Background and Methods. The expression of p53 protein in 100 large bowel cancers was studied immuno‐histochemically by use of a monoclonal antibody (PAb1801).
Results. Immunoreactivity was found in 61.0% of specimens from 100 patients with colorectal cancer. The pattern of p53 expression was mainly detected in the nuclei of the cancer cells. There was no significant correlation between the expression of p53 and the histologic grade, tumor size, serosal invasion, lymphatic invasion, venous invasion, lymph node metastasis, or liver metastasis. However, patients with p53‐positive tumors had a greater relative risk of death compared with those with p53‐negative tumors. The p53 negative‐tumors showed a recurrence rate of 5.9%; for the p53 positive‐tumors, a recurrence rate of 23.8% was recorded. The %year survival rate was 96.7% of 39 patients with p53‐negative carcinomas and 61.8% for the patients with p53‐positive tumors; there was a significant difference in the rate between the two groups of patients (P < 0.05). The growth fraction of p53‐positive tumors determined with a monoclonal antibody against DNA polymerase α (49.0%) was significantly higher than that of p53‐negative tumors (40.7%, P < 0.01).
Conclusions. These results suggest that the immunoreactivity of p53 may be a biologic marker of prognostic significance.
Pancreatic panniculitis (PP) is a rare clinical variant of subcutaneous fat necrosis, developing in patients with a variety of pancreatic diseases such as acute or chronic pancreatitis, tumors and cysts. The tumor‐associated PP represents a noteworthy skin manifestation of underlying internal malignancies, also known as dermadrome. Among causative pancreatic tumors, acinar cell carcinoma is the most frequent malignancy; however, little is known about how the origin of tumor cells and progression stage of pancreatic tumors potentially contribute to the establishment of panniculitis. Here, we present a 69‐year‐old Japanese male case of clinically aggressive PP on the bilateral legs, whose skin lesions developed prior to the diagnosis of occult pancreatic tumor and liver metastasis. Moreover, the immunopathology of the pancreatic lesion revealed neuroendocrine tumor (NET), a rare pathological variant. Skin lesions immediately spread to the upper limbs with extensive ulcerations and necrosis, accompanied by high levels of serum lipase and elastase, but not with other pancreatic enzymes. He died 2 months after the initial development of the skin lesion due to rapid deterioration of general condition. We reviewed 14 cases, including ours, of PP with NET in the pancreas thus far reported, to identify the clinicopathological characteristics regarding to what extent this rare complication could reflect the clinical course of pancreatic tumors and overall prognosis. Our published work review found that the disease has a significant male predominance (male : female, 13:1) and cases with occult pancreatic tumors died within 4 months after the development of their skin lesions. Our case was the poorest prognostic outcome. This report emphasizes that dermatologists should recognize PP with NET, reflecting a fatal prognosis, and to make a prompt diagnosis.
Summary The cell kinetics of 54 colorectal tumours were examined by immunohistochemical methods, using the monoclonal antibody DNA polymerase a which reacts with an antigen found only in proliferating cells. (Sasaki et al., 1977). More recently, the proliferative index determined by flow cytometry (Barlogie et al., 1983; Lovett et al., 1984) or BrdU labelling index (BrdU is said to localise in cells in the S-phase) have been used to examine the cell kinetics of tumours (Gratzner, 1982).DNA polymerase ox is an enzyme playing a central role in DNA replication in mammalian cells (Weissbach, 1979;Sarngadharan et al., 1978). The production of a monoclonal antibody against DNA polymerase a provided a new method for detecting proliferating cells (Bensch et al., 1982;Matsukage et al., 1982;Masaki et al., 1982;Tanaka et al., 1982;Yagura et al., 1987). Bensch et al. (1982) demonstrated intranuclear distribution of the enzyme in human cells by immunohistochemical techniques with monoclonal antibodies against the human enzyme. In this study, the cell kinetics of large bowel tumours were examined with a monoclonal antibody against DNA polymerase a, to determine its usefulness as an index of the grade of malignancy of these tumours.
Materials and methods
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