Expression of glycodelin in human breast and breast cancer

Glycodelin is a 28 kDa glycoprotein with structural homology to beta-lactoglobulins, particularly expressed in steroid-responsive tissues of the female reproductive tract. We previously found that transfection of glycodelin cDNA into MCF-7 breast cancer cells induces differentiation into organized acinar epithelium and up-regulation of epithelial markers. In this study, we used immunohistochemistry, Northern blotting and reverse transcription-polymerase chain reaction (RT-PCR) analyses to study glycodelin expression in normal and in malignant breast tissues. The results were compared with the expression of estrogen (ER) and progesterone receptors (PR) and p53 tumor suppressor protein. Glycodelin was found in ductal and lobular epithelium of 6/6 normal breast tissues, 27/29 morphologically normal breast tissues from breast cancer patients, 6/6 benign lactating adenomas, 21/35 ductal carcinomas, 9/9 tubular carcinomas, 9/9 mucinous carcinomas, 3/3 mixed ductal/tubular carcinomas and 7/11 lobular carcinomas. In the latter, of particular interest was the presence of glycodelin in paranucleolar vacuoles of carcinoma cells. Northern blot analysis of fresh frozen tissues revealed the normal full length 0.9 kb mRNA of glycodelin in ductal breast carcinoma. Using RT-PCR analysis, glycodelin messenger ribonucleic acid was found in 13/13 ductal and in 3/3 tubular tumor tissues. We also detected a splicing variant lacking exon 4, which includes the nucleotide sequence encoding the potential N-glycosylation site at Asn-85. Our results demonstrate the synthesis of glycodelin in normal breast and breast cancer. In addition, we show that the paranuclear vacuole, characteristically present in lobular breast cancer cells, contains abundant amounts of glycodelin.

Sialyl Tn is a frequently expressed antigen in colorectal cancer: No correlation with patient prognosis

Immunohistochemical expression of sialyl Tn antigen (STn), previously claimed to be a prognostic factor in colorectal cancer, was evaluated in 239 patients with colorectal adenocarcinoma. Formalin-fixed, paraffin-embedded specimens were stained with the monoclonal antibody C1282. STn immunoreactivity was seen in 189 of 239 tumors (79%). There was no significant correlation between STn immunoreactivity and Dukes stage, tumor location, histological type or gender. However, STn was significantly more often expressed in younger patients. There was so significant difference in survival between STn-negative patients (median survival 68 months) and STn-positive patients (median survival 79 months). In a Cox multivariate analysis, Dukes stage was the strongest predictor of outcome, followed by the age of the patient, whereas STn did not provide any prognostic information.

A cloned human germ cell tumor-derived cell line differentiating in culture

We have derived a clonal cell line (HGCT-1) from a lymph node metastasis of a primary testicular germ cell tumor (GCT). The tumor was negative for the embryonal carcinoma (EC) cell marker BerH2 but positive for vimentin, cytokeratin (CK) and desmin. Comparative genomic hybridization (CGH) revealed a high-level amplification at 12p that was observed in both the metastatic tumor and in the cultured HGCT-1 cells. In vitro, the phenotype of HGCT-1 cells was modulated by the culture conditions. In the presence of 10% fetal calf serum (FCS), the majority of HGCT-1 cells lacked CK and desmin. If cultured in 0.5% FCS, HGCT-1 cells acquired a uniform co-expression of vimentin, CK and desmin. Upon treatment with retinoic acid (RA), HGCT-1 cells lost the expression of desmin, but exhibited abundant CK filaments. Simultaneously, they started to express desmoplakin, form desmosomes and flatten on the culture substratum. The RA-induced changes were irreversible, whereas those following the culture in 0.5% FCS were at least partially reversible. When xenografted into an immunosuppressed rat, HGCT-1 cells formed a tumor consisting of epithelial- and mesenchymal-like structures. HGCT-1 cells thus represent a pluripotential cell system with a capacity for reversible phenotypic modulation and for irreversible differentiation into epithelial-type cells. The behavior of this novel cell line, distinct from established EC cell models, suggests a complex regulation of GCT cell differentiation.

High expression of stanniocalcin in differentiated brain neurons

Stanniocalcin (STC) is a glycoprotein hormone first found in fish, in which it regulates calcium homeostasis and protects against hypercalcemia. Human and mouse stc cDNA were recently cloned. We found a dramatically upregulated expression of STC during induced neural differentiation in a human neural crest-derived cell line, Paju. Immunohistochemical staining of sections from human and adult mouse brain revealed abundant presence of STC in the neurons with no activity in the glial cells. STC expression was not seen in immature brain neurons of fetal or newborn mice. Given that STC has been found to regulate calcium/phosphate metabolism in some mammalian epithelia, we suggest that STC may act as a regulator of calcium homeostasis in terminally differentiated brain neurons.

Prognostic value of biomarkers in malignant melanoma

Biopsy specimens from 12 patients with metastatic melanoma were longitudinally analysed to evaluate changes in proliferation activity and CD4+/CD8+ ratios during the course of the disease. The primary tumours of the patients who subsequently had metastatic disease were also each matched with tumours from two controls whose disease remained localized, and were compared with regard to tumour proliferation. Immunohistochemistry was performed using the avidin-biotin complex (ABC) immunoperoxidase technique, using bcl-2, p53, mdm-2 and Ki-67 as the primary monoclonal antibodies, and the percentage of positively stained melanocytic cells was calculated. Frozen sections were also available from metastatic lesions excised from eight of our patients before treatment initiation and at the time of disease progression. These specimens were prepared for microscopy, and quantitative characterization of CD4+ (OKT 4a) and CD8+ (OKT 8) cells was performed. Compared with the localized melanomas bcl-2 expression was higher in those primary melanomas that later metastasized (P = 0.068, Wilcoxon; P = 0.038, median test). Mdm-2 and Ki-67 expression did not differ in the primary tumours of patients and controls, but a statistically significant trend was observed towards increasing expression with the progression of the disease (two-sided exact P-values: 0.04 and 0.05, respectively). Patients with a low Ki-67 index in their first metastasis had a better prognosis when compared with patients with high indexes (P = 0.008, log-rank). Furthermore, most patients with decreasing CD4+/CD8+ ratios had increasing p53 immunoreactivity. Our findings suggest that Ki-67 and bcl-2 may be useful for predicting the prognosis of melanoma patients. Mdm-2 is a new but promising marker in melanoma and deserves further evaluation.

Epithelial expression of glycodelin in biphasic synovial sarcomas

Glycodelin is a 28 kDa glycoprotein of the lipocalin family that was previously considered to be specific for the reproductive tract. Glycodelin is found in the secretory glandular epithelium of endometrium and in seminal vesicles. Given the cyclic differentiation of normal endometrial epithelium, we studied by immunohistochemistry a possible expression of glycodelin in other tissues displaying stroma-to-epithelium maturation. We report here that 11/11 biphasic synovial sarcomas expressed glycodelin in the cells exhibiting epithelial or glandular differentiation while the sarcomatous spindle cells remained negative. Glycodelin was also found in secreted material in the lumina of the gland-like structures. In only 1 of the 7 monophasic synovial sarcomas studied, focal glycodelin reactivity was seen in some flattened spindle cells. The expression of glycodelin in biphasic synovial sarcoma tissue was further verified by the demonstration of glycodelin mRNA by reverse transcriptase-polymerase chain reaction. Considering the monoclonal origin of synovial sarcomas, our findings raise the intriguing possibility that activation of expression of the glycodelin gene is involved in the molecular regulation of mesenchyme-to-epithelium differentiation.

Satellite cell proliferation in rabbit hindlimb muscle following immobilization and remobilization: an immunohistochemical study using MIB 1 antibody

The time course and pattern of mitotic activity in the deep part of the vastus intermedius muscle (VIP) immobilized in a shortened position in 16 adult NZW rabbit hindlimbs for time periods ranging from 12 h to 56 days and in VIP muscles from 10 rabbit hindlimbs immobilized from 3 to 28 days and subsequently remobilized for 4 weeks were compared. Paraffin sections were stained immunohistochemically with monoclonal MIB 1 antibody raised against recombinant fragments of Ki-67 antigen, and a double staining with modified reticulin stain was carried out to facilitate differentiation between satellite cells and other proliferating cells outside the muscle. In samples taken 24 h after the onset of immobilization, the tissue was mitotically quiescent and at 3, 14, 28, and 56 days of immobilization 5.7%, 1.3%, 1.1% and 0.7%, respectively, of all counted nuclei were mitotically active. However, all of them were localized outside the basement membrane (BM) of the myofiber and were presumably proliferating fibroblasts, capillary endothelial cells or inflammatory cells. Satellite cell mitotic activity was first seen after 2 weeks of immobilization followed by 4 weeks of remobilization. In VIP muscle immobilized for 3 weeks and remobilized for 4 weeks the numbers of all proliferating cells as well as proliferating satellite cells reached a concomitant peak, and they were 7.5% and 3% respectively. The results indicate a late activation of satellite cell proliferation, which may relate to the initial lack of stretch and mechanical load during the cast immobilization followed by a late release of mitogenic factors during eccentric muscle work performed by the VIP muscle after removal of the cast.

Ki-67, ploidy and S-phase fraction as prognostic factors in gastric cancer

The prognostic value of the immunohistochemical expression of Ki-67 in paraffin embedded specimens was studied in 242 patients with gastric adenocarcinoma. The results were compared with ploidy and S-phase fraction (SPF) obtained by DNA flow cytometry. Both SPF and ploidy correlated with survival in univariate analysis. In multivariate survival analysis, stage of disease, DNA ploidy and presence of distant metastases emerged as independent prognostic parameters. There was no significant difference in survival between patients having tumours with high and low Ki-67 labelling, neither in univariatenor in multivariate survival analysis.

Ki-67, p53, Er-receptors, ploidy and S-phase as prognostic factors in T1 node negative breast cancer

The prognostic value of Ki-67, p53 and ER immunohistochemical labelling and flow-cytometric S-phase fraction and ploidy was evaluated in 212 pT1N0M0 breast carcinomas. The mean follow-up time was 8.3 years. Patients with breast carcinomas with high Ki-67 expression (> or = 10%) had a less favourable disease-free survival than those with low Ki-67 expression (< 10%) (p = 0.008). A positive p53 staining and high SPF were associated with a less favourable disease-free survival although it did not reach statistical significance. The subset of patients with ER negative, Ki-67 > or = 10% and p53 > or = 20% tumours, had a shorter disease-free survival compared with that of all the other patients (p = 0.03). We conclude that the potential value of Ki-67 labelling for prognostic evaluation of T1N0M0 breast carcinoma is good.

Progression from adenocarcinoma to small cell carcinoma of the prostate with normalization of prostate-specific antigen (PSA) levels

We report a case of prostatic cancer in which transformation from adenocarcinoma into small cell carcinoma was demonstrated both by histology and immunohistochemistry. This phenomenon supports the hypothesis that small cell carcinoma of the prostate originates from multipotential prostatic epithelial cells.

Ki-67 immunoreactivity, ploidy and S-phase fraction as prognostic factors in patients with gastric carcinoma

Expression of the Ki-67 antigen was determined by immunohistochemical analysis of paraffin-embedded specimens from 242 patients with gastric adenocarcinoma and the prognostic value of Ki-67 immunoreactivity was compared with ploidy and S-phase fraction (SPF) obtained by DNA flow cytometry. A high percentage of Ki-67 immunostaining was associated with the intestinal type of cancer (p = 0.0002) and male sex (p = 0.003), but correlated only weakly with the SPF (rs = 0.343) and not at all with ploidy. The intestinal type of gastric carcinoma was more frequently aneuploid and had a higher SPF than diploid tumours (p < 0.0001 for both). While the SPF was associated with male sex and stage of disease, both ploidy and SPF were associated with nodal status and age. There was no association between SPF or ploidy and tumour location or the presence of distant metastases. Both SPF and ploidy correlated with survival according to the univariate analysis. In a multivariate survival analysis, the stage of disease, DNA ploidy and presence of distant metastases emerged as independent prognostic parameters. There was no significant difference in survival between patients having tumours with high and low Ki-67 labelling, neither in univariate nor in multivariate survival analyses. In patients with gastric carcinoma, the level of Ki-67 immunoreactivity added no prognostic information to that obtained by DNA flow cytometry.

Prognostic value of immunohistochemical expression of p53 in patients with pancreatic cancer

The prognostic value of the immunohistochemical expression of p53 was evaluated in 133 patients with pancreatic cancer. Formalin-fixed paraffin-embedded specimens of ductal pancreatic adenocarcinomas retrieved at the time of operation were stained with the monoclonal antibody DO-7. Approximately half of the tumors (47%) showed a high level of p53 immunoreactivity (> or = 20% positive nuclei). No correlation was demonstrated between the level of p53 immunoreactivity and age of the patient, gender, TNM stage, resectability or site of the tumor. A high level of p53 staining was seen in a slightly smaller proportion (30%) of patients with well-differentiated tumors than in patients with moderately (50%) or poorly differentiated (50%) tumors, but the difference was not significant. In a multivariate survival analysis, stage, grade and postoperative chemotherapy emerged as independent prognostic factors. Surgical resectability, if entered instead of stage as a variable in a separate Cox model, predicted prognosis independently. In univariate analysis, the site of the tumor was also a significant prognostic variable. However, no association between the level of p53 immunoreactivity and survival in either uni- or multivariate analysis was found.

Prognostic value of Ki-67 expression, ploidy and S-phase fraction in patients with pancreatic cancer

The prognostic value of Ki-67 expression, ploidy and s-phase fraction was evaluated in 133 patients with pancreatic cancer. Formalin-fixed paraffin-embedded surgical specimens of pancreatic ductal adenocarcinomas were stained with a polyclonal Ki-67 antibody. Ploidy and s-phase fraction was assessed by flow cytometry. The median percentage of Ki-67 positive nuclei was 26% (range 0-90%). The level of Ki-67 immunoreactivity was associated with TNM-stage, surgical resectability, tumour grade, ploidy and S-phase fraction. Ninetythree patients, with a nuclear expression of Ki-67 in < 50% of malignant cells, had a median survival of 12.8 months compared with 5.5 months for 25 patients with Ki-67 > or = 50% (p = 0.0008). Ploidy (p < 0.0001) and SPF (p = 0.002) were also significant prognostic factors in a univariate survival analysis. In a multivariate analysis, stage (or alternatively resectability), grade, ploidy and postoperative chemotherapy emerged as independent prognostic factors. When ploidy was excluded from the Cox multivariate model, S-phase fraction also predicted prognosis independently. Ploidy and S-phase fraction are independent prognostic factors in patients with pancreatic cancer. A high level of Ki-67 immunoreactivity is also an indicator of poor prognosis but seems to add little prognostic information to that provided by traditional parameters such as stage, resectability and grade.

Prognostic significance of cell proliferation in mucoepidermoid carcinomas of the salivary gland: clinicopathological study using MIB 1 antibody in paraffin sections

Mucoepidermoid carcinomas of salivary gland origin have an uncertain clinical course not directly predictable by histomorphology. The MIB 1 antibody, which detects Ki-67 antigen in formalin-fixed, paraffin-embedded tissues, was used to study cell proliferation in these tumors. An MIB 1 index was developed to express the percentage of MIB 1-positive proliferating cells, and the results were compared with histomorphological tumor grade and clinical outcome. All patients with MIB 1 indices lower than 10% in their primary tumors had a favorable clinical outcome. Most patients with MIB 1 indices higher than 10% developed a recurrent or metastasizing disease. All patients who died of their tumor or who had persistent tumor had MIB 1 indices higher than 10%. Thus, the MIB 1 index defines two virtually nonoverlapping forms of the disease, an indolent one and an aggressive one. Cell proliferation in mucoepidermoid carcinomas, assessed with the MIB 1 antibody, thus represents a significant prognostic factor for improving the accuracy of conventional histological grading.

Immunohistochemical detection of progesterone receptors in paraffin sections. A novel method using microwave oven pretreatment

The benefits of microwave oven pretreatment of formalin-fixed routinely processed paraffin sections were assessed using citric acid solution to demonstrate progesterone receptors (PR). Parallel frozen and paraffin sections from 25 cases of breast cancer were stained with the PR-ICA kit (Abbott). Compared with untreated paraffin sections a great enhancement of PR immunostaining occurred after microwave irradiation. In 21 cases the percentage of positively stained tumor cell nuclei in microwave oven-pretreated paraffin sections was practically identical to that in the frozen ones. After microwave irradiation the PR score in paraffin sections was in three cases higher than in the frozen material. In comparison with the frozen sections, only one tumor of 25 showed a lower percentage of stained malignant cells after the irradiation. It is concluded that microwave oven pretreatment is a simple, reliable and reproducible method to detect PR in routinely fixed paraffin-embedded tissues.

Prognostic value of Ki-67 immunolabelling in primary operable breast cancer

The prognostic value of Ki-67 immunohistochemical labelling was evaluated in 327 operable primary carcinomas of the breast. The follow-up time was up to 4 years (mean 2.7 years). The disease-free survival in Ki-67 positive patients was shorter than in Ki-67 negative patients (P < 0.005). By combining the Ki-67 expression with ER receptors and stage, subgroups with a different disease-free survival were identified. In stage II patients there was a significant difference (P < 0.005) in disease-free survival between Ki-67 positive/ER negative and Ki-67 negative/ER positive patients. In node negative patients there was no such difference. The disease-free survival according to different prognostic factors, stage, ER and node status, were separately examined using a Cox's proportional hazards model. ER (P < 0.0001), the Ki-67 (P < 0.02), tumour size (P < 0.0001) and nodal status (P < 0.006) were independent prognostic factors. We conclude that the potential value of Ki-67 labelling for prognostic evaluation of patients with breast carcinoma is good.