Browsing by Author "Luh S.-P."

Background: E-Cadherin is a subclass of the cadherin family that plays a major role in the maintenance of intercellular junctions in normal epithelium. Decreased expression of E-cadherin might be closely related to invasiveness and dedifferentiation in human cancers. This study is aimed at investigating the clinicopathological significance of E-cadherin expression and its impact on the prognosis in surgically resected non-small-cell lung cancer patients. Methods: Using immunohistochemical staining, the expression of E-cadherin was studied in 207 surgically resected lung cancer specimens from January 1990 through December 1994. The clinicopathological data and survival status were recorded and analysed against the E-cadherin expression level in each tumor. Results: E-cadherin expression was detected in 122 of the 207 lung tumors (59.0%), and the expression was significantly lower in tumors with poor differentiation (p < 0.001), in tumors with vascular invasion (p < 0.05), and in tumors with direct invasion into surrounding structures (p < 0.01). There was no correlation between E-cadherin expression, and tumor stage and regional lymph-node metastasis. There was no significant difference in survival rate between higher (> 40%) and lower (< 40%) E-cadherin expression groups; however, in tumors 3 cm or less, a significant difference was found between higher and lower E-cadherin expressions (p < 0.0001). Conclusions: Underexpression of E-cadherin is associated with poor differentiation and invasiveness in NSCLC. In patients with small NSCLC (? 3 cm), higher E-cadherin expression (> 40%) significantly had a favorable prognosis.

The interaction of genetic and environmental factors can determine an individual's susceptibility to various cancers. We present a hospital-based case-control study, which included 90 patients of esophageal squamous-cell carcinoma (ESCC) and 254 healthy people in Taiwan, to investigate the effects of genetic polymorphisms of p53, GSTPI and NAT2 on the risk of ESCC. Polymorphisms of p53, NAT2 and GSTPI were determined by PCR-RFLP. The codon 72 p53 Pro allele was more frequently found in ESCC patients [odds ratio (OR) 1.86, 95% confidence interval (CI) 1.04-3.35 for Arg/Pro genotype and OR 2.56, 95% CI 1.29-5.08 for Pro/Pro genotype]. In cigarette smokers, the frequency of GSTPI lle/lle genotype was higher in ESCC patients (OR 2.8, 95% CI 1.4-5.7). Among alcohol drinkers, borderline significance was also found for GSTPI lle/lle genotype (OR 2.0, 95% CI 0.9-4.4). Results were not similar for the NAT2 genetic polymorphism. Using logistic analyses, we found that individuals with p53 Pro/Pro genotype had a significantly higher risk of developing ESCC than those with Arg/Arg genotype (OR 2.3, 95% CI 1.1-5.1), after adjusting for other significant environmental risk factors. This result remained similar (OR 2.2, 95% CI 1.0-4.8 for p53 Pro/Pro vs. Arg/Arg), even after further adjustment for NAT2 and GSTPI polymorphisms. The codon 72 p53 Pro/Pro genotype in the general population and GSTPI lle/lle in cigarette smokers may predict a higher risk of developing ESCC. (C) 2000 Wiley-Liss, Inc.

A variety of environmental factors were identified to be associated with the risk of esophageal cancer. The variation in capacity of DNA repair might influence environmental chemical-associated carcinogenesis. We hypothesized that the polymorphic XRCC1 genes might modify cancer susceptibility of the esophagus. To investigate the effect of XRCC1 genetic polymorphisms on codons 194, 280 and 399, we evaluated data from 105 patients of esophageal squamous cell carcinoma and 264 healthy controls, matching with age (±3 years), gender and ethnicity. The distribution of the 3 genotypes were not significantly different among patients and controls. However, among alcohol drinkers, the XRCC1399 Arg/Arg genotype was more frequently found in patients with esophageal cancer. After adjustment with other environmental confounders, the OR for the genotype of XRCC1399 Arg/Arg was 2.78 (95% C1 = 1.15-6.67) as compared with the XRCC1399 Arg/Gln and XRCC1399 Gln/Gln genotypes in the alcohol drinkers. Similar trends were observed among cigarette smokers and areca chewers. However, they did not reach a statistical significance. Our findings suggest that the polymorphic XRCC1 genes might modify the risk of alcohol-associated esophageal cancers. ? 2001 Wiley-Liss, Inc.

Sauropus androgynus (SA), a vegetable of the Euphorbiaceae family, is a common food source in Malaysia. In Taiwan, over 30 patients have developed progressive respiratory failure after consuming the extract from raw SA leaves as a means of losing weight. Symptoms consistent with a severe obstructive ventilatory defect progressed, despite cessation of SA intake and treatment with bronchodilators, corticosteroids, cytotoxic agents and plasmaphresis. Five patients with end-stage Sauropus androgynus-induced bronchiolitis obliterans (SABO) syndrome underwent lung transplantation. There was no early mortality. One patient died of post-transplant lymphoproliferative disorder and another patient died of bronchial stenosis with infection, 5 and 3.5 months, respectively, post-transplantation. The remaining 3 patients have been followed from 29 to 34 months, with improved general condition and pulmonary function. Perfusion/ventilation scans revealed that these improvements were exclusively attributed to the functional grafts. We believe that lung transplantation is the only effective modality of treatment for patients with end-stage SABO syndrome.

The prognostic value of the number of nucleolar organizer regions (NORs) (DNA loops in the nucleus) in tumor cells from various kinds of malignancies has been widely studied in recent years. During the period 1989 to 1992, a total of 73 primary lung tumors was examined for the number of NORs by silver staining AgNOR proteins on the stump smear of resected specimens in this hospital. The relations of the mean number of AgNOR per cell with other factors such as sex, age, habit of smoking, performance status, tumor location, tumor size, pathological stage, histological type, degree of differentiation, and whether histologically vascular or lymphatic invasion were analysed. It was found that the mean number of AgNOR was significantly different between positives and negatives of histologically vascular or lymphatic invasion (6.4 ± 0.4 vs 5.5 ± 0.2) (p < 0.05). Both single and multiple variate analysis of patient survival revealed that the mean number of AgNOR was a significant prognostic factor, as were pathological stage, histological type, and performance status of the patient. Patients with a higher mean number of AgNOR (> 7) had a significantly worse prognosis compared with those with less AgNOR (? 7) (median survival 28 versus 43 months) (p < 0.05). It was concluded that the mean number of AgNOR of tumor cells is a significant prognostic factor in surgically treated lung cancer patients.

Poland's syndrome is an uncommon congenital anomaly of the chest wall characterized by the absence of the pectoralis major muscle and other nearby musculoskeletal components. Many associated aberrations over the thoracic cage, intrathoracic organs, and upper limbs have been reported. However, spontaneous pneumothorax in these patients has not been reported. Here, we describe two patients with both Poland's anomaly and spontaneous pneumothorax. One patient was a 16-year-old boy with left chest wall hypoplasia and pneumothorax on the right side. The other was a 27-year-old man with right chest wall hypoplasia, hand brachydactyly, and pneumothorax. Pneumothorax in both patients was treated with bullectomy and mechanical pleurodesis with the aid of videothoracoscopy, and the postoperative courses were smooth. Blood supply disruption has been hypothesized as a pathogenic mechanism of both spontaneous pneumothorax and Poland's syndrome, suggesting an association between these two diseases.

Posttransplantation lymphoproliferative disorder (PTLD) is an uncommon but often fatal complication of solid organ transplantation. The incidence is relatively higher in pediatric patients or patients undergoing lung transplantation. The pathology of PTLD is a morphologically heterogeneous group of lymphoid proliferation of varying clonal composition, most commonly of B-cell origin, and the Epstein-Barr virus (EBV) has been implicated as a cofactor in most cases. Herein we report a 44-year-old woman who underwent right single lung transplantation because of bronchiolitis obliterans associated with Sauropus androgynus ingestion. Three nodules were noted at the grafted lung 3 months after the operation. The CT-guided biopsies and serological studies revealed that these nodules were EBV-unrelated B-cell lymphoma. Despite treatment including antiviral agents, reduction of immunosuppression, as well as conventional chemotherapy, these nodules increased in size rapidly. This patient died of sepsis and respiratory failure 5 months after the transplantation.

Primary leiomyosarcoma of the nipple-areola complex is extremely rare. Less than ten such cases have been reported in English literature so far. Herein we describe a 52-year-old female presenting with a 1.5 cm×1.1 cm×0.7 cm nodular lesion over her left nipple, and leiomyosarcoma was proved by pathological examination of the excised specimen. Positron emitted tomogram (PET) revealed no abnormal signal other than the primary site. Microscopically, this poorly circumscribed tumor was composed of interlacing bundles of smooth muscle cells with bizarre and pleomorphic nuclei, as well as prominent nucleoli. Its mitotic count was up to 7 mitoses per 10 high power fields (HPF). Immunohistochemical study of tumor cells revealed positive stain for α-smooth muscle actin and vimentin; and negative for cytokeratin, CD34 and S-100. Left simple mastectomy was undertaken and no residual mass lesion was noted on the resected specimen. Related literatures about the diagnosis and treatment for breast leiomyosarcoma will be presented here. ? Springer-Verlag 2008.

Between 1987 and 1996, five male patients ranging from 9 to 39 years old (median, 23 years), were treated for nonseminomatous germ cell tumors that appeared to arise in the anterior mediastinum without clinical involvement of the testes. The most common presenting symptom was chest pain, and the mean diameter of the tumor was 13.7 cm (range: 10.5 to 18 cm). Tumor markers were measured in four patients and all had a raised alpha-fetoprotein (AFP) level (range: 453.5 ug/L to 16469 ug/L). Echo-guided needle biopsies were performed in all five patients and only two of them had definite diagnosis. The diagnosis of the other three patients could only be obtained through exploratory sternotomy. Among these five patients, one was treated with primary surgical intervention followed by chemotherapy. He died of complications of chemotherapy one month later. Another patient who received only an operation died of surgical complications eight days after the operation. The other three patients underwent cisplatin-based chemotherapy after the diagnosis of nonseminomatous germ cell tumors was made. One of them received further radiotherapy for the residual mass on chest x-ray film after normalization of the tumor markers. He died of liver metastasis 7 months after the operation. Those two patients who received surgical excision of the residual mass after completion of chemotherapy and normalization of the tumor markers were still alive at 9 years and 12 months after the operation. The modern multimodality treatment, including cisplatin-based chemotherapy coupled with adjunctive surgery if necessary, does provide a better chance of survival in our patients of primary nonseminomatous germ cell tumors of the mediastinum.