The relationship between apoptosis and p53 protein expression in squamous cell carcinoma of the esophagus was investigated immunohistochemically in 47 biopsy specimens from 24 patients. Sixteen of the specimens were well differentiated, 11 were moderately differentiated, and 20 were poorly differentiated. The TUNEL method was used for detecting apoptosis. TUNEL-positive condensed nuclei showing characteristic morphological features were considered to indicate apoptosis. p53 protein expression was studied immunohistochemically. One thousand tumor cells were evaluated in each specimen. The incidence of apoptosis was less than 1% except in one specimen. More than 50% of the tumor cells were p53-positive in 33 specimens, while less than 10% of the tumor cells were positive in 14 specimens. There was no significant difference in the incidence of apoptosis or in the mean percentage of p53-positive cells between the 3 histological subtypes. There was also no significant correlation between the incidence of apoptosis and the extent of p53 protein expression.

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From January to July 1995, 39 patients with non-small cell lung cancer (NSCLC), including 21 with primary squamous cell carcinoma (sq) and 18 with primary adenocarcinoma (ad), were studied to determine changes of T cell subsets using fluorescent monoclonal antibodies (CD3, CD19, CD4, CD8, HLA-DR) and flowcytometry. There were differences between the T cell subsets in preoperative and postoperative patients. Postoperative sq patients showed a significant increase in the percentage of CD4+CD8- cells and the CD4+/CD8+ ratio. Postoperative ad patients showed a significant decrease in the percentage of CD3+CD19- cells and CD3+HLA-DR- cells. We also characterized the changes of T cell subsets in sq and ad patients from each clinical stage. Our results may provide information on the biological behavior of NSCLC and these parameters may be useful for assessing the efficacy of surgical treatment.

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We experienced three patients who developed villous tumors in the rectum after resection of colon carcinoma. They were all men, one had ascending colon cancer and two had sigmoid colon cancer as the primary lesion. All three patients developed severe watery diarrhea during postoperative follow-up at 7 to 35 months after colectomy. The three rectal tumors were considered to be a metachronous lesions with rapid growth. There are no synchronous or metachronous colorectal carcinomas among another 23 patients with rectal villous tumors treated at our institution. Our findings suggested that villous tumors of the rectum might have a specific pathogenesis.

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To evaluate the association between HLA status and cell-mediated immunity, we examined the lymphocyte phenotypes and the expression of 49 HLA antigens by lymphocytes in patients with gastric cancer.
Six hundred and six patients with histologically confirmed primary adenocarcinoma of the stomach underwent resection from March 1986 to October 1993. We classified these gastric cancer patients into four groups using a simple method of classifying patients according to HLA antigen status.
HLA type I patients had a low level of CD3 and CD4 cells and a high levels of CD16 cells, while HLA type III and IV patients had a high level of CD4 cells and a low level of CD16 cells. HLA type I and III patients, respectively, showed a decreased of CD57 and CD4 cells according to stage. HLA type II and IV patients did not show phenotypic changes of lymphocytes according to stage. These findings show that patients with different HLA types have a differences in immune status. A prospective randomized study using this new classification is now ongoing to confirm its clinical value in gastric cancer patients.

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The diagnostic accuracy of combined ERCP, CT and US was studied in 24 patients with liver and biliary tract diseases and 26 patients with pancreatic diseases. In liver and biliary tract diseases, ERCP, CT and US facilitated an accurate diagnosis in 58%, 46%, and 54% of the cases, respectively. Combined ERCP and CT and combined ERCP, CT and US facilitated accurate diagnosis in 88% and 92% of the cases, respectively. In patients with pancreatic diseases, ERCP, CT and US rendered accurate diagnosis in 85%, 58% and 35% of the cases, respectively, combined ERCP and CT in 92%. Compared to the other examinations, the highest diagnostic accuracy was obtained by ERCP in chronic pancreatitis (69%) and by CT in liver parenchyma diseases (100%). All malignant tumors of the liver, biliary tract and pancreas could be diagnosed, however, all of these were in advanced stage. Our results suggest that combined method is useful in diagnosing liver, biliary tract and pancreatic diseases, although more reliable methods need to be developed for the early detection of diseases, especially for tumors.

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