Actinomycosis is a rare infection caused by Actinomyces species, normal commensal inhabitants of the human bronchial and gastrointestinal tract. Infection occurs after preceding mucosal break-down by variable causes. A preoperative diagnosis is difficult because of its nonspecific clinical features, mimicking malignancy, tuberculosis or other inflammatory diseases. We report a case of abdominal actinomycosis presenting as an omental mass, which coexists with ascending colon cancer. Actinomycosis was diagnosed by histopathologic demonstration of sulfur granules in a specimen resected by laparoscopic exploration. Following surgery, the patient was treated with IV penicillin (20 million IU/day) for 3 weeks, and follow-up colonoscopy showed adenocarcinoma in the ascending colon. The patient underwent right hemicolectomy, then treated with intravenous penicillin for 4 weeks postoperatively and oral penicillin for 6 months. The patient has been free of recurrence for 6 months.
Actinomyces ; Actinomycosis ; Adenocarcinoma ; Colon ; Colon, Ascending ; Colonic Neoplasms ; Colonoscopy ; Follow-Up Studies ; Gastrointestinal Tract ; Humans ; Omentum ; Penicillins ; Recurrence ; Sulfur ; Tuberculosis

PURPOSE: We examined the clinical significance of MUC2 and MUC5AC gene expression in gastric adeno-carcinoma tissues. METHODS: Two hundred specimens were obtained from gastric carcinoma patients who underwent gastric cancer operations at Samsung Medical Center between January 2001 and January 2005. MUC2 and MUC5AC expression were examined immunohistochemically, and correlated with clinicopathologic features and prognostic significance. RESULTS: MUC2 expression was positive in 88 tissues (44.0%) and MUC5AC expression was positive in 125 tissues (62.5%). MUC2 expression was associated with cancer advancement, lymph node metastasis, T classification, distant metastasis, and endolymphatic invasion. Loss of MUC5AC expression was significantly related to cancer advancement, lymph node metastasis, advanced T stage, and distant metastasis. MUC2 expression was usually negative in early gastric cancer (78%), but usually positive in advanced gastric cancer (66%). MUC5AC was usually positive in early gastric cancer (74%). The prognosis of the MUC2(-) group was significantly better than the MUC2(+) group (P<0.001). There was no relationship with MUC5AC expression and survival. Multivariate analysis showed that T classification, lymph node metastasis, distant metastasis, endolymphatic invasion, and MUC2 expression were independent prognostic factors, but MUC5AC expression was not. CONCLUSION: MUC2 and MUC5AC expression correlated with several clinicopathologic parameters (cancer advancement, lymph node metastasis, advanced T classification, distant metastasis). MUC2 expression was a significant independent prognostic factor and positive MUC2 expression suggested poor prognosis. MUC2 expression may have prognostic significance in gastric adeno-carcinomas.
Adenocarcinoma ; Gene Expression ; Humans ; Lymph Nodes ; Multivariate Analysis ; Neoplasm Metastasis ; Prognosis ; Stomach Neoplasms

PURPOSE: To explore the role of cell cycle and apoptosis regulators during hepatocarcinogenesis, the expression of cell cycle-related proteins (cyclin D1 and p27kip1) and apoptosis-related proteins (p53, survivin, caspase 3). METHODS: Sprague-Dawley rats were given 120 ppm diethylnitrosamine (DEN) as a carcinogen and sequentially sacrificed. The expression of cell cycle and apoptotic related proteins were examined by light microscopy and immunohistochemistry. RESULTS: During the DEN-induced hepatocarcinogenesis, sequential histologic changes from preneoplastic lesions (altered hepatic cellular foci, hyperplastic nodules, and hepatocellular adenomas) and ultimately overt hepatocellular carcinomas and metastatic lesions were noted. The cyclin D1 were progressively increased from preneoplastic lesions to hepatocellular carcinomas. However, the p27kip1 and the survivine proteins did not show any other difference with the increasing degree of carcinogenesis. The p53 and caspase 3 proteins were more significantly increased in hepatocellular carcinomas than preneoplastic lesions. The cyclin D1 protein expression did not show any correlation with the expression of p27Kip1 protein, but the p53 expression was related to the expression of survivin and caspase 3. CONCLUSION: From the above results, over-expression of cyclin D1 plays a role in the early and late stages of hepatocarcinogenesis. In addition p53 and caspase 3 might be useful markers for evaluating the risk of malignant transformation.
Animals ; Apoptosis ; Carcinoma, Hepatocellular ; Caspase 3 ; Cell Cycle ; Cyclin D1 ; Cyclin-Dependent Kinase Inhibitor p27 ; Diethylnitrosamine ; Light ; Microscopy ; Proteins ; Rats ; Rats, Sprague-Dawley

PURPOSE: Chromosomal instability of chromosome 18 and inhibition of the transforming growth factor beta (TGF-beta) signaling pathway, which is mediated through Smad4, play important roles in the tumorigenesis of colon cancer. This study evaluated the value of the expression of chromosome 18 monosomy in colon cancer as a prognostic factor and its correlations with the expressions of Smad4 and TGF-beta receptor II proteins. METHODS: We analyzed the rate of the expression of chromosome 18 monosomy in 66 colon cancers with using chromogenic in situ hybridization (CISH) and we evaluated its value as a prognostic factor by determining its correlation with the pathologic factors and immunohistochemical expressions of Smad4 and TGF-beta receptor II proteins. RESULTS: Of the 66 colon cancers, monosomy of chromosome 18, as determined by CISH, was observed in 18 cases (27.3%), and the decreased expression of Smad4 and TGF-beta receptor II proteins was observed in 30 cases (45.5%) and 25 cases (37.9%), respectively. The monosomy of chromosome 18 and the decreased expression of Smad4 proteins showed statistically significant correlations with the histologic differentiation, the presence of tumor emboli, the nodal status and the stage. The decreased expression of TGF-beta receptor II proteins had statistically significant correlations with the histologic differentiation, the T-stage, the nodal status and the stage. The monosomy of chromosome 18 showed a statistically significant correlation with the decreased expression of Smad4 and TGF-beta receptor II proteins. CONCLUSION: These results suggested that chromosome 18 monosomy may have prognostic value for colon cancer.
Carcinogenesis ; Chromosomal Instability ; Chromosomes, Human, Pair 18* ; Colon* ; Colonic Neoplasms* ; In Situ Hybridization ; Monosomy* ; Receptors, Transforming Growth Factor beta* ; Smad4 Protein ; Transforming Growth Factor beta*

PURPOSE: HER-2/neu is the most frequently amplified oncogene in breast cancer. Topoisomerase II-alpha is a key enzyme in DNA replication and it is a molecular target for many anti-cancer drugs that are called topo II inhibitors; in addition, it is a new marker of proliferation. Because of the physical proximity of the ER-2/neu and topoisomerase II-alpha genes, co-amplification of the HER-2/neu and topoisomerase II-alpha may be important determinates of the response to chemotherapy for advanced breast cancer patients. METHODS: We studied the correlation of gene amplification of HER-2/neu and topoisomerase II-alpha by chromogenic in situ hybridization (CISH) in 43 infiltrating duct carcinomas of the breast. The over-expression of HER-2/neu protein and the staining index for the proliferation marker of topoisomerase II-alpha were examined immunohistochemically. The correlations between the status of HER-2/neu and topoisomerase II-alpha and the other clinicopathologic variables such as tumor size, lymph node metastasis, TNM stage, histologic grade, nuclear grade, and the estrogen receptor and progesteron receptor were investigated. RESULTS: Of the 43 infiltrating ductal carcinomas, the amplifications of HER-2/neu and topoisomerase II-alpha by CISH were observed in 8 cases (18.6%) and 14 cases (32.6%), respectively. Amplification of HER-2/neu showed the statistically significant correlations with tumor size, histologic grade and the topoisomerase II-alpha staining index. Amplification of topoisomerase II-alpha showed statistically significant correlations with axillary lymph node metastasis, the stage, the nuclear grade and the estrogen receptor status. CONCLUSION: These data suggest that amplification of HER-2/neu oncogene and topoisomerase II-alpha by CISH may be valuable for determining the response to chemotherapy, and detection of HER-2/neu and topoisomerase II-alpha in tumor sections may have prognostic value in human breast cancer.
Breast Neoplasms* ; Breast* ; Carcinoma, Ductal ; DNA Replication ; Drug Therapy ; Estrogens ; Gene Amplification ; Humans ; In Situ Hybridization* ; Lymph Nodes ; Neoplasm Metastasis ; Oncogenes*

PURPOSE: Gene amplification and/or over-expression of the c-erbB-2 are linked with poor prognosis in breast cancer. There has been only a few reports about the connection of c-erbB-2 oncogene amplification with cell regulatory proteins such as p27(kip1), cyclin D1, Rb, and E2F-1. The purpose of this study is to determine the correlation the amplification of the c-erbB-2 oncogene and protein expressions of p27(kip1), cyclin D1, Rb, and E2F-1. METHODS: Using Chromogenic in situ Hybridization (CISH) the amplification the c-erbB-2 oncogene were determined from paraffin sections of 48 infiltrating duct carcinomas (IDC). The protein expressions of p27(kip1), cyclin D1, Rb, and E2F-1 were studied immunohistochemically. RESULTS: Among the 48 evaluated IDC patients, amplifications of the c-erbB-2 oncogene by CISH were observed in 14 cases (29.1%). The amplification of the c-erbB-2 oncogene showed a significant correlation with tumor size and stage (P=0.0001 and P=0.001). The proteins of p27(kip1), cyclin D1, Rb, and E2F-1 were expressed by IHC in 23 cases (47.9%), 17 cases (35.4%), 27 cases (56.3%), and 22 cases (45.8%), respectively. Down- regulation of protein expressions showed a significant correlation with tumor size (P=0.031) in p27(kip1) and estrogen and progesterone receptor status (P=0.026 and P=0.001) in Rb. The expression of the E2F-1 protein showed a significant correlation with tumor size, stage, and histologic grade (P=0.003, P=0.030, and P=0.036). The amplification of the c-erbB-2 oncogene between down-regulation of p27(kip1) protein and E2F-1 protein showed a statistically significant correlation. CONCLUSION: The amplification of the c-erbB-2 oncogene may be correlation with cell cycle regulatory proteins such as p27(kip1) and E2F-1.
Breast Neoplasms ; Breast* ; Cell Cycle Proteins* ; Cell Cycle* ; Cyclin D1 ; Down-Regulation ; Estrogens ; Gene Amplification ; Humans ; In Situ Hybridization* ; Oncogenes* ; Paraffin ; Prognosis ; Receptors, Progesterone

PURPOSE: Survivin is an inhibitor of apoptosis protein and it is overexpressed in most human cancers. Recent data demonstrated that survivin-HSP90 complex regulate apoptosis. We assessed expression of survivin and HSP90 by using immunohistochemistry with colorectal cancer tissue and correlate it with clinicopathologic prognostic parameters. METHODS: Using immunohistochemistry, survivin and HSP90 expression were evaluated on paraffin sections of fifty-six colorectal carcinomas. Various clinicopathologic parameters including histologic differentiation grade, T-stage, nodal metastasis, stage were obtained from pathologic records. RESULTS: Survivin expression were observed in 30 cases (53.6%). The expression of survivin showed no statistically significant correlation with histologic differentiation grade, T-stage, nodal metastasis, stage. HSP90 expression were observed in 31 cases (55.4%). The expression of HSP90 showed a statistically significant correlation with histologic differentiation grade (P=0.035) and stage (P=0.017). There were a significant correlation between survivin expression and HSP90 expression (P=0.018). CONCLUSION: Survivin and HSP90 was expressed in colorectal cancer. The expression of HSP90 correlates with histologic differentiation grade, stage. The above results suggest that HSP90 could be a prognostic marker of poor outcome in colorectal carcinoma.
Apoptosis ; Colorectal Neoplasms* ; Humans ; Immunohistochemistry ; Inhibitor of Apoptosis Proteins ; Neoplasm Metastasis ; Paraffin

PURPOSE: Abnormalities of epidermal growth factor receptor (EGFR) and c-erbB-2 have been actively investigated in breast cancer. Cyclooxygenase-2 (COX-2) seems to be involved in critical steps of cancer onset and progression. The purpose of this study is to determine the correlation between the gene ampilfications of the EGFR and c-erbB-2 and expression of the COX-2. METHODS: Using Chromogenic in situ Hybridization (CISH) the gene amplification of the EGFR and c-erbB-2 were studies on paraffin sections of 47 invasive ductal carcinomas. The expression of COX-2 was studied immunohistochemically (IHC). RESULTS: Of the 47 invasive duct carcinomas, gene amplifications of the EGFR and c-erbB-2 by CISH were observed in 21 cases (44.7%) and 14 cases (29.8%), respectively. The gene amplification of EGFR was significantly correlated with tumor size, nodal metastasis, and stage. The gene amplification of c-erbB-2 showed a statistically significant correlation with tumor size and stage. The protein of COX-2 was expressed by IHC in 30 cases (63.8%). The expression of the COX-2 protein showed a statistically significant correlation with tumor size, nodal metastasis, and stage. The gene amplifications of the EGFR and c-erbB-2 between expression of COX-2 protein showed a statistically significant correlation. CONCLUSION: The gene amplification of the EGFR and c- erbB-2 may be correlated with expression of COX-2 protein in the breast cancer.
Breast Neoplasms ; Breast* ; Carcinoma, Ductal* ; Cyclooxygenase 2 ; Gene Amplification ; Genes, erbB-2* ; In Situ Hybridization ; Neoplasm Metastasis ; Paraffin ; Receptor, Epidermal Growth Factor

According to the development of new diagnostic techniques and the extension of aging population, the diagnosis of multiple primary malignant neoplasm has increased. We report a 76 years old man who had prostate cancer, colon cancer and stomach cancer metachronously and review literatures about the history, criteria, incidence and causes of the multiple primary malignant neoplasm.
Aged ; Aging ; Colonic Neoplasms ; Diagnosis ; Humans ; Incidence ; Prostatic Neoplasms ; Stomach Neoplasms

PURPOSE: An altered cell cycle regulation may underline the development and progression of human malignancies. The purpose of this study was to determine whether the degree of p16(INK4A), Rb and E2F-1 expressions are related to certain parameters such as histologic differentiation, T-stage, lymph node metastasis and TNM stage in colorectal carcinoma. The correlation between the above proteins were compared. METHODS: Immunohistochemical stain was perfomed, for p16(INK4A), Rb and E2F-1 on 84 formalin-fixed paraffin-embedded tissue sections of colorectal adenocarcinomas. RESULTS: The overall expression frequencies of the p16(INK4A), Rb and E2F-1 were 54.8 (46/84), 76.2 (64/84) and 48.8% (41/84), respectively. Loss of the p16(INK4A) expression frequency was higher with a poorly differentiated histologic grade, the presence of nodal metastasis and higher TMN stage. The expression of Rb was not correlated with any of the parameters studied. The frequency of the E2F-1 expression was higher with a poorly differentiated histologic grade, the presence of nodal metastasis and higher TNM stage. A highly significant inverse correlation between the expressions of p16(INK4A) and E2F-1 was observed. CONCLUSION: These data suggest that the loss of p16(INK4A) expression and the expression E2F-1 may play roles in the progression of colorectal adenocarcinomas and could possibly be used as prognostic factors. Further studies to determine the relationships in the expressions of p16(INK4A), Rb and E2F-1 will be required.
Adenocarcinoma ; Cell Cycle ; Colorectal Neoplasms* ; Cyclin-Dependent Kinase Inhibitor p16* ; Humans ; Lymph Nodes ; Neoplasm Metastasis