Pleomorphic giant cell carcinoma of prostate: Rare tumor with unique clinicopathological, immunohistochemical, and molecular features

Pleomorphic giant cell carcinoma (PGCC) of the prostate is a rare entity categorized as a variant of prostatic acinar adenocarcinoma in the 2016 World Health Organization (WHO) classification system. PGCC differs from conventional prostatic adenocarcinoma by having bizarre, markedly enlarged, and pleomorphic cells. It differs from high grade urothelial carcinoma by negativity for urothelial differentiation markers, and can be distinguished from sarcomatoid carcinoma by lack of spindle cells. Including two new cases described herein, there have been 51 cases of prostate PGCC reported in the English literature. Clinical features shared by cases of prostate PGCC include poor prognosis, occurrence in older patients, and frequent association with prior therapy. Pathologic features common to cases of prostate PGCC include admixture with a high-grade conventional prostate carcinoma component and absent or reduced expression of prostate differentiation markers. More recent studies have begun to elucidate the molecular characteristics of PGCC, detecting specific mutations and chromosomal translocations, and showing evidence of a high degree of molecular instability in these tumors. We report novel findings in two cases of PGCC including a PIK3CA p.His1047Arg mutation not previously described. One of our cases is the first to clearly demonstrate chronological loss of prostate markers during dedifferentiation from prior conventional prostate carcinoma to PGCC. Herein, we present our two new cases and comprehensively review the literature on all reported cases of PGCC with critical commentary on findings in cases of this rare tumor.

Missing in metastasis B, regulated by DNMT1, functions as a putative cancer suppressor in human lung giant-cell carcinoma

Missing in metastasis B (MIM-B) has been widely reported to inhibit cancer cell invasion and proliferation in a variety of human cancers. However, the functions of MIM-B in lung cancers are still controversial. In addition, the mechanisms and regulation of MIM-B are poorly understood. In the present study, we found that the invasion level of 95C human lung giant-cell carcinoma cells was elevated when MIM-B was knocked down, while the invasion of 95D was suppressed when MIM-B was overexpressed, proving that MIM-B suppresses human lung giant-cell carcinoma cell invasion, which is similar to its function in most cancers. Furthermore, we reported that an increase in DNA methylation density in the promoter of MIM-B by DNA methyltransferase 1 (DNMT1) is correlated with the silencing of MIM-B expression and the high metastasis of 95D human lung giant-cell carcinoma cell line. Taken together, MIM-B, which is regulated by DNMT1 through DNA methylation, is a putative cancer suppressor in human lung giant-cell carcinoma.

Value of uroplakin III in distinguishing variants of primary bladder urothelial carcinoma from malignancy metastatic to the urinary bladder

BACKGROUND

Urothelial carcinoma (UC) variants can be difficult to differentiate from carcinoma metastatic to the bladder.

MATERIALS AND METHODS

We examined immunostaining for uroplakin III in 43 cases of primary bladder UC variants including micropapillary UC (n=19), nested variant of UC (n=2), pleomorphic giant-cell carcinoma (n=8), plasmacytoid UC (n=4), lymphoepithelioma-like carcinoma (n=2), large cell undifferentiated carcinoma (n=2), UC with abundant myxoid stroma (n=3) and lipid cell variant (n=3) and in 11 tumors from other organs metastatic to the bladder. These tumors included invasive ductal carcinoma of the breast (n=2), colorectal adenocarcinoma (n=4), endometrioid adenocarcinoma (n=1) and serous papillary carcinoma of the uterus (n=1) melanoma (n=1), embryonal carcinoma of the testis (n=1), and renal clear cell carcinoma (n=1).

RESULTS

Out of the 43 UC variants, 35 (81%) were positive for uroplakin III, including micropapillary, lipid cell variant and UC with abundant myxoid stroma. Pleomorphic giant cell carcinoma, plasmacytoid UC and nested variant of UC were less commonly positive. Of the 11 metastatic tumors, six were found to be positive for uropIakin III: metastatic colorectal adenocarcinoma, clear cell carcinoma of the kidney and embryonal carcinoma of testis.

CONCLUSION

UP III Positivity for uroplakin III is not found only in primary bladder UC variants, but in some tumors that have metastatized to the bladder. Staining for uroplakin III alone should not be taken as evidence of UC.

[Clinical characteristics and prognosis of three rare and poor-prognostic subtypes of primary liver carcinoma]

OBJECTIVE

To explore the clinicopathological features and prognostic factors of three rare and poor-prognostic pathological subtypes of primary liver carcinoma, and improve the clinical diagnosis and surgical treatment.

METHODS

A retrospective analysis of clinicopathological data of 69 patients with rare pathological subtypes of primary liver carcinoma, diagnosed by postoperative pathology in our hospital from October 1998 to June 2013 was carried out. The data of 80 cases of common poorly differentiated hepatocellular carcinoma treated in the same period were collected as control group. Kaplan-Meier method was used to analyze the survival rate, and Cox proportional hazards model was used for prognostic analysis in the patients.

RESULTS

Thirty-four cases were combined hepatocellular carcinoma and cholangiocarcinoma (CCC, 28 males, 6 females), with a median age of 52 years (range, 33 to 73). Ninteen cases were giant cell carcinoma (GCC, 16 males and 3 females), with a median age of 59 years (range, 38 to 66). Sixteen cases were sarcomatoid carcinoma (SC, 14 males and 2 females), with a median age of 57 years (range, 46 to 70). The survival analysis revealed that median survival time and the 1-, 3-, 5-year survival rates for these 3 groups were 20 months, 61.8%, 29.4%, and 20.6% in the CCC patients, 13 months, 52.6%, 31.6%, and 0% in the GCC patients, and 8 months, 31.3%, 0%, 0% in the SC patients, respectively. The median survival time and survival rate of the SC group were significantly lower than those of the other three groups (P < 0.05). However, in the SC group, the incidences of hilar lymph nodes metastasis, vascular tumor emboli and invasion of adjacent organs were significantly higher than those in the other three groups (P < 0.05). There were no statistically significant differences among the other three groups (P > 0.05). The levels of carcino-embryonic antigen were higher in the three rare subtype groups than that of the control group. The incidences of multiple tumors of the three rare subtype groups were higher than that of the control group (P < 0.05). Positive surgical margin was an independent unfavorable prognostic factor.

CONCLUSIONS

The combined hepatocellular carcinoma and cholangiocarcinoma, giant cell carcinoma and sarcomatoid carcinoma have a poor prognosis. Among them sarcomatoid carcinoma is the most malignant and poor prognostic one. Radical resection is recommended.

[PAR-1 regulation of intracellular Ca²(+) mobilization in pulmonary giant cell carcinoma cell line PLA801D/PLA801C]

OBJECTIVES

To investigate molecular mechanisms of PAR-1 regulation on intracellular Ca²(+) mobilization in lung giant cell carcinoma cells in vitro and its involvement in tumor metastasis.

METHODS

Free intracellular Ca²(+) ([Ca²(+)]i) was measured in lung giant cell carcinoma PLA801C and PLA801D cells by confocal microscopy. Sense and anti-sense PAR-1 expression vectors were transfected into PLA801C (C+)and PLA801D(D-) cells, respectively. The effects of PAR-1 expression were investigated by thrombin and TRAP-induced mobilization of [Ca²(+)]i in the C+ and D-cells.

RESULTS

There were significant differences of the mean values of [Ca²(+)]i between PLA801D (59.55) and PLA801C cells (35.46, P < 0.01). The mean [Ca²(+)]i of C+ cells (45.77) was significantly higher than that of its control CV cells (35.46, P < 0.05), and the mean [Ca²(+)]i of D-cells (48.42) was significantly lower than that of its control DV cells (59.55, P < 0.05). The peaks of [Ca²(+)]i of C+ and CV cells were 48.19 ± 9.84 and 45.64 ± 9.87 (P < 0.05) respectively at 80 s and 100 s after thrombin treatment, but were 111.31 ± 25.00 and 52.93 ± 11.21 (P < 0.05) respectively at 60 s after TRAP treatment. The peaks of [Ca²(+)]i of D- and DV cells were 40.71 ± 5.89 and 61.07 ± 21.36 (P < 0.05) respectively at 60 s after thrombin treatment, but were 84.98 ± 11.23 and 102.58 ± 21.48 (P < 0.05) respectively at 40 s after TRAP treatment.

CONCLUSIONS

The high metastatic potential of PLA801D and PLA801C may be related to [Ca²(+)]i of the tumor cells. PAR-1 may play an important role in the metastasis of lung giant cell carcinoma cells by up-regulating the intracellular Ca²(+).

[Maldiagnosis of giant-cell tumor of the bone in a patient with hyperparathyroid osteodystrophy]

The paper describes a case of maldiagnosis of giant-cell tumor in a patient with parathyroid osteodystrophy, in this connection elbow joint resection and replacement were made. Parathyroid adenoma with the symptoms of primary hyperparathyroidism was diagnosed only two years after surgery. Progression of diseases was accompanied by severe bone changes and the development of urolithiasis complicated by chronic renal failure. Thus, the interpretation of bone tissue changes without considering clinical and laboratory data led to the unwarranted surgical intervention and the late diagnosis of primary hyperparathyroidism. Differential diagnosis of a giant-cell tumor should be made, by obligatorily considering clinical and laboratory data, including the parameters of calcium metabolism.

Gynaecomastia in a patient with a hCG producing giant cell carcinoma of the lung. Case report

Gynaecomastia, or enlargement of the male breast may result from various endocrine dysfunctions and often reflects ectopic production of substances such as hCG and estradiol. We report on the case of a 30 year old man who presented with gynaecomastia and elevated plasma levels of hCG, estradiol and testosterone. As a result of several diagnostic procedures such as selective venous sampling and magnetic resonance tomography (MRT), a hCG producing tumor of the upper lobe of the left lung was found. This hormonal overproduction induced an enhanced secretion of estradiol and testosterone in the testicular tissue. Histology revealed a giant cell carcinoma with positive immunostaining for hCG. This case report further underlines the necessity of an intensive search for ectopic beta-hCG production due to malignant tumours, in particular in the adult.

[Urinary bladder cancer producing granulocyte-colony stimulating factor: a case report and review of the literature]

We report a case of urinary bladder cancer that produced granulocyte-colony stimulating factor (G-CSF). A 56-year-old man was admitted to our hospital with the chief complaint of macroscopic hematuria. Cystoscopy demonstrated a thumb tip-sized bladder tumor. Computerized tomography and magnetic resonance imaging showed muscular invasion in the bladder, but no distant metastases. The complete blood count and laboratory examination showed leukocytosis of 25,200/mm3 and a high G-CSF level of 145 pg/ml in the peripheral blood. Although he underwent total cystectomy and adjuvant chemotherapy using methotrexate, vinblastine, doxorubicin and cis-platinum (M-VAC) under the diagnosis of locally advanced bladder cancer, he died of progressive disease of the carcinoma about eight months after the diagnosis. A temporary decrease of white blood cell count and serum GCSF were observed just after treatment. The histopathological diagnosis was undifferentiated giant and spindle cell carcinoma of the urinary bladder (grade 3, pT3b, pN1). The tumor cells exhibited positive staining for G-CSF immunohistochemically.

Overexpression of axin downregulates TCF-4 and inhibits the development of lung cancer

BACKGROUND

T cell factor 4 (TCF-4) mediates a nuclear response to wingless/int (Wnt) signals by interacting with beta-catenin. Axis inhibition protein (axin) is an important negative regulator of the Wnt signaling pathway. Our aims were to examine the relationship between axin and TCF-4 and to explore the effects of axin on the development of lung cancer.

METHODS

Expression levels of axin and TCF-4 were examined in 107 lung cancer specimens by immunohistochemistry. The axin gene was transfected into lung cancer BE1 cells. The expression levels of axin, beta-catenin, and TCF-4 were detected with immunofluorescence and reverse transcription-polymerase chain reaction (RT-PCR) experiments. Apoptosis, proliferation, and the invasive ability of lung cancer cells were examined using flow cytometry, 3-(4,5-Dimethylthiazol-2-yl)-2,5-Diphenyltetrazolium Bromide (MTT), and Matrigel invasive assays.

RESULTS

Preserved axin expression correlated negatively with TCF-4 expression (P = .031). Axin expression differed with respect to degree of differentiation (P = .025) and histological tumor type (P = .031). TCF-4 expression differed relative to tumor, node metastasis (TNM) stage (P = .024). BE1 cells transfected with axin (BE1-axin cells) exhibited a significant decrease in TCF-4 expression. The level of apoptosis in BE1-axin cells was significantly increased, while the proliferative and invasive abilities of BE1-axin cells were decreased.

CONCLUSION

These results suggest that reduced expression of axin or augmented expression of TCF-4 is associated with the malignant behavior of lung cancers. Overexpression of axin can downregulate expression of TCF-4 and can inhibit the ability of lung cancer cells to proliferate and invade.

Decreased Tc-99m Sestamibi Uptake in a Sternal Brown Tumor Indicating Response to Anti Metabolic Therapy for Secondary Hyperparathyroidism

Brown tumors are rare but serious complications of renal osteodystrophy, and can be treated by parathyroidectomy or by pharmacological treatment of hyperparathyroidism. In addition to parathyroid lesions such as adenoma, hyperplasia, and carcinoma, brown tumors have been detected effectively by using dual phase Tc-99m sestamibi and Tl-201 chloride. We describe an unusual case of brown tumor at the manibrium sterni which shows marked increased Tc-99m sestamibi uptake on the initial scan, with decreasing tracer activity on follow-up scan indicating a response to antimetabolic therapy.

Probing rotation dynamics of biomolecules using polarization based fluorescence microscopy

Fluorescence polarization, particularly fluorescence anisotropy (FA) can be used to characterize the rotation dynamics and interactions of biomolecules. We report here fluorescence polarization microscopy based on a two-photon fluorescence microscope. Two-photon fluorescence excited by a linearly polarized fs laser beam was separated into components of parallel and perpendicular polarization and then recorded simultaneously by two detectors. From the images corresponding to different combinations of the polarization for the excitation and fluorescence photons, images of FA, or polarization difference, can be derived. It is demonstrated that FA microscopy is capable of probing rotational mobility of the fluorescent molecules and their interaction with the surroundings, but displays lower axial resolution than fluorescence intensity images. It is proved that the degraded axial resolution of FA imaging is intrinsic to the current experimental set-up. Artifacts in FA imaging of aligned molecules are also discussed.

Histologic variants of papillary and follicular carcinomas associated with anaplastic spindle and giant cell carcinomas of the thyroid: an analysis of rhabdoid and thyroglobulin inclusions

We describe the histologic variants of papillary and follicular carcinomas associated with 109 spindle and giant cell carcinomas (SGCC) of the thyroid and determine the incidence of rhabdoid and thyroglobulin inclusions in these tumors. In addition, we searched for rhabdoid and thyroglobulin inclusions in 120 papillary carcinomas (PC) (all 15 variants included), 23 differentiated follicular carcinomas (DFC), (6 with insular pattern), 6 poorly differentiated follicular carcinomas (PDFC) and 34 follicular adenomas (FA). The following differentiated thyroid carcinomas coexisted with SGCC: 51 (46.8%) PC, (34 conventional type, 14 tall cell variant and 3 follicular variant), 6 (5.5%) DFC, 1 follicular carcinoma with insular pattern (0.9%), and 3 oncocytic carcinomas (2.8%). Eleven SGCC (10%) and 2 (33%) PDFC showed rhabdoid features, but lacked thyroglobulin inclusions. Thyroglobulin inclusions were found in 10 FA (29%), 8 (17%) follicular variants of PC and in 7 (30.4%) DFC. There were no rhabdoid inclusions in any of these differentiated thyroid tumors. Our findings support the hypothesis that most SGCC result from dedifferentiation or anaplastic transformation although the mechanisms that underlie this transformation remain unknown. The finding that only 1 (0.9%) SGCC was associated with follicular carcinoma with insular pattern contradicts the opinion that this tumor occupies an intermediate position between differentiated and anaplastic carcinomas. Rhabdoid features are markers of PDFC and SGCC while thyroglobulin inclusions are markers of FA and differentiated thyroid carcinomas with follicular phenotype.

[Functional aspects of protease-activated receptor 1 in promoting metastasis of lung cancer]

OBJECTIVE

To study the functional aspects of protease-activated receptor 1 (PAR-1) gene involved in tumor metastasis.

METHODS

Two human lung giant cell carcinoma cell lines PLA801C (low metastasis potential) and PLA801D (high metastasis potential) were chosen as in-vitro human cancer model systems. Sense and anti-sense expression constructs of PAR-1 gene (pC/PAR1s and pC/PAR1as) were transfected into PLA-801C and PLA-801D cells by lipofection. PAR-1 expression was determined by RT-PCR and western blot analysis. MTT growth, flow cytometry analysis, fibronectin adhesion, and matrigel invasion assays were used to study the effect of PAR-1 expression on the proliferation, adhesion, and invasion of the transfected cells.

RESULTS

Appropriate up-regulation or down-regulation of protein expression of PAR-1 was observed in both transfected cell lines (PLA801C and PLA801D) to express PAR-1s or PAR-1as, respectively. Expression of the sense PAR-1 markedly increased cellular proliferation, adhesion and invasion of PLA-801C cells. In contrast, anti-sense PAR-1 significantly inhibited cell growth, adhesion and invasion capabilities, along with cell arrest at G0/G1 phase of the PLA-801D cells.

CONCLUSIONS

Successful up- and down- regulation of expression of PAR-1 can be achieved by in-vitro transfection of sense and antisense PAR-1 constructs. PAR-1 may enhance metastasis of lung cancer through its regulation of cellular proliferation, adhesion and invasion. Down-regulation of expression of PAR-1 may provide a new therapeutic strategy against lung carcinoma.

Hepatocellular carcinoma, syncytial giant cell: a novel variant in children: a case report

Hepatocellular carcinoma (HCC) is the second most common primary malignant hepatic tumor in children. It often develops in patients with underlying liver disease. We report the clinicopathologic features of an unusual HCC occurring in an infant who presented with features of Cushing's syndrome due to bilateral adrenal hyperplasia. The tumor is characterized by epithelial syncytial giant cells. Giant cell carcinoma of the liver has been previously reported, but the cells were osteoclast-like (ie, mesenchymal type) and not epithelial type as it is in this patient. We propose to use the term HCC, syncytial giant cell type, to denote this apparently novel lesion.

Interleukin-6-producing giant cell carcinoma of the lung with multicentric Castleman's disease-like presentation

We encountered a 59-year-old man with advanced lung cancer with multiple swollen lymph nodes. At autopsy the lung cancer was revealed as giant cell carcinoma. Microscopic examination showed no cancer cells, but there was polyclonal proliferation of plasma cells in the lymph nodes and in the bone marrow. In the kidneys, proliferation of mesangial matrices and mesangial cells was found. This presentation resembled multicentric Castleman's disease (MCD), in which interleukin-6 (IL-6) has a great role. Immunohistochemical staining was positive for IL-6 in cancer cells. This is the first reported case of an IL-6-producing giant cell carcinoma of the lung with MCD-like presentation.

Primary sphenoid sinus neoplasms: a report of four cases with common clinical presentation treated with transsphenoidal surgery and adjuvant therapies

BACKGROUND

Primary neoplasms of the sphenoid sinus are a rare occurrence, accounting for approximately 1-2% of all paranasal sinus tumors. Here we report a series of four such patients.

METHODS

Four patients with sphenoid sinus neoplasms were identified (1%), all treated during the year 2003.

RESULTS

The four patients included two women and two men (mean age 61 years, range 44-70 years). Two patients presented with unilateral abducens cranial nerve (CN) palsies; one had trigeminal facial numbness and dizziness; another had headache, epistaxis, and partial third and fourth CN palsies. MRIs in all patients demonstrated large sphenoid sinus masses with partial clival and sellar bone erosion but with clear visualization of the pituitary gland above the mass. Cavernous sinus invasion was present in all four cases, including one patient with tumor in the ethmoid sinus and intra-tumoral hemorrhage. No patients had endocrinopathy. All patients underwent subtotal tumor removal via an endonasal transsphenoidal route. Tumor histology included neuroendocrine carcinoma, sinonasal undifferentiated carcinoma, mucoepidermoid carcinoma, and giant cell tumor. Post-operatively, all four patients had improved symptoms with complete resolution of diplopia in 3 of 3 patients. Metastatic work-ups were negative in all patients, and all received fractionated stereotactic radiotherapy; three received chemotherapy. One patient required a second endonasal tumor debulking 15 months after the first for new visual loss that then resolved. At a median follow-up of 21 months, all patients are alive and functional.

CONCLUSIONS

Intra-sphenoidal tumors are locally invasive tumors that include a wide pathological spectrum. In this small series, they presented with cavernous sinus symptoms and headache but not endocrinopathy. Recognizing their distinctive clinical presentation and MRI features is helpful in differentiating them from primary sellar tumors. Their aggressive nature warrants a multimodality treatment plan including surgical debulking, radiotherapy, and chemotherapy in some cases.

[Inhibitory effect of anti-type IV collagenase intrabody on invasiveness of human pulmonary giant cell carcinoma PG cells in vitro]

OBJECTIVE

To explore the inhibitory effects of endoplasmic reticulum-retained intrabody on the secretion of type IV collagenase and the invasion of human pulmonary giant cell carcinoma PG cells in vitro.

METHODS

Two expression plasmids were constructed, pcDNA3.1-CP.scFv and pcDNA3.1-ER.scFv encoding cytoplasm-retained and endoplasmic reticulum-retained single chain antibodies against the type IV collagenase, respectively. The intracellular antibody genes were transfected into the human pulmonary giant cell carcinoma PG cells. Western blot was performed to detect the expression of pcDNA3.1-CP.scFv and pcDNA3.1-ER.scFv. Gelatin zymography was performed to detect seretion of type IV collagenase in PG cells and Matrigel assay was employed for determination of the cell invasiveness.

RESULTS

Both of cytoplasm-retained and endoplasmic reticulum-retained introbodies, CP.scFv and ER.scFv, were expressed in PG cells. ER.scFv, significantly inhibited the secretion of type IV collegenase. As shown, matrix metalloproteinase 9 and matrix metalloproteinase 2 were inhibited by 85.7% and by 51.2%, respectively. However, CP.scFv did not show such inhibitory effect. The ER.scFv encoding gene-transfected PG cells were much less invasive than parental or vector control cells, the inhibition rate was 76.3% (P < 0.05), whereas CP.scFv encoding gene-transfected PG cells showed no reduction in invasiveness.

CONCLUSION

Those findings demonstrate that endoplasmic reticulum (ER)-retained intracellular antibody technology may selectively abrogate the activity of type IV collagenase in the protein trafficking and secretory pathway and effectively inhibit tumor cell invasion in vitro. Anti-type IV collagenase intrabody may be further used in cancer gene therapy.

[Expression of aurora-A kinase in human lung cancer cell lines PG, A549, and NCI-H460]

BACKGROUND & OBJECTIVE

Recent researches found that Aurora-A overexpresses in various malignancies. This study was to detect the expression of Aurora-A in lung cancer cell lines PG (highly-metastatic giant cell lung cancer), A549 (lung adenocarcinoma), and NCI-H460 (large cell lung cancer) and explore its correlation to DNA content, provide a theoretical basis for screening tumor marker and molecular therapeutic target of lung cancer.

METHODS

mRNA and protein levels of Aurora-A in PG, A549, and NCI-H460 cells were detected by reverse transcription-polymerase chain reaction(RT-PCR) and Western blot. Flow cytometry was used to analyze DNA contents in cell cycles of PG, A549, and NCI-H460 cells.

RESULTS

mRNA level of Aurora-A was 1.14 in PG cells, 1.16 in A549 cells, and 0.84 in NCI-H460 cells, respectively; protein level of Aurora-A was 8.96 in PG cells, 21.13 in A549 cells, and 6.43 in NCI-H460 cells, respectively. The proportion of cells with tetraploid DNA was 19.88% in PG cells, 14.97% in A549 cells, and 10.6% in NCI-H460 cells, respectively (P<0.01); the proportion of cells with polyploid DNA was 2.66% in PG cells, 3.59% in A549 cells, and 2.30% in NCI-H460 cells, respectively.

CONCLUSION

Aurora-A is overexpressed in the 3 lung cancer cell lines, but the mRNA levels are different.

[Differentially expressed genes in human giant-cell lung cancer lines with different metastatic potentials]

OBJECTIVE

To screen genes differentially expressed in two human giant-cell lung cancer lines of same origin but with different metastasis potentials.

METHODS

Suppression subtractive hybridization (SSH) was done twice on two giant-cell lung cancer lines, PLA-801C and PLA-801D (hereafter abbreviated as C and D), of same origin but with low (C) and high (D) metastatic potentials. In the first round, SSH C was used as tester and D as driver, while in the second round, the tester and driver were interchanged. The sequences acquired from both rounds of SSH were spotted on glass slides respectively and screened by hybridizing with two-color fluorescence probes. Clones that had different expression levels on chips were also confirmed by RNA dot blot or Northern blot.

RESULTS

There were 16 sequences with high expression in C as compared to those in D, and 79 sequences with high expression in D compared to those in C. After sequencing, most of them were found to be highly homologous to those encoding the following proteins: (1) cytokines and their receptors; (2) kinases and related proteins; (3) other proteins including enzymes, heat shock proteins, receptors, proteins of cell skeleton and mitochondria, products of oncogenes, etc; (4) some proteins deduced from gene sequences with yet unknown functions.

CONCLUSION

The alterations in expression of some known genes, including HSP70, AXL receptor tyrosine kinase and 14-3-3zeta, might have impact on metastasis of giant-cell lung cancer. Whether some differentially expressed genes newly revealed are metastasis-related needs further study.

[Study on differentially expressed molecules influencing the metastatic potential between highly and poorly metastatic human lung giant cell carcinoma]

OBJECTIVE

To study the metastasis-associated molecules differentially expressed in highly and poorly metastatic sublines and the mechanism of metastasis in lung giant cell carcinoma.

METHODS

Highly and poorly metastatic sublines (PLA801D and PLA801C)were used as metastasis model. Cell motility and invasion assay in vitro were first compared between the two sublines. Then, gelatin zymography analysis was used to determine the MMP-2 and MMP-9 activity. The protein expression level of secreted MMP-2, MMP-9, TIMP-1, TIMP-2 and intracellular expression level of p53, p16, PCNA, CD44(V6) isomeride, E-cadherin, CK18, nm23-H1 as well as the mRNA expression level of MMP-2, MMP-9, TIMP-1, TIMP-2, VEGF were compared through Western blot. Semi-quantitative RT-PCR analysis was used to determine the intracellular mRNA expression of MMP-2, MMP-9, TIMP-1, TIMP-2 and VEGF.

RESULTS

The in vitro cell invasion potential of highly metastatic subline PLA801D was significantly higher than that of poorly metastatic subline PLA801C by about 4 folds, while the cell motility potential was similar. The secreted MMP-2 activity was notably higher in PLA801D, which was initiated by the higher expression of MMP-2 at protein and mRNA level. In addition, the expression level of p53, PCNA, CK18 protein and VEGF mRNA were significantly higher, while the expression level of p16, E-cadherin and nm23-H1 protein were significantly lower in PLA801D. Some molecules such as MMP-9, TIMP-1, TIMP-2, CD44(V6) isomeride, which had been reported to be associated with tumor metastasis, were not observed to change significantly between the two sublines.

CONCLUSION

There are significant differences in metastatic potential and phenotypes between highly and poorly metastatic sublines of lung giant cell carcinoma. Some differentially expressed molecules might be playing roles in promoting or inhibiting metastasis of lung giant cell carcinoma, which may be useful to elucidate the mechanism of metastasis.

[Function of IL-18 in promoting metastasis of lung cancer]

OBJECTIVE

To study the function of IL-18 in promoting metastasis of lung cancer.

METHODS

The differential expression of IL-18 protein or mRNA level between highly and poorly metastatic sublines of human lung giant cell carcinoma metastatic model was detected by Western blot, semi-quantitative RT-PCR and northern blot analysis. The poorly metastatic PLA801C subline or highly metastatic PLA801D subline was transfected with constructed IL-18 sense or IL-18 antisense expressed plasmid by lipofectamine stable transfection technique. The metastasis-related effect mediated by IL-18, the metastatic phenotype differences, cell motility and cell invasion potential in vitro determined by MICS system and the expression level of metastasis-associated biomarkers detected by Western blot analysis, were compared between IL-18 stably transfectants and mock control, i.e. between PLA801C/IL-18(S) and PLA801C/pcDNA3.1, or between PLA801D/IL-18(As) and PLA801D/pcDNA3.

RESULTS

IL-18 was only present in highly metastatic PLA801D subline at either protein or mRNA level, which implied that IL-18 might play a role in promoting metastasis of lung cancer. After IL-18 sense expressed plasmid was transfected into poorly metastatic PLA801C subline, IL-18 fused protein with myc tag detected by Western blot analysis using either IL-18 or myc tag monoclonal antibody. In addition, cell motility ability in vitro was significantly increased about 3 times and E-cadherin protein was significantly down-regulated at about 50% in PLA801C/IL-18(S) transfectants compared with mock control. While IL-18 expressed plasmid was transfected into highly metastatic PLA801D subline, IL-18 protein and mRNA were simultaneously decreased by 30%. In addition, cell invasion ability in vitro was significantly decreased at about 75% and E-cadherin protein was significantly up-regulated in PLA801D/IL-18(As) transfectants compared with mock control.

CONCLUSION

IL-18 might play a role in enhancing tumor metastasis of lung cancer by down-regulating E-cadherin protein expression.

Gynecomastia attributable to human chorionic gonadotropin-secreting giant cell carcinoma of lung

OBJECTIVE

To describe a patient with human chorionic gonadotropin (hCG)-secreting giant cell carcinoma of the lung manifesting as painful gynecomastia, which resolved after surgical treatment.

METHODS

We present the clinical, radiologic, and clinical course of our patient, who presented with painful gynecomastia.

RESULTS

A 51-year-old man presented with a lung mass and rapidly progressing bilateral painful gynecomastia. Hormonal evaluation revealed high levels of hCG beta subunit, estradiol, and total and free testosterone and suppressed levels of luteinizing hormone and follicle-stimulating hormone. The patient underwent resection of the right upper and middle lobes of the lung. After the surgical procedure, the levels of hCG and estradiol rapidly decreased, and the gynecomastia resolved completely within 3 months. Fluctuation in the levels of serum hCG paralleled the clinical course of the lung tumor.

CONCLUSION

Although gynecomastia is a common disorder, hormonal work-up including hCG beta subunit should be done in an adult male patient presenting with rapidly progressing or recent onset of painful gynecomastia. Lung cancer should be considered in the differential diagnosis of gynecomastia attributable to ectopic production of hCG beta subunit.

[Regulatory effect of antisense VEGF121 cDNA transfection on angiogenesis and metastasis of human lung giant cell carcinoma]

OBJECTIVE

To study the regulatory effect of antisense VEGF121 cDNA transfection on endogenous VEGF secretion and angiogenesis of human metastatic lung carcinoma cell line PG and explore the significance of microvessel density (MVD) in tumor growth and metastasis.

METHODS

The eukaryotic expression vectors bearing antisense VEGF121 cDNA was transfected into PG cells. Human umbilical vein endothelial cells (HUVEC) were cultured in conditioned mediums from transfected cells, and proliferation was determined by methyl thiazolyl tetrazolium (MTT) and 3H thymidine incorporation (3H TdR) assays in vitro. Microvessel density (MVD) in xenografted tumors in nude mice was analyzed by immunohistochemistry.

RESULTS

The transfectant of antisense VEGF121 cDNA exhibited a reduction in VEGF secretion. HUVEC grown in conditioned medium from the antisense VEGF transfected cells exhibited a decrease in capacities of DNA syntheses and cell proliferation. MVD of tumor with transfected antisense VEGF gene was significantly lower than that in control vector.

CONCLUSION

Antisense VEGF gene transfection can inhibit vascular endothelial cell proliferation in vitro and tumor angiogenesis in vivo, which may explain its inhibitory effects on tumor growth and metastasis.

Pleomorphic giant cell carcinoma of the esophagus with coexpression of cytokeratin and vimentin and neuroendocrine differentiation

A pleomorphic (giant cell) carcinoma of the esophagus is reported in a 52-year-old man who had dysphagia and weakness. The 8-cm-high vegetating tumor consisted of solid sheets of poorly cohesive epithelioid cells broken into clusters by strands of stroma. Numerous giant cells showing phagocytic phenomenon were present. Immunochemical analyses demonstrated the epithelial origin of the neoplasm, although most of the tumor cells strongly expressed vimentin. Numerous tumor cells expressed synaptophysin. Neurosecretory granules were detected in some tumor cells on electron microscopic examination. The patient died 4 months after he became symptomatic. As far as we can ascertain, this is the first case report describing a pleomorphic carcinoma arising in the esophagus. This poorly differentiated carcinoma might be of neuroendocrine differentiation. In the esophagus, pleomorphic carcinoma must be distinguished from polypoid tumors such as carcinosarcoma and malignant melanoma.

Amplification and over-expression of OZF, a gene encoding a zinc finger protein, in human pancreatic carcinomas

The OZF gene encodes a protein consisting of 10 zinc finger motifs and is located on chromosome 19q3.1. We report here the amplification and over-expression of the OZF gene in pancreatic carcinomas. Increased gene copy number was detected in 3 of 12 tumour cell lines and 2 of 12 primary pancreatic carcinomas. Expression was detected in all cell lines, and the gene was over-expressed in cell lines with OZF gene amplification. Five of 8 tumours, including 2 primary tumours with OZF gene amplification, displayed high levels of OZF protein, whereas normal pancreas expressed low levels. Immuno-histochemical analysis showed that expression was restricted to tumour cells. Thus, high-level expression of OZF is frequent in pancreatic carcinomas and may contribute to the development or progression of this tumour.

[Specific point-mutate p53 mini-gene transfectimg effects on biological behaviors of a human cancer cell line PG derived from human pulmonary giant carcinoma]

OBJECTIVES

To explore the suppressive effects of a murine genomic p53 minigene containing an Arg-->Leu substitution at its encoding amino acid 172 on biological behaviors of human carcinoma cell and evaluate its potential application in cancer gene therapy.

METHODS

By LipofectaMINE and electraporation methods, this mutant p53 gene which lacked of exon 1 and intron 1 expression vector driven by CMV promoter was co-transfected with PCMVneo into PG cell in which dominant negative p53 pre-exists. A wild-type and another kind of genomic mutate-type p53 gene expression vector were transfected. The latter p53 gene encoding protein contained an Arg-->His substitution at the same position, and pBLuscript plasmid was used as control. All transfectants were screened by 500 micrograms/ml geneticin and identified by mouse specific p53 mRNA RT-PCR and Northern blot analysis. After transfection, the biological behavior changes were studied by colony formation and TUNEL test together with in-situ clone regression for chemosensitivity of anti-cancer drugs.

RESULTS

The transfecting effects of this unusual p53 gene were surprisingly strong. They were more significant than those of the wild-type p53 and could suppress the formation of transgenic colonies and passage. The transgenic colonies were sensitive to be treated in adromycin and 5-Fu, and the gene transient expression could result in cell apoptosis.

CONCLUSION

Codon 172 mutant (Arg-->Leu) p53 genomic DNA exhibited a strong suppressive transfecting effects on carcinoma cell, so it is a possible candidate to be used in cancer gene therapy.

Effect of interleukin-6 on the growth of human lung cancer cell line

OBJECTIVE

To investigate the effect of interleukin-6 (IL-6) on the growth of human lung cancer in vivo as well as in vitro.

METHODS

To examine the mRNA level of IL-6 receptor (IL-6R) in high-metastatic human lung giant cell carcinoma cell line PG by means of reverse transcription polymerase chain reaction (RT-PCR). To assess the existence of IL-6 receptor complex (including IL-6R and gp130) with the treatment of PG cells by use of recombinant human IL-6 (rhIL-6), recombinant human oncostatin M (rhOSM), and recombinant human leukemia inhibitory factor (rhLIF), respectively. To detect the expression of IL-6 by Northern blotting hybridization and bioactive assay. To identify the effect of IL-6 secreted by PG cells by use of IL-6 and IL-6R antisense oligodeoxynucleotides (ODNs), and specific neutralizing antibody to IL-6. To document the influence of IL-6 on PG cells growth in vivo through the strategy of the transfection of expression vector inserted antisense IL-6 cDNA.

RESULTS

RT-PCR analysis revealed that PG cells expressed IL-6R mRNA. Any one of the recombinant cytokine IL-6, OSM and LIF stimulated the growth of PG cells in vitro in a concentration-dependent manner. These results demonstrated IL-6 receptor complex exist in PG cells. At the same time, PG cells expressed IL-6 mRNA and secreted bioactive IL-6. Both IL-6 antisense ODNs and IL-6R ODNs inhibited PG cells proliferation. Treatment of PG cells with IL-6 antibodies reduced the growth of PG cells in vitro. PG cells transfected with IL-6 antisense expression vector showed a decreased growth in nude mice.

CONCLUSION

IL-6 functions as an autocrine growth stimulator for PG cells in vivo as well as in vitro.

Pulmonary giant cell carcinoma: pathological entity or morphological phenotype?

AIMS

To evaluate the morphological spectrum and clinical significance of giant cell carcinoma and to assess the frequency of tumour giant cell production in a consecutive series of primary (non-giant cell) lung tumours.

METHODS AND RESULTS

Forty-six cases of giant cell carcinoma of the lung were collated from two centres over a 12-year period. Giant cell carcinoma was found to be associated with areas of clear cell carcinoma, spindle cell carcinoma and showed trophoblastic differentiation (syncytiotrophoblastic giant cells and beta-human chorionic gonadotrophin immunopositivity) in 57%, 34% and 26% cases, respectively. 'Pure' giant cell carcinoma was identified in five (11%) cases. Eleven of the tumours contained diastase-resistant periodic acid-Schiff positive material and were separately designated as giant cell adenocarcinomas. Areas of squamous cell and neuroendocrine differentiation (as determined by chromogranin A and Leu-7 immunopositivity) were not found. The median survival for giant cell carcinoma (excluding the giant cell adenocarcinomas) was 18 months. Median survival was not adversely affected by the extent of tumour giant cell formation or by the presence of trophoblastic differentiation. Of 200 consecutive non-small cell lung carcinomas, tumour giant cells constituting < 10% of the tumour were identified in 32% of adenocarcinomas and 26% of squamous cell carcinomas.

CONCLUSIONS

The presence of tumour giant cells in lung carcinoma does not, in itself, indicate a more aggressive tumour type, Giant cell carcinoma of the lung does not appear to be a distinct entity but a morphological phenotype expressed by a heterogenous group of tumours. We support and advocate the use of an encompassing term such as 'pleomorphic' or 'anaplastic' carcinoma for those tumours showing no specific differentiation pattern but which express diverse morphological features such as giant cell formation, clear or spindle cell change.

[Pathological and immunohistochemical analysis of giant cells of pancreas]

Multinucleated giant cells in the pancreas (five giant cell carcinomas, a mucinous cystadenocarcinoma attended with many osteoclast-like giant cells, 42 invasive ductal carcinomas and 29 chronic pancreatitises) were examined. Three types of multinucleated giant cell were identified: epithelial type, coexpressive type, mesenchymal type. Epithelial type expressed epithelial markers, such as keratin and EMA in 23 ductal carcinomas. Coexpressive type expressed both epithelial markers and mesenchymal marker vimentin was in four ductal carcinomas. Mesenchymal type expressed mesenchymal markers, vimentin and CD68 in four osteoclastoid type giant cell carcinomas, the mucinous cystadenocarcinoma, six ductal carcinomas and ten chronic pancreatitises. Epithelial and coexpressive type were considered to be epithelial neoplastic origin, those had bizarre appearance and transitional area from definite adenocarcinoma area. Vimentin expression is associated with sarcomatous proliferation. Mesenchymal type was considered to be nonneoplastic and a certain type of macrophage polykaryons.

[Inhibition of in vivo growth of lung carcinoma cells after transfection with gap junction gene Cx43]

OBJECTIVE

To explore the effects of expression of gap junction gene and cell-cell communication on tumor growth.

METHODS

A highly metastatic human lung carcinoma cell line PG was used. PG cells were defective of gap junctional intercellular communication(GJIC) and lacking expression of gap junction gene Cx43. By transfection, Cx43 cDNA was introduced into PG cells and blank vector cDNA was used as mock control. By using Northern-blot, dye-transfer methods and examinations of in vitro/in vivo growth, stable Cx43 transfectant cells were studied.

RESULTS

The mock control cells resembled untransfected PG cells in lacking expression of Cx43 and GJIC function. They grew fast in soft agar(colony formation rate 11.6%) and in nude mice (average tumor weight 3.47 g in 28 days). The Cx43 transfectant cells showed increased level of Cx43 mRNA and increased function of GJIC. Cell growth in soft agar and in nude mice was markedly retarded. The inhibition rate was 90% and 75%, respectively.

CONCLUSION

Increased expression of gap junction gene Cx43 induced tumor-suppressing effects in human lung carcinoma cells.

[Are lung choriocarcinoma and giant cell carcinoma producing chorionic gonadotropins just variants of the same neoplasm?]

An article presents two cases of choriocarcinoma lung metastases. One case revealed the primary mediastinal choriocarcinoma and the second one had unknown primary localisation of the tumor, which could be suggestive of a spontaneously regressed primary gonadal choriocarcinoma. Authors discuss the clinico-pathological aspects of extragonadal choriocarcinomas, theories of their histogenesis and the morphological similarities to anaplastic giant cell lung carcinoma.

Spindle and giant cell carcinoma of the urinary bladder: a clinicopathological light microscopic and immunohistochemical study

OBJECTIVE

To evaluate the cellular nature and biological behaviour of spindle and giant cell carcinoma (SGCC) of the urinary bladder. The clinicopathological, light microscopic and immunohistochemical features of seven patients are reported.

PATIENTS AND METHODS

Paraffin-embedded tissue was available from each patient for microscopic and immunohistochemical studies. There were five men and two women, ranging in age from 48 to 79 years. Clinical histories and follow-up information were obtained by review of the patients' charts. The clinical outcome was compared with that of transitional cell carcinoma (TCC) and small cell carcinoma (SCC).

RESULTS

The tumours were large, polypoid and frequently ulcerated. They diffusely permeated the bladder musculature or the perivesical fat. On microscopic examination five tumours were composed mainly of interlacing sheets of spindle cells and occasional giant cells; two comprised giant cells only. Foci of identifiable TCC (papillary or in situ) were present in four tumours. Immunohistochemistry demonstrated that SGCCs exhibit a phenotype indicative of an epithelial nature.

CONCLUSIONS

The median survival (11 months) of the seven patients indicates that SGCCs have a poor prognosis and they are more aggressive than TCCs of the same stage. The unfavourable clinical course is similar to the rapidly fatal outcome of small cell carcinomas of the bladder. The prolonged survival periods of three patients who received additional chemotherapy suggest that this treatment may be profitable.

Creatine kinase isoenzyme BB increased in serum and tumor tissue of patients with giant cell tumor of bone

Increased creatine kinase isoenzyme BB (CK-BB) has been observed in sera from patients with brain injuries and occasionally in sera from patients with malignancy. We report here that, in two patients with giant cell tumor of bone (GCT), preoperative serum CK-BB increased to approximately 20 and 90 U/L, but in postoperative serum the CK-BB decreased to normal values. That the tumors contained CK-BB was indicated by electrophoretic analysis and immunohistochemical staining. Furthermore, serum CK-BB was detectable in five additional cases of GCT and in cultured tumor cells from a patient with GCT by an electrophoretic method. These results suggest that CK-BB may be a marker for GCT.