viral RNPs. Although cav-1 was incorporated into the mature virus, it was localized in clusters rather than being uniformly distributed along the length of the viral filaments. Furthermore, when RSV particles in the tissue culture medium from infected cells were examined by immuno-negative staining, the presence of cav-1 on the viral envelope was clearly demonstrated. Collectively, these findings show that cav-1 is incorporated into the envelope of mature RSV particles during egress.

Animals↗
PubMed1999

Ultrastructural characterization of Anaerobiospirillum succiniciproducens and its differentiation from Campylobacter species.

The anaerobic spiral-shaped bacterium Anaerobiospirillum succiniciproducens was isolated from the blood of an AIDS patient for the first time in Europe. Electron-microscopical methods, especially negative staining, allowed rapid morphological classification and differentiation from Campylobacter species. While A. succiniciproducens revealed lophotriche flagellation all the investigated Campylobacter species showed monotriche flagellation. The cell diameter of A. succiniciproducens was at least double that of the investigated Campylobacter species. Other ultrastructural features, such as a ring-like structure underneath the flagellar area and fibrils arranged parallel along the axis, were also specific to A. succiniciproducens.

AIDS-Related Opportunistic Infections↗
PubMed1993

MHC class I expression in HPV 16 positive cervical carcinomas is post-transcriptionally controlled and independent from c-myc overexpression.

Squamous cell carcinomas of the uterine cervix (n = 23) were selected for the presence of human papillomavirus type 16 (HPV 16) using the polymerase chain reaction (PCR). Localization of transcripts coding for the E7 protein was demonstrated in neoplastic cells with RNA in situ hybridization. Consecutive tissue sections were investigated for expression of the major histocompatibility complex class I (MHC-I) and c-myc using immunohistochemical double staining procedures, since a role has been suggested for the c-myc protein in MHC-I down-regulation and c-myc overexpression has been described in cervical carcinomas. Reduced expression of class I heavy chains was observed in neoplastic cells from 18 out of 23 carcinomas (78%). Varying levels of c-myc overexpression were observed in 12 carcinomas (52%), from which four showed positive MHC-I expression in c-myc overexpressing cells. In the remaining eight c-myc overexpressing carcinomas MHC-I down-regulation was observed. Additional RNA in situ hybridization with class I heavy chain locus-specific RNA-probes revealed presence of class I mRNAs in those neoplastic cells that show negative staining for MHC-I protein. These data strongly indicate that MHC-I down-regulation in cervical carcinomas involves post-transcriptional mechanisms, not directly related to E7 transcription and overexpression of c-myc.

Carcinoma, Squamous Cell↗
PubMed1977

Differeniated regions of human placental cell surface associated with exchange of materials between maternal and foetal blood: coated vesicles.

Coated vesicles may be an important component of the micropinocytic system of the human placenta. Regions of very dense reaction with glycocalyx stains are restricted to membranes within forming and fully formed coated vesicles. This is interpreted as evidence against permanently grouped specific binding sites having a role in the selective uptake of materials by micropinocytosis, and as support for theories of coated-vesicle formation which take into account the dynamic nature of membrane components. The pyroantimonate precipitation technique which was employed in an attempt to localize cations in placental tissue at term resulted in the deposition of electron-dense material in coated vesicles and basement membrane. Examination of the distribution of coated vesicles in placental tissue explants at 8--12 weeks of gestation revealed a restricted distribution of these organelles. Probably more than 89% of coated vesicles lie within the largest vesicles' diameter from the cell surface. Placental coated vesicles were isolated and examined using negative staining. A polygonally patterened structure was apparent on their surfaces. Analysis of the isolated fraction of coated vesicles using sodium dodecyl sulphate polyacrylamide gel electrophoresis shows the presence of a major protein of molecular weight 180000. This is the same molecular weight that has been given for clathrin, the major protein of the raised polygonally patterned structure on the cytoplasmic surface of coated vesicles from other sources.

Cell Fractionation↗
PubMed1995

Assessment of sensitivity and specificity of immunohistochemical staining of p53 in lung and head and neck cancers.

Thirty-two primary carcinomas of the lung and 17 carcinomas of the head and neck (HN) were systematically analyzed for p53 mutations in the highly conserved regions of the gene (exons 5-8). Frozen sections of the same tumors were stained immunohistochemically to assess the sensitivity and specificity of p53 expression as determined by the presence or absence of the protein. On the basis of histology, the lung tumors studied were divided into adenocarcinomas (AC; n = 15), squamous-cell carcinomas (SCC; n = 12), and large-cell carcinomas (LCC; n = 5). All the HN cancers were SCC. Mutations in the p53 gene were detected by direct sequencing of amplified polymerase chain reaction products in six AC of the lungs (40%), three SCC of the lungs (25%), and one LCC (20%), with an overall mutation frequency of 31%. Nine AC (60%) of the lungs, five SCC (42%), and four LCC (80%) were p53-positive by immunohistochemistry. Among HN cancers, p53 mutations were detected in seven tumors (41%). Nine HN tumors (53%) were positive for p53. Negative staining, despite the presence of p53 mutations, was confined to nonsense mutations with truncated p53 and to single-base mutations not causing any change in the amino acid. Although immunohistochemical staining for mutated p53 is sensitive and simple to perform as a screening method, it is not as specific for evaluation of p53 mutations in lung and HN cancers.

Adenocarcinoma↗
PubMed1997

The progression of beta-amyloid deposition in the frontal cortex of the aged canine.

Brains from 41 aged canines (> or = 10 years of age) were examined immunohistochemically to characterize the laminar distribution and age-related progression of beta-amyloid (A beta) in frontal cortex. We classified the A beta patterns into four distinct types. Type I was characterized by small, faint deposits of A beta in deep cortical layers. Type II consisted of diffuse deposits of A beta mainly in layers V and VI. Type III had both dense plaques in superficial layers, and diffuse deposits in deep layers. Finally, Type IV had solely dense plaques throughout all layers of cortex. We compared the A beta distribution pattern between the Old canines (10-15 years, n = 22) and the Very Old canines (> 15 years, n = 19). The Old group primarily had negative staining, or Type I and Type II patterns of amyloid deposition (73%). Conversely, the Very Old group had predominantly Types II, III and IV deposits (89.5%), a difference that was significant (P < 0.05). We suggest that A beta deposition in canine frontal cortex is a progressive age-related process beginning with diffuse deposits in the deep cortical layers followed by the development of deposits in outer layers. In support of this hypothesis, the deeper layer diffuse plaques in the Very Old group of dogs also contain the largest proportion of beta-amyloid with an isomerized aspartic acid residue at position 7, indicating that these deposits had been present for some time. We also observed fiber-like A beta immunoreactivity within regions of diffuse A beta deposits. These fibers appeared to be degenerating neurites, which were negative for hyperphosphorylated tau. Therefore, these fibers may represent a very early form of neuritic change that precede tau hyperphosphorylation or develop by an alternative pathway.

Aging↗
PubMed1989

Immunoelectron microscopy of Proteus vulgaris by the plasma polymerization metal-extraction replica method: differential staining of flagellar (H) and somatic (O) antigens by colloidal golds.

Flagellar (H) and somatic (O) antigens of Proteus vulgaris were differentially stained with antibodies coupled to different sizes of colloidal gold particles, and the distribution of these antigens was visualized by the plasma polymerization metal-extraction replica (PMR) method. The H antigen, labeled with 5 nm colloidal gold, was almost exclusively located on the flagella, whereas the O antigen, labeled with 10 nm colloidal gold, was almost exclusively located on the bacterial body. The marker gold particles were clearly observed as electron-dense particles on the relatively low contrast background of three-dimensional replica image of the flagellated bacteria. Thus, the PMR method may prove to be a useful tool for studying the localization of multiple substances on the cell surface, at a high resolution and in three dimensions. The diameter of the flagella measured by the replica method was about 15 nm, close to the value obtained by negative staining (16 nm). When treated with anti-flagellar (H) factor serum and protein A-gold, the diameter of flagella was significantly increased to about 35 nm. This increase in diameter was presumably caused by binding of immunoglobulins to H antigens of flagella.

Antigens, Bacterial↗
PubMed1998

[Urokinase-type plasminogen activator (uPA), uPA receptor (uPA-R) and inhibitors (PA I -1) expression in hepatocellular carcinoma in relation to cancer invasion/metastasis and prognosis].

OBJECTIVE: To study the relevance of uPA, uPA-R and PA I -1 to hepatocellular cancer (HCC). METHODS: The expression at protein level for uPA, uPA-R and PA I -1 was examined in 48 cases of HCC and 12 cases of benign tumors of the liver (as control) immunohistochemically. RESULTS: When compared to HCC-adjacent normal liver tissue and the control, positive rates of immune staining for uPA, uPA-R and PA I -1 on cell membrane were significantly higher in HCC cells (P < 0.05). Positive staining of uPA and uPA-R was seen in 16 of 22 and 19 of 22 cases of HCC with invasion, respectively (P < 0.01 and < 0.001). In 8 of 8 cases with cancer emboli, and in 6 of 6 cases with lymph node metastasis was the expression of uPA-R positive. Compared with 2 of 17 cases without recurrence, uPA-R was positive in 15 of 17 recurrent cases (P < 0.01). In 36 cases who survived, 17 was positive for uPA-R and 15 for PA I -1, while in 12 cases who died 2 years after surgery, 12 and 9 cases were positive for uPA-R and PA I -1, respectively (P < 0.01 and < 0.05). In 15 cases positive for all three parameters, 11 had cancer invasion and 7 died in 2 years, while in the controls with negative staining 2 had invasion and none died in 2 years (P < 0.05). CONCLUSION: Expression of uPA, uPA-R and PA I -1 is increased in HCC, and uPA and uPA-R may contribute significantly to HCC invasion and metastasis. uPA-R and PA I -1 are associated with poor prognosis.

Blood Proteins↗
PubMed2002

Inducible system in human hepatoma cell lines for hepatitis C virus production.

We cloned the complete complementary DNA of an isolate of the hepatitis C virus, HCV-S1, into a tetracycline-inducible expression vector and stably transfected it into two human hepatoma cell lines, Huh7 and HepG2. Twenty-six Huh7 and two HepG2-positive clones were obtained after preliminary screening. Two Huh7 (SH-7 and -9) and one HepG2 (G-19) clones were chosen for further characterisation. Expression of HCV proteins in these cells accumulated from 6 h to 4 days posttreatment. Full-length viral plus-strand RNA was detected by Northern analyses. Using RT-PCR and ribonuclease protection assay, we also detected the synthesis of minus-strand HCV RNA. Plus- and minus-strand viral RNA was still detected after treatment with actinomycin D. Indirect immunofluorescence staining with anti-E2, NS4B, and NS5A revealed that these proteins were mostly localised to the endoplasmic reticulum (ER). Culture media from tet-induced SH-9 cells was separated on sucrose density gradients and analysed for the presence of HCV RNA. Viral RNA levels peaked at two separate ranges, one with a buoyant density of 1.08 g/ml and another from 1.17 to 1.39 g/ml. Electron microscopy demonstrated the presence of subviral-like particles (approximately 20-25 nm in diameter) in the cytoplasm of SH-9 and G-19 cells, which were positively labelled by anti-HCV core antibodies. Anti-E2 antibodies strongly labelled cytoplasmic vesicular structures and some viral-like particles. Complete viral particles of about 50 nm which reacted with anti-E2 antibodies were observed in the culture media of tet-induced SH-9 cells following negative staining. Supernatant from tet-treated SH-9 cells was found to infect nai;ve Huh7 and stable Huh7-human CD81 cells.

Carcinoma, Hepatocellular↗
PubMed1999

Characterization of the particles of purified kappa-casein: trypsin as a probe of surface-accessible residues.

kappa-Casein as purified from bovine milk exhibits a rather unique disulfide bonding pattern as revealed by SDS-PAGE. The disulfide-bonded caseins present range from dimer to octamer and above and preparations contain about 10% monomer. All of these heterogeneous polymers, however, self-associate into nearly spherical particles with an average diameter of 13 nm at pH 8.0, as revealed by negatively stained transmission electron micrographs and dynamic light scattering. The weight-average molecular weight of the aggregates at pH 8.0, as judged by analytical ultracentrifugation, is 648,000. Trypsin digestion at pH 8.0 was used to probe the surface groups of the kappa-casein A polymers. The reaction with trypsin was rapid and the peptides liberated were identified by separation with reverse-phase HPLC, amino acid analysis, and protein sequencing. The most rapidly released peptides (t1/2 < 30 sec) were from cleavage at Arg 97 and Lys residues 111 and 112. These results suggest a surface orientation for these residues, and the data are in accord with earlier proposed 3D predictive models for kappa-casein. It is speculated that Arg 97, together with adjacent His residues (98 and 100) and Lys residues 111 and 112, form two positively charged clusters on the surface of the otherwise negatively charged casein. These clusters bracket the neutral chymosin cleavage site (whose hydrolysis triggers a well-known digestive process) and so these clusters may facilitate docking of the substrate caseins with chymosin.

Amino Acid Sequence↗
PubMed2000

Significance of serum and tissue carcinoembryonic antigen for the prognosis of gastric carcinoma patients.

BACKGROUND AND OBJECTIVES: Carcinoembryonic antigen (CEA) has been widely accepted as a tumor marker useful in the diagnosis and management of colorectal carcinoma. When CEA levels are positive in patients with gastric carcinoma, they could be useful prognostic indicators. The value of CEA as a tumor marker for gastric carcinoma, however, remains a matter of controversy. The purpose of this study was to determine whether preoperative serum CEA value and tissue CEA staining are useful prognostic indicators for gastric carcinoma. METHODS: We measured preoperative serum CEA levels by radioimmunoassay and stained tissue CEA production by tumor cells from gastric carcinomas using immunohistochemical staining in patients with gastric carcinoma. RESULTS: The patients with preoperative serum CEA levels >10.0 ng/mL had a more prominent serosal invasion, much more lymph node involvement, more advanced stage and more poorly differentiated than did the patients with preoperative serum CEA levels <5.0 ng/mL. The survival rate of patients with serum CEA levels >10.0 ng/mL was poorer than those of patients with serum CEA levels between 5.0 and 10.0 ng/mL, and those of patients with serum CEA levels <5.0 ng/mL (P < 0.05). The preoperative serum CEA levels and tumor CEA-positivity were correlated (P < 0.05). In patients with lymph node metastases, the CEA-positivity (78.0%) was higher than in patients without lymph node metastasis (63.2%) (P < 0.05). A correlation was also found between the depth of tumor invasion and tissue CEA-positivity (P < 0.001). The postoperative survival rate was significantly better in the CEA-negative staining group (78.0%) than in the CEA-positive staining group (60.0%). CONCLUSIONS: These data suggest that preoperative serum CEA levels and staining for CEA in gastric carcinoma tissue sections may have a predictive value in determining prognostic information for patients with resectable gastric carcinoma.

Carcinoembryonic Antigen↗