Sumary Decreased expression of E-cadherin (E-CD). a homotypic intercellular adhesion molecule, is considered to elicit detachment of tumour cells from primary lesions, which is the first stage of metastasis. Since renal cell cancer (RCC) shows a relatively high frequency of metastasis, we focused our interest on E-CD expression in RCC and its clinicopathological implications. We examined E-CD expression in normnal kidney and RCC by immunohistochemical staining. In normal kidney, E-CD expression was localised in distal tubules and collecting ducts. In RCC, 20 of 106 primary lesions (18.9%) expressed E-CD. whereas none showed positive staining for eight metastatic lesions. There was a statistically significant correlation between loss of E-CD expression and advanced stages of RCC. Kaplan-Meier analysis showed better prognosis in the group with preserved E-CD expression than without E-CD expression (Cox -Mantel test. P = 0.022, the average follow-up was 32 months or until death). This study suggests that the patients with decreased E-CD expression may be associated with metastasis, resulting in poor prognosis. However, frequency of E-CD expression in RCC is lower than in other cancers, which may be derived from the localised distribution of E-CD expression in normal kidney.Keywords E-cadherin; renal cell cancer: metastasis It is well known that cadherins, a family of Ca2+-dependent intercellular adhesion molecules, play essential roles in organogenesis and in the maintenance of normal structure and function (Behrens et al., 1985;Eidelman et al., 1989;Takeichi, 1991). Recently, E-cadherin (E-CD), a subclass of cadherins, has come to be considered to be important as an inhibitory factor in metastasis (Behrens et al., 1985; Frixen et al., 1991;Takeichi, 1991 (1991) showed that loss of E-CD can generate an invasive phenotype, which can be prevented by transfection with E-CD cDNA. Clinically, the correlation between decreased E-CD expression and advanced stages or dedifferentiation was also reported in a variety of tumours (Frixen et al., 1991;Shiozaki et al., 1991; Oka et al., 1992;Umbas et al., 1992;Bringuier et al., 1993; Oka et al., 1993;Terpe et al., 1993). However, reports in relation to the prognosis of malignant tumours have been rare until now (Bringuier et al., 1993 Immunohistochemical staining Anti-E-CD monoclonal antibody (HECD-1, Takara Biomedicals, Tokyo, Japan) was used in this study, and immunoperoxidase staining was performed by modifying the streptavidin-biotin bridge technique described previously (Katagiri et al., 1993

Retroperitoneal laparoscopic adrenalectomy is feasible for primary aldosteronism. However, Cushing's syndrome is presently a much more difficult indication than primary aldosteronism for this new operative technique.

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E-cadherin (ECD) is a homophilic Ca²⁺-dependent adhesion molecule associated with cell-to-cell interactions and normal growth. Recent reports have suggested that decrease or loss of ECD facilitates tumor progression and/or metastasis. ECD functions in a complex called an adherens junction, which includes several other proteins including α- and β-catenin. In the present study, fresh-frozen sections from 32 testis cancers, 16 seminomas and 16 non-seminomatous germ cell tumors (NSGCT), were examined immunohistochemically. E-cadherin was not expressed on normal germ cells, but expressed on 3 (18.8%) of 16 seminomas and 10 (62.5%) of 16 NSGCTs, mainly on the epithelial component of teratoma cells. α-Catenin was detected on 0 (0%) of 13 seminomas and 4 (25%) of 16 NSGCTs. β-Catenin was detected on 10 (71.4%) of 14 seminomas and 13 (81.2%) of 16 NSGCTs. ECD was detected significantly more frequently on NSGCTs than on seminomas. Immunoblot analysis confirmed the expression of ECD and β-catenin in NSGCTs. Expression of ECD and catenins may reflect the degree of differentiation and provide some information on the character of the tumor.

We report a rare case of primitive neuroectodermal tumor arising from adrenal gland in adulthood, diagnosed preoperatively as having non-functional adrenocortical adenoma. Laparoscopic adrenalectomy was performed. Immunohistological examination revealed the definite diagnosis as primitive neuroectodermal tumor of the adrenal gland. Although primitive neuroectodermal tumor is a highly malignant neoplasm, there is no evidence of local recurrence and distant metastasis 16 months after surgery.

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The p 5 3 gene product has been detected frequently in various human malignancies. We have studied the expression of p53 protein in urothelial transitional cell cancers (TCCs) and examined its correlation with pathologic grade, stage(pT) and patient survival. Specimens from 69 surgicallyresected TCCs (38 cases of urinary bladder cancer, 17 cases of ureteral cancer and 14 cases of renal pelvic cancer) were examined by immunohistochemical staining, using two anti-p53 monoclonal antibodies, PAbl801 and PAb240, and a polyclonal antibody, CM-1. Twenty-six TCCs (37.6%) were positively stained by at least one of the three antibodies. Statistical analysis showed a significant correlation between p53 expression and high pathologic grade (p < 0.05, p < 0.001) or progressive pathologic stage (p < 0.01). In addition, in 51 of the patients who were available for follow-up (23 cases of urinary bladder cancer, 13 cases of ureteral cancer, and 15 cases of renal pelvic cancer), the correlation between p53 protein expression and prognosis was examined. The survival of patients exhibiting positive p53 protein expression was significantly worse than those with p53-negative tumors (p < 0.05). These results suggest that an immunohistochemical test for p53 protein may be a useful method of evaluating the malignant potential of TCCs. Additionally, expression of p53 protein in TCCs is an indicator of a poor prognosis which should be considered in drawing up treatment strategies.Int J Urol 1994; 1 :43-48

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